Journal articles
Ponzo S, Morelli D, Kawadler JM, Hemmings NR, Bird G, Plans D (2020). Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial.
JMIR Mhealth Uhealth,
8(4)
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Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial.
BACKGROUND: University students in the United Kingdom are experiencing increasing levels of anxiety. A program designed to increase awareness of one's present levels of well-being and suggest personalized health behaviors may reduce anxiety and improve mental well-being in students. The efficacy of a digital version of such a program, providing biofeedback and therapeutic content based on personalized well-being metrics, is reported here. OBJECTIVE: the aim of this study was to test the efficacy and sustained effects of using a mobile app (BioBase) and paired wearable device (BioBeam), compared with a waitlist control group, on anxiety and well-being in university students with elevated levels of anxiety and stress. METHODS: the study employed a randomized, waitlist-controlled trial with assessments at baseline, 2 weeks, postintervention (4 weeks), and follow-up (6 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored >14 points on the Depression, Anxiety, and Stress Scale-21 items (DASS-21) stress subscale or >7 points on the DASS-21 anxiety subscale, (3) owned an iOS mobile phone, (4) did not have any previous psychiatric or neurological conditions, (6) were not pregnant at the time of testing, and (7) were able to read and understand English. Participants were encouraged to use BioBase daily and complete at least one course of therapeutic content. A P value ≤.05 was considered statistically significant. RESULTS: We found that a 4-week intervention with the BioBase program significantly reduced anxiety and increased perceived well-being, with sustained effects at a 2-week follow-up. Furthermore, a significant reduction in depression levels was found following the 4-week usage of BioBase. CONCLUSIONS: This study shows the efficacy of a biofeedback digital intervention in reducing self-reported anxiety and increasing perceived well-being in UK university students. Results suggest that digital mental health interventions could constitute a novel approach to treat stress and anxiety in students, which could be combined or integrated with existing therapeutic pathways. TRIAL REGISTRATION: Open Science Framework (OSF.io) 2zd45; https://osf.io/2zd45/.
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Murphy J, Brewer R, Coll M-P, Plans D, Hall M, Shiu SS, Catmur C, Bird G (2019). I feel it in my finger: Measurement device affects cardiac interoceptive accuracy.
Biol Psychol,
148 Abstract:
I feel it in my finger: Measurement device affects cardiac interoceptive accuracy.
In recent years, measures of cardiac interoceptive accuracy have been heavily scrutinised. The focus has been on potentially confounding physiological and psychological factors; little research has examined whether the device used to record objective heartbeats may influence cardiac interoceptive accuracy. The present studies assessed whether the device employed influences heartbeat counting (HCT) accuracy and the location from which heartbeats are perceived. In Study One, participants completed the HCT using a hard-clip finger pulse oximeter, electrocardiogram (ECG) and a smartphone application. In Study Two, an ECG, hard-clip and soft-clip oximeter were compared. Moderate-strong correlations were observed across devices, however, mean HCT accuracy and confidence varied as a function of device. Increased sensation in the finger when using a hard-clip pulse oximeter was related to increased accuracy relative to ECG. Results suggest that the device employed can influence HCT performance, and argue against comparing, or combining, scores obtained using different devices.
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Murphy J, Brewer R, Plans D, Khalsa S, Catmur C, Bird G (2019). Testing the independence of self-reported interoceptive accuracy and attention.
Quarterly Journal of Experimental Psychology Full text.
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Plans D, Morelli D, Sütterlin S, Ollis L, Derbyshire G, Cropley M (2019). Use of a Biofeedback Breathing App to Augment Poststress Physiological Recovery: Randomized Pilot Study.
JMIR Form Res,
3(1)
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Use of a Biofeedback Breathing App to Augment Poststress Physiological Recovery: Randomized Pilot Study.
