The document discusses designing biofeedback games. It proposes three key elements: 1) ensuring thematic congruence between the game's themes/art and its biofeedback system. 2) Using environmental storytelling so gameplay and narrative are informed by the player's physiological responses. 3) Creating a symbiotic relationship between gameplay and biofeedback where they mutually influence each other. The goal is to build games that provide personalized experiences for players through interoceptive awareness, which is conscious awareness of one's physiological states.
Academic peak performance training via neurofeedbackntheva
A pdf detailing how you can achieve peak performance in your academic life, increasing your IQ and stabilizing your EQ. All via simple home based software and hardware and through the science of Neurofeedback. Contact Dr. Theva Nithy for further details, ntheva@gmail.com
Neurofeedback for Peak Performance, Meditation, TherapyJonathan Banks
Neuro feedback is the most powerful form of brain training available. Is neurofeedback effective and what are the benefits you can expect to experience?
Bionic is a game designed to provide engaging training for patients using neuromuscular prosthetics. It uses music-based games that provide challenge and feedback to improve patients' control of their prosthesis while maintaining higher engagement compared to standard EMG training. Clinical studies have found Bionic leads to clinically validated improvements in prosthesis control when used as an addition to traditional clinical training methods.
The document discusses games for healthy ageing and provides an example. It announces a track on silver games at the Games for Health Europe Conference 2018. An example given is the EU FrailSafe i-PROGNOSIS project which uses games for healthy ageing.
This document discusses the development of an app called SPIRIT to help treat obsessive compulsive disorder (OCD). Exposure and response prevention (ERP) therapy is the most effective OCD treatment but has problems with high dropout rates and infrequent engagement with therapeutic exercises. SPIRIT uses gamification elements like narrative, goals, and fast feedback to empower OCD patients to regularly complete exposure exercises. The developers plan to test SPIRIT in a clinical trial with 200 OCD patients to evaluate outcomes compared to treatment without the app.
When Therapists and Researchers Collaborate to Innovate and Offer a Future to...Games for Health Europe
S'TIM is a serious game developed through collaboration between medical specialists, rehabilitation therapists, and multimedia developers to rehabilitate patients with dysexecutive syndrome resulting from frontal lobe damage. The game runs on a touchscreen table and focuses on exercises for attention, inhibition, strategy, planning, and other executive functions. Initial results found the game improved patients' self-confidence, metacognition, and ability to transfer skills to daily life. Therapists also saw new collaborative dynamics develop between themselves and their patients.
This document discusses managing hypersensitivity after an acquired brain injury and developing games to help with overstimulation. It notes that over 50% of people with an ABI experience sensory hypersensitivity. A training program is described that aims to teach people skills to deal with overstimulation in daily life. The document also covers using games based on neuropsychological principles to target cognitive rehabilitation through gameplay on smartphones. It requests expanding an existing game called The Botanist to include new games stimulating other brain areas and discusses debates around the possibility of cognitive enhancement through brain training.
Academic peak performance training via neurofeedbackntheva
A pdf detailing how you can achieve peak performance in your academic life, increasing your IQ and stabilizing your EQ. All via simple home based software and hardware and through the science of Neurofeedback. Contact Dr. Theva Nithy for further details, ntheva@gmail.com
Neurofeedback for Peak Performance, Meditation, TherapyJonathan Banks
Neuro feedback is the most powerful form of brain training available. Is neurofeedback effective and what are the benefits you can expect to experience?
Bionic is a game designed to provide engaging training for patients using neuromuscular prosthetics. It uses music-based games that provide challenge and feedback to improve patients' control of their prosthesis while maintaining higher engagement compared to standard EMG training. Clinical studies have found Bionic leads to clinically validated improvements in prosthesis control when used as an addition to traditional clinical training methods.
The document discusses games for healthy ageing and provides an example. It announces a track on silver games at the Games for Health Europe Conference 2018. An example given is the EU FrailSafe i-PROGNOSIS project which uses games for healthy ageing.
