The challenge of stress induction in serious games, considering gameplay
Resumo
Stress induction is crucial for training personnel in high-pressure situations, such as military, first responders, and healthcare professionals. The ability to perform effectively under stress is a critical skill for these professionals, as their decisions can have significant consequences. One of the most effective methods for inducing stress in training scenarios is through the use of virtual environments. Virtual Reality (VR) and Augmented Reality (AR) technologies have become increasingly sophisticated, allowing for the creation of highly realistic and immersive training environments. These technologies can simulate a wide range of scenarios, from battlefield conditions for military personnel to emergency response situations for first responders and complex surgical procedures for healthcare professionals. This type of training aims to prepare individuals to respond effectively in real-life scenarios, enhancing resilience and decision-making abilities under stress. Measuring stress levels during these trainings is essential to assess program effectiveness and adjust methodologies as needed. By monitoring physiological and psychological stress indicators, such as heart rate variability, cortisol levels, and self-reported stress scales, trainers can determine if the scenarios are inducing the desired level of stress. This measurement ensures that participants are genuinely engaged in the training, allowing for real-time adjustments to the intensity and nature of the scenarios to maximize the training benefits. Additionally, it helps in verifying that the participant is fully immersed and responding realistically to the simulated high-pressure environment, ensuring the training’s relevance and effectiveness. Therefore, through a Systematic Literature Review, this study investigated the best biomarkers and their combinations and protocols used, aiming to determine the most effective way to measure stress induction in training to improve their efficiency.
Palavras-chave:
Psychophysiology, Stress, Serious Games, Virtual Environments, Virtual Reality
Referências
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Bermudez, S., Quintero, L. V., Cameirão, M. S., Chirico, A., Triberti, S., Cipresso, P., & Gaggioli, A. (2019). Toward Emotionally Adaptive Virtual Reality for Mental Health Applications. IEEE Journal of Biomedical and Health Informatics, 23(5), 1877–1887. DOI: 10.1109/JBHI.2018.2878846
Bolls, P., Lang, A., & Potter, R. (2001). The Effects of Message Valence and Listener Arousal on Attention, Memory, and Facial Muscular Responses to Radio Advertisements. Communication Research, 28, 627–651. DOI: 10.1177/009365001028005003
Bzdúšková, D., Marko, M., Hirjaková, Z., Kimijanová, J., Hlavačka, F., & Riečanský, I. (2022). The Effects of Virtual Height Exposure on Postural Control and Psychophysiological Stress Are Moderated by Individual Height Intolerance. Frontiers in Human Neuroscience, 15, 773091. DOI: 10.3389/fnhum.2021.773091
Delahaij, R., van Dam, K., Gaillard, A., & Soeters, J. (2011). Predicting Performance Under Acute Stress: The Role of Individual Characteristics. International Journal of Stress Management, 18(1), 49–66. DOI: 10.1037/a0020891
Kawano, L. L. B. D. R. (2018). A condutância da pele como indicador de ativação emocional em mensagens persuasivas: um estudo do trailer de divulgação do filme “50 tons de liberdade”.
Drachen, A., Yannakakis, G., Nacke, L., & Pedersen, A. (2010). Correlation between Heart Rate, Electrodermal Activity and Player Experience in First-Person Shooter Games (Pre-print). DOI: 10.1145/1836135.1836143
Economou, K., Quek, D., MacDougall, H., Lewis, S. J. G., & Ehgoetz Martens, K. A. (2021). Heart Rate Changes Prior to Freezing of Gait Episodes Are Related to Anxiety. Journal of Parkinson’s Disease, 11(1), 271–282. DOI: 10.3233/jpd-202146
Ergan, S., Radwan, A., Zou, Z., Tseng, H., & Han, X. (2018). Quantifying Human Experience in Architectural Spaces with Integrated Virtual Reality and Body Sensor Networks. Journal of Computing in Civil Engineering, 33(12), 0812. DOI: 10.1061/(ASCE)CP.1943-5487.0000812
Fenz, W. D., & Epstein, S. (1967). Gradients of physiological arousal in parachutists as a function of an approaching jump. Psychosomatic Medicine.
