Abstract
Objectives
To examine the effects of mindfulness-based Virtual Reality (VR) and relaxing music VR on relieving anxiety, stress, and depression in Chinese university students, respectively.
Method
A 2-week virtual reality intervention was conducted among university students in China. Sixty participants were randomized to three groups namely: (1)“Mindfulness VR”, (2) “Relaxing Music VR”, or (3) “Blank Control”. Participants' depression, anxiety, and stress levels were measured at baseline, immediately post-intervention, and at a 12-week follow-up. One-way analysis of variance (ANOVA) and paired-sample t-tests were performed to compare the effects of interventions on negative emotions outcomes.
Results
As compared to the control group, Mindfulness VR group and Relaxing Music VR group led to a decrease in depression, anxiety, and stress levels. The least significant difference test showed that Mindfulness VR group performed the best in reducing depression, anxiety, and stress levels. However, the paired-samples t-test showed no statistically significant differences in depression, anxiety, and stress levels across the three groups at both the 2-week and 12-week follow-up periods.
Conclusions
Both Mindfulness VR and Relaxing Music VR were effective psychological interventions in alleviating negative emotions. As compared to Relaxing Music VR, Mindfulness VR was found to be significantly more effective. Therefore, future efforts could focus on enhancing the Mindfulness VR intervention to benefit more university students. Besides that, further research should also be conducted to confirm the long-term impact of both interventions on alleviating negative emotions.
Preregistration
This study is not preregistered.
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Data Availability
Data is not available for organizational data protection reasons.
References
Andersen, T., Anisimovaite, G., Christiansen, A., Hussein, M., Lund, C., Nielsen, T., Nilsson, N. C., Nordahl, R., & Serafin, S. (2017). A preliminary study of users' experiences of meditation in virtual reality [Paper presentation]. 2017 IEEE Virtual Reality (VR), Los Angeles, CA, USA. https://doi.org/10.1109/VR.2017.7892317
Anderson, A. P., Mayer, M. D., Fellows, A. M., Cowan, D. R., Hegel, M. T., & Buckey, J. C. (2017). Relaxation with immersive natural scenes presented using virtual reality. Aerospace Medicine and Human Performance, 88(6), 520–526. https://doi.org/10.3357/AMHP.4747.2017
Appel, L., Appel, E., Bogler, O., Wiseman, M., Cohen, L., Ein, N., Abrams, H. B., & Campos, J. L. (2020). Older adults with cognitive and/or physical impairments can benefit from immersive virtual reality experiences: A feasibility study. Frontiers in Medicine, 6, 329. https://doi.org/10.3389/fmed.2019.00329
Arpaia, P., D’Errico, G., De Paolis, L. T., Moccaldi, N., & Nuccetelli, F. (2022). A narrative review of mindfulness-based interventions using virtual reality. Mindfulness, 13(3), 556–571. https://doi.org/10.1007/s12671-021-01783-6
Asif, S., Mudassar, A., Shahzad, T. Z., Raouf, M., & Pervaiz, T. (2020). Frequency of depression, anxiety and stress among university students. Pakistan Journal of Medical Sciences, 36(5), 971–976. https://doi.org/10.12669/pjms.36.5.1873
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125–143. https://doi.org/10.1093/clipsy.bpg015
Barreda-Ángeles, M., & Hartmann, T. (2022). Hooked on the metaverse? Exploring the prevalence of addiction to virtual reality applications. Frontiers in Virtual Reality, 3, 1031697. https://doi.org/10.3389/frvir.2022.1031697
Bauer, C. C. C., Rozenkrantz, L., Caballero, C., Nieto-Castanon, A., Scherer, E., West, M. R., Mrazek, M., Phillips, D. T., Gabrieli, J. D. E., & Whitfield-Gabrieli, S. (2020). Mindfulness training preserves sustained attention and resting state anticorrelation between default-mode network and dorsolateral prefrontal cortex: A randomized controlled trial. Human Brain Mapping, 41(18), 5356–5369. https://doi.org/10.1002/hbm.25197
Bennett, M. P., Knight, R., Patel, S., So, T., Dunning, D., Barnhofer, T., Smith, P., Kuyken, W., Ford, T., & Dalgleish, T. (2021). Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: A narrative review and insight report. Translational Psychiatry, 11(288), 1–14. https://doi.org/10.1038/s41398-021-01397-5
Berto, R. (2014). The role of nature in coping with psycho-physiological stress: A literature review on restorativeness. Behavioral Sciences, 4(4), 394–409. https://doi.org/10.3390/bs4040394
Bojic, L. (2022). Metaverse through the prism of power and addiction: What will happen when the virtual world becomes more attractive than reality? European Journal of Futures Research, 10(1), 1–24. https://doi.org/10.1186/s40309-022-00208-4
Bowman, D. A., & McMahan, R. P. (2007). Virtual reality: How much immersion is enough? Computer, 40(7), 36–43. https://doi.org/10.1109/MC.2007.257
Bremer, B., Wu, Q., Mora Álvarez, M. G., Hölzel, B. K., Wilhelm, M., Hell, E., Tavacioglu, E. E., Torske, A., & Koch, K. (2022). Mindfulness meditation increases default mode, salience, and central executive network connectivity. Scientific Reports, 12(1), 13219. https://doi.org/10.1038/s41598-022-17325-6
Brooks, H., Oughli, H. A., Kamel, L., Subramanian, S., Morgan, G., Blumberger, D. M., Kloeckner, J., Kumar, S., Mulsant, B. H., Lenze, E. J., & Rajji, T. K. (2021). Enhancing cognition in older persons with depression or anxiety with a combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a pilot randomized clinical trial. Mindfulness, 12(12), 3047–3059. https://doi.org/10.1007/s12671-021-01764-9
Butt, M., Kabariti, S., Likourezos, A., Drapkin, J., Hossain, R., Brazg, J., & Motov, S. (2022). Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. Academic Emergency Medicine, 29(3), 270–277. https://doi.org/10.1111/acem.14412
Cai, S. (2015). Leisure patterns and constraints reported by selected Chinese university students [Unpublished master’s thesis]. University of Waterloo.