This document discusses the development of an app called SPIRIT to help treat obsessive compulsive disorder (OCD). Exposure and response prevention (ERP) therapy is the most effective OCD treatment but has problems with high dropout rates and infrequent engagement with therapeutic exercises. SPIRIT uses gamification elements like narrative, goals, and fast feedback to empower OCD patients to regularly complete exposure exercises. The developers plan to test SPIRIT in a clinical trial with 200 OCD patients to evaluate outcomes compared to treatment without the app.
When Therapists and Researchers Collaborate to Innovate and Offer a Future to...Games for Health Europe
S'TIM is a serious game developed through collaboration between medical specialists, rehabilitation therapists, and multimedia developers to rehabilitate patients with dysexecutive syndrome resulting from frontal lobe damage. The game runs on a touchscreen table and focuses on exercises for attention, inhibition, strategy, planning, and other executive functions. Initial results found the game improved patients' self-confidence, metacognition, and ability to transfer skills to daily life. Therapists also saw new collaborative dynamics develop between themselves and their patients.
This document discusses managing hypersensitivity after an acquired brain injury and developing games to help with overstimulation. It notes that over 50% of people with an ABI experience sensory hypersensitivity. A training program is described that aims to teach people skills to deal with overstimulation in daily life. The document also covers using games based on neuropsychological principles to target cognitive rehabilitation through gameplay on smartphones. It requests expanding an existing game called The Botanist to include new games stimulating other brain areas and discusses debates around the possibility of cognitive enhancement through brain training.
Dr. Roland Goetgeluk will present on LifeCyclR 1.0, a game-based rehabilitation system that motivates both healthy and unhealthy individuals to do 30 minutes of daily exercise via rehab and training on a bike. It aims to boost therapy compliance and reduce costs for conditions like cerebral palsy. Specialists input rehab programs that are translated into game landscapes by software. The system was positively tested attracting various patient groups and is now undergoing clinical trials to evaluate its effectiveness for rehab conditions like cerebral palsy and for elderly populations.
This document discusses using motion-controlled video games for rehabilitation of children with cerebral palsy and other movement disorders. It notes the struggles of traditional outpatient therapy and introduces reFit Gamo as a digital therapy system that uses games to motivate patients, provide instant biofeedback on exercises, and allow continuous evaluation of progress by patients, therapists, and parents. Examples of games are provided that target hand, full body, and cardiac rehabilitation through repetitive motions, coordination, and cognitive challenges.
Wii Fit balance training was compared to conventional balance therapy in outpatients with subacute stroke. Patients were randomly assigned to 30 minutes of either Wii Fit balance games under supervision twice a week for 8 weeks, or conventional balance exercises, both with additional home practice. The Berg Balance Scale and Dynamic Gait Index assessed balance and fall risk at baseline and post-intervention. Secondary measures included walking speed, fatigue, and independence in daily activities. The study hypothesized that Wii Fit balance training would be more effective for improving balance after stroke compared to conventional therapy in an outpatient setting.
Noreena Liu presented on using an "advergame" strategy to raise awareness and support for dementia carers. The advergame would use social media platforms to get people's attention and influence communities to help address problems carers face like a lack of communication, knowledge about dementia, and available services. It would be interactive advertising that delivers information while allowing users to provide feedback. Existing games for dementia and its carers can be used for social support, education to enhance knowledge about dementia, and health by helping carers better manage their situation.
Gwen Dziwenko developed the Glenrose Grocery Game at the Glenrose Rehabilitation Hospital in Edmonton, Alberta. The game is used by occupational therapists to engage clients with cognitive impairments in tasks related to grocery shopping and meal preparation. It assesses skills like attention, problem solving, memory, and budgeting. Players choose a character and celebrity to shop for, then must accurately collect all ingredients for a recipe within budget and time limits. The game tracks progress and provides an appropriate challenge level. Future plans include releasing the game as an iOS and Android app to distribute to other hospitals.
