Practicing emotion-regulation through biofeedback on the decision-making performance in the context of serious games: A systematic review

Jerčić, Petar; Sundstedt, Veronica · 2019 · OpenAlex-citations

DOI: 10.1016/j.entcom.2019.01.001

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Summary

This systematic review investigates the scientific evidence regarding the effects of practicing emotion regulation (ER) through biofeedback on decision-making performance within the context of serious games. The research is motivated by the established link between emotions and decision-making biases, as well as the limitations of traditional ER training methods, which are often unengaging, lack context, and suffer from high dropout rates. Serious games are proposed as a superior platform because they provide engaging, context-dependent environments that facilitate skill acquisition and transfer through direct visual or indirect gameplay biofeedback. The authors conducted a systematic search across five electronic databases (Scopus, Web of Science, IEEE, PubMed Central, and Science Direct) from inception to October 2018, supplemented by author and snowballing searches. The review focused on randomized controlled trials or quasi-experiments involving students, military personnel, and brain-injured participants. After screening 265 initial publications and assessing 135 full-text articles for quality and relevance, 16 studies were selected for analysis. These studies quantitatively assessed decision-making performance, reaction time, and attention scores in serious games that utilized biofeedback mechanisms, such as heart-rate variability (HRV) and electrodermal activity (EDA), to help players regulate arousal. The review found that participants who raised their awareness of emotional states and improved their ER skills were able to successfully regulate their arousal. This regulation resulted in significantly better decision-making performance, faster reaction times, and improved attention scores on decision-making tasks. The studies demonstrated that serious games effectively support the acquisition of ER skills through negative reinforcement instrumental conditioning, where players learn to down-regulate high arousal to avoid aversive game outcomes or achieve rewards. The findings suggest that the engaging nature of serious games helps overcome the motivational deficits of traditional biofeedback training, allowing for better skill transfer to real-world stressors. The significance of this work lies in its validation of serious games as an effective tool for training emotion regulation in decision-making contexts. By integrating physiological monitoring with interactive gameplay, these systems provide immediate feedback and reinforcement, facilitating the conscious awareness and control of physiological processes. The review concludes that this approach not only improves immediate task performance but also enhances long-term self-regulation skills, offering a scalable and engaging alternative to clinical or didactic ER interventions. This contributes to the field by providing a structured overview of experimental work that specifically links biofeedback-assisted serious games to measurable improvements in cognitive and decision-making outcomes.

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