VISVESVARAYA TECHNOLOGICAL UNIVERSITY

“JNANA SANGAMA”, BELAGAVI - 590 018

TECHNICAL SEMINAR REPORT

on

“Application of virtual reality to overcome anxiety in

children.”
Submitted by

Adib G Ahamed 4SF19IS005

In partial fulfillment of the requirements for the VIII semester

BACHELOR OF ENGINEERING
in
INFORMATION SCIENCE & ENGINEERING

Under the Guidance of

Mr. Vasudeva Rao P V

Professor, Department of ISE
at

SAHYADRI
College of Engineering & Management
Adyar, Mangaluru - 575 007
2022 - 23
 SAHYADRI
College of Engineering & Management
Adyar, Mangaluru - 575 007

Department of Information Science & Engineering

CERTIFICATE

This is to certify that the Seminar entitled “Application of virtual reality to over-
come anxiety in children.” has been carried out by Adib G Ahamed (4SF19IS005),
the bonafide students of Sahyadri College of Engineering & Management in partial fulfill-
ment of the requirements for the VIII semester of Bachelor of Engineering in Information
Science & Engineering of Visvesvaraya Technological University, Belagavi during the year
2022 - 23. It is certied that all corrections or suggestions indicated for Internal Assess-
ment have been incorporated in the Report deposited in the departmental library. The
seminar report has been approved as it satisfies the academic requirements in respect of
Technical Seminar prescribed for the said degree in eighth semester.

———————————- —————————— ——————————

Seminar Guide Seminar Co-ordinator HOD
Mr. Vasudeva Rao P V Ms. Suchetha G Dr. Mustafa Basthikodi
Abstract

The topic of using technology to overcome anxiety in children is becoming increasingly

important in today’s society. With the rise of social media and digital devices, children
are exposed to an abundance of information and stimuli that can contribute to anxiety
and stress. The use of technology to address these issues, therefore, presents a promising
opportunity to help children manage their anxiety and improve their mental health. This
technical seminar will explore the latest developments in the field of technology-based
interventions for anxiety in children. We will discuss the use of virtual reality, cognitive-
behavioral therapy apps, and other innovative technologies to help children learn coping
skills, reduce stress, and manage anxiety in their daily lives. The seminar will also cover
the challenges and ethical considerations that come with using technology in this context.
The technical seminar on virtual reality as a way to overcome anxiety in children promises
to be an insightful and informative event for professionals working in the field of child
psychology, education, and technology. Attendees will leave the seminar with a deeper
understanding of how VR technology can be used to improve the quality of life of children
who suffer from anxiety disorders.

i
Acknowledgement

It is with great satisfaction and euphoria that I am submitting the Seminar Report on
”Application of virtual reality to overcome anxiety in children”. I have completed it as a
part of the curriculum of Visvesvaraya Technological University, Belagavi in partial fulfill-
ment of the requirements for the VIII semester of Bachelor of Engineering in Information
Science & Engineering.

I am profoundly indebted to my guide, Mr. Vasudeva Rao P V, Assistant Professor,

Department of Information Science & Engineering for innumerable acts of timely advice,
encouragement and I sincerely express my gratitude.

I also thank Ms. Suchetha G, Seminar Coordinator Assistant Professor, Department

of Information Science & Engineering for their constant encouragement and support
extended throughout.

I express my sincere gratitude to Dr. Mustafa Basthikod, Professor & Head, Depart-
ment of Information Science & Engineering for his invaluable support and guidance.

I sincerely thank Dr. Rajesha S, Principal, Sahyadri College of Engineering & Man-
agement, who have always been a great source of inspiration.

Finally, yet importantly, I express my heartfelt thanks to my family & friends for their
wishes and encouragement throughout the work.

Adib G Ahamed
4SF19IS005
VIII Sem, B.E., ISE
SCEM, Mangaluru

ii
Table of Contents

Abstract i

Acknowledgement ii

Table of Contents iii

List of Figures iv

1 Introduction 1

2 Literature Survey 3

3 Problem Definition 6

4 System Design 8
4.1 Architecture Diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
4.2 Methodology Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
4.2.1 ECG for emotion detection . . . . . . . . . . . . . . . . . . . . . . 9
4.2.2 VRET for environment creation . . . . . . . . . . . . . . . . . . . 10
4.2.3 ARET for environment creation . . . . . . . . . . . . . . . . . . . 12

5 Results and Disscussion 14

5.0.1 Physiological Data in VR-Based Machine Learning Applications for
Treating Phobias . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5.0.2 Results based on different environment . . . . . . . . . . . . . . . 17

