Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning

Journal article


Rahman, M.A., Brown, D.J., Mahmud, M., Harris, M., Shopland, N., Heym, N., Sumich, A., Turabee, Z. B., Standen, B., Downes, D., Xing,Y., Thomas, C., Haddick, S., Premkumar, P., Nastase, S., Burton, A. and Lewis, J. (2023). Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning. Brain Informatics. 10 (14). https://doi.org/10.1186/s40708-023-00193-9
AuthorsRahman, M.A., Brown, D.J., Mahmud, M., Harris, M., Shopland, N., Heym, N., Sumich, A., Turabee, Z. B., Standen, B., Downes, D., Xing,Y., Thomas, C., Haddick, S., Premkumar, P., Nastase, S., Burton, A. and Lewis, J.
Abstract

Virtual reality exposure therapy (VRET) is a novel intervention technique that allows individuals to experience anxiety-evoking stimuli in a safe environment, recognise specific triggers and gradually increase their exposure to perceived threats. Public-speaking anxiety (PSA) is a prevalent form of social anxiety, characterised by stressful arousal and anxiety generated when presenting to an audience. In self-guided VRET, participants can gradually increase their tolerance to exposure and reduce anxiety-induced arousal and PSA over time. However, creating such a VR environment and determining physiological indices of anxiety-induced arousal or distress is an open challenge. Environment modelling, character creation and animation, psychological state determination and the use of machine learning (ML) models for anxiety or stress detection are equally important, and multi-disciplinary expertise is required. In this work, we have explored a series of ML models with publicly available data sets (using electroencephalogram and heart rate variability) to predict arousal states. If we can detect anxiety-induced arousal, we can trigger calming activities to allow individuals to cope with and overcome distress. Here, we discuss the means of effective selection of ML models and parameters in arousal detection. We propose a pipeline to overcome the model selection problem with different parameter settings in the context of virtual reality exposure therapy. This pipeline can be extended to other domains of interest where arousal detection is crucial. Finally, we have implemented a biofeedback framework for VRET where we successfully provided feedback as a form of heart rate and brain laterality index from our acquired multimodal data for psychological intervention to overcome anxiety.

KeywordsBiofeedback; Arousal; EEG; HRV; Glossophobia; Stress; VRET
Year2023
JournalBrain Informatics
Journal citation10 (14)
PublisherSpringer
ISSN2198-4026
Digital Object Identifier (DOI)https://doi.org/10.1186/s40708-023-00193-9
Web address (URL)https://braininformatics.springeropen.com/articles/10.1186/s40708-023-00193-9
Publication dates
Print21 Jun 2023
Publication process dates
Accepted15 May 2023
Deposited28 Jun 2023
Accepted author manuscript
License
File Access Level
Open
Permalink -

https://openresearch.lsbu.ac.uk/item/944x6

Download files


Accepted author manuscript
s40708-023-00193-9.pdf
License: CC BY 4.0
File access level: Open

  • 31
    total views
  • 12
    total downloads
  • 1
    views this month
  • 1
    downloads this month

