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Using Serious Games to Train Adaptive Emotional Regulation Strategies

Abstract

[EN] Emotional Regulation (ER) strategies allow people to influence the emotions they feel, when they feel them, how they experience them, and how they express them in any situation. Deficiencies or deficits in ER strategies during the adolescence may become mental health problems in the future. The aim of this paper is to describe a virtual multiplatform system based on serious games that allows adolescents to train and evaluate their ER strategies. The system includes an ecological momentary assessment (EMA) tool, which allows the therapist to monitor the emotional status of teenagers every day in real time. Results obtained from a usability and effectiveness study about the EMA tool showed that adolescents preferred using the EMA tool than other classical instruments.

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Using Serious Games to Train Adaptive Emotional Regulation Strategies

Author: Alcañiz Raya, Mariano Luis,Rodríguez Ortega, Alejandro,Rey, Beatriz,Parra Vargas, Elena
Publisher: Springer Verlag (Germany)
Year: 2014
DOI: 10.1007/978-3-319-07632-4_51
Source: https://riunet.upv.es/bitstream/10251/80614/5/Alca%c3%b1iz_2014_versi%c3%b3n_autor.pdf
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Sp inge Ve lag (Ge many)
Alcañiz Raya, ML.; Rod iguez O ega, A.; Rey, B.; Pa a Va gas, E. (2014). Using Se ious
Games o T ain Adap i e Emo ional Regula ion S a egies. Lec u e No es in Compu e
Science. 8531:541-549. doi:10.1007/978-3-319-07632-4_51.
Using Se ious Games o T ain Adap i e Emo ional
Regula ion S a egies
Ma iano Alcañiz1, 2, Alejand o Rod íguez1, Bea iz Rey1, 2, and Elena Pa a1
1Ins i u o In e uni e si a io de In es igación en Bioingenie ía y Tecnología O ien ada al Se
Humano, Uni e si a Poli ècnica de València, I3BH/LabHuman, Camino de Ve a s/n, 46022
Valencia, España;
2Cibe , Fisiopa ología de Obesidad y Nu ición, CB06/03 Ins i u o de Salud Ca los III, Spain
{a od iguez, b ey, malcañiz}@labhuman.i3bh.es
Abs ac . Emo ional Regula ion (ER) s a egies allow people o in luence he
emo ions hey eel, when hey eel hem, how hey expe ience hem, and how
hey exp ess hem in any si ua ion. De iciencies o de ici s in ER s a egies du -
ing he adolescence may become men al heal h p oblems in he u u e. The aim
o his pape is o desc ibe a i ual mul ipla o m sys em based on se ious
games ha allows adolescen s o ain and e alua e hei ER s a egies. The sys-
em includes an ecological momen a y assessmen (EMA) ool, which allows
he he apis o moni o he emo ional s a us o eenage s e e y day in eal ime.
Resul s ob ained om a usabili y and e ec i eness s udy abou he EMA ool
showed ha adolescen s p e e ed using he EMA ool han o he classical in-
s umen s.
Keywo ds: Se ious Games, Emo ional Regula ion, Ecological Momen a y As-
sessmen , Vi ual Reali y
1 In oduc ion
Emo ional Regula ion (ER) s a egies allow people o in luence he emo ions hey
eel, when hey eel hem, how hey expe ience hem, and how hey exp ess hem in
any si ua ion. These s a egies may be au oma ic o con olled, olun a y o in olun-
a y. ER s a egies should be di e en ia ed depending on when hey ha e hei i s
impac on he emo ion gene a ion p ocess. Despi e he ac ha he e a e di e se emo-
ional egula ion s a egies, mos esea ch has been conduc ed in o cogni i e ee alua-
ion (assigning a non-emo ional meaning o an e en ) and exp essi e supp ession
(con olling he soma ic esponse o an emo ion). Bo h he physical and psychological
implica ions will be di e en depending on he s a egy used.
