Content uploaded by Adam Lobel
Author content
All content in this area was uploaded by Adam Lobel on Mar 20, 2019
Content may be subject to copyright.
Stressful Gaming, Interoceptive Awareness,
and Emotion Regulation Tendencies:
A Novel Approach
Adam Lobel, MSc, Isabela Granic, PhD, and Rutger C.M.E. Engels, PhD
Abstract
Healthy emotion regulation is crucial for navigating stressful situations. Interoceptive awareness—the aware-
ness of one’s internal states—is important for such healthy regulation. Given the propensity for video games to
induce stress, the associations between in-game and real world emotion regulation strategies during duress are
worth exploring. We therefore present a method for measuring the interoceptive awareness of negative affect
during stressful video game play, and investigate whether individual differences in this ability relate to emotion
regulation strategies. Twenty-six proficient video game players were recruited to play a session of the video
game Starcraft II in the lab. Players’ physiological and subjective states of in-game negative arousal were
measured consecutively. A comparison of these measures was used to calculate players’ interoceptive awareness
of real time in-game arousal. The relation between interoceptive awareness and a suite of emotion regulation
strategies was then investigated. We observed a positive relation between in-game interoceptive awareness and
the self-reported tendency to actively seek a resolution to negative affect. A positive trend was also observed
between interoceptive awareness and the self-reported tendency to seek instrumental social support. Findings
are discussed in terms of the relative effectiveness of different emotion regulation strategies for aiding in-game
success. We further discuss the benefits and limitations of this pilot testing. In all, we hope to inspire future
research into the associations between in-game arousal and emotion regulation strategies used in everyday life.
Introduction
Video game playing is laden with anxiety, frustration,
and anger.
1–4
These stressful experiences are often inte-
gral in order for a game to feel challenging, indicative that
video games may implicitly encourage players to manage and
relieve their stress during goal pursuit. Video games may
therefore provide a safe context for the development of heal-
thy emotion regulation to the extent that they reward players
for successfully down-regulating their negative affective
states.
5
Thus, the extensive amount of time spent playing
video games, and their potential to promote the down-
regulation of negative affect makes it worthwhile to investi-
gate the associations between in-game and real world
responses to negative emotional arousal.
The present study builds upon the emotion regulation
benefits of interoceptive awareness. Interoceptive awareness
describes how aware one is of his or her internal physiological
state.
6
Greater interoceptive awareness provides better
awareness of internal emotional states because physiological
sensations mark, and perhaps underlie, the experience of
emotion.
7,8
Thus, heightened emotional awareness allows for
more effective emotion regulation.
9,10
For instance, when
asked to observe emotionally evocative stimuli, individuals
trained to be more aware of their internal states showed,
compared to control subjects, greater consistency between
self-reported and physiological indicators of affect.
8
Inter-
oceptive awareness is also positively related with the ability
to down-regulate negative affect,
11
and negatively related to
alexithymia, the inability to identify subjective experiences of
emotions.
12
We investigated whether the ability to recognize negative
affective states during gameplay is related to healthy emotion
regulation strategies more generally. To determine this, we
adapted a methodology developed by Gottman and Le-
venson.
13,14
In this approach, people were videotaped while
engaging in an emotionally charged conversation. The tapes
were then played back, and people were asked to use an
affect rating dial
15
to rate, moment to moment, how nega-
tively aroused they felt over the course of the conversation. In
our study, skilled video game players were invited to our lab
to play a competitive online video game. Each player’s
Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
CYBERPSYCHOLOGY,BEHAVIOR,AND SOCIAL NETWORKING
Volume 17, Number 4, 2014
ªMary Ann Liebert, Inc.
DOI: 10.1089/cyber.2013.0296
222
competitive match was recorded and presented to the par-
ticipant who used the dial while observing the match they
had just played. Each participant’s moment-to-moment per-
ceptions of negative emotional arousal were compared with
the participant’s actual in-game emotional arousal, based on
heart rate. Importantly, heart rate has been shown to be
positively associated with anxiety in general
16
and specifi-
cally with in-game tension and negative affect.