Carl, E., Stein, A. T., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P., & Powers, M. B. (2019). Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 61, 27–36. https://doi.org/10.1016/j.janxdis.2018.08.003
Casey, S. M., Varela, A., Marriott, J. P., Coleman, C. M., & Harlow, B. L. (2022). The influence of diagnosed mental health conditions and symptoms of depression and/or anxiety on suicide ideation, plan, and attempt among college students: Findings from the Healthy Minds Study, 2018–2019. Journal of Affective Disorders, 298, 464–471. https://doi.org/10.1016/j.jad.2021.11.006
Castro, W. P., Sánchez, M. J. R., González, C. T. P., Bethencourt, J. M., de la Fuente Portero, J. A., & Marco, R. G. (2014). Cognitive-behavioral treatment and antidepressants combined with virtual reality exposure for patients with chronic agoraphobia. International Journal of Clinical and Health Psychology, 14(1), 9–17. https://doi.org/10.1016/S1697-2600(14)70032-8
Cebolla, A., Herrero, R., Ventura, S., Miragall, M., Bellosta-Batalla, M., Llorens, R., & Baños, R. M. (2019). Putting oneself in the body of others: A pilot study on the efficacy of an embodied virtual reality system to generate self-compassion. Frontiers in Psychology, 10, 1521. https://doi.org/10.3389/fpsyg.2019.01521
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404
Costa, M., Bergen-Cico, D., Grant, T., Herrero, R., Navarro, J., Razza, R., & Wang, Q. (2019). Nature inspired scenes for guided mindfulness training: Presence, perceived restorativeness and mediation depth. In D. D. Schmorrow & C. M. Fidopiastis (Eds.), Augmented Cognition: 13th International Conference, AC 2019, Held as Part of the 21st HCI International Conference, HCII 2019, Orlando, FL, USA, July 26–31, 2019, Proceedings (pp. 517–532). Springer. https://doi.org/10.1007/978-3-030-22419-6_37
da Silva, C. C. G., Bolognani, C. V., Amorim, F. F., & Imoto, A. M. (2023). Effectiveness of training programs based on mindfulness in reducing psychological distress and promoting well-being in medical students: A systematic review and meta-analysis. Systematic Reviews, 12(1), 79. https://doi.org/10.1186/s13643-023-02244-y
Dantas Silva, J. (2019). Aurora-a study on the guided meditation using immersive media [Master’s thesis, Malmö University]. Digitala Vetenskapliga Arkive. https://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-20253
Dernbecher, S., & Beck, R. (2017). The concept of mindfulness in information systems research: A multi-dimensional analysis. European Journal of Information Systems, 26(2), 121–142. https://doi.org/10.1057/s41303-016-0032-z
Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2006). Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Academic Medicine, 81(4), 354–373. https://doi.org/10.1097/00001888-200604000-00009
Fu, W., Yan, S., Zong, Q., Anderson-Luxford, D., Song, X., Lv, Z., & Lv, C. (2021). Mental health of college students during the COVID-19 epidemic in China. Journal of Affective Disorders, 280, 7–10. https://doi.org/10.1016/j.jad.2020.11.032
Galante, J., Stochl, J., Dufour, G., Vainre, M., Wagner, A. P., & Jones, P. B. (2021). Effectiveness of providing university students with a mindfulness-based intervention to increase resilience to stress: 1-year follow-up of a pragmatic randomised controlled trial. Journal of Epidemiology and Community Health, 75(2), 151–160. https://doi.org/10.1136/jech-2020-214390
Gao, L., Xie, Y., Jia, C., & Wang, W. (2020). Prevalence of depression among Chinese university students: A systematic review and meta-analysis. Scientific Reports, 10(1), 15897. https://doi.org/10.1038/s41598-020-72998-1
García-Batista, Z. E., Guerra-Peña, K., Alsina-Jurnet, I., Cano-Vindel, A., Álvarez-Hernández, A., Cantisano-Guzmán, L. M., Bordas-Puras, M., Moretti, L., & Medrano, L. A. (2022). Design and validation of virtual environments for the treatment of cleaning obsessive-compulsive disorder. Heliyon, 8, e12487. https://doi.org/10.1016/j.heliyon.2022.e12487
Gardi, C., Fazia, T., Stringa, B., & Giommi, F. (2022). A short mindfulness retreat can improve biological markers of stress and inflammation. Psychoneuroendocrinology, 135, 105579. https://doi.org/10.1016/j.psyneuen.2021.105579
