Movements Indicate Threat Response Phases in Children at Risk for Anxiety

Temporal phases of threat response, including potential threat (anxiety), acute threat (startle, fear), and post-threat response modulation, have been identified as the underlying markers of anxiety disorders. Objective measures of response during these phases may help identify children at risk for anxiety; however, the complexity of current assessment techniques prevent their adoption in many research and clinical contexts. We propose an alternative technology, an inertial measurement unit (IMU), that enables noninvasive measurement of the movements associated with threat response, and test its ability to detect threat response phases in young children at a heightened risk for developing anxiety. We quantified the motion of 18 children (3-7 years old) during an anxiety-/fear-provoking behavioral task using an IMU. Specifically, measurements from a single IMU secured to the child's waist were used to extract root-mean-square acceleration and angular velocity in the horizontal and vertical directions, and tilt and yaw range of motion during each threat response phase. IMU measurements detected expected differences in child motion by threat phase. Additionally, potential threat motion was positively correlated to familial anxiety risk, startle range of motion was positively correlated with child internalizing symptoms, and response modulation motion was negatively correlated to familial anxiety risk. Results suggest differential theory-driven threat response phases and support previous literature connecting maternal child risk to anxiety with behavioral measures using more feasible objective methods. This is the first study demonstrating the utility of an IMU for characterizing the motion of young children to mark the phases of threat response modulation. The technique provides a novel and objective measure of threat response for mental health researchers.