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1.
Games Health J ; 8(5): 332-338, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31216188

ABSTRACT

Objective: The goal of this month-long controlled study was to compare the efficacy of a second antidepressant (sAD) medication with a prescribed regimen of Plants vs. Zombies™ (PvZ), a casual videogame, in reducing treatment-resistant depression symptoms (TRDS) and improving heart rate variability (HRV). Materials and Methods: Approximately ∼8 weeks after beginning antidepressant therapy, participants returned to psychiatrists for evaluation and complained of TRDS. The psychiatrist gave them a choice of self-selecting a sAD medication or playing a prescribed regimen of PvZ as part of a research study. Those who agreed were referred to researchers who then screened them for major depression, the criteria for inclusion. PvZ was prescribed four times per week for 30-45 minutes over 4 weeks. Self-reported data were collected at four different times utilizing the Patient Health Questionnaire-9. HRV, an indicator of autonomic nervous system (ANS) functioning, was also recorded each time. Results: The sAD group's TRDS significantly improved. Remarkably, the PvZ group's TRDS improved significantly beyond the control group at all measurement times except for time 1 or baseline. In addition, a single 30-minute session of playing PvZ was significantly more effective in acutely reducing TRDS when compared with the sAD group that surfed the NIHM website on depression. Changes in HRV parameters indicated increased parasympathetic engagement and ANS balance in the PvZ group compared with the sAD group. Discussion: The findings illustrate the potential of PvZ as an acute and chronic intervention for reducing TRDS. Health care practitioners such as physicians and recreational therapists can consider recommending a regimen of prescribed PvZ play as a method to ameliorate symptoms of depression for those clients who self-select this option. Finally, a psychophysiological method for measuring the efficacy of videogames in reducing TRDS and a means to quantify ANS changes during gameplay are presented.


Subject(s)
Antidepressive Agents/standards , Depressive Disorder, Treatment-Resistant/therapy , Video Games/standards , Adult , Antidepressive Agents/therapeutic use , Depressive Disorder, Treatment-Resistant/psychology , Female , Heart Rate Determination/methods , Humans , Male , Middle Aged , Psychometrics/instrumentation , Psychometrics/methods , Surveys and Questionnaires , Video Games/psychology
2.
Games Health J ; 3(5): 291-5, 2014 Oct.
Article in English | MEDLINE | ID: mdl-26192483

ABSTRACT

OBJECTIVE: Anxiety is a natural reaction to stress, but when excessive, it can develop into a debilitating disorder. Traditional treatments such as pharmaceuticals and psychotherapy have demonstrated efficacy in alleviating anxiety symptoms but are often costly and stigmatizing. This study tested whether a regimen of prescribed casual videogame (CVG) play could reduce individuals' anxiety symptom severity in a depressed population. CVGs are defined as fun, easy to play, spontaneous, and extremely popular. MATERIALS AND METHODS: Data were taken from a larger study on depression and CVGs. Participants were screened for depression using a score of ≥5 (mild depression) on the Patient Health Questionnaire-9. After completing pre-intervention questionnaires, participants were randomized into the experimental (n=30) or control (n=29) group. Participants in the experimental group were prescribed a CVG of their choice to play three times per week, for 30 minutes, over a 1-month period. The State Trait Anxiety Inventory (STAI) was used to test the hypothesis. RESULTS: Repeated-measures analysis of variance revealed significant interaction of group by time for state and trait anxiety measures, supporting the hypothesis that anxiety severity would be different by group post-intervention. When state and trait anxiety measures were compared using within-subjects contrasts and between-group analyses, significant decreases in anxiety symptom severity were demonstrated. CONCLUSIONS: A prescribed regimen of CVG play significantly reduced state and trait anxiety symptom severity as measured by the STAI. Clinicians should consider using these easy-to-use and low-cost CVGs to address symptoms associated with state and trait anxiety.

3.
Cyberpsychol Behav Soc Netw ; 16(4): 302-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23574369

ABSTRACT

Accurate and inexpensive psychophysiological equipment and software are needed to measure and monitor the autonomic nervous system for gaming and therapeutic purposes. The purpose of this study was to determine whether heart rate variability (HRV) derived from photoplethesmography (PPG) technology was predictive of autonomic nervous system (ANS) aging or biological age. Second, we sought to determine which HRV variable was most predictive of ANS change and aging. To test our hypotheses, we first conducted a criterion related validity study by comparing parameters of a 5 minute resting HRV test obtained from electrocardiography (ECG), the current "gold standard," with PPG technologies, and found them to be significantly correlated (r≥0.92) on all parameters during a resting state. PPG was strongly correlated to ECG on all HRV parameters during a paced six breaths per minute deep breathing test (r≥0.98). Further analysis revealed that maximum variation of heart rate had the highest negative correlation (r=-0.67) with age. We conclude that PPG is comparable to ECG in accuracy, and maximum variation of heart rate derived from a paced breathing test can be considered a marker of biological aging. Therapeutic interventions and games designed to reduce dysfunction in the ANS can now be developed using accurate physiological data.


