Task-evoked eye movements as candidate digital biomarkers of depression severity in adolescents and young adults

Abstract:Objective digital measures of depression severity could complement conventional symptom assessments and facilitate more timely clinical evaluation. Here, we investigated whether task-evoked eye movements provide interpretable behavioral markers of depression severity in adolescents and young adults. In this single-center, cross-sectional study, 155 participants aged 14--20 years completed emotional-spatial free-viewing and memory-guided recall tasks and were stratified by 17-item Hamilton Depression Rating Scale scores. We examined 19 prespecified eye-movement features across six task-informed domains using covariate-adjusted ordinal-trend models. Greater depression severity was associated with lower gaze-allocation entropy (standardized $\beta=-0.599$), fewer inter-area switches ($\beta=-0.526$), longer first target-entry latency ($\beta=0.572$), and lower target dwell proportion ($\beta=-0.678$; all false-discovery-rate-adjusted $q<0.001$). Emotion-specific attentional-bias measures were not associated with severity, whereas associations involving fixation dispersion weakened after adjustment for anxiety symptoms. In a complementary machine-learning analysis incorporating 44 candidate eye-movement features and demographic covariates, a three-stage cascade classifier achieved the highest four-class stratification performance (accuracy, 0.665; macro-F1, 0.670; area under the receiver operating characteristic curve, 0.869), outperforming single-stage and two-stage approaches. Together, these findings identify altered visual exploration and memory-guided gaze control as candidate digital biomarkers of depression severity, rather than generalized negative attentional bias. These results support further prospective evaluation of task-evoked eye tracking as a complementary approach for timely severity assessment and clinical decision support.

Signal Processing (eess.SP); Artificial Intelligence (cs.AI)

arXiv:2610.18494 [eess.SP]

(or arXiv:2610.18494v1 [eess.SP] for this version)

https://doi.org/10.48550/arXiv.2610.18494 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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