Geng, J., & Wu, X. (2021). Application of virtual reality technology in university education [Paper presentation]. 2021 2nd International Conference on Artificial Intelligence and Education (ICAIE), Dali, China. https://doi.org/10.1109/ICAIE53562.2021.00104
Giachos, D., Paschali, M., Datko, M. C., et al. (2022). Characterizing nature videos for an attention placebo control for MBSR: The development of Nature-Based Stress Reduction (NBSR). Mindfulness, 13(6), 1577–1589. https://doi.org/10.1007/s12671-022-01903-w
Gromala, D., Tong, X., Choo, A., Karamnejad, M., & Shaw, C. D. (2015). The virtual meditative walk: Virtual reality therapy for chronic pain management [Paper presentation]. The 33rd Annual ACM Conference on Human Factors in Computing Systems, Seoul, Republic of Korea. https://doi.org/10.1145/2702123.2702344
Han, D. I. D., Bergs, Y., & Moorhouse, N. (2022). Virtual reality consumer experience escapes: Preparing for the metaverse. Virtual Reality, 26(4), 1443–1458. https://doi.org/10.1007/s10055-022-00641-7
Hatta, M. H., Sidi, H., Siew Koon, C., CheRoos, N. A., Sharip, S., Abdul Samad, F. D., Wan Xi, O., Das, S., & Mohamed Saini, S. (2022). Virtual reality (VR) technology for treatment of mental health problems during COVID-19: A systematic review. International Journal of Environmental Research and Public Health, 19(9), 5389. https://doi.org/10.3390/ijerph19095389
Heller, A. T., Berg, S. S., & Prichard, J. R. (2023). University housing reinforces the negative relationship between interpersonal violence, psychological distress, and suicidality in undergraduates, particularly among gender diverse students. Journal of American College Health, 71(1), 102–110. https://doi.org/10.1080/07448481.2021.1878186
Holsapple, C. W., & Wu, J. (2007). User acceptance of virtual worlds: The hedonic framework. ACM SIGMIS Database: The DATABASE for Advances in Information Systems, 38(4), 86–89. https://doi.org/10.1145/1314234.1314250
Ilioudi, M., Wallström, S., Steingrimsson, S., Lindner, P., Thunström, A. O., & Ali, L. (2023). Patient experience of a virtual reality calm room in a psychiatric inpatient care setting in Sweden: a qualitative study with inpatients. BMJ Open, 13(12), e076285. https://doi.org/10.1136/bmjopen-2023-076285
Jerdan, S. W., Grindle, M., Van Woerden, H. C., & Boulos, M. N. K. (2018). Head-mounted virtual reality and mental health: Critical review of current research. JMIR Serious Games, 6(3), e9226. https://doi.org/10.2196/games.9226
Jourabloo, A., Gecer, B., Torre, F.D., Saragih, J., Wei, S., Wang, T., Lombardi, S., Belko, D., Trimble, A., & Badino, H. (2022). The efficacy of a virtual reality-based mindfulness intervention [Paper presentation]. 2022 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR), New Orleans, LA, USA. https://doi.org/10.1109/CVPR52688.2022.01968
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016
Kabat-Zinn, J. (2015). Mindfulness. Mindfulness, 6(6), 1481–1483. https://doi.org/10.1007/s12671-015-0456-x
Kalkbrenner, M. T., Jolley, A. L., & Hays, D. G. (2021). Faculty views on college student mental health: Implications for retention and student success. Journal of College Student Retention: Research, Theory & Practice, 23(3), 636–658. https://doi.org/10.1177/1521025119867639
Kamińska, D., Smółka, K., Zwoliński, G., Wiak, S., Merecz-Kot, D., & Anbarjafari, G. (2020). Stress reduction using bilateral stimulation in virtual reality. IEEE Access, 8, 200351–200366. https://doi.org/10.1109/ACCESS.2020.3035540
Kampa, M., Finke, J., Stalder, T., Bucher, L., Klapperich, H., Mertl, F., Zimmer, C., Geiger, C., Hassenzahl, M., & Klucken, T. (2022). Facilitating relaxation and stress reduction in healthy participants through a virtual reality intervention: Study protocol for a non-inferiority randomized controlled trial. Trials, 23(1), 380. https://doi.org/10.1186/s13063-022-06307-8
Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology, 15(3), 169–182. https://doi.org/10.1016/0272-4944(95)90001-2
Kaplan, S., & Berman, M. G. (2010). Directed attention as a common resource for executive functioning and self-regulation. Perspectives on Psychological Science, 5(1), 43–57. https://doi.org/10.1177/1745691609356784
