Personalized behavior modeling: depression detection d

Xuhai Xu, Prerna Chikersal, Janine M. Dutcher, Yasaman S. Sefidgar, Seo Woosuk, Michael J. Tumminia, Daniella K. Villalba, Sheldon Cohen,
Kasey G. Creswell, Creswell, J. David, Afsaneh Doryab, Paula S. Nurius, Eve Riskin, Anind K. Dey, & Jennifer Mankoff. Leveraging Collaborative-Filtering for Personalized Behavior Modeling: A Case Study of Depression Detection among College Students. Proc. ACM interact. mob. wearable ubiquitous technol., Article 41. (March 21) 27pages.

The prevalence of mobile phones and wearable devices enables the passive capturing and modeling of human behavior at an unprecedented resolution and scale. Past research has demonstrated the capability of mobile sensing to model aspects of physical health, mental health, education, and work performance, etc. However, most of the algorithms and models proposed in previous work follow a one-size-fits-all (i.e., population modeling) approach that looks for common behaviors amongst all users, disregarding the fact that individuals can behave very differently, resulting in reduced model performance. Further, black-box models are often used that do not allow for interpretability and human behavior understanding. We present a new method to address the problems of personalized behavior classification and interoperability, and apply it to depression detection among college students. Inspired by the idea of collaborative-filtering, our method is a type of memory-based learning algorithm. It leverages the relevance of mobile-sensed behavior features among individuals to calculate personalized relevance weights, which are used to impute missing data and select features according to a specific modeling goal (e.g., whether the student has depressive symptoms) in different time epochs, i.e., times of the day and days of the week. It then compiles features from epochs using majority voting to obtain the final prediction. We apply our algorithm on a depression detection dataset collected from first-year college students with low data-missing rates and show that our method outperforms the state-of the-art machine learning model by 5.1% in accuracy and 5.5% in F1 score. We further verify the pipeline-level generalizability of our approach by achieving similar results on a second dataset, with an average improvement of 3.4% across performance metrics. Beyond achieving better classification performance, our novel approach is further able to generate personalized interpretations of the models for each individual. These interpretations are supported by existing depression-related literature and can potentially inspire automated and personalized depression intervention design in the future.

Distress and resilience among marginalized undergraduates

Nurius, P. S., Sefidgar, Y. S., Kuehn, K. S, Jake, X, Zhang, H., Browning, A., Riskin, E., Dey, A. K., & Mankoff, J.  Distress among undergraduates: Marginality, stressors and resilience supports. Journal of American College Health, 1-9.

Stress and related mental health struggles are of growing concern at colleges and universities across the country and internationally, with some evidence of levels higher than general population peers. The university experience can pose considerable strain on students, in some cases adding to early and current life stressors, and, if not mitigated, can lead to impaired well-being and academic success/retention.

This study provides a 2019 data snapshot of multiple stressor effects on early-stage students, resilience resources (or the lack thereof) that can mitigate these effects, and sociodemographic characteristics reflecting minoritized identities. Participants were 253 first- and second-year undergraduate students (age =18.76; 49.80% male, 69% students of color) enrolled at the University of Washington.

Multivariate analysis demonstrated significant associations between greater stress exposures and lower levels of resilience resources with each of three mental health indicators—perceived stress (intensity of experienced stress), depression, and anxiety. Stressors such as poor physical health, discrimination exposure, experiencing one or more marginalizing status (e.g., first generation student, having disabilities, sexual minority), and using maladaptive coping strategies (e.g, denial, self-blame) significantly accounted for each of the mental health indicators. Prior stressors such as adverse childhood experiences and other life and academic adversities were also significantly correlated with the mental health variables.