Export as

Related outputs

Multiscale Fluctuation Dispersion Entropy of EEG as a Physiological Biomarker of Schizotypy
Zandbagleh, A., Azami, H., Mirzakuchaki, S., Daliri, M. R., Sanei, S. and Premkumar, P. (2023). Multiscale Fluctuation Dispersion Entropy of EEG as a Physiological Biomarker of Schizotypy. IEEE Access. pp. 110124 - 110135. https://doi.org/10.1109/ACCESS.2023.3321868
The relationships between expressed emotion, cortisol, and EEG alpha asymmetry
Wang, G.Y., Crook-Rumsey, M., Sumich, A., Dulson, D., Gao,T. T. and Premkumar, P. (2023). The relationships between expressed emotion, cortisol, and EEG alpha asymmetry. Physiology and Behavior. 269 (114276). https://doi.org/10.1016/j.physbeh.2023.114276
Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty
Premkumar, P., Leadley-Meade, Z., Moorley, C., Rye, S., Clegg, D. and Alasia, S. (2023). Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty. Equality, Diversity and Inclusion Conference 2023: The Shoulders of Giants: Listening, Learning and Improving our Practice.
Tensor factorization approach for ERP-based assessment of schizotypy in a novel auditory oddball task on perceived family stress
Zandbagleh, A, Mirzakuchaki, S., Daliri, M.R., Premkumar, P., Carretié, L. and Saeid Sanei, S. (2022). Tensor factorization approach for ERP-based assessment of schizotypy in a novel auditory oddball task on perceived family stress. Journal of Neural Engineering. https://doi.org/10.1088/1741-2552/aca69f
Conceptualising mental illness among University students of African, Caribbean and similar ethnic heritage in the United Kingdom
Dare, T., Jidong, D. E. and Premkumar, P. (2022). Conceptualising mental illness among University students of African, Caribbean and similar ethnic heritage in the United Kingdom. Ethnicity & health. 28 (7), pp. 522-543. https://doi.org/10.1080/13557858.2022.2104817
What is next for the neurobiology of temperament, personality and psychopathology?
Trofimova, I., Bajaj, S., Bashkatov, S. A., Blair, J., Brandt, A., , Chan, R. C. K., Clemens, B., Corr, P. J., Cyniak-Cieciura, M., Demidova, L., Filippi, C. A., Garipova, M., Habel, U., Haines, U., Heym, N., Hunter, K., Jones, N. A., Kanen, J., Kirenskaya, A., Kumari, V., Lenzoni, S., Lui, S. S. Y., Mathur,A., McNaughton, N., Mize, K. D., Mueller, E., Netter, P., Paul, K., Plieger, T., Premkumar, P., Raine, A., Reuter, M., Robbins, T. W., Samylkin, D., Storozheva, Z., Sulis, W., Sumich, A., Tkachenko, A., Valadez, E. A., Wacker, J., Wagels, L., Wang, L.-L., Zawadzki, B. and Pickering, A. D. (2022). What is next for the neurobiology of temperament, personality and psychopathology? Current Opinion in Behavioral Sciences. 45 (101143). https://doi.org/10.1016/j.cobeha.2022.101143
Classification of Low and High Schizotypy Levels via Evaluation of Brain Connectivity
Zandbagleh, A., Mirzakuchaki, S, Daliri, M.R., Premkumar, P. and Sanei, S. (2022). Classification of Low and High Schizotypy Levels via Evaluation of Brain Connectivity. International Journal of Neural Systems. 34 (2). https://doi.org/10.1142/S0129065722500137
Rejection sensitivity and its relationship to schizotypy and aggression: current status and future directions
Premkumar, P. and Kumari, V. (2022). Rejection sensitivity and its relationship to schizotypy and aggression: current status and future directions. Current Opinion in Behavioral Sciences. 44. https://doi.org/10.1016/j.cobeha.2022.101110
Editorial: The Use of Virtual-Reality Interventions in Reducing Anxiety
Premkumar, P., Heym, N., Anderson, P. L., Brown, D. and Sumich A. (2022). Editorial: The Use of Virtual-Reality Interventions in Reducing Anxiety. Frontiers in Virtual Reality. 3 (853678). https://doi.org/10.3389/frvir.2022.853678
The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety
Premkumar, P., Heym, Nadja, Brown, David Joseph, Battersby, Steven, Sumich, Alexander, Huntington, Bethany, Daly, Rosie and Zysk, Eva (2021). The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety. Frontiers in Psychiatry. 12, p. 694610. https://doi.org/10.3389/fpsyt.2021.694610
Cortical and subcortical neuroanatomical signatures of schizotypy in 3004 individuals assessed in a worldwide ENIGMA study
Modinos, G., Kirschner, M., Hodzic-Santor, B., Antoniades, M., Nenadic, I., Kircher, T., Krug, A., Meller, T., Grotegerd, D., Fornito, A., Arnatkeviciute, A., Bellgrove, M., Tiego, J., Dannlowski, U., Dohm, K., Hülsmann, C., Kugel, H., Enneking, V., Klug, M., Leehr, E., Boehnlein, J., Gruber, M., Mehler, D., DeRosse, P., Moyett, A., Baune, B., Green, M., Quidé, Y., Pantelis, C., Strachan, R., Wang, Y., Ettinger, U., Debbané, M., Derome, M., Gaser, C., Besteher, B., Diederen, K., Spencer, T., Fletcher, P., Rössler, W., Smigielski, L., Kumari, V., Premkumar, P., Park, H., Wiebels, K., Lemmers-Jansen, I., Gilleen, J., Allen, P., Kozhuharova, P., Marsman, J-B., Lebedeva, I., Tomyshev, A., Mukhorina, A., Kaiser, S., Fett, A.-K., Sommer, I., Schuite-Koops, S., Paquola, C., Lariviere, S., Bernhardt, B., Dagher, A., Grant, P., van Erp, T., Turner, J. A., Thompson, P. and Aleman, A. (2021). Cortical and subcortical neuroanatomical signatures of schizotypy in 3004 individuals assessed in a worldwide ENIGMA study. Molecular Psychiatry. https://doi.org/10.1038/s41380-021-01359-9