Nume ous s udies indica e he ole ha hese egula ion s a egies play in he de-
elopmen and main enance o adap i e and heal hy beha io . P e ious esea ch [1]
has concu ed in inding di e se emo ional egula ion dys unc ions in he clinical
popula ion wi h dep essi e diso de s. De iciencies o de ici s in ER a e ela ed o he
occu ence o nume ous men al and physical heal h p oblems, including bo de line
pe sonali y diso de , dep ession, anxie y, p oblems o social in e ac ion, p oblems o
adap a ions, iolen beha io and o he dis up i e beha io s.
These de ici s become especially e iden du ing he adolescence and may become
a psychosocial p oblem. Ac ually, schools and high-schools denounce a wo ying
inc ease in indiscipline and episodes o physical and psychological iolence in he
class oom. P oo o his conce n is he S udy o Violence epo by he Cen o Reina
So ía o Cisne os X [2-3] which showed ha high pe cen age alues o child en had
su e ed bullying o school-based iolence.
Many o hese dis up i e beha io s by he adolescen s a e buil upon de iciencies
in si ua ion selec ion, si ua ion modi ica ion, a en ion deploymen , cogni i e change
o esponse modula ion [4]. On he o he hand, an adap i e ER in ol es choosing and
implemen ing ER s a egies ha a e adap ed o he con ex , adap ed o how con olla-
ble he in e nal and ex e nal e en s a e, and in ha mony wi h long e m goals [1].
Be king belie es ha he e ec i eness o beha io change he apies could be im-
p o ed by iden i ying gene al emo ional egula ion abili ies, de eloping in e en ions
ha could imp o e hese abili ies and including hese in e en ions in he he apies
[5].
The cu en ools used o e alua e possible de ici s in ER s a egies a e based on
subjec i e ques ionnai es, such as he Emo ion Regula ion Checklis [6] o he Emo-
ion Regula ion Ques ionnai e [7]. These ques ionnai es ask subjec s abou how hey
eel and manipula e hei emo ions in con olled en i onmen s o in common si ua-
ions in eal li e. Ano he way o e alua ing he ER s a egies used is h ough es s in
labo a o y, whe e he subjec s ough o do emo ion gene a ing asks wi h he aim o
analyze he s a egies ha ha e o be used [8]. E en hough hese ools a e e y use ul
o he apis (dis inguishing be ween clinical and no mal popula ions), hey p esen
some limi a ions; speci ically, hey a e una ac i e o he e alua ion in adolescen s’
popula ion, who a e pa icula ly eluc an o be assessed.
These limi a ions can be o e come wi h he de elopmen o ins umen s based on
new echnologies. Speci ically, i ual eali y (VR) sys ems and In o ma ion and
Communica ion Technologies (ICT) a e a echnology ha a e e y a ac i e and e y
common o young people and adolescen s, who a e accus omed o he simula ed en i-
onmen s o ideogames.
The de elopmen o new in e ac i e echnologies based on VR has al eady had
some in luence on ce ain aspec s o he eaching/lea ning en i onmen . VR and i s
applica ion o you h educa ion is a ela i ely young ield bu in e es is g owing due o
i s s ong mo i a ional impac [9] and he c i ical easons o why and how g aphic-
based VR can g ea ly enhance he quali y o educa ion p o ided [10]. The de ices and
echniques allow na iga ing and in e ac ing h ough VR en i onmen s in mo e in ui-
i e and mo e na u al ways. In addi ion, imme si e and pe suasi e capaci ies o VR
make i a highly app op ia e echnology o assessmen and in e en ion ask.
Recen ly, se e al wo ks ha e used new echniques based on ICT o aining o ER
s a egies. Playmance p ojec [11] is a sys em ha uses mul imodal ecogni ion o
emo ions, in combina ion o se ious games o he aining o ER s a egies, wi h he
pu pose o ea ing psychological and beha iou al diso de s [12]. In o he p ojec ,
Replay [13], a sys em based on a VR en i onmen wi h a a a s and acking echnol-
ogies was de eloped wi h he aim o imp o ing he emo ional implica ion o pa ici-
pan s (s uden s wi h beha iou diso de s) and aining ER s a egies.
