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Abstract

This study explores the effectiveness of a virtual reality (VR) meditation environment in reducing exam-related anxiety among graduate engineering students. Traditional meditation can be limited by environmental constraints, while VR offers an immersive alternative. Participants (N = 14) were exposed to both VR and 2D guided meditation experiences in a within-subjects design across two exam periods. Measures included (a) the Test Anxiety Scale, (b) the Pre-Exam Anxiety Scale: using the Coping with Pre-Exam Anxiety and Uncertainty (COPEAU), and (c) the Presence Scale: using the Spatial Presence Experience Scale (SPES). While no statistically significant reduction in anxiety scores was observed between the two groups, participants reported a significantly greater sense of presence within the VR environment. Results suggest VR may enhance immersion during meditation but require a larger sample size to determine its impact on anxiety reduction.

Keywords

virtual reality meditation anxiety mental health presence exam anxiety

Introduction

Generalized Anxiety Disorder (GAD) is an emotion characterized by feelings of tension, worried thoughts, and physical changes. Being the most common mental health disorders in the United States, anxiety disorder affects 40 million adults, nearly 19.1% of the population (American Psychological Association, n.d.; Pennell, 2004). Pharmacotherapy and cognitive behavioral therapy (CBT) are two of many treatment options that showed evidence of being effective in treating GAD (Butler et al., 2006; Katon et al., 2002; Khasawneh et al., 2021; Norton & Price, 2007). CBT is viewed as the treatment of choice for GAD patients that opt out of using medicine. In addition, the majority of patients that are using medicine to treat GAD, rely partially on CBT (Meditation for anxiety Symptoms, 2014).

A central component of many CBT techniques is relaxation training and mindfulness meditation. Relaxation training and mindfulness meditation are proven to soften anxious feelings and are often used as alternative to medication to treat anxiety disorders. Since the 60’s, many studies have revealed the unique benefits of meditation techniques, including their ability to reduce signs of stress and exam anxiety (Meditation for anxiety symptoms, 2014). Considering the large number of people impacted by GAD, it is important to explore the potential of accessible, user-friendly, and engaging technologies to aid in GAD symptoms treatment. This is especially relevant for the teaching and implementation of applied relaxation and mindfulness interventions. Recent evidence indicates that immersive technologies, such as virtual reality (VR), might be suitable for this purpose when used in a specific therapeutic context (Maples-Keller et al., 2017).

A couple of VR review articles found it to be successfully utilized in treating various anxiety disorders in multiple settings (Morina et al., 2015; Motraghi et al., 2014). These therapeutic applications have been integrated within ongoing therapeutic relationships, using scenes created in a VR environment, thus enhancing the traditional model of exposure therapy. The success of these programs appears to be partly due to the ability of immersive environments, such as those in VR, to generate strong feelings of “presence” (Khasawneh et al. 2019; Riva et al., 2011, 2015). “Presence” refers to the subjective sensation of being in another place and is a crucial component of exposure-based therapies. Given VR’s immersive nature, it is unsurprising that this format can provide a greater sense of presence than two-dimensional (2D) scenes. For instance, a recent study found that 360-degree video elicited more intense feelings of awe than standard 2D videos (Chirico et al., 2017).

Meditation through VR has yet to be studied as an on-demand medium for tasks that require fear-facing such as exams/tests. Since mediation requires a quiet and “peacefully” environment to be effective, which is hard to find right before exams, VR is considered the most viable technology to make this possible. Exam anxiety in students negatively impacts academic performance (Alexander et al., 2001; Hurrelmann et al., 1992), triggering emotional (fear and panic), cognitive (loss of concentration), and neurovegetative reactions (perspiration, accelerated heart rate). Specifically, exam anxiety can cause physiological symptoms such as abdominal cramps, sweaty and trembling hands, and dry mouth; emotional/psychological symptoms such as fear, panic, memory issues, and concentration difficulties; and behavioral symptoms such as nail-biting, sleep disorders, and hyperactivity. Therefore, it is crucial to address all these components to manage and reduce exam anxiety. Therefore, it is crucial to address all these components to manage and reduce exam anxiety. In this study, our objectives were to (1) design and develop an easily accessible immersive mediation experience in VR which allows individuals who experience exam anxiety to be easily immersed into a relaxing environment, and (2) to test the hypothesis that participates who perform meditation in the developed VR environment will show reduced anxiety more than those who meditate in quiet room without the aid of VR.

