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EEG, HRV and Psychological Correlates while Playing Bejeweled II: A Randomized Controlled Study

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Stress related medical disorders such as cardiovascular disease, diabetes, depression, and anxiety are serious medical issues that can cause disability and death. Interventions to prevent their development and exacerbation are needed. Casual video games (CVGs) are fun, easy to play, spontaneous and tremendously popular. People report that they play these games because they decrease their stress and improve their mood. This study tested this theory by comparing people playing Bejeweled II a popular CVG with control subjects measured under similar conditions. Electroencephalographic (EEG) changes after playing Bejeweled II were consistent with increased mood and corroborated with similar findings on psychological reports. Moreover, heart rate variability (HRV) changes consistent with autonomic nervous system relaxation or decreased physical stress were also recorded. It is concluded, therefore, that playing a CVG like Bejeweled II can increase mood and decrease stress. These finding have broad implications and include the potential development of prescriptive interventions using Bejeweled II to prevent and treat stress related medical disorders. Finally, these findings demonstrate a method using EEG, HRV and psychological correlates to understand the psychophysiological or cybernetic interconnection between participant and video game.
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EEG, HRV and Psychological Correlates
while Playing Bejeweled II: A Randomized
Controlled Study
Carmen V. RUSSONIELLOa,1, Kevin O’BRIENa and Jennifer M. PARKSa
aEast Carolina University, Greenville, NC, USA
Abstract. Stress related medical disorders such as cardiovascular disease,
diabetes, depression, and anxiety are serious medical issues that can cause
disability and death. Interventions to prevent their development and exacerbation
are needed. Casual video games (CVGs) are fun, easy to play, spontaneous and
tremendously popular. People report that they play these games because they
decrease their stress and improve their mood. This study tested this theory by
comparing people playing Bejeweled II a popular CVG with control subjects
measured under similar conditions. Electroencephalographic (EEG) changes after
playing Bejeweled II were consistent with increased mood and corroborated with
similar findings on psychological reports. Moreover, heart rate variability (HRV)
changes consistent with autonomic nervous system relaxation or decreased
physical stress were also recorded. It is concluded, therefore, that playing a CVG
like Bejeweled II can increase mood and decrease stress. These finding have broad
implications and include the potential development of prescriptive interventions
using Bejeweled II to prevent and treat stress related medical disorders. Finally,
these findings demonstrate a method using EEG, HRV and psychological
correlates to understand the psychophysiological or cybernetic interconnection
between participant and video game.
Keywords. Bejeweled II, casual video games, electroencephalography (EEG),
heart rate variability (HRV), physical stress, mood.
Introduction
Approximately 9.5 percent of the U.S. adult population has a mood disorder1. Stress
related medical disorders such as cardiovascular disease and diabetes are major causes
of disability and death in the United States2. Cost effective preventive interventions that
improve mood, decrease stress and are self-motivating are in immediate need. Casual
Video Games (CVGs) are games considered fun, quick to access, easy to learn, and
require no previous special video game skills, expertise, or regular time commitment to
play3. CVGs are extremely popular with estimates that they are now a 55 billion dollar
per year industry4. When surveyed CVG players often indicated they played to reduce
stress and improve their mood. To test this hypothesis we measured changes EEG,
1 Corresponding Author: Ph.D., Psychophysiology Lab and Biofeedback Clinic: East Carolina
University, Belk Building Suite 2501, Greenville, NC 27858: USA; E-mail: russonielloc@ecu.edu.
189
HRV and psychological correlates pre and post video game play and compared the
results to a control group. The level of significance was set at p<.05.
1. Methods
The purpose of the study was to determine whether playing a specific CVG called
Bejeweled II (BJW II) could improve mood and/or decrease stress. Bejeweled II (BJW
II) is a matching, sequencing game where participants string together like jewels for
points. In this study we tested the hypothesis that playing Bejeweled II would produce
physiological and psychological changes consistent with increased mood and decreased
physical stress. Sixty-nine (n=69) participants were randomized into either a control
group or BJW II. Conditions for both groups were identical except instead of playing
video games the control group was instructed to surf the internet looking for articles
related to health and to put them into a file on the computer desktop. Participants
completed psychological assessments and then opened an envelope that indicated their
group assignment. Both Bejeweled II play and control Internet activity lasted 20
minutes.