Finseth, T., Keren, N., Dorneich, M., Franke, W., Anderson, C., & Shelley, M. (2018). Evaluating the Effectiveness of Graduated Stress Exposure in Virtual Spaceflight Hazard Training. Journal of Cognitive Engineering and Decision Making, 12, 155534341877556. DOI: 10.1177/1555343418775561
Gamito, P., Oliveira, J., Silva, J., Rosa, J., Mendes, M. L. R., Dias, R., Dias, F., Mansuklal, S. A., Cartaxo, J., António, H., & Salvador, Á. (2024). Stress Inoculation in Police Officers Using Virtual Reality: A Controlled Study. Cyberpsychology, Behavior, and Social Networking. DOI: 10.1089/cyber.2023.0385
Gramlich, M. A., Smolenski, D. J., Norr, A. M., Rothbaum, B. O., Rizzo, A. A., Andrasik, F., Fantelli, E., & Reger, G. M. (2021). Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder. Depression and Anxiety, 38(6), 626–638. DOI: 10.1002/da.23141
Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009). Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology, 34(2), 163–171. DOI: 10.1016/j.psyneuen.2008.10.026
Kim, K., Rosenthal, M. Z., Zielinski, D. J., & Brady, R. (2014). Effects of virtual environment platforms on emotional responses. Computer Methods and Programs in Biomedicine, 113(3), 882–893. DOI: 10.1016/j.cmpb.2013.12.024
Kitchenham, B., Brereton, O. P., Budgen, D., Turner, M., Bailey, J., & Linkman, S. (2009). Systematic literature reviews in software engineering–a systematic literature review. Information and Software Technology, 51(1), 7–15.
Kivikangas, J. M., Chanel, G., Cowley, B., Ekman, I., Salminen, M., Järvelä, S., & Ravaja, N. (2011). A review of the use of psychophysiological methods in game research. Journal of Gaming Virtual Worlds, 3(3), 181–199. DOI: 10.1386/jgvw.3.3.181_1
Kosonogov, V. V., Efimov, K. V., Rakhmankulova, Z. K., & Zyabreva, I. A. (2023). Review of Psychophysiological and Psychotherapeutic Studies of Stress Using Virtual Reality Technologies. Neuroscience and Behavioral Physiology, 53(1), 81–91. DOI: 10.1007/s11055-023-01393-w
Loureiro, J. P., Pino, A. V., & Jandre, F. C. (2019). Time-Normalized Discrete Amplitude Response Variations as New Indices of Electrodermal Activity, Costa-Felix R., Alvarenga A. V., & Machado J. C. (Eds.). IFMBE Proceedings, 70, 493–496. DOI: 10.1007/978-981-13-2517-5_74
Malmivuo, J., & Plonsey, R. (1995). Bioelectromagnetism: Principles and Applications of Bioelectric and Biomagnetic Fields. Oxford University Press. DOI: 10.1093/acprof/9780195058239.001.0001
Maples-Keller, J. L., Rauch, S. A. M., Jovanovic, T., Yasinski, C. W., Goodnight, J. M., Sherrill, A., Black, K., Michopoulos, V., Dunlop, B. W., Rothbaum, B. O., & Norrholm, S. D. (2019). Changes in trauma-potentiated startle, skin conductance, and heart rate within prolonged exposure therapy for PTSD in high and low treatment responders. Journal of Anxiety Disorders, 68, 102147. DOI: 10.1016/j.janxdis.2019.102147
Moreno-Fernández, R. D., García-León, D., Peñas, G., Martín-Romero, R., Buades-Sitjar, F., & Sampedro-Piquero, P. (2023). Immersive virtual plus-maze to examine behavior and psychophysiological-related variables in young people with problematic alcohol and cannabis consumption. Neurobiology of Stress, 26, 100564. DOI: 10.1016/j.ynstr.2023.100564
Binsch, O. (2021). Testing the applicability of a virtual reality simulation platform for stress training of first responders. Military Psychology: The Official Journal of the Division of Military Psychology, American Psychological Association.
