Research using Alive to measure outcome variables

[cbtinstitute]

Rather than using Alive to train research participants, I am considering using it to measure skin conductance and heart rate variability as outcome variables in a study of another therapeutic intervention with a treatment group and a control group. I'm trying to figure out what specific dependent variables can be most easily measured using Alive. Some ideas are:

(1) the time that it takes to complete a certain game task as an indication of ability to relax
(2) change in GSR and HRV during a game, with the game considered a stressful task

I would appreciate any thoughts on how Alive might be used to measure GSR and HRV as outcome variables in studies in which the intervention is independent of Alive (e.g., a CBT treatment for anxiety, etc.). I would also appreciate any links to current research studies, documents, etc.

Thanks

[Ryan Deluz]

Hi CBTInstitute,

You can certainly use Alive to measure skin conductance and heart rate. Just turn the screen towards you instead of the client.

Alive saves SCL, heart rate, and other measurements in a variety of files, named by the date and time of the session. These are in your Documents/Alive Sessions/[USER NAME] folder. Read the following post for more info about this:
http://www.somaticvision.com/phpbb3/vie ... ed6ac9b3cf

Alive will save all of the data, and you can add markers as you train to mark training events, such as when you had the subject start or end a certain task. Changes between between marked segments are automatically analyzed by Alive's session review (in Alive Clinical). So you could see average heart rate per segment, for example.

In a treatment for anxiety type study, you could, for example, do a pre and post treatment assessment of the anxiety. Doing something to elicit the anxiety and watching the SCL or HRV changes as a result, and seeing if they are different post treatment. I am not a researcher, so you'll need to decide how to use the data that Alive records. I would also suggest, in addition to SCL and HRV, measuring average heart rate, which should clearly show anxiety if the anxiety is severe.

I asked Yuval Oded, who does do research with Alive, if he had anything to add. Also, Here are his suggestions:
"
Being a relatively new software, so far Alive has been only used in a few research studies - none published yet except this one:
A randomized controlled trial of a self-guided, multimedia, stress management and resilience training program
Raphael D. Rose, Jay C. Buckey Jr.b, Tomislav D. Zbozineka, Sarosh J. Motivalac, Daniel E. Glenna, James A. Cartreined, Michelle G. Craskea, published in Behaviour Research and Therapy Volume 51, Issue 2, February 2013, Pages 106–112.

More studies are being conducted currently.

All studies are using Alive to collect physiological data and have not used Alive games as variables. Data is easy to extract from Alive but choosing the variables to be measured depends on the methodology of your research.If the efficacy of an intervention is examined there are several physiological outcomes that can be chosen such as:
Average heart rate, change in heart rate during a stressful task or after an emotion has been elicited by a movie (to choose the right stimuli please check - Emotion Regulation by Gross et al. Other possible measurements: delta of scl, baseline hrv (measuring at lest six minutes of hrv- see link)

I would suggest reading recent research using physiological outcomes to choose the appropriate variables for you such as this one:
Acoustic startle response in panic disorder.Psychiatry Res. 2010 Apr 30;176(2-3):2

You may want to look at the hand book of psychophysiology (free in the internet) to further explore possible variables and how to use them in research and how to establish baselines:
https://www.hse.ru/data/2011/06/29/1216 ... iology.pdf
"

Good luck with your research!

If you need more clinicians to contact you could try Nick Chesher at Alliant University who has finished (but I think not yet published) a study on using Alive's Half Life 2 mod.

Best,

Ryan Deluz
Somatic Vision Inc.

[cbtinstitute]

Thanks very much Ryan and Yuval for your detailed suggestions. Maybe I could use a Particle Editor game to elicit the anxiety. I saw that Particle Editor 3 is sold separately but elsewhere it looks like ALIVE already includes Particle Editor. Is there documentation on the games that are already included in the basic ALIVE package? Also, are there any brief games that might be particularly challenging/stressful (that involve both GSR and heart rate)?

[Ryan Deluz]

Hi CBTInstitute,

Alive includes a variety of different types of feedback, that are arranged within the program from least stressful to most stressful. When first starting Alive you practice smoothing your heart rate (OR lowering SCL) with environments designed to be calming, including particle environments, tropical oceans, beautiful music, etc. Then after you achieve some success you start to work with mini-games, which are more energetic, and finally Dual Drive, a race car game. Staying calm and with a smooth heart rate while playing Dual Drive in manual pilot (steering the car) is quite challenging. Dual Drive is included with Alive. I wouldn't say Dual Drive is as stressful is extremely stressful as a game compared with other modern (violent action) games, although it doesn't contain enough common stressors (competition, time pressure, quick reaction times) that it is a great training tool to try keep very relaxed while playing.

The following are not included in Alive, but can be purchased as Alive add-ons: Particle Editor (relaxing environments), Inner Tube (a space ship game), Tropical Heat (a modern game where you race Jet Skis), Advanced Media Player (where you can use videos as feedback).

I am a little confused by the idea of using Alive to elicit anxiety. Generally, I would say people elicit anxiety using challenging tasks combined with negative social feedback, such as an experimenter asking you to do something very difficult, while frowning or giving you negative comments as you perform, etc. Alive can certainly be stressful if you are failing to succeed, but also can be quite relaxing if you are succeeding, and by definition you must be somewhat relaxed to succeed.

Let me know if you have any further questions about this. If you are having people train with heart rate smoothness or SCL, yes Alive elicits anxiety with progressively more difficulty games, and trains you to overcome your difficulties and learn to relax and enter a positive state. If you are not having people train with feedback, Alive is not a good way to elicit anxiety.

[cbtinstitute]

Thanks again -- As we may only be measuring physiological data in a subset of the treatment and control groups, we should probably have the screen turned away from from the participants so they don't receive biofeedback training that would confound the effects of the treatment. Then maybe we could get a baseline and then a reading during some type of stressful activity (e.g., timed math problems). Another possibility would be to instruct the participants to relax and see how long it takes them to succeed in a biofeedback task (e.g., a Particle mini-game) that only the experimenter would be able to see and time (e.g., if a task involved raising a balloon, although the participant wouldn't see the screen, the experimenter would be able to time how long it takes to raise the balloon).

[Ryan Deluz]

Sounds good, there are a couple of particle environments that come with Alive under the Alive Environments drop down on the main menu. Check those out, and wishing you success with your study.

Best,

Ryan Deluz
Somatic Vision Inc.