Kaplan-Rakowski, R., Johnson, K. R., & Wojdynski, T. (2021). The impact of virtual reality meditation on college students’ exam performance. Smart Learning Environments, 8, 21. https://doi.org/10.1186/s40561-021-00166-7
Karyotaki, E., Cuijpers, P., Albor, Y., Alonso, J., Auerbach, R. P., Bantjes, J., Bruffaerts, R., Ebert, D. D., Hasking, P., Kiekens, G., Lee, S., McLafferty, M., Mak, A., Mortier, P., Sampson, N. A., Stein, D. J., Vilagut, G., & Kessler, R. C. (2020). Sources of stress and their associations with mental disorders among college students: Results of the world health organization world mental health surveys international college student initiative. Frontiers in Psychology, 11, 1759. https://doi.org/10.3389/fpsyg.2020.01759
Kim, K.-I., Won, H., Liu, X., Liu, P., & Kitanishi, K. (1997). Students’ Stress in China, Japan and Korea: A Transcultural Study. International Journal of Social Psychiatry, 43(2), 87–94. https://doi.org/10.1177/002076409704300202
King, N., Pickett, W., McNevin, S. H., Bowie, C. R., Rivera, D., Keown-Stoneman, C., Harkness, K., Cunningham, S., Milanovic, M., Saunders, K. E. A., Goodday, S., Duffy, A., U-Flourish Student Well-Being and Academic Success Research Group. (2021). Mental health need of students at entry to university: Baseline findings from the U-flourish student well-being and academic success study. Early Intervention in Psychiatry, 15(2), 286–295. https://doi.org/10.1111/eip.12939
Kosunen, I., Salminen, M., Järvelä, S., Ruonala, A., Ravaja, N., & Jacucci, G. (2016). RelaWorld: Neuroadaptive and Immersive Virtual Reality Meditation System [Paper presentation]. The 21st International Conference on Intelligent User Interfaces, Sonoma, California, USA. https://doi.org/10.1145/2856767.2856796
Kothgassner, O. D., Goreis, A., Kafka, J. X., Kaufmann, M., Atteneder, K., Beutl, L., Hennig-Fast, K., Hlavacs, H., & Felnhofer, A. (2019). Virtual social support buffers stress response: An experimental comparison of real-life and virtual support prior to a social stressor. Journal of Behavior Therapy and Experimental Psychiatry, 63, 57–65. https://doi.org/10.1016/j.jbtep.2018.11.003
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Krumholz, M. F., Pinnell, C., & Sullivan, D. (2022). Effectiveness of brief mindfulness practice for enhancing graduate students’ attention. Psychology & Neuroscience, 15(2), 177–185. https://doi.org/10.1037/pne0000268
Kuyken, W., Hayes, R., Barrett, B., Byng, R., Dalgleish, T., Kessler, D., Lewis, G., Watkins, E., Brejcha, C., Cardy, J., Causley, A., Cowderoy, S., Evans, A., Gradinger, F., Kaur, S., Lanham, P., Morant, N., Richards, J., Shah, P., … Byford, S. (2015). Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): A randomised controlled trial. The Lancet, 386(9988), 63–73. https://doi.org/10.1016/s0140-6736(14)62222-4
Lai, M., & Chung, S.W. (2021). TranScent in Stillness: Exploring the feasibility of using Incense Art with virtual reality for meditation. 10th International Conference on Digital and Interactive Arts (pp. 1–7). https://doi.org/10.1145/3483529.3483535
Lee, L. H., Braud, T., Zhou, P., Wang, L., Xu, D., Lin, Z., Kumar, A., Bermejo, C., & Hui, P. (2021). All one needs to know about metaverse: A complete survey on technological singularity, virtual ecosystem, and research agenda. ArXiv. https://doi.org/10.48550/arXiv.2110.05352
Leung, G., Hazan, H., & Chan, C. (2022). Exposure to nature in immersive virtual reality increases connectedness to nature among people with low nature affinity. Journal of Environmental Psychology, 83, 101863. https://doi.org/10.1016/j.jenvp.2022.101863
Li, W., Chen, J., Liu, Y., Liu, Y., Hu, X., Mu, F., Liu, C., Zhang, Y., & Liu, Y. (2023). The mediating effects of dysfunctional attitudes and moderating effect of sex between stressful life events and depressive symptoms among Chinese college students. Scientific Reports, 13(1), 10910. https://doi.org/10.1038/s41598-023-38103-y
Liszio, S., & Masuch, M. (2019). Interactive immersive virtual environments cause relaxation and enhance resistance to acute stress. Annual Review of Cybertherapy and Telemedicine, 17, 65–71.
