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Moran EK, Shapiro M, Culbreth AJ, Nepal S, Ben-Zeev D, Campbell A, Barch DM. Loneliness in the Daily Lives of People With Mood and Psychotic Disorders. Schizophr Bull 2024; 50:557-566. [PMID: 38429937 PMCID: PMC11059807 DOI: 10.1093/schbul/sbae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning. STUDY DESIGN The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life. STUDY RESULTS Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (β = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (β = -0.56, t = -3.29, P = .02) and phone calls (β = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life. CONCLUSIONS These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.
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Affiliation(s)
- Erin K Moran
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Madelyn Shapiro
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Adam J Culbreth
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland, Baltimore, MD, USA
| | - Subigya Nepal
- Department of Computer Science, Dartmouth College, Hanover, NH, USA
| | - Dror Ben-Zeev
- Department of Psychiatry, BRiTE Center, University of Washington, Seattle, WA, USA
| | - Andrew Campbell
- Department of Computer Science, Dartmouth College, Hanover, NH, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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2
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Lim S, Kim C, Cho BH, Choi SH, Lee H, Jang DP. Investigation of daily patterns for smartphone keystroke dynamics based on loneliness and social isolation. Biomed Eng Lett 2024; 14:235-243. [PMID: 38374905 PMCID: PMC10874350 DOI: 10.1007/s13534-023-00337-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 02/21/2024] Open
Abstract
This study examined the relationship between loneliness levels and daily patterns of mobile keystroke dynamics in healthy individuals. Sixty-six young healthy Koreans participated in the experiment. Over five weeks, the participants used a custom Android keyboard. We divided the participants into four groups based on their level of loneliness (no loneliness, moderate loneliness, severe loneliness, and very severe loneliness). The very severe loneliness group demonstrated significantly higher typing counts during sleep time than the other three groups (one-way ANOVA, F = 3.75, p < 0.05). In addition, the average cosine similarity value of weekday and weekend typing patterns in the very severe loneliness group was higher than that in the no loneliness group (Welch's t-test, t = 2.27, p < 0.05). This meant that the no loneliness group's weekday and weekend typing patterns varied, whereas the very severe loneliness group's weekday and weekend typing patterns did not. Our results indicated that individuals with very high levels of loneliness tended to use mobile keyboards during late-night hours and did not significantly change their smartphone usage behavior between weekdays and weekends. These findings suggest that mobile keystroke dynamics have the potential to be used for the early detection of loneliness and the development of targeted interventions.
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Affiliation(s)
- Seokbeen Lim
- Dept. of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Chaeyeon Kim
- Dept. of Electronic Engineering, Hanyang University, Seoul, Republic of Korea
| | - Baek Hwan Cho
- Dept. of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, Republic of Korea
- Institute of Biomedical Informatics, School of Medicine, CHA University, Seongnam, Republic of Korea
| | - Soo-Hee Choi
- Dept. of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
- Dept. of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Dept. of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Dong Pyo Jang
- Dept. of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
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3
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Hughes G, Moore L, Hennessy M, Sandset T, Jentoft EE, Haldar M. What kind of a problem is loneliness? Representations of connectedness and participation from a study of telepresence technologies in the UK. Front Digit Health 2024; 6:1304085. [PMID: 38440196 PMCID: PMC10910053 DOI: 10.3389/fdgth.2024.1304085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Loneliness is represented in UK policy as a public health problem with consequences in terms of individual suffering, population burden and service use. However, loneliness is historically and culturally produced; manifestations of loneliness and social isolation also require social and cultural analysis. We explored meanings of loneliness and social isolation in the UK 2020-2022 and considered what the solutions of telepresence technologies reveal about the problems they are used to address. Through qualitative methods we traced the introduction and use of two telepresence technologies and representations of these, and other technologies, in policy and UK media. Our dataset comprises interviews, fieldnotes, policy documents, grey literature and newspaper articles. We found loneliness was represented as a problem of individual human connection and of collective participation in social life, with technology understood as having the potential to enhance and inhibit connections and participation. Technologically-mediated connections were frequently perceived as inferior to in-person contact, particularly in light of the enforced social isolation of the COVID-19 pandemic. We argue that addressing loneliness requires attending to other, related, health and social problems and introducing technological solutions requires integration into the complex social and organisational dynamics that shape technology adoption. We conclude that loneliness is primarily understood as a painful lack of co-presence, no longer regarded as simply a subjective experience, but as a social and policy problem demanding resolution.