17
Further, we
selected a notoriously stressful video game for study. We
hypothesized that participants who were more accurate in
perceiving in-game changes in negative arousal would show
healthier emotion regulation tendencies outside the gaming
context.
Six emotion regulation strategies were examined, each
corresponding to a strategy described in a recent meta-
analysis.
18
Healthy emotion regulation tendencies include
problem solving, acceptance, and reappraisal. Problem solv-
ing can involve instrumental and emotional support seeking,
as well as direct attempts to resolve stress. Acceptance refers
to the nonjudgmental recognition of negative affect.
19
Re-
appraisal refers to patterns of thought that alter the way one
views (the consequences of) an event. These positive strate-
gies are associated with healthy functioning and effective
decreases in negative affective states.
18
Unhealthy emotion regulation tendencies, on the other
hand, include withdrawal, rumination, and suppression.
Withdrawal involves avoiding a source of negative affect.
Rumination refers to thinking repeatedly about negative af-
fect and situations, and excessive worrying.
20
Suppression
refers to patterns of thought or action that dull the intensity of
an emotional experience.
21
These negative strategies are as-
sociated with maladaptive functioning (e.g., depression) and
even the exacerbation of negative affective states.
18
Given the
regulatory benefits of interoceptive awareness, we expected
greater interoceptive awareness of in-game negative arousal
to be associated with more self-reported use of healthy and
less use of unhealthy emotion regulation strategies.
Method
Participants
Twenty-six male university students (age M=24.51 years,
SD =2.57 years) participated in exchange for a chance to
win video game–related prizes. Participants were recruited
through a local video game tournament (Nijmegen Student
Starcraft League, 2012). This sample was chosen because
(a) they were proficient gamers, and (b) the tournament’s
focal game—Starcraft II: Wings of Liberty—is notorious
for producing negative affective states, particularly anxiety.
The study was approved by the Behavioural Science In-
stitute’s ethical committee, and informed consent forms
were collected.
Procedure
Participants indicated their interest for being a part of the
study via an online emotion regulation questionnaire. In in-
dividualized lab sessions, participants watched a relaxing
film clip (3 minutes from the opening of Baraka
22
; participants
were told to watch the screen and breath normally), played a
competitive match of Starcraft II (duration M=15 minutes 1.8
second; SD =4 minutes 22.8 seconds), and immediately
thereafter viewed the match’s replay. Base heart rate was
calculated during the film clip. Replays were exact recreations
of the match, forcing players to observe their own in-game
actions. During the replay, participants used an affect rating
dial to provide continuous, retrospective ratings of their in-
game negative affect. Players were briefed on these proce-
dures beforehand.
Starcraft II is an ideal game for investigating players’ in-
teroceptive awareness of in-game negative affective states.
Played worldwide, it is among the most popular profes-
sionally played video games today.
23
Starcraft II’s primary
mode of play situates two players as overseers of a virtual
map where they each command their units—analogous to the
pieces on a chess board—to procure resources, use those re-
sources to construct an army, and defeat the army of the
opposing player. This mode generates frustration and anxiety
in at least three ways: First, players are blind to the actions of
their opponents. Players can only see what occurs in the map
areas that they control, forcing players to outthink their op-
ponent without being sure of the other’s tactics. Second, it is
inherently competitive. Players are paired against opponents
of comparable skill, thereby maintaining high engagement
and challenge. Finally, Starcraft II players are publically
ranked in skill based on their success/failure in competitive
matches they play against strangers. This public ranking
system is widely considered among players to produce stress,
termed ‘‘ladder anxiety.’’
24
Measures
Emotion regulation questionnaire. Five subscales of the
COPE,
25
the Ruminative Response Scale (RRS; a subscale of
the Response Style Questionnaire
26
), and the Emotion Reg-
ulation Questionnaire (ERQ)
21
comprised the online emotion
regulation questionnaire.