Pituitary volume in people with chronic schizophrenia: Clarifying the roles of serious violence and childhood maltreatment
Premkumar, P., Bipin, M., Das, M., Lau, J. Y. F., Sumich, A. L. and Kumari, V. (2021). Pituitary volume in people with chronic schizophrenia: Clarifying the roles of serious violence and childhood maltreatment. Psychiatry Research: Neuroimaging. 314, p. 111323. https://doi.org/10.1016/j.pscychresns.2021.111323
Mild-to-moderate schizotypal traits relate to physiological arousal from social stress
Premkumar, P., Alahakoon, P., Smith, M., Kumari, V., Babu, D. and Baker, J. (2020). Mild-to-moderate schizotypal traits relate to physiological arousal from social stress. Stress. https://doi.org/10.1080/10253890.2020.1797674
The path from schizotypy to depression and aggression and the role of family stress
Premkumar, P., Kuipers, E. and Kumiar, V. (2020). The path from schizotypy to depression and aggression and the role of family stress. European Psychiatry. 63 (1), p. e79. https://doi.org/10.1192/j.eurpsy.2020.76
Neural responses to criticism and praise vary with schizotypy and perceived emotional support
Premkumar, P., Santo, M. G. E., Onwumere, O., Schürmann, M., Kumari, V., Blanco, S., Baker, J. and Kuipers, E. (2019). Neural responses to criticism and praise vary with schizotypy and perceived emotional support. International Journal of Psychophysiology. 145, pp. 109-118. https://doi.org/10.1016/j.ijpsycho.2019.05.008
Sensitivity to criticism and praise predicts schizotypy in the non-clinical population: The role of affect and perceived expressed emotion
Premkumar, P., Dunn, A. K., Onwumere, J. and Kuipers, E. (2019). Sensitivity to criticism and praise predicts schizotypy in the non-clinical population: The role of affect and perceived expressed emotion. European Psychiatry. 55, p. 109–115. https://doi.org/10.1016/j.eurpsy.2018.10.009
Deciphering reward-based decision making in schizophrenia: a meta-analysis and behavioral modelling of the Iowa Gambling Task
Premkumar, P., Betz, Linda T, Brambilla, Paolo, Ilankovic, Andrej, Premkumar, Preethi, Kim, Myung-Sun, Raffard, Stéphane, Bayard, Sophie, Hori, Hikaru, Lee, Kyoung-Uk, Lee, Seung Jae, Koutsouleris, Nikolaos and Kambeitz, Joseph (2019). Deciphering reward-based decision making in schizophrenia: a meta-analysis and behavioral modelling of the Iowa Gambling Task. Schizophrenia Research. 204, pp. 7-15. https://doi.org/10.1016/j.schres.2018.09.009
Developing and maintaining the teacher-student relationship in one to one alternative provision: the tutor’s experience
Premkumar, P., Fitzsimmons, W. and Trigg, R. (2019). Developing and maintaining the teacher-student relationship in one to one alternative provision: the tutor’s experience. Educational Review. https://doi.org/10.1080/00131911.2019.1653265
Pituitary volume reduction in schizophrenia following cognitive behavioural therapy
Premkumar, P., Bream, D., Sapara, A., Fannon, D., Anilkumar, A. P., Kuipers, E. and Kumari.V. (2018). Pituitary volume reduction in schizophrenia following cognitive behavioural therapy. Schizophrenia Research. 192, p. 416–422. https://doi.org/10.1016/j.schres.2017.04.035
Schizotypal traits and their relation to rejection sensitivity in the general population: Their mediation by quality of life, agreeableness and neuroticism
Premkumar, P., Onwumere, J., Betts, L., Kibowski, F. and Kuipers, E. (2018). Schizotypal traits and their relation to rejection sensitivity in the general population: Their mediation by quality of life, agreeableness and neuroticism. Psychiatry Research. 267, pp. 201-209. https://doi.org/10.1016/j.psychres.2018.06.002
Vocational education: your options
Johnson, R and Harris, M (2017). Vocational education: your options. British Journal of Healthcare Assistants. 11 (5). https://doi.org/10.12968/bjha.2017.11.5.233
Neural changes following cognitive behaviour therapy for psychosis: A longitudinal study
Kumari, V., Fannon, D., Peters, E.R., Ffytche, D.H., Sumich, A.L., Premkumar, P., Anilkumar, A.P., Andrew, C., Phillips, M.L., Williams, S.C.R. and Kuipers, E. (2011). Neural changes following cognitive behaviour therapy for psychosis: A longitudinal study. Brain. 134 (8), p. 2396–2407. https://doi.org/10.1093/brain/awr154