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The effectiveness of casual video games in improving mood and decreasing stress


Abstract and Figures

Stress related medical disorders such as cardiovascular disease, diabetes and depression are serious medical issues that can cause disability and death. Techniques to prevent their development and exacerbation are needed. Casual video games (CVGs) are fun, easy to play, spontaneous and are tremendously popular. In this randomized controlled study we tested the effects of CVGs on mood and stress by comparing people playing CVGs with control subjects under similar conditions. Electroencephalography (EEG) changes during game play were consistent with increased mood and corroborated findings on psychological reports. Moreover, heart rate variability (HRV) changes were consistent with autonomic nervous system relaxation or decreased physical stress. In some cases CVGs produced different brain wave, heart rate variability and psychological effects. These finding have broad implications which include the potential development of prescriptive interventions using casual video games to prevent and treat stress related medical disorders.
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Carmen V. Russoniello1, Kevin O’Brien1and Jennifer M. Parks1
Journal of CyberTherapy& Rehabilitation
Spring 2009, Volume 2, Issue 1
© Virtual Reality Medical Institute
Stress related medical disorders such as cardiovascular
disease, diabetes and depression are serious medical
issues that can cause disability and death. Techniques to
prevent their development and exacerbation are needed.
Casual video games (CVGs) are fun, easy to play, spon-
taneous and are tremendously popular. In this random-
ized controlled study we tested the effects of CVGs on
mood and stress by comparing people playing CVGs
with control subjects under similar conditions.
Electroencephalography (EEG) changes during game
play were consistent with increased mood and corrobo-
rated findings on psychological reports. Moreover, heart
rate variability (HRV) changes were consistent with
autonomic nervous system relaxation or decreased phys-
ical stress. In some cases CVGs produced different brain
wave, heart rate variability and psychological effects.
These finding have broad implications which include
the potential development of prescriptive interventions
using casual video games to prevent and treat stress
related medical disorders.
Corresponding Author:
Carmen Russoniello, Associate Professor and Director of the Psychosphysiology Lab and Biofeedback Clinic, East Carolina University,
1East Carolina University, Greenville, NC 27858-4353, U.S.A
Keywords. Casual Video Games, Electroencephalography
(EEG), Heart Rate Variability (HRV), Psychological Mood
According to the Casual Video Game Association there
are more than 200 million casual game players worldwide.
Gamers from a multitude of cultures, ages, and lifestyles
play electronic casual games using consoles, PCs and
online communities, handhelds and mobile phones. One
example of the popularity of casual video games can be
found in the fact that Microsoft Solitaire for Windows is
the most commonly opened application on Windows XP
(Casual Games Association, 2008). Casual video games
sometimes referred to as coffee-break or web games are a
booming business that is expected to grow to $55 billion
by 2009 (JWT Intelligence, 2006).
Casual video games (CVGs) defy a standard definition
because of the diverse nature of the games. Instead the
Casual Games Association, 2007 offers a functional defini-
tion that asserts that CVGs must be considered fun, quick
to access, easy to learn, and require no previous special
video game skills, expertise, or regular time commitment to
play. CVGs are based around familiar game concepts that
consumers played as children in arcades. They are usually
easy to pause, stop and restart. Casual games are usually
played in short increments at home and at work. Some
people, however, play for hours on end (Casual Games
Market Report, 2007).
According to anecdotal evidence and survey research, people
play CVGs for varied reasons including cognitive exercise, fun,
relaxation, and to reduce stress and improve mood. The Casual
Games Association says CVGs are viewed as important in
stress reduction during lunch or after work and CVG play has
begun to replace TV in this respect. A survey of gamers con-
ducted in 2006 (n= 2,191) revealed that casual game players
(71% daily use) view CVGs as more important in their leisure
time activities than TV, reading, or spending time with family
and friends. The survey also found that 88% of respondents
derived stress relief from playing. While casual gaming is pop-
ular among all groups they are particularly attractive to women
over 30. Retired men and woman also represent a large group of
casual gamers (Casual Video Games Association, 2007).
Stress and Health
A strong link between physical health and stress was estab-
lished more than a quarter century ago when researchers
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noted that exacerbation of tumor growth occurred follow-
ing acute exposure to uncontrollable stress (Sklar &
Anisman, 1979; Sklar & Anisman, 1981). It was postulat-
ed that stress influenced neurochemical, hormonal and
immunological changes which, in turn, exacerbated the
tumor growth but the mechanisms were not well under-
stood. Researchers exploring underlying causation began
focusing on the physiology of emotional response to psy-
chosocial stimuli adding to the understanding of how neu-
rochemical, hormonal and immunological changes occur
and contribute to dysfunction. These insights have led to
the current theory on human reactions to stress now char-
acterized as the “defense/fight or flight” and “defeat/immo-
bilization” responses (Folcov, 1988). In this model limbic-
hypothalamic patterns of response are integral and serve to
protect a person from adverse stimuli by mobilizing bio-
chemicals to aid in the response (Kudielka & Kirscbaum,
2007). Untoward stress or “distress” has a deleterious
impact on people and can directly affect both psychological
and physical conditions. If stress is not ameliorated it will
contribute to the development and/or exacerbation of ill-
ness and disease (Sapolski, 2004).