In his wo k, we desc ibe GameTeen, a i ual mul ipla o m sys em based on se i-
ous games ha allows eenage s o ain and e alua e hei ER s a egies. Fu he -
mo e, he sys em includes an ecological momen a y assessmen (EMA) ool, which
allows he he apis o moni o he emo ional s a us o adolescen e e y day in eal
ime. Finally, he esul s ob ained o a usabili y and e ec i eness s udy abou he
EMA ool will be p esen ed.
2 Me hods
The GameTeen sys em is a i ual mul ipla o m sys em based on se ious games de-
signed o eenage s, which allows aining, e alua ing and moni o ing hei emo ions
and he ER s a egies ha hey apply e e yday. GameTeen was de eloped acco ding
o ecommenda ions o in e en ion p og am p inciples, which claim ha a way o
aining and assessing how ER s a egies ha e been applied by subjec s in ol es he
use o mood induc ion p ocedu es. In he con ex o hese p ocedu es, subjec s can
lea n o analyze he emo ion el and he ER s a egies ha hey employed o egula e
hemsel es [14].
Following his ecommenda ion, GameTeen sys em was designed in h ee blocks.
A i s block would be a sys em whe e a posi i e o a nega i e emo ion is induced in
he subjec s; i consis s o wo Mood Induc ion Games. A second block would consis
o wo mini-games whe e he pa icipan s may ain wo ER s a egies (ER S a egies
T aining). Finally, in he hi d block, an ecological momen a y assessmen (EMA)
would allow he he apis o moni o he emo ional s a us o adolescen e e y day in
eal ime.
2.1 Induc ion Games
The aim o he Mood Induc ion Games is o induce wo di e en emo ions in he pa -
icipan s. The emo ions induced we e joy and us a ion. To achie e he desi able
mood induc ion, se e al ools o posi i e and nega i e ein o cemen we e used e-
spec i ely, such as music, sounds, emo ional messages, e c. The moni o ing o emo-
ional le els in he wo games was pe o med h ough pe iodic in e up ions whe e he
game asked pa icipan s o indica e hei emo ional le el on a scale o 0 o 10 ep e-
sen ed as he mome e .
Joy Induc ion Game.
In he joy game (Figu e1) he ac ion ook place in an a ac ion pa k. In his game
he pa icipan s had o exploi as many balloons as possible o a showe o balloons.
Fo his, he pa icipan s had se e al weapons and ammuni ions ha hey we e ge ing
h ough he pe o mance o he di e en ER s a egies. The game had en le els o
di icul y ha a ec ed o he numbe o balloons and he eloci y o appea ance.
Fig. 1. Joy Induc ion Game. The game is loca ed in an a ac ion pa k scene. In his scene,
many balloons appea in con inuous way while playing he game.
F us a ion Induc ion Game.
In he us a ion game (Figu e 2), a e sion o he “whack a mole” game was de-
eloped. The game is loca ed in a u al land scene whe e he e a e se e al holes. In
hese holes, se e al moles can appea in a con inuous way while playing he game. In
his game, he pa icipan has o whack all moles, a he same ime ha hey a e ap-
pea ing, wi h a i ual mace. The game had h ee le els o di icul y ha a e ela ed
wi h he eloci y and equency o appea ance o he moles. To achie e he us a ion
induc ion, he game was p og ammed so ha some hi s a e no accu a e and he pa -
icipan s a e penalized.
Fig. 2. F us a ion Induc ion Game. The game is loca ed in a u al land scene whe e he e a e
se e al holes. In hese holes, se e al moles can appea in a con inuous way while playing he
game

2.2 ER S a egies T aining (Mini-Games)
Apa om hese mood induc ion games, wo mini-games we e de eloped o aining
ER s a egies. One o hem consis s o a espi a ion ask whe e he subjec s ha e o
b ea he a he same a e as indica ed in he mini-game. This espi a ion s a egy con-
sis s o a ea he (Figu e 3a), which goes up and down in he sc een. In he o he one,
subjec s ha e o click on all he numbe s ha appea sequen ially on sc een excep
one numbe , which is indica ed wi hin he mini-game (Figu e 3b).