Liu, X. Q., Guo, Y. X., & Xu, Y. (2023). Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives. World Journal of Clinical Cases, 11(7), 1442–1457. https://doi.org/10.12998/wjcc.v11.i7.1442
Lothes, J. E., II., Matney, S., Naseer, Z., & Pfyffer, R. (2023). Sitting meditation and mindfulness effects on overall anxiety and test anxiety among college students. Mind, Brain, and Education, 17, 61–69. https://doi.org/10.1111/mbe.12344
Lu, W., Bian, Q., Wang, W., Wu, X., Wang, Z., & Zhao, M. (2017). Chinese version of the Perceived Stress Scale-10: A psychometric study in Chinese university students. PLoS ONE, 12(12), e0189543. https://doi.org/10.1371/journal.pone.0189543
Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2019). The mindfulness app trial for weight, weight-related behaviors, and stress in university students: Randomized controlled trial. JMIR mHealth and uHealth, 7(4), e12210. https://doi.org/10.2196/12210
Ma, H., Bian, Y., Wang, Y., Zhou, C., Geng, W., Zhang, F., Liu, J., & Yang, C. (2021). Exploring the effect of virtual reality relaxation environment on white coat hypertension in blood pressure measurement. Journal of Biomedical Informatics, 116, 103721. https://doi.org/10.1016/j.jbi.2021.103721
Ma, J., Zhao, D., Xu, N., & Yang, J. (2022a). The effectiveness of immersive virtual reality (VR) based mindfulness training on improvement mental-health in adults: A narrative systematic review. Explore, 19(3), 310–318. https://doi.org/10.1016/j.explore.2022.08.001
Ma, Y., Zhang, B., Meng, Y., Cao, Y., Mao, Y., & Qiu, C. (2022b). Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience. Frontiers in Public Health, 10, 951717. https://doi.org/10.3389/fpubh.2022.951717
Mahmud, A. A. E., Zakaria, H., Yusoff, M. Z. M., Jaafar, N. R. N., Baharudin, A., & Tamil, A. M. (2022). Brief virtual reality exposure therapy and its effects on negative and positive emotions among healthy working adults: A feasibility study. Alpha Psychiatry, 23(5), 223–229. https://doi.org/10.5152/alphapsychiatry.2022.21781
Malik, B. M. (2022). The benefits of mindfulness meditation: A comprehensive guide. Jahan-e-Tahqeeq, 5(1), 412–420. https://www.jahan-e-tahqeeq.com/index.php/jahan-e-tahqeeq/article/view/884.
Margaryan, A., Littlejohn, A., & Vojt, G. (2011). Are digital natives a myth or reality? University students’ use of digital technologies. Computers & Education, 56(2), 429–440. https://doi.org/10.1016/j.compedu.2010.09.004
Matsuda, E., & Kikutani, M. (2022). The interactive influence of life stressor and sleep disturbance on depression: a cross-sectional examination on Chinese and Japanese University Students. SAGE Open, 12(1). https://doi.org/10.1177/21582440221086610
Mayer, G., Gronewold, N., Polte, K., Hummel, S., Barniske, J., Korbel, J. J., Zarnekow, R., & Schultz, J. H. (2022). Experiences of patients and therapists testing a virtual reality exposure app for symptoms of claustrophobia: Mixed methods study. JMIR Mental Health, 9(12), e40056. https://doi.org/10.2196/40056
Meehan, M., Insko, B., Whitton, M., & Brooks, F. P., Jr. (2002). Physiological measures of presence in stressful virtual environments. ACM Transactions on Graphics, 21(3), 645–652. https://doi.org/10.1145/566654.566630
Mimnaugh, K. J. (2018). Investigating how mindfulness promotes the restorative effects of nature exposure in virtual reality [Master's thesis, University of Illinois at Urbana-Champaign], Graduate Dissertations and Theses at Illinois. Retrieved 6 Mar 2022, from https://hdl.handle.net/2142/101079
Modrego-Alarcón, M., López-Del-Hoyo, Y., García-Campayo, J., Pérez-Aranda, A., Navarro-Gil, M., Beltrán-Ruiz, M., Morillo, H., Delgado-Suarez, I., Oliván-Arévalo, R., & Montero-Marin, J. (2021). Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial. Behaviour Research and Therapy, 142, 103866. https://doi.org/10.1016/j.brat.2021.103866
Morris, S. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational Research Methods, 11(2), 364–386. https://doi.org/10.1177/1094428106291059
Mrazek, M. D., Franklin, M. S., Phillips, D. T., Baird, B., & Schooler, J. W. (2013). Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychological Science, 24(5), 776–781. https://doi.org/10.1177/0956797612459659
Navarro-Haro, M. V., López-Del-Hoyo, Y., Campos, D., Linehan, M. M., Hoffman, H. G., García-Palacios, A., Modrego-Alarcón, M., Borao, L., & García-Campayo, J. (2017). Meditation experts try virtual reality mindfulness: A pilot study evaluation of the feasibility and acceptability of virtual reality to facilitate mindfulness practice in people attending a mindfulness conference. PLoS ONE, 12(11), e0187777. https://doi.org/10.1371/journal.pone.0187777
