Efficacy of a Virtual Reality Biofeedback Game (DEEP) to Reduce Anxiety and Disruptive Classroom Behavior: Single-Case Study

Bossenbroek, Rineke; Wols, Aniek; Weerdmeester, Joanneke; Lichtwarck‐Aschoff, Anna; Granic, Isabela; Rooij, Marieke M. J. W. van

doi:10.2196/16066

Cited by 74 publications

(72 citation statements)

References 72 publications

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“…Another contribution of this adolescent-specific review is the identification of several gaps in the literature for this population. The studies included in this review focused on pain and pain-related anxiety, however, recent studies in nonhospital settings have shown great potential for VR to be used to reduce other kinds of psychological distress in adolescents in a range of circumstances [78][79][80][81][82]. Emergency departments are a hospital environment that adolescents are more likely to use than other age groups [83], but also one that adolescents find particularly distressing due to long waits, loud sounds, bright lights, privacy intrusions, and exposure to the distress of others [84].…”

Section: Implications For Future Researchmentioning

confidence: 99%

Effectiveness of Virtual Reality Interventions for Adolescent Patients in Hospital Settings: Systematic Review

Ridout¹,

Kelson²,

Campbell³

et al. 2021

J Med Internet Res

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Background Given the high level of interest and increasing familiarity with virtual reality among adolescents, there is great potential to use virtual reality to address adolescents’ unique health care delivery needs while in hospital. While there have been reviews on the use of virtual reality for specific health conditions and procedures, none to date have reviewed the full scope of virtual reality hospital interventions for adolescents who are often combined with children as a homogenous group, despite the fact that adolescents experience virtual environments different from children. Objective The aim of this review was to systematically identify available evidence regarding the use of virtual reality interventions for adolescent patients in hospital settings to evaluate effectiveness, suitability, and safety and identify opportunities for future research. Methods PubMed, PsycINFO, Medline, and Scopus databases were searched using keywords and phrases. Retrieved abstracts (n=1525) were double screened, yielding 276 articles for full-text screening. Of these, 8 articles met inclusion criteria. Data were extracted to a standardized coding sheet, and a narrative synthesis was performed due to the heterogeneity of the studies. Results Four RCTs and 4 single-case reports were identified for inclusion, all of which aimed to reduce pain or anxiety. The scenarios targeted were burn pain, venipuncture, chemotherapy, preoperative anxiety, and palliative care. Three out of 4 RCTs found significant reductions in pain or anxiety outcomes measures when using virtual reality compared to standard care or other distraction techniques; however, only 1 study combined self-reported experiences of pain or anxiety with any physiological measures. Single-case reports relied primarily upon qualitative feedback, with patients reporting reduced pain or anxiety and a preference for virtual reality to no virtual reality. Conclusions Virtual reality can provide a safe and engaging way to reduce pain and anxiety in adolescents while in hospital, particularly when virtual reality software is highly immersive and specifically designed for therapeutic purposes. As VR becomes more accessible and affordable for use in hospitals, larger and more diverse studies that capitalize on adolescents’ interest in and aptitude for virtual reality, and on the full range of capabilities of this emerging technology, are needed to build on these promising results. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020198760; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020198760

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Section: Implications For Future Researchmentioning

confidence: 99%

Effectiveness of Virtual Reality Interventions for Adolescent Patients in Hospital Settings: Systematic Review

Ridout¹,

Kelson²,

Campbell³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Another example is DEEP, an applied game that teaches diaphragmatic breathing in a gamified VR-environment via biofeedback. Although the effect was small, after using DEEP, anxiety was reduced in children in special education ( 52 ). These types of engaging, experience-based approaches might also be a good fit for enhancing relaxation skills in the often unmotivated forensic psychiatric patient populations ( 44 ).…”

Section: Ehealth and The Need Principlementioning

confidence: 99%

A Perspective on the Integration of eHealth in Treatment of Offenders: Combining Technology and the Risk-Need-Responsivity Model

Kip

Bouman²

2021

Front. Psychiatry

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While there are multiple ways in which eHealth interventions such as online modules, apps and virtual reality can improve forensic psychiatry, uptake in practice is low. To overcome this problem, better integration of eHealth in treatment is necessary. In this perspective paper, we describe how the possibilities of eHealth can be connected to the risk-need-responsivity (RNR) model. To account for the risk-principle, stand-alone eHealth interventions might be used to offer more intensive treatment to high-risk offenders. The need-principle can be addressed by connecting novel experience-based interventions such as VR and apps to stable and acute dynamic risk factors. Finally, using and combining personalized interventions is in line with the responsivity-principle. Based on research inside and outside of forensic psychiatry, we conclude that there are many possibilities for eHealth to improve treatment—not just based on RNR, but also on other models. However, there is a pressing need for more development, implementation and evaluation research.

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“…This type of game is often defined in the literature as a “serious game” [ 69 ], as gaming features are used as the primary medium for serious purposes [ 66 ]. Several custom-made video games for relaxation integrate biofeedback techniques into the game modes, such as Deep [ 70 , 71 ], Nevermind [ 72 ], MindLight [ 73 , 74 ], Dojo [ 75 , 76 ], and StressJam [ 77 ]. Furthermore, studies have shown that ad hoc video games could help adults with anxiety better handle emotional and physiological responses to stressors [ 78 ] and improve behavioral performance on anxiety-related stress tasks [ 79 ].…”

Section: Introductionmentioning

confidence: 99%

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review

Pallavicini¹,

Pepe²,

Mantovani³

2021

JMIR Ment Health

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Background Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games. Objective The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play). Methods A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [(“video game*”) OR (“computer game*”)] AND [(“stress”) OR (“anxiety”) OR (“relaxation”)] AND [(“study”) OR (“trial”) OR (“training”)]. Results A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety. Conclusions Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety. Trial Registration International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081

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Efficacy of a Virtual Reality Biofeedback Game (DEEP) to Reduce Anxiety and Disruptive Classroom Behavior: Single-Case Study

Cited by 74 publications

References 72 publications

Effectiveness of Virtual Reality Interventions for Adolescent Patients in Hospital Settings: Systematic Review

Effectiveness of Virtual Reality Interventions for Adolescent Patients in Hospital Settings: Systematic Review

A Perspective on the Integration of eHealth in Treatment of Offenders: Combining Technology and the Risk-Need-Responsivity Model

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review

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