The term allostasis relates to a person’s ability to adapt to
adverse stimuli (McKewen, 1998). Allostatic load is con-
sidered the neurochemical, hormonal and immunological
costs of adapting to stress (Sternberg, 1997). The allostasis
model consists of four different causes of allostatic load that
require biological responses. 1. Frequent exposure to stress
2. Inability to habituate to repeated challenges 3. Inability
to terminate a stress response and 4. Inadequate allostatic
response (Webster, Tonelli & Sternberg, 2002). Under nor-
mal circumstances a person can manage their allostatic
load. However too often the demands of life overwhelm a
person’s normal coping abilities and additional help is
needed. Unfortunately, these self prescribed interventions
often involve potentially devastating after effects i.e. the use
of food, alcohol or drugs. Hence, people need to learn and
practice healthy methods to decrease stress and improve mood.
Psychological experiences can cause or be caused by stress.
Fear is a good example because it can be either real or imag-
ined. The body reacts as if it were real regardless. This expe-
rience in turn influences immune function and ultimately
the course of a disease. For instance, when a person
encounters a stressful circumstance, cortisol increases turn-
ing up energy producing mechanisms, while inhibiting less
essential functions. Specifically, cortisol has a significant
effect on numerous processes including metabolism, fluid
regulation, emotional and cognitive functioning and the
immune system (Thayer & Sternberg, 2006). Researchers
applying the Tier Social Stress Test for example, found cor-
tisol levels increased two to three-fold in about 70-80% of
subjects within 1 to 20 minutes after task demonstrating a
link between a psychosocial task and allostatic response
(Hjemdahl, 2002). When this short-term response is not
curtailed through the hypothalamic-pituitary-adrenal
(HPA) feedback loop or when the demand exceeds the per-
son’s capacity to respond, a number of changes occur which
can sometimes lead to physical and mental illness (Adinoff,
Iranmanesh, Veldhuis & Fisher, 1998).
Stress and Mood
Everyone at some point experiences sadness or the blues.
There are multiple causes for these feelings including situ-
ational circumstances such as losing a loved one, a job or
even by the weather which when wet and dreary can cause
a condition known as seasonal affective disorder syndrome
(SADS). Generally people will find social support, or a
coping activity that help them to improve their mood.
These activities vary from shopping to movies, exercise, and
recreational activities. The growing use of CVGs may be
directly related to their ability to assist in decreasing stress
and improving mood without the potential negative side
effects of other choices.
Depression is a clinical term used to describe extreme neg-
ative mood characterized by persistent sadness and impair-
ment in functioning. According to the National Institute
of Mental Health approximately 20.9 million American
adults, or about 9.5 percent of the U.S. population age 18
and older in a given year, have a mood disorder. Major
depression affects 14.8 million adults and is the leading
cause of disability for ages 15-44. Dysthymic disorder
affects approximately 1.5 percent of the U.S. population
age 18 and older in a given year or 3.3 million American
adults. The median age of onset of both disorders is
approximately 30 years (National Institutes of Mental
Health, 2008).
While individuals experiencing depression do not all
exhibit the same symptoms or the intensity, frequency and
duration there are commonalities that provide criteria to
define the disorder and those are: persistent sad, anxious or
Casual Video Games, Stress and Mood
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"empty" feelings; feelings of hopelessness and/or pes-
simism; feelings of guilt, worthlessness and/or helplessness;
irritability, restlessness; loss of interest in activities or hob-
bies once pleasurable, including sex; fatigue and decreased
energy; difficulty concentrating, remembering details and
making decisions; insomnia, early–morning wakefulness, or
excessive sleeping; overeating, or appetite loss; thoughts of
suicide, suicide attempts.
Stress and depression are inexorably intertwined. The com-
bined effect has dramatic physical and psychological conse-
quences. It is important therefore to develop and test new
interventions to determine if they can decrease stress and/or
improve mood. These interventions may eventually help
people manage their allostatic load and help ameliorate
symptoms of stress related medical disorders like cardiovas-
cular disease and depression.
Preliminary evidence suggests that non-pharmacological
interventions can help facilitate ANS and HPA balance
and thereby decrease stress and improve mood. For exam-
ple mindfulness-based stress reduction significantly
improved quality of life, symptoms of stress and sleep in
those with early stage breast and prostate cancer (Carlson,
Speca, Patel & Goodey, 2003). When researchers meas-
ured cytokine changes they found that T cell production
of IL-4 increased and IFN-y decreased. In addition, NK
cell production of IL-10 also decreased, prompting them
to conclude that there was a shift from one immune pro-
file associated with depressive symptoms to a more normal
immune profile. Using the same intervention another
study reported an overall reduction in mood disturbance
(65%) and a (31%) decrease in stress symptoms (Speca,
Carlson, Goodey & Angen, 2000).
Other novel interventions like music have been shown to posi-
tively affect the immune system. Significant increases in secreto-
ry immunoglobulin-A (S-IgA) were found after listening to
recorded, classical music (Abrams, 2001) and using music as a
vehicle for relaxation, researchers found IL-6 levels were signif-
icantly lowered afterwards whereas IL-1b, Il-10 remained
unchanged (Stefano, Zhu, Cadet, Salamon, Manitone, 2004).
Esch and colleagues report that complementary and alternative
medicine (CAM) therapies are important in producing ANS &
HPA balance as well as positively impacting the immune
response (Esch, Massimo, Bianchi, Zhu & Stefano, 2003; Esch,
Fricchione & Stefano, 2004).
Recreational activities provide a wide array of health ben-
efits and, as a result, have been used by humans since the
beginning of recorded history for excitement, relaxation,
fitness, sport, meditation and fun (O’ Morrow, 1989).
