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Original Article

Combining VR and Biofeedback

The Effects on Perceived Restorativeness and Presence

Published Online:https://doi.org/10.1027/1864-1105/a000270

Abstract. This study explored the effects of combining virtual reality (VR) and biofeedback on the restorativeness of the created experience as judged by the user and the user’s sense of presence. In a between-subjects experiment, we disentangled the effects of display type (VR vs. computer screen) and biofeedback (electrodermal activity biofeedback vs. no biofeedback) in the context of immersive simulated relaxation environments. After a stress induction, 94 healthy participants were randomly assigned to one of four relaxing treatments. There were no treatment-specific differences in subjective stress or physiological arousal. However, VR compared with computer screen increased the sense of presence and, partly, perceived restorativeness. When combined with VR, biofeedback increased physical presence and, in part, perceived restorativeness. The study offers insight that allows for the identification of future research avenues.

References

  • Anderson, A. P., Mayer, M. D., Fellows, A. M., Cowan, D. R., Hegel, M. T., & Buckey, J. C. (2017). Relaxation with immersive natural scenes presented using virtual reality. Aerospace Medicine and Human Performance, 88, 520–526. https://doi.org/10.3357/AMHP.4747.2017 First citation in articleCrossrefGoogle Scholar

  • Annerstedt, M., Jönsson, P., Wallergård, M., Johansson, G., Karlson, B., Grahn, P., & Währborg, P. (2013). Inducing physiological stress recovery with sounds of nature in a virtual reality forest – results from a pilot study. Physiology & Behavior, 118, 240–250. https://doi.org/10.1016/j.physbeh.2013.05.023 First citation in articleCrossrefGoogle Scholar

  • Baños, R. M., Etchemendy, E., Castilla, D., Garcia-Palacios, A., Quero, S., & Botella, C. (2012). Positive mood induction procedures for virtual environments designed for elderly people. Interacting with Computers, 24, 131–138. First citation in articleCrossrefGoogle Scholar

  • Bohil, C. J., Alicea, B., & Biocca, F. A. (2011). Virtual reality in neuroscience research and therapy. Nature Reviews Neuroscience, 12, 752–762. https://doi.org/10.1038/nrn3122 First citation in articleCrossrefGoogle Scholar

  • Boucsein, W. (2012). Electrodermal activity. Berlin, Germany: Springer Science & Business Media. First citation in articleCrossrefGoogle Scholar

  • Collado, S., Staats, H., Corraliza, J. A., & Hartig, T. (2017). Restorative environments and health. In G. Fleury-BahiE. PolO. NavarroEds., Handbook of environmental psychology and quality of life research (pp. 127–148). Cham, Switzerland: Springer. First citation in articleGoogle Scholar

  • Cowley, B., Filetti, M., Lukander, K., Torniainen, J., Henelius, A., Ahonen, L., & Ravaja, N. (2016). The psychophysiology primer: A guide to methods and a broad review with a focus on human–computer interaction. Foundations and Trends in Human–Computer Interaction, 9, 151–308. First citation in articleCrossrefGoogle Scholar

  • Cummings, J. J., & Bailenson, J. N. (2016). How immersive is enough? A meta-analysis of the effect of immersive technology on user presence. Media Psychology, 19, 272–309. https://doi.org/10.1080/15213269.2015.1015740 First citation in articleCrossrefGoogle Scholar

  • de Kort, Y., Meijnders, A. L., Sponselee, A. A. G., & Ijsselsteijn, W. A. (2006). What’s wrong with virtual trees? Restoring from stress in a mediated environment. Journal of Environmental Psychology, 26, 309–320. First citation in articleCrossrefGoogle Scholar

  • Diemer, J., Alpers, G. W., Peperkorn, H. M., Shiban, Y., & Mühlberger, A. (2015). The impact of perception and presence on emotional reactions: A review of research in virtual reality. Frontiers in Psychology, 6, 26. https://doi.org/10.3389/fpsyg.2015.00026 First citation in articleCrossrefGoogle Scholar

  • Freeman, D., Reeve, S., Robinson, A., Ehlers, A., Clark, D., Spanlang, B., & Slater, M. (2017). Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological Medicine, 47, 2393–2400. https://doi.org/10.1017/S003329171700040X First citation in articleCrossrefGoogle Scholar

