Developing a stress-management training (SMT) system and protocol for soldiers can help them cope better with stress experienced in theatre operations. Using 3D horror games in virtual reality (VR) can present an attractive simulation method for soldiers. This study was conducted to find out whether it is possible to stress soldiers moderately using VR and which technology is more efficient to do so. A total of 47 soldiers returning from Afghanistan played two 3D first-person shooter (FPS)/horror games (Killing Floor and Left 4 Dead) on three different types of immersive technologies (a 22-inch stereoscopic monitor, a 73-inch stereoscopic TV and a CAVE™). As a control and reference comparison of induced stress, participants were exposed to the Trier Social Stress Test (TSST), a standardized stress-inducing procedure. Results were supporting of our work, devising an effective low-cost and high-buy-in approach to assist in teaching and practicing stress-management skills. Repeated measures analyses of variance (ANOVAs) revealed statistically significant increases in the soldiers’ respiration rates and heart rates while playing the 3D games and during the TSSTs. No significant interactions were found. Increases in physiological arousal among the soldiers were significant when comparing the baseline to the immersion and to the TSST, but not when comparing both stressors. Immersion in 3D games is proposed as a practical and cost-effective option to create a context that allows practicing SMT.
FreemanD.Creating emotion in games: the craft and art of emotioneering. Berkerley (CA): New Riders Games, 2003.
2.
FromeJ.Eight ways video games generate emotion. In Proceedings of the DIGRA 2007 international conference, Tokyo, Japan, 2007, pp. 831–835).
3.
SharmaRKheraSMohanA. Assessment of computer games as a psychological stressor. Indian J Physiol Pharmacol2006; 50(4): 367–374.
4.
KirschbaumKMPirkeDHHellhammerDH.The Trier Social Stress Test—a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology1993; 28: 76–81.
5.
NackeLLindleyCA.Flow and immersion in first-person shooters: measuring the player’s gameplay experience. In Proceedings of FuturePlay, Toronto, Canada, 2008.
6.
Arroyo-PalaciosJRomanoDM. A flexible bio-affective gaming interface. In Proceedings of the 3rd AIBS 2010 Symposium: AI and Game, Leicester, United Kingdom, 2010.
7.
BersakDMcDarbyGAugenblickN. Intelligent biofeedback using an immersive competitive environment. In Proceedings of the Designing Ubiquitous Computing Games Workshop at Ubicomp, 2001.
8.
GugerCEdlingerGLeebRPfurtschellerG. Heart-rate variability and event-related ECG in virtual environments. In Proceedings of the PRESENCE 2004, Valencia, Spain, 2001, pp. 240–245.
9.
HerbelinBBenzakiPRiquierF. Using physiological measures for emotional assessment: a computer-aided tool for cognitive and behavioural therapy. In Proceedings of the 5th Conference on Disability, Virtual Reality and Associated Technologies, Oxford, UK, 2005, pp. 307–314.
10.
IJsselsteijnWde KortYPoelsK. Characterising and measuring user experiences in digital games. In Proceedings of the International Conference on Advances in Computer Entertainment Technology, Hollywood, CA, 2007.
11.
NakasoneAPrendingerHIshizukaM.Emotion recognition from electromyography and skin conductance. In Proceedings of the 5th International Workshop on Biosignal Interpretation, Tokyo, Japan, 2005, pp. 219–222.
12.
RavajaNLaarniJSaariT. Spatial presence and emotional responses to success in a video game: a psychophysiological study. In Proceedings of the PRESENCE 2004 Conference, Valencia, Spain, Day Month 2004, pp. 112–116.
13.
RavajaNSaariTSalminenM. Phasic emotional reactions to video game events: a psychophysiological investigation. Media Psycho2006; 8(4): 343–367.
14.
RavajaNKivikangasJM.Psychophysiology of digital game playing: the relationship of self-reported emotions with phasic physiological responses. In Proceedings of Measuring Behaviour, Maastricht, The Netherlands, 2008, pp. 26–29.
15.
TammenHLoviscachJ.Emotion in video games: quantitative studies?J Emoti HCI–Design People2010; pp. 25–29.
16.
WeberRBehrKMTamboriniR. What do we really know about first-person-shooter games? An event-related, high-resolution content analysis. J Comput-Mediate Commun2009; 14(4): 1016–1037.
17.
IvoryJDKalyanaramanS.The effects of technological advancement and violent content in video games on players’ feelings of presence, involvement, physiological arousal, and aggression. J Commun2007; 57(3): 532–555.