Among the numerous studied benefits are social interac-
tion and physical activity(Wankel, L. M., & Berger, B. G.
1990), mental distraction (Wassman & Iso-Ahola, 1985),
and laughter (Stone, 1992). In general, good things hap-
pen to people when they are having fun. Psychological
constructs attempting to explain the benefits of recreation
include a positive mental state coupled with a feeling of
relaxation and being in balance. One psychologist called
this hyper-focused state "flow,” noting that participants
in a variety of recreational activities consistently report
positive mental outcomes (Csikszentmihalyi, 1997). The
physiological processes that underlie the psychological
balanced state known as flow are very important as
knowledge of them will help with the understanding of
these types of interventions but we are just beginning to
see the connections.
A preliminary link between the HPA (hypothalamic-pitu-
itary-adrenal) axis, mood and recreation has been estab-
lished with decreases in cortisol and mood reported after
therapist directed recreational activity (Russoniello, 1991;
2008). According to the findings of these studies, which
involved adults being treated for acute alcoholism, recre-
ational activities can decrease stress and improve mood. The
findings revealed that plasma cortisol levels were signifi-
cantly lowered after participation in low physical intensity
board games/card games and produced an autonomic nerv-
ous system relaxation response. Casual video games have
become the board and card games of today. Many are very
similar to the board games of yesteryear, they are simply
modernized for today’s Internet based world. This study
tested whether there would be a similar autonomic nervous
system response while playing CVGs. If there is a consis-
tent integrated positive HPA axis response while playing
casual video games similar to board games then this poses
the intriguing possibility of prescribing CVGs to ameliorate
stress related medical disorders.
Formal research surrounding video gaming has been
focused primarily on negative effects such as violence and
addiction (Anderson & Bushman, 2001; Lee & Vessey,
2000; Clay &. Richards 2005; Funk, 2005; Wallenius,
Punamäki & Rimpelä. 2007). There are just a few studies
Russoniello, O’Brien and Parks
JCR_inga_3:Layout 1 12/06/09 17:39 Page 55
that mention positive effects of gaming such as a means
to; develop social relationships (Hutchinson, 2007), facilitate
education (Simpson, 2005) development skills and multi-task-
ing (Agosto, 2004). Little is known about the positive health
effects of CVG play and even less about the physiological
processes or health benefits that underlie participation.
The purpose of the study was therefore to determine
whether casual video games could improve mood and/or
decrease stress in players using valid and reliable psycholog-
ical and physiological measures. Specifically this study test-
ed whether playing three popular casual video games;
Bejeweled 2 (BJW 2), Bookworm Adventures (BWA)
and/or Peggle (PGL) could change the autonomic and cen-
tral nervous systems consistent with decreased stress and
improved mood.
One hundred and forty three (n=143) participants were
recruited for the study and one hundred and thirty four
(n=134) were included in the data analysis. Nine partici-
pants were excluded, as data was unsalvageable due to
improper data collection (sensor came off, software was
mistakenly not started). There were 57 females and 44
males. The average age of all participants was 24 years.
Participants were recruited from fliers placed in and
around the campus community. Most of the subjects were
students, faculty members and staff at the university. The
study was explained to the participants who signed an
informed consent form before being included. Participants
then supplied demographic information and completed
the Profile of Mood States questionnaire. At this point, an
envelope with random assignments was opened by the par-
ticipants. This revealed their designated group. If assigned
to the experimental group participants chose one of three
casual video games to play. If assigned to the control group
participants completed an Internet task that involved
searching for articles on health related topics and placing
them in a folder on the desktop.
Experimental participants chose which game that they
wanted to play from three popular video games that met
the functional definition of a CVG. BJW 2 is a matching,
sequencing game where participants string together jewel-
like objects for points. PGL is a pachinko/pinball type of
game that allows participants to gain more control as they
clear strings of multi-colored balls for points and BWA is a
crossword/scrabble type puzzle game where participants
gather points by building words and progress through an
animated adventure. Once a game was chosen, sensors were
connected and signals were checked, participants played
the game uninterrupted for twenty minutes.
The control participants were seated in front of the same
computer in the same chair and hooked to measuring
equipment in the exact manner as the experimental group.
The control group was then instructed to surf the internet
looking for articles related to health and to put them into a
file on the desktop for twenty minutes.
Measurement of Mood
It was hypothesized that playing casual video games
would result in decreases in left frontal alpha power,
increases in right frontal alpha power and overall alpha
symmetry when compared to controls. Increases in alpha
power in the left hemisphere are associated with nega-
tive mood, depression and avoidance/withdrawal behav-
iors. Conversely, decreases in left alpha power improve
mood and decrease avoidance/withdrawal behaviors.
Decreases in right hemisphere alpha power are also asso-
ciated with negative mood. Conversely, increases in right
alpha power improve mood and increase
approach/engage behaviors. The ratio between right and
left brain alpha has also been used to measure emotion-
al stability/mental relaxation (Davidson, 1988: Fox, 1991
and Monastra, 2003).
Some therapies have been successful in helping people
change dysfunctional brain activity associated with
depression and stress to positive states associated with
relaxation and alertness (Field, Grizzle, Scafidi, Abrams,
Richardson, Kuhn, & Schanberg, 1996; Field, Grizzle,
Scafidi, & Schanberg, 1996; Field, Ironson, Scafidi,
Nawrocki, Goncalves, Pickens, Fox, Schanberg & Kuhn,
1996 and Marshall & Fox, 2000). In this study the effects
of CVG play on mood were tested to determine if they
would produce similar results using EEG measurements
and following the alpha/mood assessment protocol estab-
lished and tested by Davidson (1988). Changes in the
CNS or alpha brain wave activity were recorded using a
10 channel electroencephalography device (Mind Media
Corporation, 2008).
