Brain Brook: Studying the Effects of Relaxing Video Games on Anxiety

Grant Basler, Yuxing (Aaron) Li, Austin Szema and Bastión Toledo-Altamirano

GAME2650: Intro to Game Research Methods

Prof. Bob De Schutter

April 28, 2022

Abstract

        With anxiety being such a significant problem in modern society, we wish to explore the possibilities of using immersive relaxing video games as a potential clinical treatment for the illness and expand on the field of research for medical games. Certain games such as Animal Crossing have been stated as being relaxing during times of stress and social isolation (Zhu, 2020). In this study, we found that playing relaxing games does not correlate to measurable cardiovascular responses, but does provide psychological alleviation to players.

Introduction

Anxiety is a complex phenomenon that can cause great psychological distress in individuals. Its troubling effects became especially apparent during the COVID-19 pandemic, when worldwide lockdowns threatened the mental health of millions. Many turned to video games such as Animal Crossing (Zhu, 2020) which provided a temporary relief and an online social space during quarantine (Pearce, et al., 2021). During said anxiety-inducing times, gamers reported spending more time playing video games than they usually had before the wave of lockdowns, playing primarily relaxing games as opposed to action-heavy games (Barr & Copeland-Stewart, 2022).

This anxiety self-treatment with relaxing games interested us, because it brought up the question of using them as a possible clinical treatment method for individuals who suffer from chronic anxiety. We suspected that if video games were able to relax anxious individuals, said games would not be intended to replace their current treatments (e.g. psychotherapy, medication, etc.) but rather accompany them to provide further relief. We formulated the following hypothesis:

H1: Immersive video games with relaxing gameplay can lower anxiety levels.

We defined ‘immersive’ as an experience that requires extended periods of concentration which might result in a disconnect from reality. By ‘relaxing’, we mean gameplay that contrasts with more action-intense genres like first person shooters or MOBAs. We also defined ‘anxiety levels’ as the state of anxiety in a given moment, measured by its physiological effects like heart rate and facial expressions.

Literature Review

Games have become a way for many people to be entertained and disconnect from reality. According to Reinecke (2009), “The results of the present study demonstrate that video and computer games have a significant recovery potential and are frequently used after stress and strain and for recovery reasons” (p. 26). Games like Animal Crossing are popular among players because this type of game makes players feel immersed and disconnected from reality, and has also become a way for many people to recover from stress. According to Zhu (2020), “New Horizons [a version of Animal Crossing] provides a dreamland for the players to temporally[sic] escape from the cruel reality with a risk of losing in escapism. On the other hand, the New Horizons’ world becomes a perfect social platform to keep social interaction with others and diminish loneliness” (para. 1).

Moreover, during the COVID-19 pandemic, people faced with uncomfortable circumstances in life like social isolation and anxiety might turn to games as a means of escaping from the outside world. According to Pearce et al. (2021), “In this study, we found families' use of AC:NH [Animal Crossing: New Horizons] as a coping tool was reflected in many behaviors at many levels. Emotion-focused coping behaviors included escapism/avoidance, distraction, mood management and emotional regulation with relaxation and calmness, emotional expression, and spending time together. Escapism, distraction, and mood management were consistently an individual coping behavior. Parents exclusively used AC:NH as an escape; no evidence suggests protective buffering, social coping, or communal coping” (p. 13).

Research also shows a positive impact on mental health, physical fitness, and body composition in children and adolescents. Santos et al. (2021) found that playing active video games for 10 to 90 minutes a day can positively impact mental health and physical functioning if played between one and three times a week. Military personnel's use of video games is another example of the game's impact on mental health and physical fitness. US military and veteran gamers (MVGs) are able to be rehabilitated and recover from Post Traumatic Stress Disorder by reliving their trauma in an enclosed and safe environment (Banks and Cole, 2016).

Methods

        Our hypothesis was centered around the notion that relaxing video games could potentially be used to treat anxiety, so we conducted an experiment to test it. Participants played a neutral, stressful, and relaxing game, and their heart rate was measured before and after to see if there was a correlation between relaxing gameplay and heart rate. Participants were also asked about any changes in their psychological state after playing the relaxing game. Since anxiety is complex and manifests itself in the mind as well as the body, we chose a mixed methods experiment: coded data and numerical ECG/EKG values.

