JMIR Publications

ABSTRACT

Background:

Stress is a multifaceted problem with different stressors yielding different responses and consequences. Stress studies traditionally rely on psychological, performance or social tests; but, recently, immersive virtual reality (VR) has emerged as a suitable framework for investigating specific stressors. However, previous studies have not explored multiple VR stressors to investigate different stress manifestations.

Objective:

We set out to design a study in which, instead of tailoring to a specific stress domain, we focused on a comprehensive set of stress domains. Specifically, based on neurocardiac models, we aimed to design different VR stress exercises in order to systematically test cardiac functioning within specific contexts of self-regulation (executive functioning, physical efforts and emotional regulation).

Methods:

The study design was developed using an iterative process comprising of three phases - preparation, development and verification phase. We conceived a theoretical model for relating six different aspects of workload and task demands (mental, physical and temporal demand, effort, frustration and performance) with optimal vagal tone. Based on the conceptual model, specific hypotheses were formulated, and four VR exercises were designed to test the hypotheses. Additionally, by integrating VR with photoplethysmography and electromyography, we captured various physiological measures along with subjective ratings of stress for specific stress dimensions and mood.

Results:

The results of the verification trials demonstrated that our study protocol was feasible and valid. Specifically it was seen that the different VR exercises elicited different stress demands and physiological responses. The exercises were well-tolerated, with high ratings in terms of usability, play engrossment and personal gratification.

Conclusions:

Our study design can thus be tailored to different stress domains and measurable behavioural and physiological outputs demonstrating the potential to capture a systematic and individualized assessment of stress response.