A randomized controlled trial assessing the efficacy of a virtual reality biofeedback video game: Anxiety outcomes and appraisal processes.

This study assessed the efficacy of a virtual reality biofeedback video game (DEEP) in reducing anxiety symptoms. In addition, changes engagement and cognitive appraisals including self-efficacy, locus control, threat-challenge were measured it was explored how these factors related to regulation. Undergraduates with elevated symptoms (N = 112) randomly assigned four training sessions DEEP or smartphone-guided breathing application. Trait at screening, pretest, posttest, 3 months later. State before after each session. Participants both conditions showed significant decrease trait from pre- posttest this remained stable follow-up. Furthermore, all participants decreased state postsession, except for that included exposure. users increased self-efficacy observed resources cope throughout training. felt more engaged initial than those who used control application, but their toward final contrast, group no change nor engagement. Taken together, results demonstrate potential digital interventions such as games guided relaxation applications regulation tools show particular are mechanisms interventions.