We created our own relaxing game for the purposes of the experiment. We successfully built a prototype, received playtest feedback, and uploaded the polished version onto itch.io, a game hosting platform. The game is called Brain Brook, features a pastel color palette, and has many images of nature and environmental scenery. The player is in an ethereal pink forest, and they are supposed to collect fruit lying on the ground to put into buckets. The objective of the game is to have 120 interactions with objects in the world, where every time the player grabs a fruit or fills a bucket counts as one interaction. We also scattered 10 statues about the map, which count as six interaction points each. When interacting with a statue, the player will be prompted to a short breathing exercise, where the screen turns violet and text reading “BREATHE IN” and “BREATHE OUT” cycle through twice before continuing to the rest of the game.

        Our sample was eight college students who were 18 or older. We ensured the participants did not know the purpose of the study prior, and were debriefed after the experiment. The study procedure is as follows:

1. Take an EKG for 30 seconds. (Pre-Neutral)
2. Participant plays Snake, a neutral game, for 5 minutes.
3. Take an EKG for 30 seconds. (Post-Neutral)
4. Participant reads a passage of text for 1 minute to get their heart rate back to baseline.
5. Take an EKG for 30 seconds. (Pre-Stressful)
6. Participant plays Getting Over It, a stressful game, for 5 minutes.
7. Take an EKG for 30 seconds. (Post-Stressful)
8. Participant reads another passage of text for 1 minute to get their heart rate back to baseline.
9. Take an EKG for 30 seconds. (Pre-Relaxing)
10. Participant plays Brain Brook, a relaxing game, for 5 minutes.
11. Take an EKG for 30 seconds. (Post-Relaxing)
12. Conduct a short interview, centered around asking them if they felt the relaxing game made them feel calmer.

After the fourth participant, the games in step 2 and step 10 were switched. This was to ensure that the order of the games was not affecting our results. In addition to the interview, we watched the participants’ body language and took notes on what we observed.

Results

        We did not find a significant correlation between the game played and heart rate. We had expected participants to have a lower heart rate after Brain Brook compared to other games, but this was not the case. Using JASP statistical software, we ran three one-way independent ANOVAs (game types: neutral, stressful, relaxing) with pre-game/post-game as the independent variable did not find a significant effect from the game played on heart rate (EKG) for the data filtered for neutral (F(1, 14) = 0.045, p = n.s.), stressful (F(1, 14) = 0.048, p = n.s.), or relaxing (F(1, 14) = 0.125, p = n.s.). Thus, simply playing a game (neutral, stressful, or relaxing) is not an accurate predictor of heart rate.

        In terms of reported psychological effects from coded interview data, a majority of our participants claimed to have felt a calming effect. Of our eight participants, seven reported feeling relaxed during the Brain Brook gameplay. Six reported feeling at least slightly calmer after the gameplay, and two claimed feeling highly calm after the gameplay. Only three participants reported feeling disconnected from reality. In terms of actual enjoyment, three participants said they enjoyed playing Snake the most, three said Brain Brook, and two said Getting Over It.

        Our participant observation notes on body language were coded as well. The most common physical expressions varied per game, but were overall positive. Participants playing Snake mostly laughed, smiled during Getting Over It, and smiled during Brain Brook. Participants also had relaxed facial tension during Brain Brook gameplay. This demonstrates that while heart rate was not a good predictor of anxiety levels, body language helped to paint a clearer picture of what was happening in the participants’ minds.

Discussion

Despite our evidence not directly linking the playing of a certain type of video game to reduced heart rate/anxiety, nearly all participants reported feeling calmer after playing Brain Brook. From this, we can surmise that while gameplay may not directly impact the player’s heart rate, playing certain types of video games can generate a sensation of calmness, mainly caused by music, art direction, and a general sense of “zoning out”. This study would greatly benefit from having a broader and more diverse scope of participants, as we were only able to test eight participants total, a limitation which we were aware of prior to the conduction of the experiment.