Fig. 3. Emo ional Regula ion S a egies T aining. In he espi a ion s a egy (a) consis in a
ea he ha goes up and down in he sc een o eloci y mode a e; and he dis ac ion s a egy
(b) consis an sequence o numbe and one c oss ha a e appea ing sequen ially.
2.3 Ecological Momen a y Assessmen (EMA)
To e alua e con inuous changes in he emo ions o subjec s in hei daily li e we also
de eloped an EMA sys em (Figu e 4). The pu pose o his sys em is o ha e a dia y
eco d o he emo ions el by he subjec s by means o an and oid de ice, which can
be con igu ed and moni o ed om a webpage. This sys em includes a cus om a a a
who asks a se o ques ions abou he eeling o he eenage s in p ede ined momen s
du ing he day. Mo eo e , he sys em has a web page whe e he he apis can au hen-
ica e himsel /he sel wi h he pu pose o moni o ing he emo ional ac i i y o all
subjec s in his/he s udy.
Fig. 4. EMA. Cap u e an example a a a and he example a ques ion.
2.4 Technological Aspec s
The Mood Induc ion Games and he Mini-Games we e de eloped wi h he pu pose o
being used bo h on PC and on And oid pla o ms (Figu e 5). Fo his eason, we used
he Uni y3d as he de elopmen en i onmen . I was p og ammed in C-Sha p. C-
Sha p is a iendly p og amming language ha has many communica ion de ices
lib a ies and web se ices lib a ies.
Fig. 5. Induc ion Games in an And oid sma phone.
Mainly, he PC pla o m was hough o be used wi h keyboa d and mouse in he
pa icipan s’ home bu in addi ion his sys em has he op ion o be used in labo a o y
unde he apeu ic supe ision. Fo his, GameTeen has he op ion o egis e ing he
ECG signal o pa icipan s synch onized wi h game e en s, allowing he apis s o
moni o changes in he hea a e in eal ime in labo a o y condi ions.
2.5 Design Usabili y S udy
The GameTeen pla o m has been e alua ed wi h s uden s o a high school. In his
wo k, we p esen he p elimina y esul s ob ained o a usabili y s udy pe o med wi h
eenage s.
Twen y one pa icipan s, 10 men and 11 women, we e e alua ed in his s udy, all
o hem wi h ages be ween 12-14 yea s old (mean 13.20 yea s old) wi h no mal o
co ec ed- o-no mal ision. The subjec s we e s uden s o Ramón Llull High-School
o València wi hou any psychological diso de and none o hem was unde psycho-
logical supe ision. Thei pa en s signed an in o med consen o allowing hei da a
o be used in his s udy.
The adolescen s we e di ided in wo g oups. The i s g oup had o exp ess hei
emo ions daily h ough he EMA sys em. Fo ha , we len se e al sma phones (Sony
Xpe ia Neo V), whose unc ions we e banned o excep he EMA sys em. On he
o he hand, he second g oup had o do he same ask; howe e hey used ques ion-
nai es in pape . The ques ions in pape we e he same ha he EMA sys em eques ed.
All pa icipan s had o do his ask wice a day du ing one week. A he end o he i s
week, g oups we e exchanged, and he pa icipan s had o do he same ask du ing
o he week.
When all pa icipan s we e in he wo g oups, we asked o hem ha hey comple -
ed he usabili y ques ionnai e, which egis e ed in o ma ion abou he usabili y o he
pape ques ionnai e, EMA sys em and he compa a i e be ween he wo p ocedu es o
daily egis e o emo ions.
3 Resul s
In his wo k, we p esen p elimina y esul s ob ained in he usabili y o EMA sys em
when his is compa ed wi h he usabili y o classical ools used o measu ed emo ions,
ques ionnai es in pape .