All participants were prepared by locating and marking F3,
F4 and CZ using the 10/20 standard measurement cap.
The sensor placement sites were cleaned using alcohol
Casual Video Games, Stress and Mood
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pads. Active EEG leads were placed at F3 and F4. The ref-
erence sensor was placed at CZ. The ground lead placed on
C7. Signal impedance was kept below 25,000K Ohm per
manufacturers recommendations for alpha recordings. In
addition, the EEG signal was visibly inspected prior to
recording for extraneous signal noise. If necessary, adjust-
ments were made before data recording began.
To quantify emotional changes participants completed a
self-administered psychological assessment of mood using
the Profile of Mood States (POMS) assessment. The
POMS (McNair, Lorr & Droppleman, 1981), is a factor
analytically derived inventory that measures six subscales:
tension, depression, anger, vigor, fatigue, and confusion and
can be used with “Last Week” and “Right Now” administra-
tions. Internal consistency for the POMS has been report-
ed at .90 or above. Test re-test reliability is reported
between .68 and .74 for all factors. Construct and predic-
tive validity have been established in four areas: brief psy-
chotherapy, controlled outpatient drug studies, studies of
response to emotional conditions and studies of concurrent
validity coefficients and other POMS correlates (McNair,
Heuchert & Shilony, 2003).
Measurement of Physical Stress
Heart Rate Variability (HRV) is a physiological measure-
ment that directly reflects a balance of the autonomic
nervous system regulation, which has control over the
human body. HRV is a multidimensional measurement of
sympathetic and parasympathetic nervous system inner-
vations of the heart. HRV reflects the state of sympathet-
ic (stress, anxiety) or parasympathetic (relaxation, calm-
ness) activation in the body. Heart rate variability (HRV)
is considered a marker of cardiac parasympathetic and
sympathetic activity and is of great interest to health care
practitioners (Malliani, Lombardi & Pagani, (1994);
Kleiger, Stein, Bosner & Rottman, (1992); Pomeranz
Macaulay & Caudill, (1985).
Heart rate variability (HRV) provides an accurate assess-
ment of autonomic nervous system stress based upon vari-
ability in the inter-beat interval of heart beats (Task force
of the European Society of Cardiology and the North
American Society of Pacing and Electrophysiology, 1996).
A robust HRV is associated with balance between the sym-
pathetic and parasympathetic branches of the autonomic
nervous system (ANS). In this study HRV changes were
used as a measure of ANS change (Hayano, Sakakibarea, &
Yamada, Yamada, Mukai, Fujinami, Yokoyama, Watanabe
& Takata, 1991). HRV was recorded during the entire ses-
sion using a small ear clip sensor. Both time and frequency
parameters of HRV were used to determine the effects of
CVGs on the ANS.
HRV was recorded using photoplethysmography (PPG)
technology. PPG was developed in the 1960’s and 1970’s
by psychophysiology researchers. PPG is based upon the
premise that all living tissue and blood have different
light-absorbing properties. PPG works by placing a pho-
tocell clip on the participant’s ear that converts light to
electrical energy. The blood in the ear lobe scatters light
in the infrared range, and the amount of light reaching
the cell is inversely related to the amount of blood in the
ear lobe. Hence, when blood vessels in the earlobe dilate,
the increased blood flow allows less light to reach the
photocell, when blood vessels constrict, blood flow is
decreased and increased light reaches the photocell
(Cohen, 1995).
PPG measures pulse volume or phasic changes, which are
related to beat variations in the force of blood flow. These
beat-to-beat changes in peripheral blood flow reflect the
heart’s interbeat intervals similar to ECG. PPG there-
fore, gives summary information reflecting both cardiac
and blood vessel components and is an accurate measure
of cardiac function when compared to electrocardiogra-
phy (Cohen, 1995; Russoniello, Mahar, Rowe,
Pougatchev & Zirnov, 2003).
A repeated measures design was employed to study the
impact of different games on the variables and to contrast
with the control group. Since the experimental and the con-
trol group both did activities requiring similar physical and
cognitive involvement, and the study was exploratory in
nature, the level of significance was set at p=<.1. The least
significant difference (LSD) was used for the post hoc
analysis. Cohen’s Delta or d (Cohen, 1988) is a measure of
effect size or the standard mean difference. Cohen’s d is a
standard measure used to calculate treatment effect and
describes differences in means relative to an assumed com-
mon variance. According to Cohen, effect size changes can
be classified as: small (.20); medium (.50); and large (.80).
In this study Cohen’s d was used to show large changes oth-
erwise not detected due to large variances.
Russoniello, O’Brien and Parks
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Participating in CVGs produces changes in brain waves
consistent with improved mood. Remarkably, different
games affected brain waves in unique ways. For example
BJW 2 players (Table 1) experienced significant decreases
in left alpha power when compared to controls. Participants
who played PGL experienced significant increases in right
alpha power while playing (Table 2) but did not statisti-
cally differ from the control group due to very large vari-
ations in individual brain waves. Cohen’s d, used to statis-
tically equalize differences between groups (d= 1.8), illus-
trates there was a very large difference between PGL and
control groups.
