Virtual Reality-Based Support of Unipolar Depression

Project Justification

The Trier Social Stress Test (TSST) is a standardized paradigm simulating a job application interview and is currently one of the most used methods to elicit high levels of stress in experimental laboratory settings. However, the disadvantages of this procedure are that it is a context-specific stress induction, there are interindividual fluctuations in effectiveness, and considerable personnel resources are required. Therefore, the study addressed whether high immersive virtual reality (VR) environments can induce comparable or even higher amounts of intrapersonal stress in a more resource–efficient way. Both approaches were compared using objective psychological and physiological measurement methods.

Device setup during the experiment (right). Mounting of the instruments EEG, EDA, PPG measuring pulse wave, skin conductance and heart rate of the participants (left). 

Our Approach

Participants’ affective states were experimentally manipulated using specifically designed affect inducing tasks while recording psychophysiological responses. For this purpose, electrodermal activity (EDA), electrocardiographic (ECG), photoplethysmographic (PPG), and electro-encephalographic (EEG) data was recorded in a sample of 60 adults while playing a commercially available VR horror game and participating in the TSST. Moreover, salivary cortisol concentrations were measured before and after the TSST as neuroendocrinological markers for the individual stress reaction.

Participants during session 1 (VR-games) and session 2 (TSST)

Insights and Outcomes

The manipulation of affective states was accompanied with measurable changes in multiple physiological parameters such as skin conductivity, blood flow, and heart rate. Additionally, the neuroendocrinological measurements verified that the implementation of the TSST procedure was highly effective in inducing the desired stress reaction. The incorporation of various settings and affective tasks strengthens the generalizability of results to a wide range of affective states. The results underline the potential of VR applications for an easy to apply emotion and stress induction in experimental settings and for the development of stress-management settings. Moreover, the collected volume of data serves as a solid empirical basis which allows for the testing of various hypothesis and the drawing of scientifically valid conclusions regarding the association of physiological and affective states.

(A) Exemplary PPG and EDA measurements recorded in session 1 (VR-games). (B) Exemplary PPG, EDA, and blood flow measurements recorded in session 2 (TSST). Visualizations of the physiological data indicate intra-individual task-specific changes in physiological markers and confirm that the manipulation of physiological states with various tasks was successfull in both experimental sessions, e.g., increases in skin counductance (EDA) and heart rate during VR horror game as well as during TSST. 

Fear and distress induction. ECG with real-time heartrate extraction and skin conductance response during VR horror-game.

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