Virtual reality biofeedback interventions for treating anxiety

Kothgassner, Oswald D.; Goreis, Andreas; Bauda, Ines; Ziegenaus, Amelie; Glenk, Lisa Maria; Felnhofer, Anna

doi:10.1007/s00508-021-01991-z

Cited by 22 publications

(11 citation statements)

References 51 publications

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“…Our data confirms once more that experience can modulate mental and somatic responses mediated by sympathetic nervous system activity positively affecting performance outcomes Pijpers, 2009, 2010;Kusserow et al, 2012). It also confirms the habituation of sympathetic responses to repeated psychosocial stress induced by real and virtual stressors (Kothgassner et al, 2021), with heart rates significantly decreasing after repeated exposure to the same stressor over different periods of time (Schommer et al, 2003;Kothgassner et al, 2021Kothgassner et al, , 2022.…”

Section: Hr Physical Versus Mental Componentssupporting

confidence: 84%

“…Other authors have already demonstrated habituation of sympathetic responses to repeated psychosocial stress induced by real and virtual stressors (Kothgassner et al, 2021). Higher heart rates (i.e., higher sympathetic activity) have been shown to decrease significantly (i.e., lower sympathetic activity) after repeated exposure to the same stressor -in this study, a live audience -over different periods of time (Schommer et al, 2003;Kothgassner et al, 2021Kothgassner et al, , 2022.…”

Section: Introductionmentioning

confidence: 67%

“…Thus, an important marker of increased sympathetic activity, and therefore of MPA, is a higher HR ( Schmidt et al, 2019 ). Not surprisingly, several authors have included HR measurements in studies on for example stress during sports ( Oudejans and Pijpers, 2009 , 2010 ; Kusserow et al, 2010 ), repeated psychosocial stress induced by real and virtual stressors, including the same stressor over different periods of time ( Schommer et al, 2003 ; Kothgassner et al, 2021 , 2022 ), acute psychological stress ( Trotman et al, 2019 ) and MPA ( Yoshie et al, 2008 ; Yoshie et al, 2009 ; Kusserow et al, 2012 ; Kenny et al, 2013 ; Studer et al, 2014 ). In addition to HR, several authors have used heart rate variability (HRV) in the context of sports and exercise psychology to measure stress ( Mosley and Laborde, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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Repeated stage exposure reduces music performance anxiety

et al. 2023

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BackgroundHigh heart rate (HR) and restlessness are two important features of music performance anxiety (MPA). In a case report of a cellist suffering from this condition, we showed that HR and restlessness decreased after repeated live performances of the same musical excerpt, thereby positively modulating objective performance criteria and subjective components. Here, we largely replicate these results in a group of 18 string players reporting MPA.MethodsObjective measurement devices included a miniaturized electrocardiogram monitor and three 3-axis accelerometer loggers. Subjective measures included the Multidimensional Mental Health Questionnaire (MDBF) and a customized visual analogue scale (VAS) questionnaire for MPA. Non-artistic performance errors were assessed by music experts using a composite score for technical playing errors (i.e., intonation errors, omission of notes, and bowing noise). Data were collected from each study participant during three brief public solo performances of the same musical excerpt, with each performance occurring before a new audience on the same day.ResultsFrom the 1st to the 3rd performance, HR, VAS, and playing error scores decreased significantly. MDBF (RU scale) showed a significant increase in calmness from the 1st to the 3rd performance on stage. HR and RU, VAS, and RU, as well as bow acceleration and overall duration of playing correlated significantly across participants and performances.Discussion and conclusionWe conclude that repeated stage exposure significantly reduces HR as well as restlessness and playing errors linked to MPA. Public performances are still successful when HR is significantly higher than during rest periods. These results underscore the importance of stage training to become accustomed to realistic public self-exposure. Musicians – especially students – should consider this component of stage training as an integral part of their practice routine. Therefore, stage training can reduce MPA, promote better live performances and prevent stress-related mental disorders and physical injuries. These result from excessive self-exercise strategies common in musicians experiencing MPA. HR monitoring should be an integral part of evaluating the effectiveness of interventions for better MPA management and efficient performance training.