Casual Video Games, Stress and Mood
Left Alpha
md sd df p
Group (n=22)
.99 1.5 25 .50
Bejeweled 2
-3.3 1.3 31 .014
Significantly differs from control p=.032
Table 1
Alpha Ratio
md sd df p
Group (n=22)
.17 .19 21 .37
Bejeweled 2
.31 .19 25 .093
Significantly differs from control p=.071
Table 3
Right Alpha
md sd df p
Group (n=22)
.427 10 21 .996
Bejeweled 2
17.9 9 28 .048
Table 2
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Playing BWA significantly improved the right/left brain
alpha ratio (Table 3) another indicator of improved mood
and the changes were significantly different from control.
All three games improved mood and affected alpha brain
wave activity differently.
Changes in psychological mood reported on the POMS cor-
roborated EEG findings as the overall impact of all three
games significantly differed from the control group (p=.007).
BJW, BWA and PGL pre-post game changes and compar-
isons with the control group are presented in (Table 4).
Russoniello, O’Brien and Parks
md sd df p
Group (n=31) 2.6 2.4 30 .284
7.9 2.5 28 .000
Bejeweled II
-11.3 2.3 37 .002
(n= 36) -14.9 2.3 35 .000††
Significantly differs from control p=.009
†† Significantly differs from control p=.000
Table 4
Changes in
md sd df p
Group (n=31) -1.6 .70 30 .022
-7.9 2.5 28 .005
Bejeweled II
-11.3 2.2 37 .000
(n= 36) -14.9 2.3 35 .000
Significantly differs from control p=.026
Table 5
Individual POMS subscales, tension, depression, anger, vigor, fatigue and confusion changed as follows.
Participants reported significant decreases in POMS tension (Table 5) after each game. Overall, CVGs reduced tension
versus control (p=.003). Participants that played PGL reported the largest decreases in tension.
JCR_inga_3:Layout 1 12/06/09 17:39 Page 59
Changes in
md sd df p
Group (n=31) -.77 .56 30 .169
-1.0 .58 28 .076
Bejeweled II
-2.2 .50 37 .000††
(n= 35) -2.1 .53 34 .000
Significantly differs from control p=.084.
††Significantly differs from control p=.069.
Table 7
Changes in
md sd df p
Group (n=31) -1 .58 30 .084
-1.7 .59 28 .004
Bejeweled II
-1.6 .52 37 .002
(n= 36) -1.8 .53 35 .001
Table 6
POMS Anger scores decreased after all three CVGs (Table 7). BJW 2 and PGL significantly differed from the control
group. The reductions in anger are contradictory to the notion that all video games provoke violence.
Participants reported decreases in the POMS Depression sub scale scores after all three games (Table 6). While none of
the games statistically differed from the control, secondary analysis with Cohen’s d revealed large decreases in depression
scores after all three, PGL (d= 1.4); BWA (d= 1.2); BJW 2 (d= 1.1) games when compared with the control group.
The overall effect of all three CVGs and control in increasing vigor was statistically significant (p=.018). Individual games
changes are presented in Table 5. Changes in vigor after playing BJW 2 were statistically different from the control group.
Casual Video Games, Stress and Mood
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Changes in
md sd df p
Group (n=31) -1.4 .79 30 .180
-1.5 .72 28 .865
Bejeweled II
-.14 .81 37 .037
(n= 36) -.34 .74 35 .643
Significantly differs from control p=.007
Table 8
Changes in
md sd df p
Group (n=31) -1.4 .53 30 .010
-.18 .55 28 .001
Bejeweled II
-2.8 .48 37 .000
(n= 36) -3.6 .49 35 .000††
†Significantly differs from control p=.053
††Significantly differs from control p=.003
Table 9
The overall effect of CVGs on fatigue versus control was statistically significant (p=.061). Individual games changes are
listed in Table 9. BJW 2 and PGL both had significant positive impacts on fatigue versus control.
Russoniello, O’Brien and Parks
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Changes in
md sd df p
Group (n=31) -.26 .46 30 .576
-1.2 .48 28 .010
Bejeweled II
-2.0 .42 37 .000††
(n= 36) -2.3 .43 35 .000††
†Significantly differs from control p=.025
††Significantly differs from control p=.000
Table 10
†Significantly differs from control (p= .051)
Table 11. Heart Rate Variability Changes
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
HF/LF -.24 .32 29 .46 .6 .28 39 .034
Casual Video Games, Stress and Mood
In this study the game BJW 2 had the greatest impact of all
three games on physical stress. Participants who played
BJW 2 experienced statistically significant decreases in
ANS activity with corresponding increase in variables asso-
ciated with positive cognitive engagement. All HRV
parameters changed significantly when measured pre-post
game play including TP (p. = 003). When compared to
control participants BJW 2 players experienced
decreases in: heart rate (d= 1.3), VLF (d= 1) and corre-
sponding increases in LFN (d= 1.6) and LF/HF ratio
(d= 1.2). These findings support the theory that some
CVGs do decrease physical stress and presents a possi-
bility that CVGs produce a “more power with less
effort” ANS effect.
The overall effect of all three games on confusion (Table 10) was statistically significant (p=.09). BWA, BJW 2 and PGL
all significantly decreased confusion when compared with the control group. The improvement in cognition was very dra-
matic and begs the question of whether these games could assist in Alzheimers and other dementia type disorders.
