JMIR Publications

ABSTRACT

Background:

The measurement and monitoring of Generalized Anxiety Disorder (GAD) requires frequent interaction with psychiatrists or psychologists. Access to mental health professionals is often difficult due to high costs or insufficient availability. The ability to assess GAD passively and at frequent intervals could be a useful complement to conventional treatment and help with relapse monitoring. Prior work suggests that higher anxiety levels are associated with changes in human speech. As such, monitoring speech using personal smartphones or other wearable devices may be a means to achieve passive anxiety monitoring.

Objective:

To validate the association of previously suggested acoustic and linguistic features of speech with anxiety severity.

Methods:

A large number of participants (N=2,000) were recruited and participated in a single online study session. Participants completed the Generalized Anxiety Disorder-7 item scale (GAD-7) assessment and provided an impromptu speech sample in response to a modified version of the Trier Social Stress Test. Acoustic and linguistic speech features were a-priori selected based on the existing speech and anxiety literature, together with related features. Associations between speech features and anxiety levels were assessed using age and personal income included as covariates.

Results:

Word count and speaking duration were negatively correlated with anxiety scores (r=-0.12; P<.001), indicating that participants with higher anxiety scores spoke less. Several acoustic features were also significantly (P<.05) associated with anxiety including the Mel Frequency Cepstral Coefficients (MFCCs), Linear Prediction Cepstral Coefficients (LPCCs), Shimmer, Fundamental Frequency, and first formant. In contrast to previous literature, the acoustic features, second and third formant, Jitter, and ZCR-zPSD were not significantly associated with anxiety. Linguistic features, including negative emotion words, were also associated with anxiety (r=0.10; P<.001). Additionally, some linguistic relationships were sex-dependent. The number of sentences produced was strongly associated with anxiety in females (r=0.12; P<.001). The use of personal pronouns was strongly associated with anxiety in males (r=0.11; P<.001).

Conclusions:

Both acoustic and linguistic speech measures are associated with anxiety scores. The amount of speech, acoustic quality of speech, and gender-specific linguistic characteristics of speech may be useful as part of a system to screen for anxiety, detect relapse, or treatment monitoring.