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Section: Hr Physical Versus Mental Componentssupporting

confidence: 84%

Section: Introductionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Repeated stage exposure reduces music performance anxiety

et al. 2023

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“…A survey about the effects of biofeedback interventions in patients with pelvic pain, focusses on this very relevant but often forgotten clinical syndrome [6]. Virtual reality as a modern basis for treatment of stress, especially in children and adolescents, is described by Kothgassner et al [7]. The application of neurofeedback in patients suffering from autism is shown in an interesting paper concerning children and adolescents suffering from this disorder [8].…”

mentioning

confidence: 99%

Biofeedback in medicine with a focus on cancer rehabilitation

Crevenna

2022

Wien Klin Wochenschr

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The method of biofeedback is known to be an effective instrumental psychophysiological method with the power to enhance self-competence in healthy people but also in patients suffering from different diseases. For some medical indications it has been shown to be an effective additive tool within state of the art treatment. By using a biofeedback apparatus and with the help of a so-called biofeedback therapist clients and patients are able to gain selfcompetence, the principle effective is self-efficacy. Such a biofeedback system is able to transform (disturbed) bodily functions into electrical signals and so-called parameters and by giving feedback of these biological signals to help the patient to get an insight into his/her body and to gain awareness about these disturbed bodily functions. Typical parameters used are skin conductance level and response, peripheral temperature, heart rate and different pulse qualities, heart rate variability, electromyography, electroencephalography, and hem-encephalography. With the feedback of these biosignals and by using skills given by the biofeedback therapist, the patient becomes able to change deficits in bodily functions according to a treatment goal [1][2][3].Typical indications for biofeedback are stress management and hypertension, dependencies, anxiety disorders, attention deficit disorder, depression, burnout syndrome, school problems and sport psychological interventions (such as peak performance training). Further indications are female and male incontinence and pain syndromes (migraine, tension type headache, cervical syndrome, back pain and

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“…Immersive virtual reality systems, naturally stimulating human perceptual experiences through interactive tools (e.g., helmet displays, bodysuits, and data gloves) [18,19], are widely used in the assessment and intervention of mental health problems [20][21][22][23][24]. The effective VR interventions for anxiety and depression are VR exposure-based cognitive behavioral therapy [25], VR biofeedback [26], and VR exercise [27]. However, current research focuses on mental disorders, ignoring the growing public anxiety and depression emotion.…”

Section: Introductionmentioning

confidence: 99%

Effects of Restorative Environment and Presence on Anxiety and Depression Based on Interactive Virtual Reality Scenarios

Wang

et al. 2022

IJERPH

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Anxiety and depression have been growing global mental health problems. The following studies explored the effect of interactive VR scenarios to find a low-cost and high-efficiency solution. Study 1 designed a 2 (anxiety and depression state) ×4 (interactive VR scenarios) experiment, the results of 20 participants showed that the designed scenarios had good restoration and presence, assisting to improve depression mood for people with mild to moderate anxiety and depression. Study 2 further investigated the intervention effects of two environment types (urban and park) and four interactive activities (automatic viewing, free-roaming, fishing, and watering plants in the park environment), based on data from a 10-minute experiment conducted by 195 participants with mild to moderate anxiety and depression. The subjective scales, EEG and EMG, and scenario experience were analyzed and the results showed that: (1) the restorative and present VR scenarios were beneficial in alleviating state anxiety and depression; (2) the restorative environment and presence were significantly and positively related to the reduction of anxiety and depression respectively, moreover, presence mediated the restorative environment on the recovery from anxiety and depression; (3) the environmental settings, the complexity of interaction, human factors, and maturity of VR devices and technology were also key factors that influenced the effects of interactive VR scenario experience and intervention. These studies revealed VR psychological intervention scenarios could be designed with comprehensive factors. Moreover, they might help pave the way for future study in exploring the physiology and psychology mode in virtual and real spaces, enhancing intervention effectiveness.

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Virtual reality biofeedback interventions for treating anxiety

Cited by 22 publications

References 51 publications

Repeated stage exposure reduces music performance anxiety

Repeated stage exposure reduces music performance anxiety

Biofeedback in medicine with a focus on cancer rehabilitation

Effects of Restorative Environment and Presence on Anxiety and Depression Based on Interactive Virtual Reality Scenarios

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