Navarro-Haro, M. V., Modrego-Alarcón, M., Hoffman, H. G., López-Montoyo, A., Navarro-Gil, M., Montero-Marin, J., García-Palacios, A., Borao, L., & García-Campayo, J. (2019). Evaluation of a mindfulness-based intervention with and without virtual reality Dialectical Behavior Therapy® mindfulness skills training for the treatment of generalized anxiety disorder in primary care: A pilot study. Frontiers in Psychology, 10, 55. https://doi.org/10.3389/fpsyg.2019.00055
Naylor, M., Morrison, B., Ridout, B., & Campbell, A. (2019). Augmented experiences: Investigating the feasibility of virtual reality as part of a workplace wellbeing intervention. Interacting with Computers, 31(5), 507–523. https://doi.org/10.1093/iwc/iwz033
Niedermeier, J., Mumba, M. N., Barron, K., Andrabi, M., Martin, R., & McDiarmid, A. (2022). Relationships among exercise, mindfulness, mental health, and academic achievement among prelicensure nursing students. Nurse Educator, 47(3), 184–189. https://doi.org/10.1097/NNE.0000000000001106
Noronha, H., & Campos, P. (2021). Harnessing virtual reality nature to promote well-being. Interacting with Computers, 33(4), 353–366. https://doi.org/10.1093/iwc/iwac004
Odriozola-González, P., Planchuelo-Gómez, Á., Irurtia, M. J., & de Luis-García, R. (2020). Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Research, 290, 113108. https://doi.org/10.1016/j.psychres.2020.113108
Oh, J., Kim, S., Lee, S., Jeong, S., Ko, S. H., & Bae, J. (2021). A liquid metal based multimodal sensor and haptic feedback device for thermal and tactile sensation generation in virtual reality. Advanced Functional Materials, 31(39), 2007772. https://doi.org/10.1002/adfm.202007772
Oliveira, T., Noriega, P., Carvalhais, J., Rebelo, F., Lameira, V. (2020). How Deep Is a Virtual Reality Experience? Virtual Environments, Emotions and Physiological Measures. In F. Rebelo & M. Soares (Eds.), Advances in Ergonomics in Design: Proceedings of the AHFE 2019 International Conference on Ergonomics in Design, July 24–28, 2019, Washington DC, USA 10 (pp. 462–471). Springer. https://doi.org/10.1007/978-3-030-20227-9_43
Ørskov, P. T., Lichtenstein, M. B., Ernst, M. T., Fasterholdt, I., Matthiesen, A. F., Scirea, M., Bouchard, S., & Andersen, T. E. (2022). Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial. Frontiers in Psychiatry, 13, 991755. https://doi.org/10.3389/fpsyt.2022.991755
Paes, D., Irizarry, J., Billinghurst, M., & Pujoni, D. (2023). Investigating the relationship between three-dimensional perception and presence in virtual reality-reconstructed architecture. Applied Ergonomics, 109, 103953. https://doi.org/10.1016/j.apergo.2022.103953
Pizzoli, S. F. M., Mazzocco, K., Triberti, S., Monzani, D., Alcañiz Raya, M. L., & Pravettoni, G. (2019). User-centered virtual reality for promoting relaxation: An innovative approach. Frontiers in Psychology, 10, 479. https://doi.org/10.3389/fpsyg.2019.00479
Planert, J., Machulska, A., Hildebrand, A. S., Roesmann, K., Otto, E., & Klucken, T. (2022). Self-guided digital treatment with virtual reality for panic disorder and agoraphobia: A study protocol for a randomized controlled trial. Trials, 23(1), 426. https://doi.org/10.1186/s13063-022-06366-x
Popa, C. O., Sava, F. A., Muresan, S., Schenk, A., Cojocaru, C. M., Muntean, L. M., & Olah, P. (2022). Standard CBT versus integrative and multimodal CBT assisted by virtual-reality for generalized anxiety disorder. Frontiers in Psychology, 13, 1008981. https://doi.org/10.3389/fpsyg.2022.1008981
Proulx, K. (2003). Integrating mindfulness-based stress reduction. Holistic Nursing Practice, 17(4), 201–208. https://doi.org/10.1097/00004650-200307000-00007
Ren, L., Wang, Y., Wu, L., Wei, Z., Cui, L. B., Wei, X., Hu, X., Peng, J., Jin, Y., Li, F., Yang, Q., & Liu, X. (2021). Network structure of depression and anxiety symptoms in Chinese female nursing students. BMC Psychiatry, 21(1), 279. https://doi.org/10.1186/s12888-021-03276-1
Riches, S., & Smith, H. (2022). Taking a break in the “new normal”: Virtual reality relaxation for a stressed workforce. Mental Health Review Journal, 27(2), 133–136. https://doi.org/10.1108/MHRJ-06-2022-095
Riches, S., Azevedo, L., Bird, L., Pisani, S., & Valmaggia, L. (2021). Virtual reality relaxation for the general population: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 56(10), 1707–1727. https://doi.org/10.1007/s00127-021-02110-z
Riva, G., Wiederhold, B., & Mantovani, F. (2019). Neuroscience of virtual reality: From virtual exposure to embodied medicine. Cyberpsychology, Behavior, and Social Networking, 22(1), 82–96. https://doi.org/10.1089/cyber.2017.29099.gri
Rosset, M., Baumann, E., & Altenmüller, E. (2022). A longitudinal study of physical and mental health and health-related attitudes among music students: Potentials and challenges for university health promotion programs. Frontiers in Psychology, 13, 885739. https://doi.org/10.3389/fpsyg.2022.885739