The document discusses a presentation called "ParkinsonGaming" given at the Games for Health Europe Conference 2018 by Peter David Faasse and Lianne de Haan from Radboud University. It describes using gaming to help the 55,000 people in the Netherlands with Parkinson's disease work on motor skills and exercise, which can slow progression of the disease. Previous studies found Parkinson's patients enjoyed using the Kinect for retraining movements at home. The presenters want to develop a simple home game using criteria like few colors and short rounds to help patients achieve exercise goals and motivate continued physical activity. They are looking for investors to help create the game.
Detlef La Grand discusses how virtual reality can make healthcare training more engaging and effective by allowing trainees to learn through experience in virtual environments. VR provides opportunities for storytelling, hands-on learning, and practicing skills anywhere by simulating real-world healthcare scenarios. It can also help foster empathy by allowing people to experience healthcare from others' perspectives through immersive VR tours and simulations.
This document discusses stress and mindsets. It summarizes research showing that an optimistic mindset is associated with better health outcomes and longer life. Additionally, those who view stress as enhancing rather than harmful are more likely to respond adaptively to stress. The document then outlines a pilot study showing that the VR game Stressjam was effective in changing players' mindsets to view stress positively, was highly engaging to play, and helped a broad range of people.
This document discusses trends in rehabilitation and the role of technology. It notes an increasing prevalence of chronic disorders and rising healthcare costs. Rehabilitation aims to help people adapt and self-manage their conditions. Technology such as robotics, virtual reality, and assistive devices can help regain function and autonomy. The ability to adapt is key for both patients and rehabilitation technology. Technology should be affordable and support self-reliance and participation.
This document discusses appropriate innovation and gamification in healthcare. It notes several urgent issues driving change, such as aging populations, increasing care demands, and rising costs. Gamification could help address workforce shortages and access issues if applied properly. Key criteria for determining what innovations are appropriate include whether they target individual health needs effectively and efficiently without overtreatment. Gamification must improve quality from a patient-centered perspective and be evidence-based, affordable, and sustainable to qualify for basic insurance coverage under the Dutch system. Overall, healthcare innovations require understanding problems, analyzing demands and processes, measuring impacts, and developing solutions centered on quality improvement.
Rabobank wants to invest in communities to address healthcare challenges. Healthcare expenses in the Netherlands are projected to double by 2040 due to issues like an aging population and rising obesity rates. There is a need for cooperation between healthcare providers, investors, and entrepreneurs to develop innovative solutions that help people live healthier lives and reduce costs. One example is a initiative called "Sarah" that brought these groups together to support the needs of an individual.
The document describes the BLISS project which aims to develop a behavior-based language-interactive speaking system to help elderly people with health problems like dementia remain independent at home. The system will use natural language processing techniques on big data like text, speech, and video from interviews to build a personalized model of individual clients and facilitate their self-management of health, well-being, and happiness. It will be evaluated on a large scale to assess how well it can increase client health outcomes.
This document summarizes research into using brain-computer interfaces (BCI) to treat addiction. In an initial trial, researchers gave 14 addicted subjects BCI training to control craving-inducing images, finding they developed better ability to resist than controls. However, desire levels did not change. Researchers now aim to develop the treatment into a serious video game combining BCI, transcranial direct current stimulation and virtual/augmented reality to further reduce craving and involve subjects. They will seek Horizon 2020 funding to create a prototype for wider network testing.
