Assessing Social Anxiety Through Digital Biomarkers Embedded in a Gaming Task

Digital biomarkers of mental health issues offer many advantages, including timely identification for early intervention, ongoing assessment during treatment, and reducing barriers to assessment stemming from geography, age, fear, or disparities in access to systems of care. Embedding digital biomarkers into games may further increase the reach of digital assessment. In this study, we explore game-based digital biomarkers for social anxiety, based on interaction with a non-player character (NPC). We show that social anxiety affects a player's accuracy and their movement path in a gaming task involving an NPC. Further, we compared first versus third-person camera perspectives and the use of customized versus predefined avatars to explore the influence of common game interface factors on the expression of social anxiety through in-game movements. Our findings provide new insights about how game-based digital biomarkers can be effectively used for social anxiety, affording the benefits of early and ongoing digital assessment.