Methods

Design and Development

The content of the VR meditation environment was designed through consultation with a meditation expert. Then, the meditation expert recorded a session of mindful mediation, a technique called relaxation breathing, in a quiet room using GarageBand (Väkevä, 2010). An Insta360 Titan (2024) camera recorded a 360° video of a desolate spot near a waterfall. The two recordings (meditations session and 360 video) were edited and meshed using Final Cut Pro to create an immersive meditation experience (Final Cut Pro for Mac). Following, the video was installed on Pico Neo 3 Eye Pro VR headsets (Pico Neo 3, 2024). The video was uploaded onto the Primary Researchers’ Dropbox account where the same meditation environment was displayed in a two-dimensional format (2D) to be played on a flat screen. The total meditation time was approximately 15 min.

Participants

The sample consists of 14 student volunteers from Mercer University’s School of Engineering. These students were recruited from a graduate level course (10 males/4 females). Further demographic information can be viewed in Table 1 below. All participants had to read and sign the study consent form which has been approved by Mercer University Institutional Review Board (IRB). IRB number is H24-02058.

Table 1.

Demographic Information.

Category	Number	%
Gender
Male	10	71
Female	4	29
Race
White/Caucasian	10	79
African American	3	21
Asian	1	7
Age
18–21	1	86
22–24	12	7
25–31	1
VR experience
Yes	2	14
Rarely	9	65
No	3	21
Meditation experience
Yes	9	64
No	5	36

Apparatus

The study was conducted in two separate classrooms within Mercer University’s School of Engineering. The apparatus used to develop the VR environment were (a) Tascam DR-05X Stereo Handheld Audio Recorder, (b) Insta360 Titan camera, and (c) Apple Mac Studio. The apparatus used to test the VR meditation were (a) six Pico Neo 3 Eye Pro VR headsets with joysticks, and (b) a large projector screen.

Experimental Design

This study utilized a within-subject experimental design where participants were split into two different study groups/conditions. Students were randomly assigned to each group (VR or 2D). This study consisted of two parts, meaning the participants were randomly assigned during part 1 (exam 1), and switched to the opposing group for part 2 (exam 2). The two conditions were:

Experimental group: 7 of the 14 participants meditated using the developed 360 experience using the VR headsets.

Control group: 7 of the 14 participants meditated in a quiet room using the same meditation experience played on a large screen projector in 2D format.

Dependent Variables

Upon completion of the meditation experience, each participant completed the following questionnaires:

Test Anxiety: Measured using the instrument provided by Stöber & Pekrun, 2004. This instrument has 10 items that were assessed using 1 to 5 Likert scale. The total anxiety score is calculated by adding up the score for all the items, ranging from 10 to 50. Scores up to 19 are considered low anxiety, while any score above 35 is considered high anxiety. The participants filled this scale twice, before and after meditation.

Pre-exam anxiety: Measured using the Coping with Pre-Exam Anxiety and Uncertainty (COPEAU) recommend by Stöber (2004). COPEAU is a scale adopted from two separate scales developed by Carver et al. (1989) (Stöber, 2004). This instrument has 13 items that were assessed using 1 to 4 Likert scale and is calculated by averaging the scores for all the items, with an average score of 1 being low anxiety while 4 is high anxiety.

Presence: Measured using the Spatial Presence Experience Scale (SPES) developed by Hartmann et al. (2016) . This instrument has two sub-constructs, self-location (SL) and possible actions (PA), each has 10 items that were assessed using 1 to 5 Likert scale. Each sub-constructs score is calculated by averaging the scores for all the items, with an average score of 1 being low presence while 4 is high presence.