Pallavicini, F., Cipresso, P., Raspelli, S., Grassi, A., Serino, S., Vigna, C., Triberti, S., Villamira, M., Gaggioli, A., & Riva, G. (2013). Is virtual reality always an effective stressor for exposure treatments? Some insights from a controlled trial. BMC Psychiatry, 13, 52. DOI: 10.1186/1471-244X-13-52
Ribeiro, G., Rogers, K., Altmeyer, M., Terkildsen, T., & Nacke, L. E. (2020). Game Atmosphere: Effects of Audiovisual Thematic Cohesion on Player Experience and Psychophysiology. In Proceedings of the Annual Symposium on Computer-Human Interaction in Play (Virtual Event, Canada) (CHI PLAY ’20), 107–119. DOI: 10.1145/3410404.3414245
Richesin, M., Oliver, M., Baldwin, D., & Wicks, L. (2019). Game Face Expressions and Performance on Competitive Tasks. Stress and Health, 36. DOI: 10.1002/smi.2899
Schell, A., & Dawson, M. E. (2001). Psychophysiology. In International Encyclopedia of the Social Behavioral Sciences, Neil J. Smelser & Paul B. Baltes (Eds.). Pergamon, Oxford, 12448–12452. DOI: 10.1016/B0-08-043076-7/03424-0
Turbyne, C., de Koning, P., Smit, D., & Denys, D. (2021). Affective and Physiological Responses During Acute Pain in Virtual Reality: The Effect of First-Person Versus Third-Person Perspective. Frontiers in Virtual Reality, 2. DOI: 10.3389/frvir.2021.694511
van der Vijgh, B., Beun, R. J., Rood, M., & Werkhoven, P. (2015). Meta-analysis of digital game and study characteristics eliciting physiological stress responses: Meta-analysis of stressor game and methodologies. Psychophysiology, 2015, 1–19. DOI: 10.1111/psyp.12431
Rao, K. P. V., Ashwini, H. K., & Akshatha, S. (2021). Emotional stress recognition system using EEG and psychophysiological signals. In 2021 International Conference on Advancements in Electrical, Electronics, Communication, Computing and Automation (ICAECA), 1–6. DOI: 10.1109/ICAECA52838.2021.9675782
Wout, M., Spofford, C., Unger, W., Sevin, E., & Shea, T. (2017). Skin Conductance Reactivity to Standardized Virtual Reality Combat Scenes in Veterans with PTSD. Applied Psychophysiology and Biofeedback, 42. DOI: 10.1007/s10484-017-9366-0
Xiao, Y., Sharma, H., Zhang, Z., Bergen-Cico, D., Rahman, T., & Salekin, A. (2024). Reading Between the Heat: Co-Teaching Body Thermal Signatures for Non-intrusive Stress Detection. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 7(4), Article 189. DOI: 10.1145/3631441
Yin, J., Zhu, S., Macnaughton, P., Allen, J., & Spengler, J. (2018). Physiological and cognitive performance of exposure to biophilic indoor environment. Building and Environment, 132, 1–6. DOI: 10.1016/j.buildenv.2018.01.006
Zimmer, P., Wu, C. C., & Domes, G. (2019). Same same but different? Replicating the real surroundings in a virtual trier social stress test (TSST-VR) does not enhance presence or the psychophysiological stress response. Physiology and Behavior, 212, 112690. DOI: 10.1016/j.physbeh.2019.112690
Abd-Alhamid, F., Kent, M., Calautit, J., & Wu, Y. (2020). Evaluating the impact of viewing location on view perception using a virtual environment. Building and Environment, 180, 106932. DOI: 10.1016/j.buildenv.2020.106932
Bermudez, S., Quintero, L. V., Cameirão, M. S., Chirico, A., Triberti, S., Cipresso, P., & Gaggioli, A. (2019). Toward Emotionally Adaptive Virtual Reality for Mental Health Applications. IEEE Journal of Biomedical and Health Informatics, 23(5), 1877–1887. DOI: 10.1109/JBHI.2018.2878846
Bolls, P., Lang, A., & Potter, R. (2001). The Effects of Message Valence and Listener Arousal on Attention, Memory, and Facial Muscular Responses to Radio Advertisements. Communication Research, 28, 627–651. DOI: 10.1177/009365001028005003
Bzdúšková, D., Marko, M., Hirjaková, Z., Kimijanová, J., Hlavačka, F., & Riečanský, I. (2022). The Effects of Virtual Height Exposure on Postural Control and Psychophysiological Stress Are Moderated by Individual Height Intolerance. Frontiers in Human Neuroscience, 15, 773091. DOI: 10.3389/fnhum.2021.773091
Delahaij, R., van Dam, K., Gaillard, A., & Soeters, J. (2011). Predicting Performance Under Acute Stress: The Role of Individual Characteristics. International Journal of Stress Management, 18(1), 49–66. DOI: 10.1037/a0020891
Kawano, L. L. B. D. R. (2018). A condutância da pele como indicador de ativação emocional em mensagens persuasivas: um estudo do trailer de divulgação do filme “50 tons de liberdade”.
