Breathing Biofeedback for Police Officers in a Stressful Virtual Environment: Challenges and Opportunities

Brammer, Jan C.; Peer, Jacobien M. van; Michela, Abele; Rooij, Marieke M. J. W. van; Oostenveld, Robert; Klumpers, Floris; Dorrestijn, Wendy; Granic, Isabela; Roelofs, Karin

doi:10.3389/fpsyg.2021.586553

Cited by 29 publications

(43 citation statements)

References 36 publications

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“…Together, these findings show that integration of psychophysiological states as well as action context into our decision models yields new mechanistic insight into how approach–avoidance conflict decisions are made under threat. This has implications for behavior in real-life threatening situations, such as for first-responders, anxiety patients, and anyone facing conflict-decisions in daily life (see Supplementary Information for a real-world example), suggesting that it may be beneficial to learn to control freezing-related states (e.g., using bio-feedback 46 , 47 or non-invasive brain stimulation techniques 48 ) to help optimally weighing values in the decision. Given this relevance of approach–avoidance conflict decision-making for real-life threatening situations, these findings call for models of value-based decision-making that better integrate internal (e.g., value, psychophysiology, and action tendencies) and external (e.g., action context) components of the decision.…”

Section: Discussionmentioning

confidence: 99%

Defensive freezing and its relation to approach–avoidance decision-making under threat

Klaassen

Held

Figner

et al. 2021

Sci Rep

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Successful responding to acutely threatening situations requires adequate approach–avoidance decisions. However, it is unclear how threat-induced states—like freezing-related bradycardia—impact the weighing of the potential outcomes of such value-based decisions. Insight into the underlying computations is essential, not only to improve our models of decision-making but also to improve interventions for maladaptive decisions, for instance in anxiety patients and first-responders who frequently have to make decisions under acute threat. Forty-two participants made passive and active approach–avoidance decisions under threat-of-shock when confronted with mixed outcome-prospects (i.e., varying money and shock amounts). Choice behavior was best predicted by a model including individual action-tendencies and bradycardia, beyond the subjective value of the outcome. Moreover, threat-related bradycardia (high-vs-low threat) interacted with subjective value, depending on the action-context (passive-vs-active). Specifically, in action-contexts incongruent with participants’ intrinsic action-tendencies, stronger bradycardia related to diminished effects of subjective value on choice across participants. These findings illustrate the relevance of testing approach–avoidance decisions in relatively ecologically valid conditions of acute and primarily reinforced threat. These mechanistic insights into approach–avoidance conflict-resolution may inspire biofeedback-related techniques to optimize decision-making under threat. Critically, the findings demonstrate the relevance of incorporating internal psychophysiological states and external action-contexts into models of approach–avoidance decision-making.

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Section: Discussionmentioning

confidence: 99%

Defensive freezing and its relation to approach–avoidance decision-making under threat

Klaassen

Held

Figner

et al. 2021

Sci Rep

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“…Both interventions resulted in altered activity in fronto-amygdala-motor circuits. Behavioral interventions could focus on training a psychophysiological state compatible with bradycardia and increased heart rate variability prior to approach-avoidance decision making, such as recently developed in a biofeedback-integrated virtual reality game, where people make speeded approach avoidance decisions under acute threat (Brammer et al, 2021).…”

Section: Predictions Based On the Modelmentioning

confidence: 99%

Approach-Avoidance Decisions Under Threat: The Role of Autonomic Psychophysiological States

et al. 2021

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Acutely challenging or threatening situations frequently require approach-avoidance decisions. Acute threat triggers fast autonomic changes that prepare the body to freeze, fight or flee. However, such autonomic changes may also influence subsequent instrumental approach-avoidance decisions. Since defensive bodily states are often not considered in value-based decision-making models, it remains unclear how they influence the decision-making process. Here, we aim to bridge this gap by discussing the existing literature on the potential role of threat-induced bodily states on decision making and provide a new neurocomputational framework explaining how these effects can facilitate or bias approach-avoid decisions under threat. Theoretical accounts have stated that threat-induced parasympathetic activity is involved in information gathering and decision making. Parasympathetic dominance over sympathetic activity is particularly seen during threat-anticipatory freezing, an evolutionarily conserved response to threat demonstrated across species and characterized by immobility and bradycardia. Although this state of freezing has been linked to altered information processing and action preparation, a full theoretical treatment of the interactions with value-based decision making has not yet been achieved. Our neural framework, which we term the Threat State/Value Integration (TSI) Model, will illustrate how threat-induced bodily states may impact valuation of competing incentives at three stages of the decision-making process, namely at threat evaluation, integration of rewards and threats, and action initiation. Additionally, because altered parasympathetic activity and decision biases have been shown in anxious populations, we will end with discussing how biases in this system can lead to characteristic patterns of avoidance seen in anxiety-related disorders, motivating future pre-clinical and clinical research.

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“…To substantiate this claim, the ecological validity of single and combinations of stress cues must be tested, as well as the effect of stress cues in VR compared to real-life situations. In addition to HRV, we plan to integrate measurements such as breath rate, eye movement, and pupillometry data (see e.g., [4]). An algorithm will use these inputs to measure and visualize experienced stress and the impact of stress cues in trainees.…”

Section: Discussion and Future Workmentioning

confidence: 99%

Stress Out: Translating Real-World Stressors into Audio-Visual Stress Cues in VR for Police Training

Nguyen

Jaspaert

Murtinger

et al. 2021

Lecture Notes in Computer Science

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Virtual Reality (VR) training has become increasingly important for police first responders in recent years. Improving the training experience in such complex contexts requires ecological validity of virtual training. To achieve this, VR systems need to be capable of simulating the complex experiences of police officers ‘in the field.’ One way to do this is to add stressors into training simulations to induce stress similar to the stress experienced in real-life situations, particularly in situations where this is difficult (e.g., dangerous or resource-intensive) to achieve with traditional training. To include stressors in VR, this paper thus presents the concept of so-called ‘stress cues’ for operationalizing stressors to augment training in VR simulations for the context of police work. Considering the level of complexity of police work and training, a co-creation process that allows for creative collaboration and mitigation of power imbalances was chosen to access the police officers’ knowledge and experience. We assert that stress cues can improve the training experience from the trainer’s perspective as they provide novel interaction design possibilities for trainers to control the training experience. E.g., by actively intervening in training and dynamically changing the interaction space for trainees which also improves the trainee’s experience. Stress cues can also improve the trainee’s experience by enabling personalizable and customizable training based on real-time stress measurements and supplementing information for improved training feedback.

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Breathing Biofeedback for Police Officers in a Stressful Virtual Environment: Challenges and Opportunities

Cited by 29 publications

References 36 publications

Defensive freezing and its relation to approach–avoidance decision-making under threat

Defensive freezing and its relation to approach–avoidance decision-making under threat

Approach-Avoidance Decisions Under Threat: The Role of Autonomic Psychophysiological States

Stress Out: Translating Real-World Stressors into Audio-Visual Stress Cues in VR for Police Training

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