  • Goessl, V. C., Curtiss, J. E., & Hofmann, S. G. (2017). The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis. Psychological Medicine, 47, 2578–2586. https://doi.org/10.1017/S0033291717001003 First citation in articleCrossrefGoogle Scholar

  • Gromala, D., Tong, X., Choo, A., Karamnejad, M., & Shaw, C. D. (2015). The virtual meditative walk: Virtual reality therapy for chronic pain management. In B. BegoleJ. KimK. InkpenW. WooEds., Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (pp. 521–524). New York, NY: ACM. First citation in articleGoogle Scholar

  • Hartig, T., Korpela, K., Evans, G. W., & Gärling, T. (1997). A measure of restorative quality in environments. Scandinavian Housing and Planning Research, 14, 175–194. First citation in articleCrossrefGoogle Scholar

  • Herzog, T. R., Maguire, P., & Nebel, M. B. (2003). Assessing the restorative components of environments. Journal of Environmental Psychology, 23, 159–170. https://doi.org/10.1016/S0272-4944(02)00113-5 First citation in articleCrossrefGoogle Scholar

  • Hølledig, M. L., & Petersen, R. K. (2018). ZenVR: A biofeedback virtual reality experience for assisting meditation. (Unpublished master’s thesis). Copenhagen, Denmark: Aalborg University. First citation in articleGoogle Scholar

  • Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology, 15, 169–182. https://doi.org/10.1016/0272-4944(95)90001-2 First citation in articleCrossrefGoogle Scholar

  • Kaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspective. Cambridge, NY: Cambridge University Press. First citation in articleGoogle Scholar

  • Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The ‘Trier Social Stress Test’ – a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81. First citation in articleCrossrefGoogle Scholar

  • Kosunen, I., Salminen, M., Järvelä, S., Ruonala, A., Ravaja, N., & Jacucci, G. (2016). RelaWorld: Neuroadaptive and immersive virtual reality meditation system. In J. Nicols, et al. (Eds.), Proceedings of the 21st International Conference on Intelligent User Interfaces (pp. 208–217). New York, NY: ACM. First citation in articleGoogle Scholar

  • Lessiter, J., Freeman, J., Davidoff, J. B., & Keogh, E. (2001). A cross-media presence questionnaire: The ITC-Sense of Presence Inventory. Presence Teleoperators and Virtual Environments, 10, 282–297. First citation in articleCrossrefGoogle Scholar

  • Lindner, P., Miloff, A., Hamilton, W., & Carlbring, P. (2019). The potential of consumer-targeted Virtual Reality relaxation applications: Descriptive usage, uptake and application performance statistics for a first-generation application. Frontiers in Psychology, 10, 132. https://doi.org/10.3389/fpsyg.2019.00132 First citation in articleCrossrefGoogle Scholar

  • Liszio, S., Graf, L., & Masuch, M. (2018). The relaxing effect of virtual nature: Immersive technology provides relief in acute stress situations. Annual Review of Cybertherapy and Telemedicine, 16, 87–93. First citation in articleGoogle Scholar

  • Marselle, M. R., Irvine, K. N., Lorenzo-Arriba, A., & Warber, S. L. (2016). Does perceived restorativeness mediate the effects of perceived biodiversity and perceived naturalness on emotional well-being following group walks in nature? Journal of Environmental Psychology, 46, 217–232. First citation in articleCrossrefGoogle Scholar

  • Ohly, H., White, M. P., Wheeler, B. W., Bethel, A., Ukoumunne, O. C., Nikolaou, V., & Garside, R. (2016). Attention restoration theory: A systematic review of the attention restoration potential of exposure to natural environments. Journal of Toxicology and Environmental Health, 19, 305–343. https://doi.org/10.1080/10937404.2016.1196155 First citation in articleCrossrefGoogle Scholar

  • Rockstroh, C., Blum, J., & Göritz, A. S. (2019). Virtual reality in the application of heart rate variability biofeedback. International Journal of Human–Computer Studies, 130, 209–220. First citation in articleCrossrefGoogle Scholar

  • Schoenberg, P. L., & David, A. S. (2014). Biofeedback for psychiatric disorders: A systematic review. Applied Psychophysiology and Biofeedback, 39, 109–135. https://doi.org/10.1007/s10484-014-9246-9 First citation in articleCrossrefGoogle Scholar