The COPE subscales (4 items; 5-point Likert scale, ‘‘I usu-
ally don’t do this at all’’ to ‘‘I usually do this a lot’’) measured
the frequency with which participants manage stressful sit-
uations through (a) three forms of problem solving, namely,
seeking instrumental social support (‘‘I try to get advice from
someone about what to do’’; a=0.90), seeking emotional so-
cial support (‘‘I try to get emotional support from friends or
relatives’’; a=0.89), and actively seeking a resolution (‘‘I take
additional action to try to get rid of the problem’’; a=0.74); (b)
withdrawal (‘‘I admit to myself that I can’t deal with it, and
quit trying’’; a=0.82), and (c) acceptance (‘‘I accept that this
has happened, and that it can’t be changed’’; a=0.85).
The RRS (22 items; 4-point Likert scale, ‘‘almost never’’ to
‘‘almost always’’) measured the frequency with which par-
ticipants engaged in ruminative thinking (‘‘Think about
shortcomings, failings, faults, mistakes’’; a=0.82).
The ERQ (7-point Likert scale, ‘‘strongly disagree’’ to
‘‘strongly agree’’) measured the extent to which participants
regulate their emotions through (a) reappraisal (6 items; ‘‘I
control my emotions by changing the way I think about the
situation I’m in’’; a=0.83); and (b) suppression (4 items; ‘‘I
control my emotions by not expressing them’’; a=0.69).
Heart rate. Electrocardiography (ECG) was recorded
using a 2-Lead system configured to a BioPac MP30, sampled
at 500 Hz with AcqKnowledge. Electrodes were placed 2 cm
below the clavicle and 2 cm medially from the anterior medial
GAMING AND EMOTION REGULATION 223
edge of the deltoid, and the other, half the distance between
the final rib and the superior iliac crest.
Affect rating dial. The dial’s signal (range -4to +4 volts)
was sent to the BioPac MP30 system and was sampled by
AcqKnowledge at 200 Hz.
Data preparations
ECG data from the baseline and game sessions were
transformed using a 2 Hz High Pass Filter. Heart rate was
then calculated in beats per minute, and manually cleaned of
artifacts. Participants’ heart rate time series were resampled
to a rate of 2 Hz, and a 3 second Gaussian window was used
to smooth the data. To control for individual differences in
baseline heart rate, a time series representing in-game percent
change in heart rate was calculated for each participant. This
time series (hereafter referred to as HR) represents the percent
change in heart rate from each participant’s baseline every
500 milliseconds.
The dial ratings were also resampled to a rate of 2 Hz, and
were smoothed using a 3 second Gaussian window (hereafter
referred to as DIAL).
Analytic strategy
Interoceptive awareness was calculated based on differ-
ences between the change in HR and the change in DIAL
along a sliding window. Figure 1 depicts a screenshot from
a player’s game. The screenshot is overlaid with an image
of the participant’s face, the HR and DIAL values from a
50 second segment of the game, during which this screenshot
occurred. Figure 2 depicts the HR and DIAL time series and
the interoceptive awareness score of two participants.
HR values were standardized. Each participant’s HR was
rescaled to match the dial rating’s scaling. The rescaled HR
FIG. 1. Screenshot of in-game session.
Legend, graph, participant’s face, and
numbers are laid over the original
screenshot. HR, percent change in
participant’s heart rate; DIAL, negative
emotional arousal self-reported while
watching a replay of the game. HR, DIAL,
and participant’s photograph are all taken
from the same 50 second portion of
gameplay from which the screenshot was
extracted. Participant consented to use of his
photograph.
FIG. 2. HR and DIAL from two participants’ full sessions. HR, percent change in participant’s heart rate; DIAL, negative
emotional arousal self-reported while watching a replay of the game; IA, interoceptive awareness score.
224 LOBEL ET AL.
and the DIAL were each segmented into 10 second epochs
with a 5 second overlap. For each pair of epochs, the value at
the beginning of the 10 second epoch was subtracted from the
value at the end of the epoch, rendering a difference score for
both the rescaled HR and the DIAL epochs. The absolute
value of the difference between these difference scores rep-
resents the discrepancy between actual and perceived change
in negative affect over each 10 second period. Interoceptive
awareness was estimated by calculating the mean discrep-
ancy between these measures across all epochs. Thus, higher
values indicated greater discrepancy between actual and
perceived change in negative affect and therefore poorer in-
teroceptive awareness. For ease of interpretation, we multi-
plied this value by -1, making higher values indicative of
better interoceptive awareness. Ten seconds was chosen as an
appropriate epoch duration based on previous studies,
8,27
and
because we expected a 5–10 second lag between actual and
perceived changes in negative affect as a result of participants
having to process the affective significance of the in-game
events that were unfolding during the dial rating session.