Sapra, A., Bhandari, P., Sharma, S., Chanpura, T., & Lopp, L. (2020). Using Generalized Anxiety Disorder-2 (GAD-2) and GAD-7 in a primary care setting. Cureus, 12(5), e8224. https://doi.org/10.7759/cureus.8224
Sarpourian, F., Samad-Soltani, T., Moulaei, K., & Bahaadinbeigy, K. (2022). The effect of virtual reality therapy and counseling on students’ public speaking anxiety. Health Science Reports, 5(5), e816. https://doi.org/10.1002/hsr2.816
Seabrook, E., Kelly, R., Foley, F., Theiler, S., Thomas, N., Wadley, G., & Nedeljkovic, M. (2020). Understanding how virtual reality can support mindfulness practice: Mixed methods study. Journal of Medical Internet Research, 22(3), e16106. https://doi.org/10.2196/16106
Segawa, T., Baudry, T., Bourla, A., Blanc, J. V., Peretti, C. S., Mouchabac, S., & Ferreri, F. (2020). Virtual reality (VR) in assessment and treatment of addictive disorders: A systematic review. Frontiers in Neuroscience, 13, 1409. https://doi.org/10.3389/fnins.2019.01409
Shadiev, R., Yang, L., & Huang, Y. M. (2022). A review of research on 360-degree video and its applications to education. Journal of Research on Technology in Education, 54(5), 784–799. https://doi.org/10.1080/15391523.2021.1928572
Smallwood, J., & Schooler, J. W. (2015). The science of mind wandering: Empirically navigating the stream of consciousness. Annual Review of Psychology, 66, 487–518. https://doi.org/10.1146/annurev-psych-010814-015331
Stankov, L. (2010). Unforgiving Confucian culture: A breeding ground for high academic achievement, test anxiety and self-doubt? Learning and Individual Differences, 20(6), 555–563. https://doi.org/10.1016/j.lindif.2010.05.003
Sun, J., Liang, K., Chi, X., & Chen, S. (2021). Psychometric properties of the Generalized Anxiety Disorder Scale-7 item (GAD-7) in a large sample of Chinese adolescents. Healthcare, 9(12), 1709. https://doi.org/10.3390/healthcare9121709
Tang, R., Friston, K. J., & Tang, Y. Y. (2020). Brief mindfulness meditation induces gray matter changes in a brain hub. Neural Plasticity, 2020, 8830005. https://doi.org/10.1155/2020/8830005
Tay, J. L., Xie, H., & Sim, K. (2023). Effectiveness of augmented and virtual reality-based interventions in improving knowledge, attitudes, empathy and stigma regarding people with mental illnesses: A scoping review. Journal of Personalized Medicine, 13(1), 112. https://doi.org/10.3390/jpm13010112
Valim, C. P. R. A. T., Marques, L. M., & Boggio, P. S. (2019). A positive emotional-based meditation but not mindfulness-based meditation improves emotion regulation. Frontiers in Psychology, 10, 647. https://doi.org/10.3389/fpsyg.2019.00647
van Meggelen, M., Morina, N., van der Heiden, C., Brinkman, W. P., Yocarini, I. E., Tielman, M. L., Rodenburg, J., van Ee, E., van Schie, K., Broekman, M. E., & Franken, I. H. A. (2022). A randomized controlled trial to pilot the efficacy of a computer-based intervention with elements of virtual reality and limited therapist assistance for the treatment of post-traumatic stress disorder. Frontiers in Digital Health, 18(4), 974668. https://doi.org/10.3389/fdgth.2022.974668
Vidyarthi, J., Riecke, B. E., & Gromala, D. (2012). Sonic Cradle: designing for an immersive experience of meditation by connecting respiration to music [Paper presentation]. Designing Interactive Systems Conference 2012, Newcastle upon Tyne, UK. https://doi.org/10.1145/2317956.2318017
Villani, D., & Riva, G. (2012). Does interactive media enhance the management of stress? Suggestions from a controlled study. Cyberpsychology, Behavior, and Social Networking, 15(1), 24–30. https://doi.org/10.1089/cyber.2011.0141
Vorontsova-Wenger, O., Ghisletta, P., Ababkov, V., Bondolfi, G., & Barisnikov, K. (2022). Short mindfulness-based intervention for psychological and academic outcomes among university students. Anxiety, Stress, and Coping, 35(2), 141–157. https://doi.org/10.1080/10615806.2021.1931143
Wang, J. (2023). Research on employment anxiety of college graduates based on Self Efficacy Theory. Advances in Psychology, 13(5), 1876–1880. https://doi.org/10.12677/AP.2023.135229
Wang, Z., Li, Y., An, J., Dong, W., Li, H., Ma, H., Wang, J., Wu, J., Jiang, T., & Wang, G. (2022). Effects of restorative environment and presence on anxiety and depression based on interactive virtual reality scenarios. International Journal of Environmental Research and Public Health, 19(13), 7878. https://doi.org/10.3390/ijerph19137878
Wang, T., Yao, Z., Liu, Q., Zhao, J., Wang, X., Wong, J.P.-H., Vahabi, M., & Jia, C. (2023). The mediating effect of stress between extracurricular activities and suicidal ideation in Chinese college students. International Journal of Environmental Research and Public Health, 20(4), 3105. https://doi.org/10.3390/ijerph20043105
Witmer, B. G., & Singer, M. J. (1998). Measuring presence in virtual environments: A presence questionnaire. Presence: Teleoperators and Virtual Environments, 7(3), 225–240. https://doi.org/10.1162/105474698565686