6 Conclusion 18

References 19

iii
List of Figures

4.1 System Architecture Diagram . . . . . . . . . . . . . . . . . . . . . . . . 8

5.1 Emotion detection using ECG. . . . . . . . . . . . . . . . . . . . . . . . . 15

5.2 Graphical user interface of the Windows desktop application. . . . . . . . 15
5.3 Biosignal readings and accuracy. . . . . . . . . . . . . . . . . . . . . . . . 17

iv
Chapter 1

Introduction

Anxiety is a common mental health problem among children and can have a significant
impact on their overall well-being and quality of life. According to the World Health
Organization, an estimated 10 percent of children worldwide have anxiety disorders.
Therefore, it’s crucial to develop effective interventions to help these children manage
their anxiety and lead a healthy and happy life.
In recent years, virtual reality (VR) has emerged as a promising tool for treating
anxiety disorders in children. VR technology provides an immersive and interactive en-
vironment that can simulate real-life situations and experiences. By exposing children to
anxiety-provoking situations in a safe and controlled environment, VR therapy can help
them learn coping skills and reduce their anxiety levels.
During this seminar, we will explore the current research on the use of VR in treat-
ing anxiety disorders in children. We will discuss the advantages of VR therapy over
traditional therapies and the challenges associated with implementing VR interventions
in clinical settings. We will also review some of the most promising VR applications for
anxiety in children and their effectiveness.
Overall, this presentation aims to provide an overview of the potential benefits of VR
therapy for children with anxiety disorders. It is my hope that this information will help
raise awareness of the importance of early intervention and encourage further research
in this field to improve the lives of children struggling with anxiety. Thank you for your
attention, and I look forward to sharing my findings with you.

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 Chapter 1

Anxiety disorders can be challenging to treat, particularly in children, who may

not fully understand or articulate their symptoms. Traditional interventions, such as
cognitive-behavioral therapy and medication, can be effective, but they may not be suit-
able for all children. For instance, some children may be resistant to exposure therapy,
where they are gradually exposed to anxiety-provoking situations. Others may experience
side effects from medication or have a preference for non-pharmacological interventions.
In conclusion, the application of virtual reality to overcome anxiety in children is a
promising area of research and practice. By providing a safe and controlled environment,
VR therapy can help children learn coping skills and reduce their anxiety levels. Although
there are challenges associated with implementing VR therapy, the benefits are significant,
and further research and investment in this field can help improve the lives of children
struggling with anxiety.

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Chapter 2

Literature Survey

Ferraz-Torres, Marta, et al. evaluated the use of Virtual Reality (VR) as a distraction
technique for reducing pain and anxiety in pediatric patients during venipuncture[1]. The
study found that VR was effective in reducing pain and anxiety levels, with interactive
VR being more effective than passive VR.

Ahmadpour, Naseem, et al. presents a study that Virtual Reality (VR) can be an
effective and affordable complementary or alternative non-pharmacological analgesic for
pain management, according to studies[2]. The use of portable VR headsets for pain
therapy shows promise, but further research is required to establish long-term benefits
and develop bespoke interventions for different cohorts. VR analgesia is an exciting
area with potential applications in all levels of healthcare, but research on its long-term
benefits is still limited.

Wong, Cho Lee, Miranda Mei Wa Lui, and Kai Chow Choi. proposed IVR intervention
will potentially provide significant practical implications in addressing pain, anxiety, and
stress of the patients[3]. The ultimate impact of this intervention is to increase procedural
compliance, consequently decreasing the length and cost of the procedure while possibly
improving the satisfaction of the healthcare providers with the procedure.

Osmanlliu, Esli, et al. outlines how Virtual reality (VR) was found to be feasible and
acceptable for managing pain and distress in children during intravenous procedures in the
pediatric emergency department[4]. There were no significant differences in self-reported
pain between the control and intervention groups, and occasional mild, self-resolving side
effects were observed in the intervention group.

Özkan, Tuba Koç, and Filiz Polat. proposed a study involving 139 children aged 4

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 Chapter 2

to 10 years, who underwent venipuncture while using either virtual reality goggles or
kaleidoscope[5]. The study found that both methods were effective in reducing children’s
perception of pain and anxiety, but the virtual reality goggles were found to be more
effective. The data was collected using various tools including the Children’s Anxiety
Scale, Visual Analogue Scale, and Wong-Baker Faces Pain Scale.