This document discusses how to engage players in health games. It begins by defining what a game is, noting that games have goals, rules, feedback, and voluntary participation. It then discusses two models of player typology: Bartle's taxonomy of achievers, explorers, killers and socializers, and BrainHex's seeker, survivor, daredevil, mastermind, conqueror, socializer and achiever types. The document defines health games and categorizes them into those where gaming is the primary feature with some health impact, those focused on health goals integrated with gaming, and those where health is the primary goal supplemented with gamification. It stresses the importance of defining goals, understanding the core audience and what they value
This document summarizes Tako Dojo, a game app designed to help kids with diabetes learn about managing their condition. The app includes 6 games in the Dojo area to engage kids and motivate them. It is connected to glucose meters so kids can earn points by checking blood glucose levels, which are recorded in the House monitoring area. The Library information area contains short videos about diabetes. The Square social area allows kids to connect and compete with friends. The app was created in partnership with a diagnostics company to help improve diabetes education and treatment adherence for children.
Dr. Roland Goetgeluk will present on LifeCyclR 1.0, a game-based rehabilitation system that motivates both healthy and unhealthy individuals to do 30 minutes of daily exercise via rehab and training on a bike. It aims to boost therapy compliance and reduce costs for conditions like cerebral palsy. Specialists input rehab programs that are translated into game landscapes by software. The system was positively tested attracting various patient groups and is now undergoing clinical trials to evaluate its effectiveness for rehab conditions like cerebral palsy and for elderly populations.
This document discusses using motion-controlled video games for rehabilitation of children with cerebral palsy and other movement disorders. It notes the struggles of traditional outpatient therapy and introduces reFit Gamo as a digital therapy system that uses games to motivate patients, provide instant biofeedback on exercises, and allow continuous evaluation of progress by patients, therapists, and parents. Examples of games are provided that target hand, full body, and cardiac rehabilitation through repetitive motions, coordination, and cognitive challenges.
Wii Fit balance training was compared to conventional balance therapy in outpatients with subacute stroke. Patients were randomly assigned to 30 minutes of either Wii Fit balance games under supervision twice a week for 8 weeks, or conventional balance exercises, both with additional home practice. The Berg Balance Scale and Dynamic Gait Index assessed balance and fall risk at baseline and post-intervention. Secondary measures included walking speed, fatigue, and independence in daily activities. The study hypothesized that Wii Fit balance training would be more effective for improving balance after stroke compared to conventional therapy in an outpatient setting.
Noreena Liu presented on using an "advergame" strategy to raise awareness and support for dementia carers. The advergame would use social media platforms to get people's attention and influence communities to help address problems carers face like a lack of communication, knowledge about dementia, and available services. It would be interactive advertising that delivers information while allowing users to provide feedback. Existing games for dementia and its carers can be used for social support, education to enhance knowledge about dementia, and health by helping carers better manage their situation.
Gwen Dziwenko developed the Glenrose Grocery Game at the Glenrose Rehabilitation Hospital in Edmonton, Alberta. The game is used by occupational therapists to engage clients with cognitive impairments in tasks related to grocery shopping and meal preparation. It assesses skills like attention, problem solving, memory, and budgeting. Players choose a character and celebrity to shop for, then must accurately collect all ingredients for a recipe within budget and time limits. The game tracks progress and provides an appropriate challenge level. Future plans include releasing the game as an iOS and Android app to distribute to other hospitals.
The document discusses a presentation called "ParkinsonGaming" given at the Games for Health Europe Conference 2018 by Peter David Faasse and Lianne de Haan from Radboud University. It describes using gaming to help the 55,000 people in the Netherlands with Parkinson's disease work on motor skills and exercise, which can slow progression of the disease. Previous studies found Parkinson's patients enjoyed using the Kinect for retraining movements at home. The presenters want to develop a simple home game using criteria like few colors and short rounds to help patients achieve exercise goals and motivate continued physical activity. They are looking for investors to help create the game.
Detlef La Grand discusses how virtual reality can make healthcare training more engaging and effective by allowing trainees to learn through experience in virtual environments. VR provides opportunities for storytelling, hands-on learning, and practicing skills anywhere by simulating real-world healthcare scenarios. It can also help foster empathy by allowing people to experience healthcare from others' perspectives through immersive VR tours and simulations.