Wu, D., Yu, L., Yang, T., Cottrell, R., Peng, S., Guo, W., & Jiang, S. (2020). The impacts of uncertainty stress on mental disorders of Chinese college students: Evidence from a nationwide study. Frontiers in Psychology, 11, 243. https://doi.org/10.3389/fpsyg.2020.00243
Xu, W., Liang, H. N., Baghaei, N., Ma, X., Yu, K., Meng, X., & Wen, S. (2021). Effects of an immersive virtual reality exergame on university students’ anxiety, depression, and perceived stress: Pilot feasibility and usability study. JMIR Serious Games, 9(4), e29330. https://doi.org/10.2196/29330
Yang, M. (2018). Application of virtual reality technology in college students' mental health education. First International Conference on Advanced Algorithms and Control Engineering (pp. 1–6). IOP Publishing. https://doi.org/10.1088/1742-6596/1087/6/062056
Yildirim, C., & O’Grady, T. (2020). The efficacy of a virtual reality-based mindfulness intervention [Paper presentation]. 2020 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR), Utrecht, Netherlands. https://doi.org/10.1109/AIVR50618.2020.00035
Yu, Y., Yan, W., Yu, J., Xu, Y., Wang, D., & Wang, Y. (2022). Prevalence and associated factors of complains on depression, anxiety, and stress in university students: An extensive population-based survey in China. Frontiers in Psychology, 13, 842378. https://doi.org/10.3389/fpsyg.2022.842378
Yun, M. R., Shin, N., Kim, H., Jang, I. S., Ha, M. J., & Yu, B. (2020). Effects of school-based meditation courses on self-reflection, academic attention, and subjective well-being in South Korean middle school students. Journal of Pediatric Nursing, 54, e61–e68. https://doi.org/10.1016/j.pedn.2020.05.002
Zhai, X., Wu, N., Koriyama, S., Wang, C., Shi, M., Huang, T., Wang, K., Sawada, S. S., & Fan, X. (2021). Mediating effect of perceived stress on the association between physical activity and sleep quality among Chinese college students. International Journal of Environmental Research and Public Health, 18(1), 289. https://doi.org/10.3390/ijerph18010289
Zhang, Y., Zhang, L., Hua, H., Jin, J., Zhu, L., Shu, L., Xu, X., Kuang, F., & Liu, Y. (2021). Relaxation degree analysis Using Frontal Electroencephalogram under virtual reality relaxation scenes. Frontiers in Neuroscience, 15, 719869. https://doi.org/10.3389/fnins.2021.719869
Zhang, S., Chen, M., Yang, N., Lu, S., & Ni, S. (2023). Effectiveness of VR based mindfulness on psychological and physiological health: A systematic review. Current Psychology, 42, 5033–5045. https://doi.org/10.1007/s12144-021-01777-6
Zheng, G., Zhang, Q., & Ran, G. (2023). The association between academic stress and test anxiety in college students: The mediating role of regulatory emotional self-efficacy and the moderating role of parental expectations. Frontiers in Psychology, 14, 1008679. https://doi.org/10.3389/fpsyg.2023.1008679
Zhou, S. J., Wang, L. L., Qi, M., Yang, X. J., Gao, L., Zhang, S. Y., Zhang, L. G., Yang, R., & Chen, J. X. (2021). Depression, anxiety, and suicidal ideation in Chinese university students during the COVID-19 pandemic. Frontiers in Psychology, 12, 669833. https://doi.org/10.3389/fpsyg.2021.669833
Acknowledgements
Special thanks to the contributions of our colleagues, institutions, and agencies that greatly aided the research.
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This study is funded by China National University Students' Innovation and Entrepreneurship Training Program (R2022018), China Hebei Provincial Medical Science Research Key Project Fund Project (20210103), China Hebei Provincial University Fundamental Scientific Research Operation Fund Project Science and Technology Basic Research Project (JQN2020011), and China Hebei Provincial Higher Education Teaching Reform Research and Practice Project (2022GJJG218).
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Yan Peng: conceptualization, methodology, funding acquisition, writing–review and editing, supervision. Lange Zheng: conceptualization, methodology, data analysis, writing–original draft, supervision. Wangze Li: conceptualization, methodology, investigation, project administration, supervision. Su Rou Low: conceptualization, methodology, writing–review and editing, supervision. Shaogang Song, Xuemiao Xiao, Yue Zhang, and Xiaoyu Yu: conceptualization, methodology, data curation, supervision.
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Zheng, L., Li, W., Song, S. et al. Effectiveness of Mindfulness-Based Virtual Reality Training on Stress, Anxiety, and Depression among Chinese University Students. Mindfulness 15, 899–913 (2024). https://doi.org/10.1007/s12671-024-02335-4
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DOI: https://doi.org/10.1007/s12671-024-02335-4