Race/ethnicity was less clearly patterned, although students of Asian descent reported significantly greater depression and anxiety, and females reported higher levels on all distress forms. In terms of resilience supports, those reporting greater social support and perception of oneself as a “bounce back” kind of person reported lesser psychological distress and these variables reduced the effects of stressors. Assessment of student well-being from this same project during the 2020 COVID-19 context indicated that students entering the pandemic with mental health vulnerabilities experienced significantly greater psychological distress and academic strain as the university pivoted toward remote instruction, signaling highly consequential differences (Morris et al., 2021)

These results support the value of “poly-strengths” –multiple forms of resilience- fostering resources–for mitigating the effects of stressors on psychological distress. College leaders are noting increases in the severity of students’ mental health concerns and demand for services, changing the roles of campus counseling centers, and requiring new institutional responses. Better understanding cumulative stress/resilience resource profiles, particularly among marginalized students and those experiencing discrimination, can help universities in prioritizing institutional support responses toward prevention, strengthening resilience, and mitigating psychological distress.

College during COVID

Mental health of UW students during Spring 2020 varied tremendously: the challenges of online learning during the pandemic were entwined with social isolation, family demands and socioeconomic pressures. In this context, individual differences in coping mechanisms had a big impact. The findings of this paper underline the need for interventions oriented towards problem-focused coping and suggest opportunities for peer role modeling.

College from home during COVID-19: A mixed-methods study of heterogeneous experiences. Morris ME, Kuehn KS, Brown J, Nurius PS, Zhang H, Sefidgar YS, Xuhai X, Riskin EA, Dey A, Consolvo S, Mankoff JC. (2021) PLoS ONE 16(6): e0251580. (reported in UW News and the Hechtinger Report)

A lineplot showing anxiousness (Y axis, varying from 0 to 4) over time (X axis). Each student in the study is plotted as a different line over each day of the quarter. The plot overall looks very messy, but two things are clear; Every student has a very different trajectory from every other, with all of them going up and down multiple times. And the average, overall, shown is a fit line, is fairly low and slightly increasing (from about .75 to just under 1).
Heterogeneity in individuals’ levels of anxiety (reported in ESM). Individual trajectories of anxiety are shown in different line types and colors (dotted versus solid lines represent different participants). Although the mean level of anxiety is 1 on a scale of 0–4, the significant variation in responses invites examination of individuals and subgroups.

This mixed-method study examined the experiences of college students during the COVID-19 pandemic through surveys, experience sampling data collected over two academic quarters (Spring 2019 n1 = 253; Spring 2020 n2 = 147), and semi-structured interviews with 27 undergraduate students. 

There were no marked changes in mean levels of depressive symptoms, anxiety, stress, or loneliness between 2019 and 2020, or over the course of the Spring 2020 term. Students in both the 2019 and 2020 cohort who indicated psychosocial vulnerability at the initial assessment showed worse psychosocial functioning throughout the entire Spring term relative to other students. However, rates of distress increased faster in 2020 than in 2019 for these individuals. Across individuals, homogeneity of variance tests and multi-level models revealed significant heterogeneity, suggesting the need to examine not just means but the variations in individuals’ experiences. 

Thematic analysis of interviews characterizes these varied experiences, describing the contexts for students’ challenges and strategies. This analysis highlights the interweaving of psychosocial and academic distress: Challenges such as isolation from peers, lack of interactivity with instructors, and difficulty adjusting to family needs had both an emotional and academic toll. Strategies for adjusting to this new context included initiating remote study and hangout sessions with peers, as well as self-learning. In these and other strategies, students used technologies in different ways and for different purposes than they had previously. Supporting qualitative insight about adaptive responses were quantitative findings that students who used more problem-focused forms of coping reported fewer mental health symptoms over the course of the pandemic, even though they perceived their stress as more severe. 

Example quotes:

I like to build things and stuff like that. I like to see it in person and feel it. So the fact that everything was online…. I’m just basically reading all the time. I just couldn’t learn that way

Insomnia has been pretty hard for me . . .  I would spend a lot of time lying in bed not doing anything when I had a lot of homework to do the next day. So then I would become stressed about whether I’ll be able to finish that homework or not.”

“It was challenging … being independent and then being pushed back home. It’s a huge change because now you have more rules again”

For a few of my classes I feel like actually [I] was self-learning because sometimes it’s hard to sit through hours of lectures and watch it.”

I would initiate… we have a study group chat and every day I would be like ‘Hey I’m going to be on at this time starting at this time.’ So then I gave them time to all have the room open for Zoom and stuff. Okay and then any time after that they can join and then said I [would] wait like maybe 30 minutes or even an hour…. And then people join and then we work maybe … till midnight, a little bit past midnight

Passively-sensing Discrimination

See the UW News article featuring this study!