This document discusses stress and mindsets. It summarizes research showing that an optimistic mindset is associated with better health outcomes and longer life. Additionally, those who view stress as enhancing rather than harmful are more likely to respond adaptively to stress. The document then outlines a pilot study showing that the VR game Stressjam was effective in changing players' mindsets to view stress positively, was highly engaging to play, and helped a broad range of people.
This document discusses trends in rehabilitation and the role of technology. It notes an increasing prevalence of chronic disorders and rising healthcare costs. Rehabilitation aims to help people adapt and self-manage their conditions. Technology such as robotics, virtual reality, and assistive devices can help regain function and autonomy. The ability to adapt is key for both patients and rehabilitation technology. Technology should be affordable and support self-reliance and participation.
This document discusses appropriate innovation and gamification in healthcare. It notes several urgent issues driving change, such as aging populations, increasing care demands, and rising costs. Gamification could help address workforce shortages and access issues if applied properly. Key criteria for determining what innovations are appropriate include whether they target individual health needs effectively and efficiently without overtreatment. Gamification must improve quality from a patient-centered perspective and be evidence-based, affordable, and sustainable to qualify for basic insurance coverage under the Dutch system. Overall, healthcare innovations require understanding problems, analyzing demands and processes, measuring impacts, and developing solutions centered on quality improvement.
Rabobank wants to invest in communities to address healthcare challenges. Healthcare expenses in the Netherlands are projected to double by 2040 due to issues like an aging population and rising obesity rates. There is a need for cooperation between healthcare providers, investors, and entrepreneurs to develop innovative solutions that help people live healthier lives and reduce costs. One example is a initiative called "Sarah" that brought these groups together to support the needs of an individual.
The document describes the BLISS project which aims to develop a behavior-based language-interactive speaking system to help elderly people with health problems like dementia remain independent at home. The system will use natural language processing techniques on big data like text, speech, and video from interviews to build a personalized model of individual clients and facilitate their self-management of health, well-being, and happiness. It will be evaluated on a large scale to assess how well it can increase client health outcomes.
This document summarizes research into using brain-computer interfaces (BCI) to treat addiction. In an initial trial, researchers gave 14 addicted subjects BCI training to control craving-inducing images, finding they developed better ability to resist than controls. However, desire levels did not change. Researchers now aim to develop the treatment into a serious video game combining BCI, transcranial direct current stimulation and virtual/augmented reality to further reduce craving and involve subjects. They will seek Horizon 2020 funding to create a prototype for wider network testing.
This document discusses how to engage players in health games. It begins by defining what a game is, noting that games have goals, rules, feedback, and voluntary participation. It then discusses two models of player typology: Bartle's taxonomy of achievers, explorers, killers and socializers, and BrainHex's seeker, survivor, daredevil, mastermind, conqueror, socializer and achiever types. The document defines health games and categorizes them into those where gaming is the primary feature with some health impact, those focused on health goals integrated with gaming, and those where health is the primary goal supplemented with gamification. It stresses the importance of defining goals, understanding the core audience and what they value
This document summarizes Tako Dojo, a game app designed to help kids with diabetes learn about managing their condition. The app includes 6 games in the Dojo area to engage kids and motivate them. It is connected to glucose meters so kids can earn points by checking blood glucose levels, which are recorded in the House monitoring area. The Library information area contains short videos about diabetes. The Square social area allows kids to connect and compete with friends. The app was created in partnership with a diagnostics company to help improve diabetes education and treatment adherence for children.
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Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
Good morning, and thanks for being here. My name is Adam Lobel, and I’m a PhD Candidate at the Radboud University in Nijmegen, and I’m going to talk with you today about the biofeedback game Nevermind. My hope is to impart good design techniques for making games which try to engross players and for games which want to use biofeedback.
Now. Disclaimer. I am not a designer. I did not design or develop Nevermind. I am just a scientist with a critical eye for design, and someone who very fortunately got to intimately work with Nevermind and its designers.