Drachen, A., Yannakakis, G., Nacke, L., & Pedersen, A. (2010). Correlation between Heart Rate, Electrodermal Activity and Player Experience in First-Person Shooter Games (Pre-print). DOI: 10.1145/1836135.1836143
Economou, K., Quek, D., MacDougall, H., Lewis, S. J. G., & Ehgoetz Martens, K. A. (2021). Heart Rate Changes Prior to Freezing of Gait Episodes Are Related to Anxiety. Journal of Parkinson’s Disease, 11(1), 271–282. DOI: 10.3233/jpd-202146
Ergan, S., Radwan, A., Zou, Z., Tseng, H., & Han, X. (2018). Quantifying Human Experience in Architectural Spaces with Integrated Virtual Reality and Body Sensor Networks. Journal of Computing in Civil Engineering, 33(12), 0812. DOI: 10.1061/(ASCE)CP.1943-5487.0000812
Fenz, W. D., & Epstein, S. (1967). Gradients of physiological arousal in parachutists as a function of an approaching jump. Psychosomatic Medicine.
Finseth, T., Keren, N., Dorneich, M., Franke, W., Anderson, C., & Shelley, M. (2018). Evaluating the Effectiveness of Graduated Stress Exposure in Virtual Spaceflight Hazard Training. Journal of Cognitive Engineering and Decision Making, 12, 155534341877556. DOI: 10.1177/1555343418775561
Gamito, P., Oliveira, J., Silva, J., Rosa, J., Mendes, M. L. R., Dias, R., Dias, F., Mansuklal, S. A., Cartaxo, J., António, H., & Salvador, Á. (2024). Stress Inoculation in Police Officers Using Virtual Reality: A Controlled Study. Cyberpsychology, Behavior, and Social Networking. DOI: 10.1089/cyber.2023.0385
Gramlich, M. A., Smolenski, D. J., Norr, A. M., Rothbaum, B. O., Rizzo, A. A., Andrasik, F., Fantelli, E., & Reger, G. M. (2021). Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder. Depression and Anxiety, 38(6), 626–638. DOI: 10.1002/da.23141
Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009). Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology, 34(2), 163–171. DOI: 10.1016/j.psyneuen.2008.10.026
Kim, K., Rosenthal, M. Z., Zielinski, D. J., & Brady, R. (2014). Effects of virtual environment platforms on emotional responses. Computer Methods and Programs in Biomedicine, 113(3), 882–893. DOI: 10.1016/j.cmpb.2013.12.024
Kitchenham, B., Brereton, O. P., Budgen, D., Turner, M., Bailey, J., & Linkman, S. (2009). Systematic literature reviews in software engineering–a systematic literature review. Information and Software Technology, 51(1), 7–15.
Kivikangas, J. M., Chanel, G., Cowley, B., Ekman, I., Salminen, M., Järvelä, S., & Ravaja, N. (2011). A review of the use of psychophysiological methods in game research. Journal of Gaming Virtual Worlds, 3(3), 181–199. DOI: 10.1386/jgvw.3.3.181_1
Kosonogov, V. V., Efimov, K. V., Rakhmankulova, Z. K., & Zyabreva, I. A. (2023). Review of Psychophysiological and Psychotherapeutic Studies of Stress Using Virtual Reality Technologies. Neuroscience and Behavioral Physiology, 53(1), 81–91. DOI: 10.1007/s11055-023-01393-w
Loureiro, J. P., Pino, A. V., & Jandre, F. C. (2019). Time-Normalized Discrete Amplitude Response Variations as New Indices of Electrodermal Activity, Costa-Felix R., Alvarenga A. V., & Machado J. C. (Eds.). IFMBE Proceedings, 70, 493–496. DOI: 10.1007/978-981-13-2517-5_74
Malmivuo, J., & Plonsey, R. (1995). Bioelectromagnetism: Principles and Applications of Bioelectric and Biomagnetic Fields. Oxford University Press. DOI: 10.1093/acprof/9780195058239.001.0001
Maples-Keller, J. L., Rauch, S. A. M., Jovanovic, T., Yasinski, C. W., Goodnight, J. M., Sherrill, A., Black, K., Michopoulos, V., Dunlop, B. W., Rothbaum, B. O., & Norrholm, S. D. (2019). Changes in trauma-potentiated startle, skin conductance, and heart rate within prolonged exposure therapy for PTSD in high and low treatment responders. Journal of Anxiety Disorders, 68, 102147. DOI: 10.1016/j.janxdis.2019.102147
Moreno-Fernández, R. D., García-León, D., Peñas, G., Martín-Romero, R., Buades-Sitjar, F., & Sampedro-Piquero, P. (2023). Immersive virtual plus-maze to examine behavior and psychophysiological-related variables in young people with problematic alcohol and cannabis consumption. Neurobiology of Stress, 26, 100564. DOI: 10.1016/j.ynstr.2023.100564
Binsch, O. (2021). Testing the applicability of a virtual reality simulation platform for stress training of first responders. Military Psychology: The Official Journal of the Division of Military Psychology, American Psychological Association.