2. Results
EEG monitoring was used to determine mood changes and followed a standard
protocol for collection of alpha brain waves5. It was hypothesized that playing casual
video games would result in decreases in left frontal alpha brain waves which would be
indicative of improved mood 6, 7,8. Results outlined in table 1 illustrate that playing
Bejeweled II did indeed change brain waves towards a more positive mood when
compared to controls. Experimental participants also reported a significant
improvement in mood on Profile of Mood States9 (POMS) assessment. The pre-post
game reductions in total disturbed mood compared with the control group are presented
in table 1. Changes in individual POMS variables were as follows: Tension
significantly decreased after Bejeweled II (p=.000) but did not significantly differ from
control; Depression significantly decreased pre-post Bejeweled II (p=.002) but also did
not significantly differ from control. Positive changes in Anger; Vigor; Emotional
Fatigue and Confusion were all significant when compared controls.
Table 1.POMS Variables
md
se
df
Left Alpha Changes
Significantly differs from control p=.032
Control (n=26)
.985
1.5
30
Bejeweled II (n=32)
-3.3
1.3
31
Reduction in Disturbed Mood
Significantly differs from control p=.009
Control (n=31)
-2.6
2.4
30
Bejeweled II (n=38)
-11.3
2.2
37
Reduction in Anger
Control (n=31)
-.77
.56
30
Bejeweled II (n=38)
-2.2
.5
37
Increases in Vigor
Significantly differs from control p=.007
Control (n=31)
-1.4
.80
30
Bejeweled II (n=38)
1.5
.72
37
190
Decreases in Emotional Fatigue
Differs from control p=.053
Control (n=31)
-1.4
.53
30
Bejeweled II (n=38)
-2.8
.48
37
Decreases in Confusion
Significantly differs from control p=.000
Control (n=26)
.26
.46
30
Bejeweled II (n=32)
-2.0
.42
37
Table 2. Heart Rate Variability Changes
Control
(n=30)
md
se
df
p
B II (n=40)
md
se
df
p
HR
-.82
.61
29
.184
-1.6
.53
39
.003
TP
488
151
29
.002
394
130
39
.003
VLF
-106
100
29
.290
-198
87
39
.024
LFN
1.8
2.7
29
.521
5.8
2.4
39
.015
HFN
-1.7
2.7
29
.533
-6.3
2.3
39
.008
LF/HF
-.24
.30
29
.458
.60
.28
39
.034
Heart rate variability (HRV) reflects the state of sympathetic (stress, anxiety) or
parasympathetic (relaxation, calmness) activation in the body10. HRV is considered a
marker of cardiac activity and is of great interest to health care practitioners11 ,12,13.
Participants who played BJW II experienced statistically significant decreases in ANS
activity with corresponding increase in variables associated with positive cognitive
engagement. Results are presented in Table 2.
3. Discussion
This study demonstrated that playing BJW II changes EEG brain wave activity
consistent with enhanced mood. These changes along with the concurrent reports of
improved mood indicated by scores on psychological tests support the hypothesis that
playing BJW II improves mood. Significant changes in all HRV parameters were
reported pre-post BJW II. Cohen’s delta or d14 was used to compare differences in
HRV means in the BJW II and control groups relative to an assumed common variance.
Results indicated very large changes pre and post BJW II including decreases in heart
rate (d= 1.3), VLF (d= 1) and corresponding increases in LFN (d= 1.6) and LF/HF ratio
(d= 1.2). These changes are consistent with a “more power with less effort” response
also reported by researchers15 as TP and LFN increases coupled with VLF activity
decreases after the relaxation response and meditation exercises. The data supports the
theory that BJW II decreases physical stress and increases efficiency in a manner
similar to these self-regulation techniques.
The results of this study suggest a potentially important role for the use of games
like BJW II in physical and psychological disorders such as diabetes and depression.
Other interventions with similar inherent characteristics like meditation16,17 and
card/board games18 have demonstrated positive stress reduction and mood elevating
benefits when prescribed in clinical populations. Thus, protocols with prescriptive
parameters need to be developed and tested against disorders such as depression to
determine the efficacy of such an intervention in a clinical population. Moreover, the
methods used in this study represent a much needed rubric to further understand unique
responses of humans while playing video games and as such provides new
191
opportunities for researchers and clinicians to develop tools for diagnosing and treating
various physical and mental disorders.
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Functioning and Disability. Retrieved from Internet source http://www.cdc.gov/nchs/icd9.htm on
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