That aside, I’m going to spend the next 10 minutes telling you the story of just one of Nevermind’s levels.
Nevermind casts the player as a Neuroprober – a therapist of the future. As a Neuroprober it’s your job to enter the minds of Clients suffering from severe, life hindering psychological distress. The challenge is that your Clients can’t remember the root cause of their anxiety; they have a traumatic memory locked up somewhere in their subconscious, and it’s your job to unravel that memory.
This brings us to the biofeedback mechanic in the game which in the case of Nevermind, relies on the player’s heart rate.
Biofeedback refers to a system whereby the player’s physiology provides the game world with input.
<<<<<<<<<<<<<<animation>>>>>>>>>>>>>>
The game world then reacts to this input, which provides feedback to the player.
In the case of Nevermind, your Client’s subconscious is not happy that another person is lurking about, digging for clues. So the more stress the player feels – and the higher their heart rate – the more hostile the game world becomes.
I’ll offer concrete examples shortly.
But right now, I want to dive into one of Nevermind’s levels. So: SPOILER ALERT – I am going to walk through one level of Nevermind - the story of Client #251. I am going to totally spoil the mystery for you. Also, this case deals with mature themes such as alcoholism, firearms, domestic unrest, suicide, and car crashes. If anyone here is not comfortable with having this part of the game spoiled for them, or with these themes, now is a good chance to take a bathroom break.
So let’s enter the mind of Client #251. The game opens with a monologue from a young-middle-aged woman.
She was the “perfect little girl” she says… she remembers a happy childhood,
playing jigsaw puzzles with her father. Her father passed away when she was young, she says.
She can’t remember it well, but her mother says there was a car accident.
The Client’s mother also passed away recently, and that’s when some problems started to emerge. She often becomes paranoid around people,
it seems like people are looking at her, judging her – this makes her feel guilty and angry, she says.
But everything used to be so normal, she remembers with a sigh…
And with that, we’ve entered the mind of Client #251, and we found ourselves in a bright, if somewhat warped garden.
A child’s teddy bear and tea-set and lies innocently beside the tree
And this is where we collect our first of ten photographs. Each photograph represents a memory, and it will be our job to solve puzzles in order to unlock all the memories. Once they have all been unlocked, we must place the memories in the correct order; this way we will unlock the traumatic memory that is the root cause of Client #251’s anxiety.
As we pick up the photograph, we hear a door creak open. We proceed forward.
The house is a bit bare and a bit dark…
but otherwise, nothing seems out of the ordinary. … At least until the player goes upstairs
[VIDEO]
The player is now engulfed in a nightmare; the world has fundamentally changed.
Light…
…is replaced with darkness.
Bloodstains appear on the…
…walls and floor.
If we investigate the rest of the house we see how unsettling the world has become.
The player is literally in a broken home.
If we go to the kitchen…
… a spilled milk carton appears to have leaked blood.
And the living room which was once bright…
… is now shrouded in darkness and filled with ominous faces.
Even the paintings on the walls have changed…
Faces are blotched out
And ominous messages are scrawled on them…
It is in this environment that the player has to continuously master their anxiety level in order to solve the game’s puzzles. In each room, the more stress the player experiences, the more difficult it becomes to progress. Let’s go back to the kitchen for an example.
<Talk over about rising and subsiding milk>
So as the player overcomes these challenges by remaining calm in the face of truly creepy scenarios, the player will collect more photographs which help tell the story of Client #251…
For instance that her mother was a heavy drinker…
… and that her father may have been facing a debt crisis. “Daddy and his letters” - the photo reads - “he never wanted to play after the mailman brought new ones.”
And the player is also reminded that Client #251’s father was said to die in a car accident – “He died in a car accident, Mommy said… She hated questions about it.”
And it would seem that Client #251’s childhood was not as perfect as she seems to recall – “It was pretty lonely”
We also learn the possible source for the spilled milk carton.