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Affiliation(s)
- Gemma Hughes
- School of Business, University of Leicester, Leicester, United Kingdom
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Lucy Moore
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Megan Hennessy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Tony Sandset
- Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elian E. Jentoft
- Centre for the Study of Digitalization of Public Services and Citizenship, Oslo Metropolitan University, Oslo, Norway
| | - Marit Haldar
- Centre for the Study of Digitalization of Public Services and Citizenship, Oslo Metropolitan University, Oslo, Norway
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4
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Babichenko D, Radovic A, Patel R, Hester A, Powell K, Eggers N, Happe D. Evaluating the Feasibility of a Multiplayer Role-Playing Game as a Behavioral Health Intervention in Adolescent Patients With Chronic Physical or Mental Conditions: Protocol for a Cohort Study. JMIR Res Protoc 2023; 12:e43987. [PMID: 37368477 DOI: 10.2196/43987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/28/2023] [Accepted: 04/04/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Numerous studies have revealed that adolescents with chronic physical or mental conditions (CPMCs) are at an increased risk for depression and anxiety, with serious direct and indirect negative effects on treatment adherence, family functioning, and health-related quality of life. As game-based approaches are effective interventions in treating anxiety and depression, we propose to explore the use of a multiplayer role-playing game (RPG) as a potential intervention for social isolation, anxiety, and depression. OBJECTIVE The objectives of this study were to (1) determine the feasibility of using Masks, a multiplayer RPG, as an intervention for social isolation, anxiety, and depression in adolescents with CPMCs; (2) evaluate the viability of the research process; and (3) gauge participation in and engagement with RPG-based interventions. METHODS This study is a remote synchronous game-based intervention for adolescents with CPMCs aged 14-19 years. Eligible participants completed a web-based baseline survey to assess anxiety, depression, and social isolation and to identify their gaming habits. After completing the baseline survey, they participated in 5 moderated Masks game sessions. In Masks, players assume the roles of young superheroes; select their character types, superpowers; and perform actions determined by the game's rule system and dice rolls. All game sessions were played using Discord, a communication platform commonly used by gaming communities. Games were led and moderated by game masters (GMs). After each game session, participants completed surveys to assess changes in anxiety, depression, and social isolation, and their attitude toward the game and the user experience. The participants also completed an exit survey after all 5 game sessions (modified version of the Patient Health Questionnaire and the Generalized Anxiety Disorder Questionnaire, and 17 open-ended questions). The GMs rated each game session and reported on gameplay, player behavior, comfort, and engagement levels of the players. RESULTS As of March 2020, six participants were recruited for the pilot study to participate in moderated web-based game sessions of Masks; 3 completed all game sessions and all required assessments. Although the number of participants was too low to draw generalizable conclusions, self-reported clinical outcomes did seem to indicate a positive change in depression, anxiety, and social isolation symptoms. Qualitative analysis of postgame survey data from participants and GMs indicated high levels of engagement and enjoyment. Furthermore, the participants provided feedback about improved mood and engagement related to weekly participation in Masks. Lastly, responses to the exit survey showed interest in future RPG-related studies. CONCLUSIONS We established a workflow for gameplay and evaluated a research protocol for evaluating the impact of RPG participation on isolation, anxiety, and depression symptoms in adolescents with CPMCs. Preliminary data collected from the pilot study support the validity of the research protocol and the use of RPG-based interventions in larger clinical studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/43987.