Procedure

One hour prior to the students’ examination, they were asked if they would like to volunteer to participate in the study. All 14 participants were asked to read and sign an informant consent form. Following, the participants were randomly assigned to one of the two study conditions, VR and 2D. Participants were then asked to scan a QR code, linking them to a Google forms survey. The lead researcher then read a script to ensure all participants understood the purpose and instructions of the study. Following, the group split up into two large quiet rooms depending on their assigned experience. Once in their respective rooms, participants were asked to fill out a pre-study survey. The survey consisted of (a) demographic information, (b) VR and meditation experience, and (c) test anxiety questionnaire by Nist and Diehl (1990). Then, the team of researchers help both groups set up their meditation experience. The VR group participants completed the meditation on a separate VR headset while the 2D group did the same on a large projector screen. Upon meditation completion, both groups were asked to fill out a post-study survey. The survey consisted of (a) Test Anxiety scale, (b) Pre-Exam Anxiety scale, and (c) Presence scale. At the end of the study, all participants were thanked for their time and released to their professor to begin their mid-term examination. Participants received extra credit on their exam for their participation in the study.

For the second part of the study, participants followed the same procedure for their final examination. Those who had previously been in the experimental group were reassigned to participate in the control group, and vice versa. New surveys were completed to collect identical measures for the second meditation experience.

Results

After ensuring all data collected from the surveys proved to be normally distributed, an outlier test known as Cook’s Distance, for each set was conducted which proved no outliers were present in the study’s data. Then, a within-subject ANOVA was used to compare reduction in Test Anxiety Questionnaire score (pre vs post meditation) between the two meditating groups, well as to compare the mean coping with pre-exam anxiety and uncertainty, and SPES scores.

A summary for the descriptive statistics for the study comparing the VR and 2D meditation groups across each measure can be viewed below in Table 2. Mean and standard deviation (SD) values, along with the corresponding p-values for the VR vs. 2D comparison, are included.

Table 2.

Result Summary.

Measure	VR Mean (SD)	2D Mean (SD)	p-Value (2D vs VR)
Pre-meditation TAQ	25.57 (6.858)	25.00 (6.102)	.784
Post-meditation TAQ	21.57 (6.711)	21.57 (6.060)	.784
COPEAU	3.020 (0.566)	3.031 (0.502)	.932
SPES: Possible Action	3.336 (0.889)	1.493 (0.599)	<.001
SPES: Self Location	3.393 (0.814)	1.471 (0.608)	<.001

To assess the potential influence of the control variables (previous VR experience, gender, and previous meditation experience), these variables were initially included as between-subjects factors in the analysis. A between-subject ANOVA revealed no significant main effects of VR experience, F(1, 13) = 0.713, p = .446, with an effect size of $η_{p}^{2}$ = .446; gender, F (1, 13) = 0.905, p = .395, with an effect size of $η_{p}^{2}$ = .395 or previous meditation experience, F (1, 13) = 1.765, p = .255,with an effect size of $η_{p}^{2}$ = .255, on the dependent variable. Furthermore, no significant interactions were observed between these control variables and the within-subjects factor (all p-values > .05). Given the lack of significant effects, these variables were removed from the subsequent analyses.

After removing the non-significant between-subjects factors, a repeated-measures ANOVA was conducted to examine the effect of the Test Anxiety Questionnaire scores. Results showed there was no statistically significant difference in the reduction of Test Anxiety Questionnaire score between the two groups (2D vs VR), F (1,13) = 0.079, p = .784, with an effect size of $η_{p}^{2}$ = .784, indicating that those in the VR group experienced no difference in anxiety compared to those in the 2-dimensional group. There was a statistically significant reduction in Test Anxiety Questionnaire scores (pre vs. post mediation) regardless of the group, F (1, 13) = 6.375, p = .025, with an effect size of $η_{p}^{2}$ = .025, indicating that participants experienced a notable decrease in anxiety levels following the meditation intervention, regardless of whether they were in the VR or 2-dimensional groups. Therefore, the meditation itself is shown to be effective here, but the medium did not have any influence on the outcome. This can also be viewed below in Figure 1.

Figure 1.

Test anxiety scores.