18.
BallardMEWiestJ R.Mortal Combat: the effects of violent video game play on males’ hostility and cardiovascular responding, J Appl Soc Psychol1996; 26(8): 717–730.
19.
BarlettCPHarrisRJBaldassaroR.Longer you play, the more hostile you feel: examination of first-person shooter video games and aggression during video game play. Aggressive Behav2007; 33(6): 486–497.
20.
AndersonCA.An update on the effects of playing violent video games. J Adolesc2001; 27(1): 113–122.
21.
JeongEJBioccaFABohilCJ.Effects of representational realism in 3D violent games. In Proceedings of the 2008 PRESENCE conference, Padova, Italy, 2008, pp. 191–200.
22.
GrayJA.Elements of a two-process theory of learning. New York: Academic Press, 1975.
23.
Rajae-JoordensRJE.Measuring experiences in gaming and TV applications. Prob Experience2008; 77–88.
24.
ArriagaPEstevesFCarneiroP. Are the effects of unreal violent video games pronounced when playing with a virtual reality system?Aggressive Behav2008; 34(5): 521–538.
25.
PerskySBlascovichJ.Consequences of playing violent video games in immersive virtual environments. In SchroederRAxelssonAS (eds), Avatars at Work and Play. Dordrecht: Springer, 2006, pp. 167–186.
26.
Cruz-NeiraCSandinDJDeFantiTA.Surround-screen projection-based virtual reality: the design and implementation of the CAVE. In Proceedings of the 20th Annual SIGGRAPH Conference, 1993.
27.
BouchardS.Initial steps in inducing stress to teach stress-management skills to soldiers: testing stressors, immersive technologies and avatars. Internal Research Report, Defence R & D Canada–ValCartier, 2010.
28.
FirstMBSpitzerRLGibbonM. Structured clinical interview for DSM-IV axis I disorders. Research version, non-patient ed. 2000.
29.
KennedyRSLaneNEBerbaumKS. Simulator sickness questionnaire: an enhanced method for quantifying simulator sickness. Int J Aviat Psychol1993; 3(3): 203–220.
30.
WitmerBGSingerMJ.Measuring presence in virtual environments: a presence questionnaire. Presence1998; 3: 225–240.
31.
KudielkaBMHellhammerDHKirschbaumC. Ten years of research with the Trier Social Stress Test (TSST)—revisited. In: Harmon-JonesEWinkielmanP (eds.) Social neuroscience: integrating biological and psychological explanations of social behavior. New York: The Guilford Press, 2007, pp. 56–83.
32.
CohenJ.Statistical power analysis for the behavioral sciences. 2nd ed.Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
33.
TaylorSESeemanTEEisenbergerNI. Effects of a supportive or an unsupportive audience on biological and psychological responses to stress. J Pers Soc Psychol2010; 98(1): 47–56.
34.
RimmeleUZellwegerBCMartiB. Trained men show lower cortisol, heart rate and psychological responses to psychosocial stress compared with untrained men. Pseudoneuroendocrinology2007; 32: 627–635.
35.
RimmeleUSeilerRMartiB. The level of physical activity effect adrenal and cardiovascular reactivity to psychosocial stress. Psychoneuroendocrinology2008; 34: 190–198
36.
FriesEHellhammerD HHellhammerJ.Attenuation of the hypothalamic-pituitary-adrenal axis responsivity to the Trier Social Stress Test by the benzodiazepine alprazolam. Psychoneuroendocrinology2006; 31: 1278–1288.
37.
ToetAvan WelieMHoutkampJ.Is a dark virtual environment scary?Cyber Psychol Behav2009; 12(4): 363–371.
38.
SjörsALarssonBDahlmanJ. Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia. BMC Musculoskel Disord2009; 10: 63.
39.
CoxDHallamRO’ConnorK. An experiment analysis of fearlessness and courage. Br J Psychol1983; 74: 107–117.
40.
ParsonsTDCourtneyCCosandL. Assessment of psychophysiological differences of West Point cadets and civilian controls immersed within a virtual environment. Foundations of augmented cognition. Neuroergonomics and Operational Neuroscience. Heidelberg: Springer, 2009, pp. 514–523.
41.
BouchardSSt-JacquesJRenaudP. Side effects of immersions in virtual reality for anxious people. J Cyberther Rehab2009; 2(2): 127–137.