Canares, Therese, et al. carried a experiment where a randomized controlled pilot trial
assessed coping and distress between child life-supported virtual reality (VR) engagement
and child life specialist support without VR during painful procedures in children aged 7-
22 years in the pediatric emergency department[6]. Results showed that VR and child life
specialists improved coping in children during venipuncture procedures. Future studies
are recommended to evaluate the efficacy of VR as a low-cost and low-risk tool to improve
children’s coping during medical procedures.

Bălan, Oana, et al. developed a virtual reality game with machine learning-based
decision support to adapt levels of exposure to patients’ physiological characteristics for
acrophobia therapy[7]. They trained several classifiers and proposed two classifiers to
estimate fear levels and predict the next exposure scenario. The validation accuracy was
measured using three fear level scales, and the most important features for fear level
classification were GSR, HR, and EEG values. Future directions include implementing
the VR game for other phobias, involving more subjects, and performing real-world tests
with acrophobic patients. The study’s author contributions were not mentioned.

Ihmig, Frank R., et al. presented a results on anxiety level detection using supervised
machine learning techniques based on biosignals acquired from spider-fearful individu-
als[8]. Ten approaches for data labeling were applied, and trained models showed remark-
able accuracy of 89.8 percent for two-level classification and 74.4 percent for three-level
classification. The models will have a practical impact on a feasibility study of augmented
reality exposure therapy for treating arachnophobia.

Olbrecht, Vanessa A., et al. conducted a study at Cincinnati Children’s Hospital,

51 children and adolescents with postoperative pain participated in a single VR-GR
session[9]. Questionnaires were completed before the session and the primary outcome
was a change in pain intensity immediately, 15 minutes, and 30 minutes following the
session, with secondary outcomes including changes in pain unpleasantness and anxiety.
The study found that the VR-GR session resulted in transient reductions in pain intensity,

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 Chapter 2

pain unpleasantness, and anxiety, suggesting a need for a future randomized controlled
trial to assess its efficacy.

Smith, Vinayak, et al. provides review of primary articles focusing on the use of
virtual reality therapy for acute pain management in clinical settings was conducted
through various databases[10]. The review found that virtual reality therapy can provide
analgesia for acute pain and also alleviate anxiety, but its effects may vary based on
patient population and indication. The review highlights the need for individualized pilot
testing of virtual reality therapy for specific clinical use cases. The study also suggests
using a head-mounted display and active virtual reality for analgesia in clinical settings.
However, the effect of virtual reality on autonomic arousal requires further investigation.

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Chapter 3

Problem Definition

Anxiety is a common mental health problem in children and can significantly impact their
quality of life. Traditional therapy methods, such as talk therapy or play therapy, may
not be effective for all children. Virtual reality (VR) has emerged as a promising tool
for anxiety reduction in kids, providing a safe and controlled environment for exposure
therapy. However, VR therapy requires specialized equipment and software, which can
be costly and difficult to implement in a clinical setting. Additionally, therapists may
struggle to customize the VR experience for each individual child’s needs and anxiety
triggers. Machine learning (ML) algorithms can be used to analyze data from the child’s
behavior in the VR environment, allowing for a more personalized and effective treatment
plan. However, developing and training ML algorithms requires a large amount of data
and expertise, which may not be readily available to all therapists. Therefore, there
is a need for an accessible and user-friendly VR and ML platform that can be easily
integrated into a therapist’s practice, while also providing a customized and effective
treatment plan for each child’s anxiety symptoms Anxiety is a pervasive mental health
issue affecting millions of children worldwide. The symptoms of anxiety can range from
mild to severe, and they can significantly impact children’s academic performance, social
interactions, and overall well-being. Traditional interventions such as medication and
cognitive-behavioral therapy have been effective in reducing anxiety symptoms in some
children. However, these interventions may not be appropriate for all children due to
various factors such as side effects, cost, and accessibility.
In recent years, virtual reality (VR) technology has emerged as a promising tool for
reducing anxiety symptoms in children. VR technology allows therapists to create an
immersive and interactive environment where children can face their fears and anxieties
in a safe and controlled environment. By gradually exposing children to anxiety-provoking

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 Chapter 3

situations in a customized virtual environment, VR therapy can help children learn coping
skills and reduce anxiety levels.
However, despite the potential benefits of VR therapy, there are significant challenges
to its widespread adoption. One of the primary challenges is the limited availability of
evidence-based VR programs that are tailored to the unique needs and preferences of
children. Additionally, the high cost of VR equipment and the need for trained thera-
pists to deliver the therapy can make it challenging to implement VR therapy in clinical
settings.
Moreover, the effectiveness of VR therapy for anxiety reduction in children is still an
area of active research, and there are many unanswered questions regarding the optimal
use of VR technology and its potential impact on the psychological well-being of children.
Therefore, it is essential to identify the potential benefits and challenges associated with
the use of virtual reality therapy for anxiety reduction in children and to explore areas
for future research and development to maximize its effectiveness as a treatment option.

