Augmented reality is teenage anxiety’s newest foe
Two Pitt researchers are out to prove it
The rocky road from childhood to adolescence is formed, in part, by the shift from structured parent-child relationships to the Wild West of teenage social interactions.
With an estimated 20% of American youth reporting significant anxiety symptoms, an estimated 19.3% prevalence of specific phobia in adolescence, and one study noting a 58% incidence of social anxiety in adolescents and young adults, something needs to smooth the path.
That something might be augmented reality, at least according to two University of Pittsburgh researchers.
“It’s often hard for teens to put words to exactly how they’re feeling about situations that make them fearful. It’s also hard to bring some of those social fears into the clinic,” said Mary Woody, clinical psychologist, assistant professor of psychiatry at Pitt and principal investigator of this effort. “We saw our brain-computer interface — that combines AR with EEG assessment — as the perfect marriage to address both of these problems.”
Their research reimagines exposure therapy, the clinical technique of gradually exposing a patient to increasingly triggering situations and activities — social interactions, flying in airplanes, etc. — until they master their thoughts and feelings enough to no longer fear them as intensely.
But in traditional settings, the risk in this therapeutic risk-taking sits with clinicians as well.
Therapists often cannot accompany patients to these real-world exposures, causing them to rely on patient reports about whether the exercise occurred and how it unfolded. Even when therapists can attend, there are then confidentiality risks, uncontrollable factors (such as the weather) and potential additional expenses to reach that destination together.
When those scenarios occur via augmented reality, however, they’re experienced with a trusted therapist just feet away and potentially visible, since AR overlays digital situations onto the physical environment, much like imagery in the popular mobile game Pokémon Go.
In the early stages of the research, which are currently underway, Ms. Woody and co-investigator Murat Akcakaya use standardized images of classic teenage stressors — think tests and social situations — while later stages will likely tailor scenarios to each patient, potentially incorporating images taken with their cellphones.
By monitoring the teens, ages 13 to 17, via EEG (electroencephalogram), Ms. Woody and Mr. Akcakaya are able to correlate the subjects’ reported levels of stress with their brainwaves.
This information not only validates the use of AR simulations as being comparable to real-world stimuli, but can inform more robust clinical uses for EEG with AR.
“We want to summarize these EEG signals through machine learning and AI, and extract biomarkers that can be highly correlated with fear,” said Mr. Akcakaya, an associate professor in Pitt’s school of engineering with expertise in bioengineering. “The uniqueness here is we want to do this in real time.”
Investigations into the use of simulated images to treat mental health disorders dates back to 1995, with results that show effectiveness similar to traditional cognitive behavioral therapy. Validation studies (ones like Mr. Akcakaya and Ms. Woody are working on), technology and more have been stumbling blocks. But these days, the field is growing in all directions.
Mr. Akcakaya is working on another project that combines AR and EEG for the improvement of stroke patients suffering from visual aspects of hemispatial neglect. With this technology, he hopes to help clinicians map the gaps in patients’ visual fields, providing personalized rehabilitation programs and shortened hospital stays.
The Veterans Health Administration recently began
using VR for treatmentresistant depression, with 3,000 VR headsets already distributed to facilities across the country.
And in 2022, the American Medical Association adopted terms like “VR-mediated therapy” into the Current Procedural Terminology ( CPT) code, which serves as a dictionary for legitimate medical language.
In contrast to augmented reality, which incorporates elements of the real world, the world created using VR is completely virtual.
If Ms. Woody and Mr. Akcakaya prove what they hope to, clinicians will be able to observe the brainwaves of teens in the midst of AR simulations to objectively know their levels of stress, adjust the scenario if that stress level is too high or too low, and observe the effects of coping strategies as patients use them in response to AR triggers right before their eyes.
As patients progress through treatment, EEG data can be compared over time as a measurement, in the best cases, of improvement.
“Sometimes, when I tell a teen they’re making progress, they hear me,” Ms. Woody said. “But when I can physically show them something, that can make a world of difference.”
The data generated by this technique may also lighten the load on therapists.
With an estimated current shortage of up to 31,000 mental health practitioners in the U.S. and a high level of burnout in the field, the use of VR and AR has the potential to someday provide at least some therapy sessions without a practitioner’s presence.
The potential upsides for the field of mental health care include increased patient reach and decreased decision fatigue, as objective EEG data can guide their next steps as clinicians, all while offering a tool that captures teens’ interest for the sake of their mental health.
“Teens are playing video games and using this technology in their everyday lives, so it’s instant buy-in for the therapists,” Woody said. “OK, maybe mom and dad made you come here, but we’re going to do some stuff that’s more engaging than the stodgy trip to the doctor’s that you were imagining. That’s a win.”