Results
To determine whether participants were on average able to
use the dial correctly to indicate their negative affect, each
participant’s HR was correlated with their DIAL. This cor-
relation was significant ( pp0.05) for all 26 participants (al-
though negative in two cases), and a ttest confirmed that the
average correlation was different from 0 (mean r=0.327,
t(25) =7.67, p<0.001). Table 1 presents the means and stan-
dard deviations for interoceptive awareness and the emotion
regulation questionnaires.
Table 2 presents these correlations and their associated
pvalues. As hypothesized, interoceptive awareness was sig-
nificantly positively related to actively seeking a resolution,
and the relation between interoceptive awareness and seek-
ing instrumental social support showed a positive trend
(pp0.10). Other correlations were not significant.
Discussion
The emotion regulation benefits of interoceptive awareness
provided the theoretical
9
and empirical
11,12
impetus for the
present study. Our primary goal was to determine whether
the interoceptive awareness of in-game negative affective
states might be indicative of emotion regulation strategies.
On self-reported emotion regulation measures, we expected
interoceptive awareness of negative in-game affect to be re-
lated to healthier reactivity to real world stress. Only the re-
lationship between interoceptive awareness and actively
seeking a resolution was significant. The relationship be-
tween interoceptive awareness and seeking instrumental
support showed a trend in the hypothesized direction.
These findings indicate that interoceptive awareness of
negative affect during stressful game play may be uniquely
related to regulatory strategies that are more problem fo-
cused than emotion focused (see Folkman and Lazarus
28
),
and that are relevant for in-game success. In games such as
Starcraft II, negative emotional arousal during game play is a
direct consequence of a player’s in-game choices. Win–lose
states are clearly linked to the decisions players make of
which resources they procure, how they invest their re-
sources, and how they manage offensive rallies against their
opponents. To prevent future negative emotional arousal,
players must therefore learn how to make better in-game
decisions. It is therefore logical that recognizing negative
emotional arousal in these contexts would relate to emotion
regulation strategies that are action and problem solving
focused, and which lead to improvements in in-game per-
formance.
Albeit speculative, this reasoning may also account for
why the other emotion regulation strategies measured in this
study showed no association with interoceptive awareness.
Regarding other healthy emotion regulations strategies,
seeking emotional social support—such as comfort—does not
seem to be an effective strategy for relieving in-game stress.
Likewise, acceptance would prove maladaptive should it
constitute ‘‘giving up,’’
29
and withdrawal is antithetical to the
game’s core goal—to engage and defeat one’s opponent. Fi-
nally, rumination and reappraisals are likely to be too cog-
nitively demanding for players to engage in during such fast
paced games as Starcraft II. As player’s attention is most de-
manded for making the best in-game decisions as quickly as
possible, in-game negative affect is not likely to inspire
players to halt and re-examine (the reasons for) their negative
Table 1. Means and Standard Deviations
Variable IA SIS
1
SES
1
ACT
1
ACC
1
REAPP
3
WIT
1
RUM
2
SUP
3
Mean 1.11 2.39 2.16 2.73 2.48 4.53 1.51 2.00 3.55
SD 0.22 0.77 0.71 0.53 0.71 1.16 1.67 0.42 0.89
Note. All scores based on mean score.
1
5-point scale;
2
4-point scale;
3
7-point scale.
IA, interoceptive awareness; SIS, seek instrumental social support; SES, seek emotional social support; ACT, seek active resolution; ACC,
acceptance; REAPP, reappraise; WIT, withdrawal; RUM, rumination; SUP, suppression.
Table 2. Correlations: Interoceptive Awareness and Emotion Regulation
SIS SES ACT ACC REAPP WIT RUM SUP
r=0.335 r=-0.181 r=0.513 r=0.170 r=0.230 r=-0.244 r=0.076 r=0.117
p=0.095 p=0.377 p=0.007 p=0.407 p=0.259 p=0.229 p=0.713 p=0.568
GAMING AND EMOTION REGULATION 225
state. Our results therefore seem to indicate that player’s in-
teroceptive awareness of in-game negative affect may be
specifically related to problem-focused strategies that are
relevant to in-game success.