For the COPEAU measure, the control variables (previous VR experience, gender, and previous meditation experience) were initially included as between-subjects factors in the analysis. A repeated-measures ANOVA indicated no significant main effects of VR experience, F (1, 13) = 0.255, p = .640, with an effect size of $η_{p}^{2}$ = .060; gender, F (1, 13) = 0.155, p = .714, with an effect size of $η_{p}^{2}$ = .037; or previous meditation experience, F (1, 13) = 1.319, p = .315, with an effect size of $η_{p}^{2}$ = .248, on the dependent variable. Additionally, no significant interactions were found between these control variables and the between-subjects factor (p > .05 for all variables). Given these nonsignificant effects, the control variables were excluded from further analyses.

After removing the non-significant between-subjects factors, a repeated-measures ANOVA was conducted to examine the effect of the COPEAU scores. Results showed there was no statistically significant difference in the reduction of COPEAU score between the two meditating groups (2D vs VR), F (1, 13) = 0.008 p = .932, with an effect size of $η_{p}^{2}$ = .001, indicating students who meditated using VR did not cope with pre-exam anxiety and uncertainty significantly better or worse than those who meditated using a 2D method. This can also be viewed below in Figure 2.

Figure 2.

COPEAU scores.

Finally, both SPES measures (Possible Action and Self Location), control variables (previous VR experience, gender, and previous meditation experience) were initially included as between-subjects factors in the analysis. For the Possible Action measure, a repeated-measures ANOVA indicated no significant main effects of VR experience, F (1, 13) = 0.008, p = .933, with an effect size of $η_{p}^{2}$ = .002; gender, F (1, 13) = 6.415, p = .064, with an effect size of $η_{p}^{2}$ = .616; or previous meditation experience, F (1, 13) = 0.017, p = .904, with an effect size of $η_{p}^{2}$ = .004, on the dependent variable. The Self Location ANOVA indicated the same, with no significant main effects of VR experience, F (1, 13) = 0.019, p = .898, with an effect size of $η_{p}^{2}$ = .005; gender, F (1, 13) = 0.517, p = .512, with an effect size of $η_{p}^{2}$ = .114; or previous meditation experience, F (1, 13) = 1.29, p = .737, with an effect size of $η_{p}^{2}$ = .031; on the dependent variable. Therefore, no significant interactions were found between these control variables and the between-subjects factor (p > .05 for all variables). Given these nonsignificant effects, the control variables were excluded from further analyses.

Then, a repeated-measures ANOVA was conducted to examine the effect of the Presence scores (PA, SL). Results showed there was a statistically significant difference in the Possible Action between the two groups (2D vs VR), F(1, 13) = 56.528, p < .001, with an effect size of $η_{p}^{2}$ = .813, indicating those meditating in the VR group experienced greater potential actions they could perform within the environment. Results also showed a statistically significant difference in Self Location scores between the two meditating groups, F (1, 13) = 55.332, p < .001, with an effect size of $η_{p}^{2}$ = .810, showing participants felt they were truly immersed in the VR meditation. This can also be viewed below in Figures 3 and 4.

Figure 3.

Possible action scores.

Figure 4.

Self-location scores.

Conclusion

The goal of this study was to design an accessible VR meditation experience to help reduce exam-related anxiety. While participants in the VR group reported a stronger sense of presence than those in the control group, there was no statistically significant difference in anxiety reduction between the two groups. Several factors may explain these results. A single, brief meditation session may be insufficient to impact anxiety meaningfully. Additionally, the novelty or mild discomfort of using VR technology could have offset its calming potential, especially for participants unfamiliar with such environments.

Although the p-value (.065) suggests a possible trend, our aim is not to rely solely on statistical thresholds. Rather, these findings highlight the need for deeper exploration into how and for whom VR-based meditation is effective. Future work will expand the sample size, incorporate repeated sessions, and explore individual differences such as prior meditation experience or baseline anxiety levels. These steps will help clarify the conditions under which immersive technologies can play a meaningful role in academic stress management.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Amro Khasawneh

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Evaluating VR-Based Meditation as a Tool to Manage Test Anxiety in Academic Settings

Abstract

Keywords

Introduction

Methods

Design and Development

Participants

Apparatus

Experimental Design

Dependent Variables

Procedure

Results

Conclusion

Footnotes

Declaration of Conflicting Interests

Funding

ORCID iD

References