19 December, 2022

How eye trackers can help us understand mental health issues around performance anxiety

Can eye trackers and biosensors help us understand mental health issues surrounding performance anxiety? 

In a recent podcast episode, we featured iMotions Product Specialist Dr. Pernille Bülow and Dr. Erick Bourassa, an Associate Professor in the Department of Biological Sciences and Physician Assistant Studies at Mississippi College. 

iMotions is a fully-integrated, hardware-agnostic software platform that allows researchers to use the power of any neuroscience technology, as well as traditional surveys and focus groups, to gain unparalleled insight into what people actually think and feel. At iMotions, Pernille consults and trains academic and commercial researchers on multimodal biometric data collection and study design.

We were joined by iMotions customer Dr. Bourassa, who joined MC’s faculty in 2014 and currently teaches Vertebrate Histology, Pharmacology, Virology, Cell Physiology, Pharmacology of Infectious Diseases, and Pharmacology & Therapeutics. One area of his research expertise includes alterations of normal attention and memory in patients with anxiety disorders. Currently, his research efforts are focused on identifying the abnormal neural circuitry that induces and maintains anxiety in patients with anxiety disorders.

The group talked about mental health in education and performance research, the role of biosensors in mental health research and Dr. Bourassa’s work in studying test anxiety in students using biosensors. Here are a few highlights from the conversation: 


1 – Why is it important to address mental health in education and performance research? 


Almost half of all high school students struggle with long periods of feeling sad and lonely, while 1 in 3 college students as well as college athletes experience depression and anxiety – but only 40% of those people receive therapy or other forms of mental health support. 66% of college students struggle with loneliness, which is a risk factor for developing mental illness. 

In contrast, “only” 1 in 5 adults (18+ without focusing on college specifically) experience mental illnesses. When zooming in on the people that do high level performances there is a huge lack of speaking out about mental health challenges, which means it is usually underreported.
Thankfully we are seeing changes in that with for example the tennis players Serena Williams and Naomi Osaka and the swimmer Michael Phelps. So it cannot be understated how important it is that we address mental health in the education and performance arenas.


2 – When we talk about performance, oftentimes we can forget that the education system is one big performance hall. We know that, especially now, a lot of students struggle with mental health. How is this being studied with biosensors? 


I absolutely agree that the education system often turns into a performance assessment, in part due to the large number of tests that students are evaluated on. One of the reasons that it is actually worth it for teachers and schools to care about students’ mental health is not just because it is nice to do, but because we know that students are much better performers when they are alert, engaged and happy.

There are several ways student mental health and performance are evaluated with biosensors.  Some studies happen in the lab: for example testing depression, anxiety, stress during different tasks and general assessment of wellbeing, as well as intervention methods to relieve stress in students. This could include sitting in front of a computer screen while performing a test, or watching a lecture, while the researcher measures what their eyes pay attention to on the screen, the activity state of their autonomic nervous system (for example with HR and GSR) and their brain activity. 

Currently, education research is very survey heavy, meaning that biosensors have not made a huge impact on their research yet. We have much more biometric research data that informs us on best teaching practices that leads to improved student performance. 

The good thing about this lab-based set up is of course that it’s a really controlled environment where you can use high-grade biosensors. However, a challenge is ecological validity: the studies are not taking place where real life is lived – does the stress, anxiety or intervention that you found in the lab actually translate to the classroom?

This is where wearable biosensors are starting to make an impact – just like with sports performance research. Some studies have been done that use wearable technology to measure heart rate, skin temperature, and electrodermal activity during real academic tests and classroom designs that give physiological insights into a student’s performance, health and wellbeing. But this research is still in its infancy, but has a huge potential to impact mental health among students in the education system. 


3 – How long do you think it will be before we start implementing biosensors in for example monitoring high performance people’s mental health? Could you envision a time where all performers have their mental health evaluated in a way that can inform their training practices? 


It’s already happening; everyone nowadays has a wearable watch with various sensors. The main question right now is: how accurate is that data – can we actually inform and improve performance and mental health based on it?

One thing is to track performance, another is to use the metrics to change behavior and training. For that we need research to test out best approaches, as well as the validity of the sensors themselves. That is an ongoing field, but we already now have a good sense of which, for example, wristbands and watches provide the most reliable data, so the time is ripe for researchers to get started. 

As for whether we will reach a time where all performers have their mental health evaluated – absolutely. I think we are, very slowly, seeing a paradigm change in how performer’s health are addressed. 

For example, the change in how football player’s performance is evaluated by doctors now instead of their trainers which determines if they can play again. And how we are seeing a greater focus on mental health initiatives in different NFL teams. But these are ongoing issues that we need to address and they are by no means solved yet. That’s where researchers have a possibility to make a huge impact. What if we could develop platforms that use wearable biosensors to register if a performer is depressed, anxious, cognitively and physically fatigued, and maybe even suicidal before the performer notices it themselves? That would save many lives, improve life quality, and make them better learners – performing is not just about, well, performing, but about acquiring skills and that requires that you are rested and engaged – both end products of practicing physical and mental wellbeing. 

But again, research needs to validate the biosensors before we can start using these reliably, which will happen both in the lab and in the field.

Learn more: listen to the full podcast episode, and register for the biosensors in mental health webinar.

Written by Ashley McManus
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