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Changes in EEG recorded in this study support the
hypothesis that playing a CVG of your choice can improve
your mood and decrease your stress. Remarkably all three
games had different yet complimentary mood lifting
effects. BJW 2 decreased left alpha brain waves associated
with a decrease in withdrawal and depressive type behaviors
and PGL increased right alpha brain wave activity associ-
ated with excitement or euphoric behaviors. BWA on the
other hand increased the stability of alpha brain waves
between the left and right side of the brain.
The POMS scores on Total Mood Disturbance significant-
ly changed for all three games supporting the theory that
while there were effects on brain wave activity in different
parts of the brain, the end result was improved perceived
mood. Significant subscale changes in anger, tension, vigor,
depression, fatigue and confusion by different games and not
by others again seems to infer that there are specific changes
associated, to a degree, with particular games and not so
much with others. If these finding are consistently upheld
then protocols with treatment specificity could be developed
to take advantage of CVGs that produce specific results.
Changes in HRV during BJW 2 were consistent with a
recent report by Peng, Henry, Mietus, Hausdorff, Khalsa,
Benson, & Goldberger, (2004) in which they revealed that
TP and low frequency norms increased while very low fre-
quency activity decreased after the relaxation response and
meditation exercises. When changes after BJW 2 were
compared with the control group a similar “more power
with less exertion” profile emerged, which provides a poten-
tial framework for future research.
Many modern medical disorders are stress related and the
need for effective interventions that are low cost and help
ensure compliance is high. The potential of CVGs to
become an intervention is encouraged by the results of this
study. Future studies can build upon this work by studying
the impacts of CVG play on conditions such as depression,
anxiety, autism, and stress related medical disorders such
diabetes and cardiovascular disease.
The limitations of this study included a lack of measure-
ment for respiration and the variability of physiological
data which, in some cases, made it difficult to determine
changes if they existed. In future studies blue tooth tech-
nology should be used to reduce lead noise. Respiration rate
should be recorded to determine its impact on HRV vari-
ables. When possible neuroendocrine markers like cortisol
or salivary amylase should be added to get a psychoneu-
roendocrine picture of changes.
Finally, psychophysiological measurement provides a
method for understanding the mind/body effects of games
and can therefore help in game modification and develop-
ment. For instance while a person is being measured phys-
iologically their reactions to different aspects of the game
are recorded. These can be relaxing or stressed reactions or
they can be excitement. Depending on the goal of the game
a programmer could increase or decrease the amount of a
certain variable (i.e. music, visuals etc.) to increase or
decrease the effect. A game that is physiologically tailored
to meet individual specific human needs seems plausible in
the near future.
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... Yee et al. [27] found some contrasting results; achievement and social motivations were negative predictors of quests, exploration, and professions, with achievement being the only negative predictor for world events; both achievement and social motivation were positive predictors of dungeons; immersion was a positive predictors of doing quests and exploration, but it was a negative predictor of PvP and dungeons. 144 Human Behavior and Emerging Technologies Table 6: The table reports how many studies found positive and negative correlations for each motivation and also how many found that motivation to be a positive predictor of hours played per week. Loss-aversion 43 --(n =1) Hilgard et al. [34] found it to be the best predictor for people who played less 145 Human Behavior and Emerging Technologies that could not fit inside all the other clusters outlined before such as sociodemographic, behavioural, and psychological ones. ...
... This overview could be helpful for different purposes: (a) it is found that there is no difference between addicted and nonaddicted players in terms of gaming motivation. It is known that motivation is the most important key in treatment, and clinical researcher could use these information to use videogames as a way to promote a healthy lifestyles, to reduce stress [144], to increase physical activity in sedentary people [145,146], for educational purposes by learning useful information [147,148], or for therapy with children with special educational needs, ADHD, or neurodevelopmental disorder [149,150]. As stated, motivation is strictly related to age and gender; thus, this systematic review could help in identifying which games with which characteristics could be helpful for the target population. ...
Full-text available
Nowadays, video games are part of our everyday life, and the number of players is increasing each day passing by. Thus, understanding what motivations drive people to play video games is becoming a very important topic for researchers. That is why this systematic review had the objective to summarize the existing literature about gaming motivation by including papers that used a validated tool to do so while excluding those that did address just the psychopathological aspect of gaming. The systematic review was carried out through the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRSIMA). A total of 53 papers were included in this systematic review, and the findings revealed that nonaddicted players and addicted players seem both to play for social, achievement, and competition motivations. Male players appeared more oriented to play to compete with others, while female players seemed to use games for relationship and social reasons. Gaming motivation was stronger in younger people.
... Other researchers state that socializing counters the deterioration of Theory-of-Mind abilities [5]. Medical studies on playing video games prove the following effects: the decrease of withdrawal and depressive type behaviors and the stimulation of excitement and euphoric behaviors [6]. It's been concluded that casual video games are comparable in effect with mindfulness-meditation, helping with decreasing blood pressure and the heart rate, while also provoking "decreases in an individual's reactivity towards a negative emotional stimulus" [7]. ...
Full-text available
In order to gain insight into how to create a successful game, a developer should learn about the end user of the product, the player. For this exact reason, there must be a deeper understanding of the effects games can have on the one who plays them. The main question addressed in this paper is “How can the games positively affect the player on a psychological and emotional level?”. This question has been divided into 3 different sub-question. To answer them, a combination of thematic analysis and literature study was used. Multiple studies have been previously made on the relationship between video games and the human mind, either focusing on the negative or on the positive effects. This paper has a new approach, consisting of dividing the benefits into categories determined by the main reason a player chooses to play games. The main 6 categories were established empirically, and 200 answers were arranged under the category most fitting for each. A total of 14 benefits were found for the previously mentioned categories. Additionally, 5 less noticeable benefits have been included into a new category.
