Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Mar 25, 2025)
Date Submitted: Jan 9, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Exploring Heart Rate Variability and Heart Rate Dynamics Using Wearable Before, During and After Speech Activity: Insights from a Controlled Study in a Low-Middle-Income Country
ABSTRACT
Background:
Social Anxiety Disorder (SAD) is a prevalent mental health condition worldwide. Its clinical diagnosis and management are challenging to scale due to reliance on frequent, motivated clinical visits for detection, monitoring, and therapy. The absence of objective biomarkers further hampers timely detection. Advances in wearable technology now enable the measurement of physiological parameters such as Heart Rate (HR) and Heart Rate Variability (HRV) through electrocardiogram (ECG) data. However, the relationship between these physiological markers and SAD remains unclear, necessitating exploratory research to evaluate their potential as objective indicators of SAD.
Objective:
This study aims to investigate the physiological markers of SAD by examining the relationship between ECG-derived measures and speech, a known anxiety-inducing activity, in a controlled setting.
Methods:
A total of 99 participants visited the research lab in groups of three and participated in an impromptu speech task in front of a research assistant and their peers. Clinical-grade Shimmer sensors were used to collect ECG data, capturing HR and HRV across four phases: baseline, anticipation, speech, and reflection. After data cleaning, 51 participants (31 with SAD and 20 without) were included in the analysis. Hierarchical Linear Modeling and correlation analyses were used to examine phase-specific changes in physiological markers and their association with self-reported anxiety.
Results:
Both SAD and Non-SAD groups exhibited phase-dependent changes, with HRV decreasing and HR increasing during the anticipation and speech phases relative to baseline. In contrast, HRV increased, and HR decreased during the reflection phase. Additionally, participants with SAD exhibited lower HRV, higher HR, and reported greater self-perceived anxiety compared to those without SAD.
Conclusions:
These findings suggest that HRV and HR may serve as potential physiological markers for SAD, offering promising avenues for wearable technology to facilitate scalable detection and monitoring. The publicly available dataset from this study provides a valuable resource for further research into anxiety detection across multiple stages of speech-based activities.
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