To expand upon this study, the use of games with greater degree of extremity, such as an extremely calming game, followed by an extremely stressful game, could prove beneficial. In addition, the setting in which the participants are being studied is not insignificant. We theorized that one factor that led to an overall decrease in heart rate of players from the beginning of the playtest until the end could be the participants becoming more comfortable with their surroundings and being tested while in a lab. The juxtaposition between the heart rate data and the statements made by participants after playing the games shows that heart rate may not be a reliable predictor of anxiety, as anxiety is a complex issue, with many factors that impact it. Another limitation in our study could be due to the fact that our available EKG equipment is not as reliable as that of a medical facility, and we detected some anomalies due to high pitched interference within the lab room. With more participants and a more reliable way to measure anxiety, this study would be much more successful.

Conclusion

Overall, our experiment did not yield the results we were expecting. The data we gathered gave no indication that relaxing gameplay lowered anxiety. However, what we did find is that over the course of the experiment, the participants’ level of psychological anxiety did decrease. We speculate either this effect could be a result of our sample size being too small, it could mean that the players got more comfortable in the lab as they spent more time in there, or perhaps playing for an extended period of time could reduce anxiety regardless of the type of game you play. Our next course of action would be to try to run this study again with more participants and control the environment more to reduce initial anxieties of coming to an unfamiliar cramped lab.

In the field of clinical games treatment and anxiety, the results of this study cannot provide definitive biological data or correlation between relaxing games and a lowering of heart rate. However, we obtained qualitative data showing our participants becoming more relaxed during gameplay and afterwards feeling calmer. While not all participants found our experimental game immersive, the majority experienced a pleasant state which could arguably be experienced by any tranquil activity, such as gardening, painting, or stargazing. For a medical researcher, our findings do not seem useful, but to an artist or game designer seeking to create a relaxing experience for their users, our findings can definitely guide their creative decisions.

Figures

Figure 1

One-way Independent ANOVA of Neutral Game Data: Pre/Post vs EKG

Figure 2

One-way Independent ANOVA of Stressful Game Data: Pre/Post vs EKG

Figure 3

One-way Independent ANOVA of Relaxing Game Data: Pre/Post vs EKG

Figure 4

Coded Interview Data

Note. Interviewees were not given fixed answers, but were asked open-ended questions. Their responses were coded after all data was collected.

Figure 5

Coded Body Language Observation Data

Note. Totals in each game do not add up to 8 because we counted multiple expressions per participant.

References

Banks, J., & Cole, J. G. (2016, December). Diversion Drives and Superlative Soldiers: Gaming as Coping Practice among Military Personnel and Veterans. Game Studies - Diversion Drives and Superlative Soldiers: Gaming as Coping Practice among Military Personnel and Veterans.

Barr, & Copeland-Stewart, A. (2022). Playing Video Games During the COVID-19

Pandemic and Effects on Players’ Well-Being. Games and Culture, 17(1),

122–139. https://doi.org/10.1177/15554120211017036

Pearce, Yip, J. C., Lee, J. H., Martinez, J. J., Windleharth, T. W., Bhattacharya, A., & Li, Q. (2021). Families Playing Animal Crossing Together: Coping With Video Games During the COVID-19 Pandemic. Games and Culture, 155541202110561–. https://doi.org/10.1177/15554120211056125

Reinecke, L. (2009). Games and recovery: The use of video and computer games to recuperate from stress and strain. Journal of Media Psychology: Theories, Methods, and Applications, 21(3), 126-142.

Santos, I. K. dos, Medeiros, R. C. da S. C. de, Medeiros, J. A. de, Almeida-Neto, P. F. de, Sena, D. C. S. de, Cobucci, R. N., Oliveira, R. S., et al. (2021). Active Video Games for Improving Mental Health and Physical Fitness—An Alternative for Children and Adolescents during Social Isolation: An Overview. International Journal of Environmental Research and Public Health, 18(4), 1641. MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijerph18041641

Zhu, L. (2020, September 9). The psychology behind video games during COVID‐19

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