Single-session virtual reality biofeedback game improves anxiety growth mindset during stress induction: a preliminary study

Biofeedback, wherein people learn to regulate their physiological stress responses, offers a potentially useful approach to managing anxiety. One important question is whether the development of this self-regulation skill might also engender a sense of empowerment in individuals and thus confer resilience in their more long-term attitudes and approaches to anxiety. We sought to determine whether a virtual reality (VR) game-based approach might positively influence participants’ anxiety growth mindset, signifying enhanced confidence in their capacity to manage anxiety. We assessed mindset in 53 healthy adult participants before and after a two-phase VR game-based biofeedback intervention between March and May 2022. This intervention comprised an initial slow-paced breathing training, followed by a subsequent stress-induction in the context of a biofeedback-based game. The biofeedback intervention was associated with an increase in growth mindset of anxiety, and this change was greater in those showing with lower levels of physiological stress response as indexed by heart rate (HR) during the game. Thus, in addition to producing an acute effect on the capacity to manage physiological stress responses, experience of a VR biofeedback training package may confer a greater sense of empowerment in managing anxiety.