BACKGROUND: the speed of physiological recovery from stress may be a marker for cardiovascular disease risk. Stress management programs that incorporate guided breathing have been shown to moderate the stress response and augment recovery. OBJECTIVE: the aim of this study was to examine the effectiveness of an app-based brief relaxation intervention (BioBase) for facilitating physiological recovery in individuals exposed to a brief psychological stressor. METHODS: a total of 75 participants (44 women) completed a stressor speech task and were randomly assigned to one of three conditions: control, rumination, or an app-based relaxation breathing (BioBase) conditions. Heart rate variability (HRV) was assessed as a measure of autonomic function at baseline (6 min), during stress (6 min), and during recovery (6 min). RESULTS: There was a significant increase in subjective stress following stress exposure, but the ratings returned to baseline after recovery in all three groups. In addition, there was a significant decrease in vagally mediated HRV in the poststress period. During recovery, the root mean square of successive differences (P50 ms (pNN50; P
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Morelli D, Bartoloni L, Colombo M, Plans D, Clifton DA (2018). Profiling the propagation of error from PPG to HRV features in a wearable physiological-monitoring device.
Healthcare Technology Letters,
5(2), 59-64.
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Profiling the propagation of error from PPG to HRV features in a wearable physiological-monitoring device.
Wearable physiological monitors are becoming increasingly commonplace in the consumer domain, but in literature there exists no substantive studies of their performance when measuring the physiology of ambulatory patients. In this Letter, the authors investigate the reliability of the heart-rate (HR) sensor in an exemplar 'wearable' wrist-worn monitoring system (the Microsoft Band 2); their experiments quantify the propagation of error from (i) the photoplethysmogram (PPG) acquired by pulse oximetry, to (ii) estimation of HR, and (iii) subsequent calculation of HR variability (HRV) features. Their experiments confirm that motion artefacts account for the majority of this error, and show that the unreliable portions of HR data can be removed, using the accelerometer sensor from the wearable device. The experiments further show that acquired signals contain noise with substantial energy in the high-frequency band, and that this contributes to subsequent variability in standard HRV features often used in clinical practice. The authors finally show that the conventional use of long-duration windows of data is not needed to perform accurate estimation of time-domain HRV features.
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Bacciu D, Colombo M, Morelli D, Plans D (2018). Randomized neural networks for preference learning with physiological data.
Neurocomputing,
298, 9-20.
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Cropley M, Plans D, Morelli D, Sütterlin S, Inceoglu I, Thomas G, Chu C (2017). The Association between Work-Related Rumination and Heart Rate Variability: a Field Study.
Frontiers in Human Neuroscience,
11 Abstract:
The Association between Work-Related Rumination and Heart Rate Variability: a Field Study.
The objective of this study was to examine the association between perseverative cognition in the form of work-related rumination, and heart rate variability (HRV). We tested the hypothesis that high ruminators would show lower vagally mediated HRV relative to low ruminators during their leisure time. Individuals were classified as being low (n = 17) or high ruminators (n = 19), using the affective scale on the work-related rumination measure. HRV was assessed using a wrist sensor band (Microsoft Band 2). HRV was sampled between 8 pm and 10 pm over three workday evenings (Monday to Wednesday) while individuals carried out their normal evening routines. Compared to the low ruminators, high affective ruminators demonstrated lower HRV in the form of root mean square successive differences (RMSSDs), relative to the low ruminators, indicating lower parasympathetic activity. There was no significant difference in heart rate, or activity levels between the two groups during the recording periods. The current findings of this study may have implications for the design and delivery of interventions to help individuals unwind post work and to manage stress more effectively. Limitations and implications for future research are discussed.
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Plans D, Morelli D (2012). Experience-driven procedural music generation for games.
IEEE Transactions on Computational Intelligence and AI in Games,
4(3), 192-198.
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Experience-driven procedural music generation for games.
As video games have grown from crude and simple circuit-based artefacts to a multibillion dollar worldwide industry, video-game music has become increasingly adaptive. Composers have had to use new techniques to avoid the traditional, event-based approach where music is composed mostly of looped audio tracks, which can lead to music that is too repetitive. In addition, these cannot scale well in the design of today's games, which have become increasingly complex and nonlinear in narrative. This paper outlines the use of experience-driven procedural music generation, to outline possible ways forward in the dynamic generation of music and audio according to user gameplay metrics. © 2009-2012 IEEE.
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