Methodological contribution
One of the main goals of the current paper was to introduce
an innovative methodology to study the associations between
in-game and everyday emotion regulation strategies. In light
of our small sample size, we consider our findings a prom-
ising first step. Our findings support the possibility that
particular emotion regulation skills may be engaged and even
trained during stressful video game play.
The method employed in this study seems promising for
diverse avenues of future research. First, this method may be
tested with other video games, particularly those in which
more cognitive and emotion focused regulatory strategies are
promoted. Such studies could help determine whether in-
game interoceptive awareness specifically relates to emotion
regulation strategies that are contextually relevant. Second,
longitudinal research is critical to conduct in order to under-
stand the causal link better (if there is one) between in-game
interoceptive awareness and emotion regulation skills. It may
be worthwhile to identify video games that implicitly promote
interoceptive awareness and to track whether such games lead
to improvements in in-game success and in everyday emotion
regulation skills. Lastly, as this study only included self-report
measures, future research would benefit significantly from
using behavioral measures of emotion regulation. These sug-
gestions highlight this study’s limitations. The correlational
design makes it impossible to determine whether overcoming
in-game experiences of negative affect is beneficial for man-
aging everyday experiences of stress and negative affect.
Second, recall and social desirability biases somewhat impugn
the validity of self-report measures.
Video game playing has become ubiquitous. Researchers
have only begun to investigate the relationships between in-
game emotional states, the regulation of those states, and
individuals’ patterns of emotional reactivity in everyday life.
The method we presented here is unobtrusive, easy to im-
plement, engaging for participants, and shows promise. It
seems likely that the relevance of research into gaming and
emotion regulation will only increase as gaming technology
evolves. For instance, the recently released Xbox One’s Kinect
is designed to detect heart rate and facial expressions,
30
al-
lowing designers to construct games where players’ emo-
tional reactions dynamically interact with the game space.
This will allow emotion regulation to become an explicit
component of game play. In this line, our hope is that this
study provides a springboard from which more in-depth re-
search can be conducted into the role of video game play and
(the development of) emotion regulation tendencies.
Author Disclosure Statement
No competing financial interests exist.
References
1. Juul J. (2013) The art of failure: an essay on the pain of playing
video games. Cambridge: MIT Press.
2. Weber R, Behr KM, Tamborini R, et al. What do we really
know about first-person-shooter games? An event-related,
high-resolution content analysis. Journal of Computer-
Mediated Communication 2009; 14:1016–1037.
3. Ravaja N, Turpeinen M, Saari T, et al. The psychophysiology
of James Bond: phasic emotional responses to violent video
game events. Emotion 2008; 8:114–120.
4. Baldaro B, Tuozzi G, Codispoti M, et al. Aggressive and
non-violent videogames: short-term psychological and car-
diovascular effects on habitual players. Stress & Health 2004;
20:203–208.
5. Granic I, Lobel A, Engels RCME. The benefits of playing
video games. American Psychologist 2013; in press.
6. Mehling WE, Price C, Daubenmier JJ, et al. The multidi-
mensional assessment of interoceptive awareness (MAIA).
PloS ONE 2012; 7:e48230.
7. Niedenthal PM. Embodying emotion. Science 2007; 316:
1002–1005.
8. Sze JA, Gyurak A, Yuan JW, et al. Coherence between
emotional experience and physiology: does body awareness
training have an impact? Emotion 2010; 10:803–815.
9. Barrett LF, Gross J, Christensen TC, et al. Knowing what
you’re feeling and knowing what to do about it: mapping
the relation between emotion differentiation and emotion
regulation. Cognition & Emotion 2001; 15:713–724.
10. Hastings PD, Nuselovici JN, Klimes-Dougan B, et al. Dys-
regulated coherence of subjective and cardiac emotional
activation in adolescents with internalizing and externaliz-
ing problems. Journal of Child Psychology & Psychiatry
2009; 50:1348–1356.
