In April, the software company Cogito was halfway through a clinical trial to see if it could detect symptoms of depression and post-traumatic stress disorder (PTSD) through a smartphone app. All of the 100 participants in the study lived around Boston. Then, on 15 April, two bombs went off near the finish line of the Boston Marathon, killing three people and injuring hundreds. Suddenly, Cogito’s clinical trial was a lot more relevant.
The trial was funded by the Defense Advanced Research Projects Agency (DARPA) under its Detection and Computational Analysis of Psychological Signals program. To address the troubling number of psychological problems and suicides among active-duty military personnel and veterans, the U.S. Department of Defense is seeking technologies that can identify at-risk individuals so professionals can help them.
Cogito, a Boston-based MIT spin-off, developed an app that keeps track of a person’s social behavior and vocal characteristics. The app monitors the phone’s location and time of use and also logs phone calls and text messages. (It doesn’t look at the content of those calls and texts.) Finally, there’s an active component: Participants can choose to fill out questionnaires about their mood and can record audio diaries. Cogito’s expertise is in automated speech analysis, which it applies to those audio diaries; future iterations could mine phone conversations for information as well.
Put all the data together and you’re able to tell a lot about a person, says Cogito CEO Joshua Feast. Sometimes you even find signs of distress that people don’t want to admit to or haven’t recognized themselves. “We’re able to look at sleep, mood, social isolation, and physical isolation,” says Feast, all of which can serve as “honest signals” of psychological trouble. In the Boston trial, Cogito was only testing the sophisticated algorithms it developed to aggregate the data. If the trial works out, future versions of the software could provide these summaries to clinicians to allow them to intervene and could also give the information to the subjects themselves.
All of this can seem rather creepy—apps that get inside your head and reveal your emotional secrets. But Feast says that’s why his company places so much emphasis on privacy and trust. If Cogito’s system becomes a commercial product, there will be legal guarantees that a user will always own and control his or her own data. For example, a user could choose whether or not to share the data with a clinician. Feast says he doesn’t think users would have it any other way. “Morally it’s the right thing to do, and also for adoption it’s the right thing to do,” he says.
The participants in the Boston trial included veterans, civilians with histories of trauma or depression, and some healthy civilians. While the bulk of the data from the study is still being analyzed, Feast says the impact of the April bombing is already clear. The algorithms picked up more markers of stress in the participants, including decreased use of the app’s interactive components. “Fewer survey questions were being answered, and fewer audio diaries were being recorded,” he says.
Further study of the data will answer other important questions about the nature of depression and PTSD, says Feast: “What is resilience? What kind of people fared better after the bombing? What happens to people with vulnerability when things like this happen?” The company is still formulating its research questions, he says.
The Durkheim Project, another initiative funded by this DARPA program, focuses more narrowly on identifying veterans at risk of suicide. Chris Poulin, director of the project, explains that his system predicts suicide risk by analyzing veterans’ text messages and their posting on social-networking sites like Facebook and Twitter. Poulin says he’s impressed with the scope of Cogito’s data collection and its incorporation of voice monitoring. “There are other people out there collecting mobile data and looking at activity metrics, but very few people have integrated voice data,” he says.
Cogito’s voice-analysis software, Cogito Dialog, monitors vocal characteristics such as level of excitement and fluidity of speech. Feast explains that it’s tricky to get clear data in this area because there’s so much natural variation in people’s speech habits. However, the system can detect changes to an individual’s speech patterns over time and can also be useful in telemedicine. For example, if a clinician calls veterans and asks them all the same series of questions, a monitoring system can flag people with unusual responses. “Speech analysis is well suited for looking at population norms and deviation from the norms,” says Feast.
Feast believes that the company’s experience with the Boston bombing provides a preview of a possible future where psychological monitoring apps are as common as the fitness and activity gadgets that proliferate today. “When there’s an earthquake or terrorist attack or traumatic event that hits a population center, this technology could support a rapid response team for psychological distress,” he says. “It would be like the CDC [Centers for Disease Control] responding to a flu outbreak.”