Pallavicini, F., Cipresso, P., Raspelli, S., Grassi, A., Serino, S., Vigna, C., Triberti, S., Villamira, M., Gaggioli, A., & Riva, G. (2013). Is virtual reality always an effective stressor for exposure treatments? Some insights from a controlled trial. BMC Psychiatry, 13, 52. DOI: 10.1186/1471-244X-13-52
Ribeiro, G., Rogers, K., Altmeyer, M., Terkildsen, T., & Nacke, L. E. (2020). Game Atmosphere: Effects of Audiovisual Thematic Cohesion on Player Experience and Psychophysiology. In Proceedings of the Annual Symposium on Computer-Human Interaction in Play (Virtual Event, Canada) (CHI PLAY ’20), 107–119. DOI: 10.1145/3410404.3414245
Richesin, M., Oliver, M., Baldwin, D., & Wicks, L. (2019). Game Face Expressions and Performance on Competitive Tasks. Stress and Health, 36. DOI: 10.1002/smi.2899
Schell, A., & Dawson, M. E. (2001). Psychophysiology. In International Encyclopedia of the Social Behavioral Sciences, Neil J. Smelser & Paul B. Baltes (Eds.). Pergamon, Oxford, 12448–12452. DOI: 10.1016/B0-08-043076-7/03424-0
Turbyne, C., de Koning, P., Smit, D., & Denys, D. (2021). Affective and Physiological Responses During Acute Pain in Virtual Reality: The Effect of First-Person Versus Third-Person Perspective. Frontiers in Virtual Reality, 2. DOI: 10.3389/frvir.2021.694511
van der Vijgh, B., Beun, R. J., Rood, M., & Werkhoven, P. (2015). Meta-analysis of digital game and study characteristics eliciting physiological stress responses: Meta-analysis of stressor game and methodologies. Psychophysiology, 2015, 1–19. DOI: 10.1111/psyp.12431
Rao, K. P. V., Ashwini, H. K., & Akshatha, S. (2021). Emotional stress recognition system using EEG and psychophysiological signals. In 2021 International Conference on Advancements in Electrical, Electronics, Communication, Computing and Automation (ICAECA), 1–6. DOI: 10.1109/ICAECA52838.2021.9675782
Wout, M., Spofford, C., Unger, W., Sevin, E., & Shea, T. (2017). Skin Conductance Reactivity to Standardized Virtual Reality Combat Scenes in Veterans with PTSD. Applied Psychophysiology and Biofeedback, 42. DOI: 10.1007/s10484-017-9366-0
Xiao, Y., Sharma, H., Zhang, Z., Bergen-Cico, D., Rahman, T., & Salekin, A. (2024). Reading Between the Heat: Co-Teaching Body Thermal Signatures for Non-intrusive Stress Detection. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 7(4), Article 189. DOI: 10.1145/3631441
Yin, J., Zhu, S., Macnaughton, P., Allen, J., & Spengler, J. (2018). Physiological and cognitive performance of exposure to biophilic indoor environment. Building and Environment, 132, 1–6. DOI: 10.1016/j.buildenv.2018.01.006
Zimmer, P., Wu, C. C., & Domes, G. (2019). Same same but different? Replicating the real surroundings in a virtual trier social stress test (TSST-VR) does not enhance presence or the psychophysiological stress response. Physiology and Behavior, 212, 112690. DOI: 10.1016/j.physbeh.2019.112690
Publicado
30/09/2024
Como Citar
GONÇALVES, Thiago da Silva; SILVA-CALPA, Greis Francy M.; PORCINO, Thiago Malheiros; E ALMEIDA, Raphael de Souza; RAPOSO, Alberto Barbosa.
The challenge of stress induction in serious games, considering gameplay. In: SIMPÓSIO DE REALIDADE VIRTUAL E AUMENTADA (SVR), 26. , 2024, Manaus/AM.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2024
.
p. 177-184.