... However, they do seem like a highly feasible method for in situ assessment of cognitive impairment [26]. Typical entertainment games that do not have an evidence-based foundation had also shown a positive effect on mood [27] or symptoms of post-traumatic stress [28] and depression [29] when nothing else was available. VR serious games are the ultimate rage in regards to a serious game format. ...
... The games usually elicit such effects via the narrative that guides the gameplay. For instance, video games hold the potential to have a positive emotional impact, e.g. by increasing perceived well-being and emotional stability, providing an opportunity to 'let off steam', and reducing stress (Johnson et al, 2013;Hazel et al, 2022;Russoniello et al, 2009). Some video games have been used as therapy tools, for instance to facilitate a more positive self-perception in patients with depression (Fleming et al, 2016;Rosenberg et al, 2011;Carras et al, 2018). ...
Full-text available
Although a causal link between gaming and radicalization could not be established thus far, thevexploitation of gaming by extremist actors has become a growing concern. P/CVE practitioners invparticular are devoting an increasing amount of attention to the issue. This report reviews existingvliterature on the positive effects of gaming in light of the specific needs of the P/CVE field and deducesvrecommendations for practitioners seeking to develop a bespoke game for the P/CVE context.
... Whilst pre-match activity duration was not measured in chapters 6 & 7 of the thesis, it is unlikely that professional male and academy players would be able to continuously use their smartphones 30/45-min in the two hours leading up to kickoff. Conversely, the use of video games has been associated with increased mood and reduced stress in university students (Russoniello, O'Brien, & Parks, 2009). Indeed, found that university students playing the popular video game FIFA 15 reported no impact on mental fatigue. ...
... Neben den physischen Einflüssen hat das Videospielen ebenfalls Auswirkungen auf die Psyche und den Schlaf. Einerseits kann das Spielen von Videospielen zur Entspannung beitragen, Stress reduzieren oder die Stimmung anheben [24]. Andererseits können die mit dem Videospielen einhergehenden langen Sitz-und Bildschirmzeiten einen negativen Einfluss auf das Schlafverhalten und somit indirekt auf die kognitive Leistung haben [29]. ...
Full-text available
Background Playing video games before going to bed may have an impact on the quality and quantity of sleep.Objectives The determination of factors that are influenced by playing video games and how these factors can be made measurable.Methods Recent studies were analyzed and discussed to conduct an overview and create recommendations for practice.ResultsEspecially in children and adolescents, playing video games before going to bed leads to an increased sleep onset latency and an overall increase in fatigue. Decisive factors are the screen brightness (exposure of blue light) and the activation of the sympathetic nervous system caused by playing video games. Action video games in particular can lead to a greater activation than calmer video games or watching a movie.Conclusion In summary, video gaming can have a negative impact on the sleep of video gamers. Prolonged sleep onset latency and reduced deep sleep phases can occur because of video gaming in the evening. Especially sympathicotonia appears to play a more dominant role than blue light exposure. Children, adolescents, and professional video game players are potential risk groups and thus need to be educated about responsible video game behavior. Various parameters can be used to quantify sympathetic nerve activity. In particular, heart rate variability is a feasible parameter.
... Playing video games has also reduced hostile feelings and improved one's mood [9,18]. Even simple games have reduced treatment-resistant depression symptoms [38], stress [39] and physical pain [14,36]. ...
During the COVID-19 pandemic, video game playing increased exponentially. The question if playing could offer benefits to cope with the pandemic stressors emerged. This study compares how non-players and players who may or may not re-experience (e.g., seeing, hearing) game content after playing [i.e., Game Transfer Phenomena (GTP)] cope with the pandemic stressors, emotion regulation and resilience. It also examines the impact of GTP on the perception of self and the world. A total of 567 completed a survey (59.6% male, MeanAge = 28.55). The measures include emotional regulation (ERC), resilience to stress (BRCS) and fear of contamination (PI). No differences between players and non-players on ERC, BRCS and PI were found. Players with moderate GTP levels were more likely to report contamination fears and show preventive COVID coping behaviours. The positive impact of GTP was associated with high resilience and cognitive reappraisal as an emotion regulation strategy. The results suggest that attention should be paid to players who experience GTP more frequently and with a negative impact. Maladaptive coping styles can exacerbate distress from GTP and situational stressors. Identifying methods of protecting vulnerable individuals from these psychological burdens can guide interventions and mitigate consequences in similar situations.