Subject(s)
Aging/physiology , Autonomic Nervous System/physiology , Heart Rate/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Electrocardiography , Female , Humans , Male , Middle Aged
4.
Games Health J ; 2(6): 341-6, 2013 Dec.
Article in English | MEDLINE | ID: mdl-26197075

ABSTRACT

BACKGROUND: Depression is a debilitating illness that is estimated to affect more than 300 million people worldwide. Although there has been some success in treatment of this illness with pharmaceuticals and behavioral techniques like cognitive behavioral therapy, these are often costly and have stigma associated with them. The purpose of this study was to test whether a prescribed regimen of casual videogame (CVG) play could reduce symptoms associated with depression. SUBJECTS AND METHODS: Participants were screened for depression using the Patient Health Questionnaire-9 (PHQ-9). They were then randomized into the control (n=29) or experimental (n=30) group. Experimental participants were prescribed to play CVGs three times per week (with 24 hours between each session), for 30 minutes, over a 1-month period. Control participants surfed the National Institute of Mental Health's Web page on depression. The instrument used to test the hypothesis was the PHQ-9. RESULTS: Repeated-measures statistical analyses revealed there was a significant interaction of group and time, supporting the hypothesis that the groups would be different after the intervention. Moreover, when data were compared using tests of within-subjects contrasts between baseline (Time 1) and the end of the 1-month study (Time 3), we found significant decreases in depression symptoms in the experimental group. When this was compared with the control group changes, the results were still significant. CONCLUSIONS: We found that a prescribed regimen of playing CVGs significantly reduced symptoms of clinical depression as measured by the PHQ-9. Clinicians should consider these low-cost CVGs as a possible intervention to address psychological and somatic symptoms associated with depression.

6.
Acta Derm Venereol ; 90(4): 354-61, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20574599

ABSTRACT

Atopic dermatitis is a stress-responsive disorder that involves the autonomic nervous system. The current study used heart rate variability to examine the effect of itch, scratching and mental stress in atopic patients with moderate to severe disease. Twenty-one patients with active disease and 24 healthy volunteers participated in the study. Heart rate variability measurements were taken at 5 min intervals at rest and after each of 3 acute stress tests, which included histamine-induced itch at the forearm, scratching around the itch site, and the Trier Social Stress Test. Atopic patients displayed a higher heart rate than healthy controls in all 4 experimental settings, which was statistically significant using Cohen's delta analysis. The very low frequency component of the power spectrum, indicative of sympathetic activity, showed a 200% increase after scratching in patients with atopic dermatitis. The high frequency component, reflecting parasympathetic tone, responded swiftly to itch and scratching in healthy controls, but displayed a limited adaptability in atopic dermatitis. This study supports the concept that atopic dermatitis is a stress-responsive disorder and involves autonomic nervous system dysfunction. Atopic subjects exhibited an overactive sympathetic response to itch and scratching, while the parasympathetic tone was persistently and rigidly elevated, showing a lack of adaptability in response to stress.


Subject(s)
Autonomic Nervous System/physiopathology , Dermatitis, Atopic/physiopathology , Heart Rate , Pruritus/physiopathology , Stress, Psychological/physiopathology , Adaptation, Psychological , Administration, Cutaneous , Adolescent , Adult , Case-Control Studies , Dermatitis, Atopic/psychology , Electric Capacitance , Female , Histamine/administration & dosage , Humans , Iontophoresis , Male , Middle Aged , Plethysmography , Pruritus/psychology , Severity of Illness Index , Stress, Psychological/psychology , Time Factors , Water Loss, Insensible , Young Adult
7.
Stud Health Technol Inform ; 144: 189-92, 2009.
Article in English | MEDLINE | ID: mdl-19592761

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.


Subject(s)
Autonomic Nervous System , Heart Rate , Anxiety Disorders , Electroencephalography , Humans , Video Games/psychology
8.
Behav Med ; 28(2): 61-71, 2002.
Article in English | MEDLINE | ID: mdl-12613287

ABSTRACT

The authors report on the level of posttraumatic stress disorder (PTSD) experienced by fourth-grade children 6 months after Hurricane Floyd and describe the children's efforts to cope with their stress. All of the children they studied were directly affected by the hurricane, secondary to the destruction of their school by floodwaters. The homes of 37% of these children were also flooded. Ninety-five percent of the children experienced at least mild symptoms of PTSD, and 71% had symptoms that were moderate to very severe. Children who reported that their homes were flooded were 3 times more likely to report symptoms than those whose homes were not flooded, and the girls were twice as likely as the boys to report symptoms. The high PTSD prevalence rates are comparable to findings from other studies involving violence in which 94% of the victims reported experiencing symptoms. For further analyses, the authors used symptom clusters of hyperarousal, numbing/avoidance, and reexperiencing symptoms.


Subject(s)
Adaptation, Psychological , Disasters , Stress Disorders, Post-Traumatic/psychology , Arousal , Child , Cohort Studies , Defense Mechanisms , Female , Gender Identity , Humans , Individuality , Male , North Carolina , Risk Factors , Stress Disorders, Post-Traumatic/diagnosis
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