  • Schubert, T., Friedmann, F., & Regenbrecht, H. (2001). The experience of presence: Factor analytic insights. Presence: Teleoperators & Virtual Environments, 10, 266–281. First citation in articleCrossrefGoogle Scholar

  • Schuemie, M. J., van Der Straaten, P., Krijn, M., & van Der Mast, C. A. (2001). Research on presence in virtual reality: A survey. CyberPsychology & Behavior, 4, 183–201. https://doi.org/10.1089/109493101300117884 First citation in articleCrossrefGoogle Scholar

  • Serrano, B., Baños, R. M., & Botella, C. (2016). Virtual reality and stimulation of touch and smell for inducing relaxation: A randomized controlled trial. Computers in Human Behavior, 55, 1–8. https://doi.org/10.1016/j.chb.2015.08.007 First citation in articleCrossrefGoogle Scholar

  • Skoluda, N., Strahler, J., Schlotz, W., Niederberger, L., Marques, S., Fischer, S., … Nater, U. M. (2015). Intra-individual psychological and physiological responses to acute laboratory stressors of different intensity. Psychoneuroendocrinology, 51, 227–236. https://doi.org/10.1016/j.psyneuen.2014.10.002 First citation in articleCrossrefGoogle Scholar

  • Slater, M., & Wilbur, S. (1997). A framework for immersive virtual environments (FIVE): Speculations on the role of presence in virtual environments. Presence: Teleoperators & Virtual Environments, 6, 603–616. First citation in articleCrossrefGoogle Scholar

  • Sona, B., Dietl, E., & Steidle, A. (2019). Recovery in sensory-enriched break environments: Integrating vision, sound and scent into simulated indoor and outdoor environments. Ergonomics, 62, 521–536. https://doi.org/10.1080/00140139.2018 First citation in articleCrossrefGoogle Scholar

  • Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press. First citation in articleGoogle Scholar

  • Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 420–421. First citation in articleCrossrefGoogle Scholar

  • Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11, 201–230. First citation in articleCrossrefGoogle Scholar

  • Van Rooij, M., Lobel, A., Harris, O., Smit, N., & Granic, I. (2016). DEEP: A biofeedback virtual reality game for children at-risk for anxiety. In J. KayeA. DruinC. LampeD. MorrisJ. P. HourcadeEds., Proceedings of the 2016 CHI Conference Extended Abstracts on Human Factors in Computing Systems (pp. 1989–1997). New York, NY: ACM. First citation in articleGoogle Scholar

  • Valmaggia, L. R., Latif, L., Kempton, M. J., & Rus-Calafell, M. (2016). Virtual reality in the psychological treatment for mental health problems: A systematic review of recent evidence. Psychiatry Research, 236, 189–195. First citation in articleCrossrefGoogle Scholar

  • Valtchanov, D., Barton, K. R., & Ellard, C. (2010). Restorative effects of virtual nature settings. Cyberpsychology, Behavior, and Social Networking, 13, 503–512. https://doi.org/10.1089/cyber.2009.0308 First citation in articleCrossrefGoogle Scholar

  • Villani, D., Riva, F., & Riva, G. (2007). New technologies for relaxation: The role of presence. International Journal of Stress Management, 14, 260–274. https://doi.org/10.1037/1072-5245.14.3.260 First citation in articleCrossrefGoogle Scholar

  • Villani, D., & Riva, G. (2012). Does interactive media enhance the management of stress? Suggestions from a controlled study. Cyberpsychology, Behavior, and Social Networking, 15, 24–30. First citation in articleCrossrefGoogle Scholar

  • White, M. P., Yeo, N. L., Vassiljev, P., Lundstedt, R., Wallergård, M., Albin, M., & Lõhmus, M. (2018). A prescription for “nature” – the potential of using virtual nature in therapeutics. Neuropsychiatric Disease and Treatment, 14, 3001–3013. https://doi.org/10.2147/NDT.S179038 First citation in articleCrossrefGoogle Scholar

  • Yu, B., Funk, M., Hu, J., Wang, Q., & Feijs, L. (2018). Biofeedback for everyday stress management: A systematic review. Frontiers in ICT, 5, 23. First citation in articleCrossrefGoogle Scholar