Using Serious Games to Train Adaptive Emotional Regulation Strategies

Documen downloaded om: This pape mus be ci ed as: The inal publica ion is a ailable a Copy igh Addi ional In o ma ion h p://doi.o g/10.1007/978-3-319-07632-4_51 h p://hdl.handle.ne /10251/80614 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. 5 Re e ences 1. Mennin, D. & Fa ach, F., (2007). 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