The following is a summary of “Utility of Wrist-Wearable Data for Assessing Pain, Sleep, and Anxiety Outcomes After Traumatic Stress Exposure,” published in the January 2023 issue of Psychiatry by Straus, et al.

Negative posttraumatic neuropsychiatric sequelae following exposure to traumatic stress are widespread and more likely to occur in socioeconomically deprived people. It had been noted that people experience discomfort, despair, avoidance of traumatic reminders, reliving trauma, anxiety, hyperarousal, disturbed sleep, and nightmares. Many wrist-worn devices with accelerometers can measure 24-hour rest-activity characteristics that may be useful in monitoring these results. For a study, researchers sought to assess if wrist-worn devices might offer practical biomarkers for recovery following acute stress exposure.

As part of the Advancing Understanding of Recovery After Trauma (AURORA) research, data were evaluated from a varied group of patients who had been visited in the emergency room following traumatic stress exposure. Participants were chosen from 27 emergency rooms, and they had serial examinations of neuropsychiatric symptoms while wearing wrist-wearable devices for 8 weeks, starting in the emergency room. About 19,019 people in total underwent screening. Around 3,040 of them satisfied the requirements for the study, gave their informed consent, and finished the baseline exams. 2,021 individuals in all participated in the 8-week assessment, submitted data from wrist-wearable devices, and were examined in this study. To identify and validate the biomarkers, the data were randomly split into two equal portions (n = 1,010). Data was gathered between September 2017 and January 2020, and it was examined between May 2020 and November 2022. Wrist-wearable devices linked to certain self-reported symptom domains at a particular moment and variations in symptom severity over time were used to generate and validate rest-activity characteristics.

The mean (SD) age of 2,021 included patients was 35.8 (13.0), with 1,257 (62.2%) of them being female. In the derivation cohort, eight wrist-wearable device biomarkers for signs of negative posttraumatic neuropsychiatric sequelae achieved significance levels. Reduced 24-hour activity variance was one of them, and it was linked to more severe pain (r = -0.14; 95% CI, -0.20 to -0.07). The number of transitions between sleep and wakefulness over time was linked to changes in pain, sleep, and anxiety. Variations in six rest-activity indicators were also linked to changes in pain over time. Straightforward cutoffs for these biomarkers had a strong predictive value for identifying people who had satisfactory recovery from pain (positive predictive value [PPV], 0.85; 95% CI, 0.82-0.88), sleep (PPV, 0.63; 0.59-0.67), and anxiety (PPV, 0.76; 0.72-0.80).

According to the results, wrist-wearable device biomarkers may be useful as screening tools for high-risk individuals’ pain, sleep, and anxiety symptom outcomes following trauma exposure.

Reference: jamanetwork.com/journals/jamapsychiatry/article-abstract/2800174