Stress Detection for PTSD via the StartleMart Game

Abstract

Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD severity and skin conductance responses. Significant correlations between physiological responses and subjective evaluations of the stressfulness of experiences, represented as pairwise preferences, are also found. We conclude that this supports the use of the simulation as a relevant treatment tool for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools.

Personalization in Game Design for Healthcare: a Literature Review on its Definitions and Effects

“…Four studies involved mainly designers and domain experts as stakeholders in the Problem Definition Phase and designers, domain experts and end-users in Embodiment of the Product Design Phase [38,[40][41][42], for example, by observing end-users and giving cultural probes (ambiguous stimuli and assignments that bring inspiration to design) to domain experts and relatives [42]. Two other studies included stakeholders, mainly designers and domain experts, in the Problem Definition Phase and Ideation of the Product Design Phase [5,6], by letting end-users test game scenarios that were designed by domain experts and designers. Lastly, two studies involved stakeholders in Problem Definition Phase and Ideation and Embodiment of Product Design Phase [39,43].…”

“…Other results showed that end-users improved their knowledge regarding diabetes [6], cardiopulmonary resuscitation [39], and obesity and nutrition [43]. Significant correlations were found between physiological responses to stressful experiences and subjective evaluations on stress in PTSS (Post-Traumatic Stress Syndrome) patients, and a clear correlation between diagnostic PTSD severity and skin conductance responses [5], which could be important for stress inoculation training. End-users with ASD and healthy controls matched on IQ, gender and age, showed difficulties in respecting the personal space of virtual others, but acknowledged that behaving in a virtual environment was different from daily life [38].…”

To rank or to classify? Annotating stress for reliable PTSD profiling

“…The work presented here is inspired by previous pioneering work on the use of virtual environments and games as tools supporting affective learning in PTSD patients [15], [21] and it builds upon previous work [8], [9] in which it is demonstrated that features from affective responses to game play sessions in the StartleMart game contain useful indications of the symptom severity of PTSD patients, pointing to the relevance of simulations and games for affective learning and profiling. Here, we move from correspondence analysis at the game session level to analyzing event-based stress responses in order to obtain not only general indications of the patient's affective response but also to identify responses to individual events.…”

“…This paper describes a game-based method for profiling post traumatic stress disorder (PTSD) using affective responses to events in a virtual environment incorporating principles of game design, called the StartleMart game [8], [9]. We describe how we construct a specific paradigm for eliciting and capturing affective responses to particular in-game events of 13 PTSD patients through the StartleMart game.…”

The experience-driven perspective

“…Physiology offers the primary medium for detecting a player's experience via objective measures [33]: signals obtained from electrocardiography (ECG) [34], photoplethysmography [34,28], galvanic skin response (GSR) [9], respiration [28], electroencephalography (EEG) [18] and electromyography (among others) are commonly used for the detection of player experience given the recent advancements in sensor technology and physiology-based game interfacing [33]. In addition to physiology the player's bodily expressions may be tracked at different levels of detail and real-time cognitive or affective responses to game content may be inferred.…”