Some of the later photographs become more gruesome…
And the final photograph is highly suggestive – This one says: “What is Daddy eating?”
But eventually, the player will have collected all 10 photographs, and he/she must return to the open garden to decipher what really happened to Client #251.
The player looks up to 10 photographs, and must choose 5 photographs and put them in the correct order that tell Client #251’s true story.
… and as the player pieces it all together, the game triggers a final cutscene.
VIDEO – Final cutscene
[Exhale] OK. So that was Client #251. If you’re all still with me,
I want to focus on three aspects of Nevermind’s design that help maximize player’s involvement. OK – so three design characteristics…
First design characteristic – Thematic congruence.
Thematic congruence means that there is an overlap between the themes of the game and the player’s visual experience. So themes like social anxiety, domestic unrest, guilt, and separating fact from fiction are all reflected by the game’s art and colors, and in the objects that appear in the game. So for example,
The idea that Client #251’s family unit corroded is depicted by a literally broken home.
Also, Client #251 spoke about this intense guilt she feels when she is being looked at.
Also, Client #251 talks about this intense guilt she feels when she is being looked at. So not only do all the portraits have blank faces, but in the nightmare version of the home, these faces are blotched out aggressively. And not only do these images recur throughout the game…
…but in certain portions, faces follow your player, staring in judgment.
And as a final example: At the heart of it, Client #251 feels personally responsible for her father’s suicide. The crux of the trauma is that she associates ‘spilling the milk’ with her father’s death.
And what do we see when we encounter spilled milk?
Spilled blood.
Second design characteristic – Environmental storytelling.
When your game has such consistent thematic congruence, as a designer, you can convey your story via the game world. So if all the art in the game has a purpose that matches the themes in your game, then exploring the world comes to have meaning for the player.
The more they explore, the more they are rewarded with details that help tell a story. Moreover, because exploration is voluntary, the things that players discover feel special. They experience a sense of ownership. “Oh wow – I found this!”
These sorts of details are sometimes called “Easter Eggs”, special treats which the designer tucks away for the player to find. And Nevermind has these in spades.
From the onset, there are signs in the environment that Client #251’s family was facing a debt problem. Did you notice the letter in the mailbox upon entering?
And did you notice what was scrawled on this painting?
Here it is again in the bedroom.
Here’s one that’s a bit more subtle. This is a jigsaw puzzle box before the player turns the lights off.
And here it is after. “Fractured Family, Inc.”
Now this one is really messed up. For players who dare to investigate the spilled over milk carton, they get treated to these super dark messages:
“Happy home milk” this is obvious sarcasm
But in extreme attention to detail… <<<<<<<<<<<<<<<<Animation>>>>>>>>>>>>>>>>>>>>>
The nutrition facts read “Total fault. They know. Your Fault.”
I could go on and on with more examples, but let me just drive my point home here. These instances of environmental story-telling not only compel players to explore, but with each discovery, the player feels more and more like they are cultivating their own personalized experience.
And that brings us to the third design characteristic…
Symbiotic biofeedback. So while environmental storytelling is one great way of making each player feel like their experience in Nevermind is unique to them…
what makes Nevermind feel especially personalized is its use of biofeedback.
So in the first place…
… the biofeedback mechanic in Nevermind is consistent with the game’s aims and design. This is a really important point, because it’s very easy for biofeedback games to get this wrong. So you could imagine a game where an increased heart rate leads to the player being faster in the game, for example. So the more active you feel, the more active you are. But in Nevermind, this would oppose the core design of the game. Instead, elevated heart rate indicates and stimulates adversity, forcing the player to recognize their change in physiology and then resolve it healthily.
In this sense, Nevermind’s biofeedback mechanic is deeply embedded in the design.
Second, different players will experience different levels of stress in different places.