Resul s showed ha eenage s pe cei ed mo e discom o while hey did he pape
ques ionnai es han wi h he EMA sys em (p=0.001). The 50% o subjec s con i med
ha he EMA sys em was e y com o able and i s ala ms we e use ul o emembe
he eenage s o comple e he ques ions. This was e lec ed in he ac ha he 100%
o subjec s pe cei ed as nega i e quali y ha he pape ques ionnai e did no ha e any
ala m. Agains , he 19% o adolescen s liked ha ing eedom o schedule o answe
he pape ques ionnai e.
On he o he hand, he pa icipan s app ecia ed ha he EMA sys em was mo e use-
ul han pape ques ionnai e (p=0.004). The 42% pa icipan s indica ed ha he EMA
sys em was easie o use han pape ques ionnai es, and he 100% pa icipan s showed
hei disag eemen by ha ing o mo e so many pape s om one place o ano he .
4 Discussion
This pape desc ibes he GameTeen p ojec , a psycho he apeu ic mul ipla o m based
on se ious games o ain and e alua e he ER s a egies in eenage s. This mul ipla -
o m was de eloped using news echnologies in VR and ICTs wi h he aim o im-
p o e he classical ools used in he ield o ER, o imp o e he mo i a ion and o help
o ca ch he a en ion o eenage s ha can ha dly be a ac ed by o he ins umen s,
such as ques ionnai es.
GameTeen allows he adolescen s o ain wo ER s a egies when a posi i e o
nega i e emo ion has been induced hem. These ER s a egies a e based on wo mini-
games, a slowly espi a ion ask and an a en ion ask. In addi ion, GameTeen helps
he he apis o e alua e he ER s a egies used by he subjec s and i also enables o
ollow he emo ion el du ing he e alua ion. Fo his eason, GameTeen sys em has
been de eloped o being used as much in a con ollable si ua ion h ough a PC, as
day- o-day h ough an EMA sys em.
In his pape , we ha e showed p elimina y esul s ob ained o a usabili y s udy,
which was ca ied o he EMA sys em. The ob ained esul s sugges ha he EMA
sys em can be used o moni o emo ions in he adolescen popula ion.
The pa icipan s app ecia ed he com o ably o EMA abo e he pape ques ion-
nai e. In addi ion, hey emphasized ha he EMA sys em was e y use ul. This can be
caused by di e en ac o s: he ease o anspo a ion; he ac ha he pape ques ion-
nai e was a huge numbe o pieces o pape ; and he use ulness o he eminde s
h ough he ala ms. These quali ies we e no p esen ed in pape o ma .
Howe e , we a e awa e ha he popula ion used o his analysis was a non-clinical
popula ion. This will equi e, in he u u e, o alida e he sys em wi h a clinical popu-
la ion o eenage s, i.e. wi h adolescen s who ha e been diagnosed an ER diso de .
Ne e heless, because o hese esul s, we a e op imis ic and we belie e ha he sys-
em migh be used o help he apis s o moni o he emo ions wi h a clinical popula-
ion.
In u u e wo ks, we will e alua e he eliabili y o GameTeen as he apeu ic ool
o he ea ly de ec ion o ER pa e ns wi h a high isk o leading o heal h o beha -
io al p oblems. In addi ion, we will analyze how hei use as aining ool would ena-
ble hei in eg a ion in o psychoeduca ional p og ams o p e en ion o emo ional
diso de s. Finally, we will also use physiological measu emen ools, such as elec o-
encephalog am, o s udy he in luence o he ER s a egies in he human physiologic
beha io wi h he aim o measu ing and quan i ying his e ec .
Acknowledgmen s. This s udy was unded by Vice ec o ado de In es igación de la
Uni e si a Poli ècnica de València, Spain, PAID-06-2011, R.N. 1984; by Minis e io
de Educación y Ciencia, Spain, P ojec Game Teen (TIN2010-20187) and pa ially by
p ojec s Consolide -C (SEJ2006-14301/PSIC), “CIBER o Physiopa hology o Obesi-
y and Nu i ion, an ini ia i e o ISCIII” and Excellence Resea ch P og am
PROMETEO (Gene ali a Valenciana. Conselle ía de Educación, 2008-157).
The wo k o Alejand o Rod íguez was suppo ed by he Spanish MEC unde an
FPI G an BES-2011-043316.
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