11. Fu
¨sto
¨s J, Gramann K, Herbert BM, et al. On the embodiment
of emotion regulation: interoceptive awareness facilitates
reappraisal. Social Cognitive & Affective Neuroscience 2012
Sep 23 [Epub ahead of print].
12. Herbert BM, Herbert C, Pollatos O. On the relationship be-
tween interoceptive awareness and alexithymia: is intero-
ceptive awareness related to emotional awareness? Journal
of Personality 2011; 79:1149–1175.
13. Gottman JM, Levenson RW. A valid procedure for obtaining
self-report of affect in marital interaction. Journal of Con-
sulting & Clinical Psychology 1985; 53:151–160.
14. Levenson RW, Gottman JM. Marital interaction: physiolog-
ical linkage and affective exchange. Journal of Personality &
Social Psychology 1983; 45:587–597.
15. Ruef AM, Levenson RW. (2007) Continuous measurement of
emotion. In Coan JA, Allen JBJ, eds. Handbook of emotion
elicitation and assessment. New York: Oxford University
Press, pp. 286–297.
16. Kreibig SD. Autonomous nervous system activity in emo-
tion. A review. Biological Psychology 2010; 84:394–421.
17. Drachen A, Nacke LE, Yannakakis G, et al. (2010) Correlation
between heart rate, electrodermal activity and player experi-
ence in first-person shooter games. Paper presented at the 5th
ACM SIGGRAPH Symposium on Video Games, New York.
18. AldaoA,Nolen-HoeksemaS,Schweizer,S.Emotion-regulation
strategies across psychopathology: a meta-analytic review.
Clinical Psychology Review 2010; 30:217–237.
19. Hofmann SG, Asmundson GJG. Acceptance and mindful-
ness-based therapy: new wave or old hat? Clinical Psy-
chology Review 2008; 28:1–16.
20. Abela JR, Hankin BL. Rumination as a vulnerability factor to
depression during the transition from early to middle ado-
lescence: a multiwave longitudinal study. Journal of Ab-
normal Psychology 2011; 120:259–271.
226 LOBEL ET AL.
21. Gross JJ, John OP. Individual differences in two emotion
regulation processes: implications for affect, relationships,
and well-being. Journal of Personality & Social Psychology
2003; 85:348–362.
22. Magidson M (Producer), Frick R (Director). Baraka [Motion
Picture].
23. E-sport Eye. (2011) Starcraft 2 pays over 1.7 million USD in
prize money! Richest game on the Internets! http://esporteye
.net/starcraft-2-pays-17-million-usd-prize-money-richest-game-
internets (accessed May 13, 2013).
24. Team Liquid. (2012) Dealing with anxiety. http://wiki
.teamliquid.net/starcraft2/Dealing_with_anxiety (accessed
May 13, 2013).
25. Carver CS, Scheier MF, Weintraub JK. Assessing coping
strategies: a theoretically based approach. Journal of Per-
sonality & Social Psychology 1989; 56:267–283.
26. Nolen-Hoeksema S, Morrow J. A prospective study of de-
pression and posttraumatic stress symptoms after a natural
disaster: the 1989 Loma Prieta Earthquake. Journal of Per-
sonality & Social Psychology 1991; 61:115–121.
27. Mauss IB, Levenson RW, McCarter L, et al. The tie that
binds? Coherence among emotion experience, behavior, and
physiology. Emotion 2005; 5:175–190.
28. Folkman S, Lazarus RS. Coping as a mediator of emotion.
Journal of Personality & Social Psychology 1988; 54:466–475.
29. Wilson GT. Acceptance and change in the treatment of eating
disorders and obesity. Behavior Therapy 1996; 27:417–439.
30. Stuart, K. (2013) Xbox One: hands-on with the new con-
troller and Kinect. The Guardian. www.theguardian.com/
technology/2013/may/22/xbox-one-kinect-controller-hands-
on (accessed Nov. 15, 2013).
Address correspondence to:
Adam Lobel
Radboud University
Montessorilaan 3
6525HR Nijmegen
The Netherlands
E-mail: a.lobel@pwo.ru.nl
GAMING AND EMOTION REGULATION 227