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Affiliation(s)
- Dmitriy Babichenko
- School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ana Radovic
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ravi Patel
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alexis Hester
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Koehler Powell
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nicholas Eggers
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Happe
- School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States
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5
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Rees J, Liu W, Ourselin S, Shi Y, Probst F, Antonelli M, Tinker A, Matcham F. Understanding the psychological experiences of loneliness in later life: qualitative protocol to inform technology development. BMJ Open 2023; 13:e072420. [PMID: 37336536 DOI: 10.1136/bmjopen-2023-072420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES Loneliness is a public health issue impacting the health and well-being of older adults. This protocol focuses on understanding the psychological experiences of loneliness in later life to inform technology development as part of the 'Design for health ageing: a smart system to detect loneliness in older people' (DELONELINESS) study. METHODS AND ANALYSIS Data will be collected from semi-structured interviews with up to 60 people over the age of 65 on their experiences of loneliness and preferences for sensor-based technologies. The interviews will be audio-recorded, transcribed and analysed using a thematic codebook approach on NVivo software. ETHICS AND DISSEMINATION This study has received ethical approval by Research Ethics Committee's at King's College London (reference number: LRS/DP-21/22-33376) and the University of Sussex (reference number: ER/JH878/1). All participants will be required to provide informed consent. Results will be used to inform technology development within the DELONELINESS study and will be disseminated in peer-reviewed publications and conferences.
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Affiliation(s)
- Jessica Rees
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Wei Liu
- Department of Engineering, King's College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Yu Shi
- School of Design, University of Leeds, Leeds, UK
| | - Freya Probst
- Department of Engineering, King's College London, London, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Anthea Tinker
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Faith Matcham
- School of Psychology, University of Sussex, Falmer, UK
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6
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Khan SS, Gu T, Spinelli L, Wang RH. Sensor-based assessment of social isolation in community-dwelling older adults: a scoping review. Biomed Eng Online 2023; 22:18. [PMID: 36849963 PMCID: PMC9969951 DOI: 10.1186/s12938-023-01080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/10/2023] [Indexed: 03/01/2023] Open
Abstract
Social isolation (SI) is a state of low social interaction with peers associated with various adverse health consequences in older adults living in the community. SI is most often assessed through retrospective self-reports, which can be prone to recall or self-report biases and influenced by stigma. Ambient and wearable sensors have been explored to objectively assess SI based on interactions of a person within the environment and physiological data. However, because this field is in its infancy, there is a lack of clarity regarding the application of sensors and their data in assessing SI and the methods to develop these assessments. To understand the current state of research in sensor-based assessment of SI in older adults living in the community and to make recommendations for the field moving forward, we conducted a scoping review. The aims of the scoping review were to (i) map the types of sensors (and their associated data) that have been used for objective SI assessment, and (ii) identify the methodological approaches used to develop the SI assessment. Using an established scoping review methodology, we identified eight relevant articles. Data from motion sensors and actigraph were commonly applied and compared and correlated with self-report measures in developing objective SI assessments. Variability exists in defining SI, feature extraction and the use of sensors and self-report assessments. Inconsistent definitions and use of various self-report scales for measuring SI create barriers to studying the concept and extracting features to build predictive models. Recommendations include establishing a consistent definition of SI for sensor-based assessment research and development and consider capturing its complexity through innovative domain-specific features.
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Affiliation(s)
- Shehroz S. Khan
- grid.231844.80000 0004 0474 0428KITE, University Health Network, 550, University Avenue, Toronto, M5G 2A2 Canada
| | - Tiancheng Gu
- grid.17063.330000 0001 2157 2938Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Avenue, Toronto, M5G 1V7 Canada
| | - Lauren Spinelli
- grid.17063.330000 0001 2157 2938Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Avenue, Toronto, M5G 1V7 Canada
| | - Rosalie H. Wang
- grid.17063.330000 0001 2157 2938Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Avenue, Toronto, M5G 1V7 Canada
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7
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Henriquez AR, Snow SJ, Jackson TW, House JS, Alewel DI, Schladweiler MC, Valdez MC, Freeborn DL, Miller CN, Grindstaff R, Kodavanti PRS, Kodavanti UP. Social isolation exacerbates acute ozone inhalation induced pulmonary and systemic health outcomes. Toxicol Appl Pharmacol 2022; 457:116295. [PMID: 36341779 PMCID: PMC9722630 DOI: 10.1016/j.taap.2022.116295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
