Game that provides feedback on breathing reduces anxiety

Those who experience intense feelings of fear for a long time are at risk of developing an anxiety disorder. Anxiety disorders are one of the most common mental health problems among young adults. PhD research by Joanneke Weerdmeester of Radboud University Nijmegen has now shown that a special game called DEEP, which uses virtual reality, reduces anxiety symptoms.

Through DEEP, participants end up in an underwater world that does not exist. Players have a special belt around their abdomen that measures their breathing. Taking deep belly breaths will propel you forward in the game. The shallow chest breaths, which usually occur in anxious states, are not captured from this girdle and thus impede progress.

Also, players see in different ways how they are breathing at that moment. For example, there are many things that reflect the players’ breathing, such as the circle and plants that get smaller with each exhale and get bigger with each inhale. Since you can see how you are breathing and how far you are moving at any given moment, you can estimate how well you are doing and whether you need to adjust your breathing. This technique in which you receive feedback about signals from the body is called biofeedback.

dark tunnels

“We’ve known for some time from previous studies that deep abdominal breathing can reduce anxiety and stress,” explains Weerdmeester. Through the game we try to motivate the participants to continue practicing this breathing technique. And because you get instant feedback, you know right away if you’re doing it right. Most of the game environment is quiet, but you can also find yourself in stressful situations, such as dark tunnels. Weerdmeester: “The idea is that in the game you first practice this deep belly breathing in a calm environment, but also in a more stressful environment in the game. This increases the likelihood that youngsters will also be able to apply the breathing technique learned outside of the game when they are in a stressful situation.

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In one of her studies, it involved young people between the ages of 17 and 25 with symptoms of anxiety. Some were allowed to play DEEP multiple times, while some anxious young men practiced breathing techniques only through their smartphones, without biofeedback.

The research showed that participants who played the game DEEP had fewer problems with their anxiety symptoms. The volunteers who practiced the breathing technique through their smartphones also had fewer problems. They all reported this through surveys.

However, there was a difference between the two groups. Weerdmeester also investigated how all participants assessed their abilities in stressful situations. In particular, participants who played the game began to evaluate themselves more positively and have more confidence in themselves. Perhaps because participants who played the game DEEP learned better how to control their breathing through observations. If you practice the breathing technique on your own, without feedback, you learn less well whether you are doing it right or not.

Weerdmeester concludes that DEEP helps reduce symptoms of anxiety. Perhaps it will help to better deal with other complaints, such as aggressiveness or even complaints related to the coronavirus. Aggressive behavior can stem from fear, and this breathing technique can make you more aware of your feelings and help you regulate them better. With Covid lung disease, you may have forgotten to take deep abdominal breaths, which you can try again via DEEP.

More research is needed to find out how long the effects of games like DEEP last, and whether people who really suffer from an anxiety disorder benefit from them as well. She already has all kinds of ideas for the game application. Those who are afraid of the dentist, for example, can play the game in the waiting room for ten minutes or the game can be added to existing anti-anxiety treatments.

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Joanneke Weerdmeester defended her thesis Take a Deep Breath: Exploring the Potential of Game-Based Biofeedback Interventions for Regulating Anxiety on November 22, 2021.

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