İnternet ve teknoloji bağımlılığı günümüzde salgının etkisi ile beraber çok ciddi problem haline gelmiştir. Araştırma kapsamında teknoloji bağımlılığına müdahale etmek amacına ilişkin araştırmacı tarafından geliştirilmiş olan “Pozitif Psikoloji ve Pozitif Psikoterapi Yönelimli Psikoeğitim Programı” ile bağımlılık problemine müdahale edilmesi amaçlanmıştır. Bu kapsamda “Pozitif Psikoloji ve Pozitif Psikoterapi” yaklaşımları esas alınmıştır. “Pozitif Psikoloji ve Pozitif Psikoterapi” yaklaşımı ile bireylerin yaşamlarında yer alan “ilişki, başarı, beden ve maneviyat” boyutları ile denge kurabilmesini sağlayarak internet bağımlılığı sorununun çözülmesi amaçlanmıştır. Bu araştırma, deneme modelinde olup gerçek deneme modellerinden olan ön-test/son-test kontrol guruplu model olarak tasarlanmıştır. Desende bağımlı değişken Teknoloji Bağımlılığı, Duygusal Zekâ Puanları ve Mutluluğu Artırma Stratejileri puanlarıdır. Bireylerin Teknoloji Bağımlılık Düzeylerine ve Duygusal Zekâlarına ve Mutluluğu Artırma Stratejilerine etkisi incelenen bağımsız değişken ise Pozitif Psikoloji ve Pozitif Psikoterapi yönelimli grupla psikolojik danışma programıdır. Çalışmada deney grubuna seçilen teknoloji bağımlılık puanı yüksek, duygusal zekâ düzeyi ve mutluluğu artırma stratejileri puanı düşük bireylere Pozitif Psikoloji ve Pozitif Psikoterapi temelli grupla psikolojik danışma programı uygulanırken, kontrol grubundaki bireylere herhangi bir program uygulanmamıştır. Araştırmacı tarafından uygulanan 13 haftalık Grupla Psikolojik Danışma Programı Pilot Çalışmasının bulguları şu şekildedir. Deney grubundaki bireylerin İnternet Bağımlılığı Ölçeği (İBÖ), Duygusal Zekâ Özelliği Ölçeği (DZÖÖ) ve Yetişkinler İçin Mutluluğu Artırma Stratejileri Ölçeğinin (YİMAÖ) ön test ve son test puanları arasında anlamlı bir farklılık görülmüştür (p
The purpose of this controlled study was to determine whether prescribed recreation activity (RA) could decrease stress and improve mood. The study involved 20 male and female participants who were in alcohol rehabilitation. Ten participants served as matched controls. Treatment consisted of three groups of RAs classified according to physical intensity or the amount of oxygen required to perform them. Prescribed RAs (RXA) lasted 20 minutes and included three intensity levels. Biochemical analyses were coupled with psychological changes to test the study hypothesis. Results of the study indicated that participation in the RXAs reduced depression in the experimental group when compared with the control. Overall mood as well as its subcomponents, anger, tension, depression, fatigue, and vigor scores improved after both the low intensity (RXA1) and moderate intensity (RXA2) interventions. RXA1 and RXA2 interventions also produced statistically significant reductions in cortisol, a biochemical marker of stress. It is, therefore, concluded that prescribed RAs can produce biochemical and psychological changes consistent with decreased stress and improved mood. The ability to evoke positive physiological and psychological changes by more natural and less addicting behaviors provides rationale for this type of intervention as a potential complementary and alternative medicine. The findings of this study underscore the importance of recreational therapy in the treatment of alcoholism and other stress-related medical disorders.
Spectral analysis of spontaneous heart rate fluctuations were assessed by use of autonomic blocking agents and changes in posture. Low-frequency fluctuations (below 0.12 Hz) in the supine position are mediated entirely by the parasympathetic nervous system. On standing, the low-frequency fluctuations increase and are jointly mediated by the sympathetic and parasympathetic nervous systems. High-frequency fluctuations, at the respiratory frequency, are decreased by standing and are mediated solely by the parasympathetic system. Heart rate spectral analysis is a powerful noninvasive tool for quantifying autonomic nervous system activity.
This introductory chapter gives an overview on the biological bases of the stress response. The major components of the stress response system are the corticotropin-releasing hormone (CRH) and the locus coeruleus (LC)-noradrenaline/autonomic system with their peripheral effectors, the pituitary-adrenal (HPA) axis and the autonomic system. After an introduction on stress, the chapter discusses the physiological stress research encompassing the origin of stress research, definitions of stress, stress research, and McEwen's concept of allostatic load, along with the major components of biological stress response system. In the body, the stress system interacts with several other important physiological systems. Therefore, other stress-responsive classical endocrine axes like the hypothalamus-pituitary-gonadal (HPG) axis, the hypothalamus-pituitary-growth hormone (HPGH) axis, the hypothalamus-pituitary-prolactinergic (HPP) system, and the hypothalamus-pituitary-thyroid (HPT) axis are also introduced. Furthermore, two important stress-responsive systems, the immune system and the blood coagulation system, are addressed.
Forty full-term 1- to 3-month-old infants born to depressed adolescent mothers who were low socioeconomic status (SES) and single parents were givn 15 min of either massage (n = 20) or rocking for 2 days per week for a 6-week period. The infants who experienced massage therapy compared to infants in the rocking control group spent more time in active alert and active awake states, cried less, and had lower salivary cotisol levels, suggesting lower stree. After the massage versus the rocking sessions, the infants spent less time in an active awake state, suggesting that massage may be more effective than rocking for inducing sleep. Over the 6-week period, the massage-therapy infants gained more weight, showed greater improvement on emotionality, sociability, amd soothability temperament dimensions and had greater decreases in urinary stress catecholamines/hormones (norepinephrine, epinephrine, cortisol).
In this article the author explores the construction of place within virtual worlds and, in particular, in video games that appeal widely to children and youths. With the notable exception of "edutainment" titles, gaming and education have traditionally been viewed as separate pursuits. Yet, after school, millions of children and teens spend inordinate amounts of time immersed in virtual worlds that invite exploration and reward. Although they are ignored or, worse yet, dismissed by many adults, video game environments are valued place contexts for millions of young people. The author explores the elements of design that make virtual worlds so attractive to gamers and suggests strategies for incorporating video games into educational programs in a pedagogically sound way.