Psychosocially-stressed individuals might have exacerbated responses to air pollution exposure. Acute ozone exposure activates the neuroendocrine stress response leading to systemic metabolic and lung inflammatory changes. We hypothesized chronic mild stress (CS) and/or social isolation (SI) would cause neuroendocrine, inflammatory, and metabolic phenotypes that would be exacerbated by an acute ozone exposure. Male 5-week-old Wistar-Kyoto rats were randomly assigned into 3 groups: no stress (NS) (pair-housed, regular-handling); SI (single-housed, minimal-handling); CS (single-housed, subjected to mild unpredicted-randomized stressors [restraint-1 h, tilted cage-1 h, shaking-1 h, intermittent noise-6 h, and predator odor-1 h], 1-stressor/day*5-days/week*8-weeks. All animals then 13-week-old were subsequently exposed to filtered-air or ozone (0.8-ppm) for 4 h and immediately necropsied. CS, but not SI animals had increased adrenal weights. However, relative to NS, both CS and SI had lower circulating luteinizing hormone, prolactin, and follicle-stimulating hormone regardless of exposure (SI > CS), and only CS demonstrated lower thyroid-stimulating hormone levels. SI caused more severe systemic inflammation than CS, as evidenced by higher circulating cytokines and cholesterol. Ozone exposure increased urine corticosterone and catecholamine metabolites with no significant stressor effect. Ozone-induced lung injury, and increases in lavage-fluid neutrophils and IL-6, were exacerbated by SI. Ozone severely lowered circulating thyroid-stimulating hormone, prolactin, and luteinizing hormone in all groups and exacerbated systemic inflammation in SI. Ozone-induced increases in serum glucose, leptin, and triglycerides were consistent across stressors; however, increases in cholesterol were exacerbated by SI. Collectively, psychosocial stressors, especially SI, affected the neuroendocrine system and induced adverse metabolic and inflammatory effects that were exacerbated by ozone exposure.
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Affiliation(s)
- Andres R Henriquez
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Samantha J Snow
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Thomas W Jackson
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - John S House
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709, USA
| | - Devin I Alewel
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Mette C Schladweiler
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Matthew C Valdez
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Danielle L Freeborn
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Colette N Miller
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Rachel Grindstaff
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Prasada Rao S Kodavanti
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Urmila P Kodavanti
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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8
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Buck B, Munson J, Chander A, Wang W, Brenner CJ, Campbell AT, Ben-Zeev D. The relationship between appraisals of auditory verbal hallucinations and real-time affect and social functioning. Schizophr Res 2022; 250:112-119. [PMID: 36399900 PMCID: PMC9750498 DOI: 10.1016/j.schres.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/03/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022]
Abstract
In addition to being a hallmark symptom of schizophrenia-spectrum disorders, auditory verbal hallucinations (AVH) are present in a range of psychiatric disorders as well as among individuals who are otherwise healthy. People who experience AVH are heterogeneous, and research has aimed to better understand what characteristics distinguish, among those who experience AVH, those who experience significant disruption and distress from those who do not. The cognitive model of AVH suggests that appraisals of voices determine the extent to which voices cause distress and social dysfunction. Previous work has relied largely on comparisons of "clinical" and "non-clinical" voice hearers, and few studies have been able to provide insight into the moment-to-moment relationships between appraisals and outcomes. The current study examines longitudinal data provided through ecological momentary assessment and passive sensors of 465 individuals who experience cross-diagnostic AVH. Results demonstrated associations of AVH appraisals to negative affect and social functioning. Above and beyond within-individual averages, when a participant reported increased appraisals of their voices as powerful and difficult to control, they were more likely to feel increased negative affect and reduced feelings of safety. AVH power appraisals were also associated with next-day number and duration of phone calls placed, and AVH controllability appraisals were associated with increased time near speech and reduced next-day time away from primary location. These results suggest that appraisals are state-like characteristics linked with day-to-day and moment-to-moment changes in impactful affective and behavioral outcomes; intervention approaches should aim to address these domains in real-time.
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Affiliation(s)
- Benjamin Buck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America.
| | - Jeffrey Munson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Ayesha Chander
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Weichen Wang
- Department of Computer Science, Dartmouth College, Hanover, NH, United States of America
| | - Carolyn J Brenner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Andrew T Campbell
- Department of Computer Science, Dartmouth College, Hanover, NH, United States of America
| | - Dror Ben-Zeev
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
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