<<<<<<<<<<<<animation>>>>>>>>>>>>
For some players, the atmosphere in the kitchen might be particularly unnerving, whereas for others the car maze or the funeral sequence may be when the stress especially kicks in. And for each of these areas, stress has a unique effect, leading to unique experiences for players depending on their sensitivity.
PAUSE
Finally, biofeedback in Nevermind lets players self-monitor. So if we think of Nevermind as a game which affords players a potential place for them to work through their anxiety and to regulate their physiology in the face of stress, then repeated plays Nevermind can help players track their progress. “Oh – this time, I was more quickly able to get the milk down”
So the hope is that on repeated plays, players should notice themselves getting better adept at dealing with stress.
I want to close by talking about the science of why Nevermind has so much promise as a tool for helping people.
What Nevermind gets at with its biofeedback mechanic, is something called Interoceptive Awareness.
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Interoceptive Awareness refers to the ability to consciously perceive one’s physiological states. So are my muscles calm or relaxed, is that pain coming from here or here, how is my breathing?
And there is good reason to expect that Interoceptive Awareness is a valuable skill for dealing with our emotions in the face of stress.
First,
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our emotions seem to be intrinsically linked to our physiological states. Physiological states can trigger emotional states and vice versa. For this reason, emotion theorists have argued that better internal awareness equips individuals for healthy emotion regulation.
A number of recent studies support these notions:
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-IA has also been negatively associated with Alexithymia, the inability to recognize one’s emotions
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-IA has been positively associated with the ability to down-regulate negative affect.
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-And people with a greater IA experience less negative affect when being socially excluded.
Taken together, Interoceptive Awareness, or the ability to recognize changes in your own physiology can be an important skill for managing stress and anxiety. This gives great promise to Nevermind as a potential tool for training people how to better recognize the physiological changes which underpin our emotions.
So last Fall, I conducted a study at USC in Los Angeles to see whether Nevermind is a feasible context for people to train their emotion regulation skills. The idea of the study was simple: We asked people to answer questions about how they deal with negative emotions in their everyday life and then we observed how they dealt with stress in Nevermind.
To answer our question, we are now looking at their heart rate data to identify different patterns of emotion regulation. The hope is that we can draw clear parallels between how well people were able to regulate their physiology in Nevermind and how well they regulate their emotions in their everyday life.
I want to quickly show you some of our data to give a quick idea of the types of questions we look to answer:
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To close: Nevermind shows promise as a tool for training emotion regulation skills, in my opinion,
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because it is designed to cultivate a personalized experience for it users.
How does it do this?
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Through Thematic Congruence and with Environmental Storytelling; and finally
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By having a biofeedback mechanic that not only works technically, but which is relevant and logical for its aims.
Thank you
I can’t help but remark how this talk brings things full circle for me. 3 years ago, at the beginning of my PhD, I came to this very conference to deliver my first public presentation as a PhD. I presented data from a study that was all about looking at the physiological experience of stress during video game playing. And at the end of my talk,
I mentioned this video game which I had chanced across via the internet – a game called Nevermind. At the time, Nevermind was just some far off thing; a game being designed halfway around the world… But interestingly enough, a game where the more stress the player would experience, the more difficult it would became to play.
And today, full circle, here I am to talk to you about the intricacies of Nevermind’s design. Specifically, I will talk about the design features of Nevermind that make it so promising as game to help teach people how to resolve anxiety in their everyday lives.
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Nevermind is a bio-feedback horror game developed by Flying Mollusk. That’s Erin Reynolds on the left, the game’s creator and lead designer, and to the right is Michael Annetta, the game’s creative producer.
We also learn that her father would drive to work everyday
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Nevermind began as a Master’s project at the University of Southern California’s IMGD program for game designers.
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It went on to garner the attention of Intel in large part because the game’s biofeedback mechanic – which I’ll get to – maps so well to Intel’s recently developed RealSense technology.
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And on the tails of that partnership, Nevermind also received funding via Kickstarter about one year ago.