A deeper understanding of how discrimination impacts psychological health and well-being of students would allow us to better protect individuals at risk and support those who encounter discrimination. While the link between discrimination and diminished psychological and physical well-being is well established, existing research largely focuses on chronic discrimination and long-term outcomes. A better understanding of the short-term behavioral correlates of discrimination events could help us to concretely quantify the experience, which in turn could support policy and intervention design. In this paper we specifically examine, for the first time, what behaviors change and in what ways in relation to discrimination. We use actively-reported and passively-measured markers of health and well-being in a sample of 209 first-year college students over the course of two academic quarters. We examine changes in indicators of psychological state in relation to reports of unfair treatment in terms of five categories of behaviors: physical activity, phone usage, social interaction, mobility, and sleep. We find that students who encounter unfair treatment become more physically active, interact more with their phone in the morning, make more calls in the evening, and spend less time in bed on the day of the event. Some of these patterns continue the next day.

Passively-sensed Behavioral Correlates of Discrimination Events in College Students. Yasaman S. Sefidgar, Woosuk Seo, Kevin S. Kuehn, Tim Althoff, Anne Browning, Eve Ann Riskin, Paula S. Nurius, Anind K Dey, Jennifer Mankoff. CSCW 2019.

A bar plot sorted by number of reports, with about 100 reports of unfair treatment based on national origin, 90 based on intelligence, 70 based on gender, 60 based on apperance, 50 on age, 45 on sexual orientation, 35 on major, 30 on weight, 30 on height, 20 on income, 10 on disability, 10 on religion, and 10 on learning
Breakdown of 448 reports of unfair treatment by type. National, Orientation, and Learning refer to ancestry or national origin, sexual orientation, and learning disability respectively. See Table 3 for details of all categories. Participants were able to report multiple incidents of unfair treatment, possibly of different types, in each report. As described in the paper, we do not have data on unfair treatment based on race.
A heatplot showing sensor data collected by day in 5 categories: Activity, screen, locations, fitbit, and calls.
A heatplot showing compliance with sensor data collection. Sensor data availability for each day of the study is shown in terms of the number of participants whose data is available on a given day. Weeks of the study are marked on the horizontal axis while different sensors appear on the vertical axis. Important calendar dates (e.g., start / end of the quarter and exam periods) are highlighted as are the weeks of daily surveys. The brighter the cells for a sensor the larger the number of people contributing data for that sensor. Event-based sensors (e.g., calls) are not as bright as sensors continuously sampled (e.g., location) as expected. There was a technical issue in the data collection application in the middle of study, visible as a dark vertical line around the beginning of April.
A diagram showing compliance in surveys, organized by nweek of study. One line shows compliance in the large surveys given at pre, mid and post, which drops from 99% to 94% to 84%. The other line shows average weekly compliance in EMAs, which goes up in the second week to 93% but then drops slowly (with some variability) to 89%
Timeline and completion rate of pre, mid, and post questionnaires as well as EMA surveys. Y axis
shows the completion rates and is narrowed to the range 50-100%. The completion rate of pre, mid, and post questionnaires are percentages of the original pool of 209 participants, whereas EMA completion rates are based on the 176 participants who completed the study. EMA completion rates are computed as the average completion rate of the surveys administered in a certain week of the study. School-related events (i.e., start and end of quarters as well as exam periods) are marked. Dark blue bars (Daily Survey) show the weeks when participants answered surveys every day, four times a day
Barplot showing significance of morning screen use, calls, minutes asleep, time in bed, range of activities, number of steps, anxiety, depression, and frustration on the day before, of, and after unfair treatment. All but minutes asleep are significant at p=.05 or below on the day of discrimination, but this drops off after.
Patterns of feature significance from the day before to two days after the discrimination event. The
shortest bars represent the highest significance values (e.g., depressed and frustrated on day 0; depressed on day 1; morning screen use on day 2). There are no significant differences the day before. Most short-term relationships exist on the day of the event, a few appear on the next day (day 1). On the third day one
significant difference, repeated, from the first day is observed.