JMIR Publications

ABSTRACT

Background:

Valuable insights on the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, labor-intensive and cannot be scaled to bigger cohorts nor transferred to daily life scenarios.

Objective:

We aim to provide a scalable digital tool that enables the standardized induction and (video-)recording of acute stress responses in outside-the-lab settings without any experimenter contact.

Methods:

Based on well-described stress protocols we develop a Digital Stress Test (DST), and evaluate its feasibility and stress induction potential in a large online study. Two-hundred-eighty-four participants either completed the DST (n = 103, female = 52, MAge= 31.34 years) or an adapted control version (C-DST, n = 181, female = 96, MAge = 31.51 years) with their smartphones via a web application. We compared their affective responses using the international positive and negative affect schedule short-form (I-PANAS-SF) before and after stress induction. Additionally, we assessed participants’ stress-related feelings indicated in visual analogue scales before, during and after the procedure and further analysed the implemented stress-inducing elements. Finally, we compared the DST participants’ stress reactivity with results obtained in a classical stress test paradigm using data previously collected in four independent Trier Social Stress Test (TSST) studies, including 122 participants overall.

Results:

Participants of the DST manifested significantly higher perceived stress indices compared to C-DST participants at all measurements after the baseline (p<.001). Furthermore, the effect size of the increase in DST participants’ negative affect (dz=0.427) lies in the range of effect sizes for the increase in negative affect in the previously conducted TSST experiments (0.281 - 1.015).

Conclusions:

We present evidence that a digital stress paradigm administered by smartphones can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.