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Chapter 4

System Design

4.1 Architecture Diagram

The figure 4.1 shows the architecture design of the system and the overview of the Frame-
work.

Figure 4.1: System Architecture Diagram

Before discussing the actual proposed BlockEdge framework, explaining very briefly
the key network entities along with its role in this section.

1. VRET Virtual Reality Exposure Therapy (VRET) is a form of cognitive-behavioral

therapy that uses immersive virtual reality technology to simulate anxiety-provoking
situations in a safe and controlled environment. By gradually exposing individuals
to anxiety-provoking situations in VR, therapists can help them learn coping skills
and reduce anxiety levels. VRET has shown promising results in treating anxiety

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 Chapter 4

disorders such as specific phobias, post-traumatic stress disorder, and social anxiety
disorder.

2. ARET Augmented Reality Exposure Therapy (ARET) is a relatively new approach

to treating anxiety disorders that uses augmented reality technology to superim-
pose virtual stimuli onto the real-world environment. ARET provides a unique
opportunity to expose individuals to anxiety-provoking situations in a naturalistic
setting, allowing them to learn and practice coping skills in real-world situations.
Although research on ARET is still limited, preliminary findings suggest that it
may be effective in treating specific phobias and other anxiety disorders.

4.2 Methodology Used

This section presents the state of the art related to the VR related machine learning
technologies used.

4.2.1 ECG for emotion detection

Electrocardiography (ECG) is a non-invasive technique used to measure the electrical

activity of the heart. ECG can be used to detect anxiety by measuring changes in heart
rate variability (HRV) and other cardiac parameters associated with anxiety. In this
section, we will explore how ECG can be used to detect anxiety in children and its
potential applications in the context of virtual reality therapy.
Research has shown that anxiety is associated with changes in HRV, which is a mea-
sure of the variation in time between heartbeats. Specifically, anxiety is associated with
decreased HRV, which reflects an imbalance in the sympathetic and parasympathetic
nervous systems. ECG can be used to measure HRV and other cardiac parameters such
as heart rate and heart rate variability to detect anxiety in children.
One potential application of ECG in the context of virtual reality therapy is real-
time feedback. By using ECG to detect anxiety in real-time, therapists can provide
immediate feedback to children during virtual reality exposure therapy (VRET) sessions.
For example, if a child’s heart rate increases during a VRET session, the therapist can
pause the session and provide the child with relaxation techniques to reduce anxiety. This
approach can help children learn coping skills and enhance the effectiveness of VRET.
Another potential application of ECG in the context of anxiety reduction is biofeed-

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 Chapter 4

back. Biofeedback is a technique that uses feedback from physiological signals such as
ECG to help individuals learn self-regulation skills. By using ECG as a biofeedback tool,
children can learn to regulate their physiological responses to anxiety and reduce symp-
toms of anxiety. For example, children can learn to slow down their breathing or use
relaxation techniques to reduce their heart rate during VRET sessions.
Moreover, ECG can be used to monitor the progress of anxiety reduction in children
over time. By measuring changes in HRV and other cardiac parameters over the course of
VRET sessions, therapists can track the effectiveness of therapy and make adjustments
as needed. This approach can help optimize treatment and ensure that children are
receiving the most effective and tailored therapy possible.
However, there are also some limitations to using ECG in detecting anxiety. For
example, ECG requires electrodes to be placed on the skin, which may be uncomfortable
or distressing for some children. Additionally, ECG measurements can be affected by
factors such as movement or electrical interference, which can affect the accuracy of the
readings.
In conclusion, ECG is a promising tool for detecting anxiety in children and has
potential applications in the context of virtual reality therapy. By measuring changes in
HRV and other cardiac parameters, ECG can provide real-time feedback, biofeedback,
and progress monitoring during VRET sessions. Although there are some limitations
to its use, ECG has the potential to improve the effectiveness of anxiety reduction in
children and provide a more personalized and tailored approach to therapy.

4.2.2 VRET for environment creation

Virtual Reality Exposure Therapy (VRET) is a type of therapy that uses immersive vir-
tual reality technology to simulate anxiety-provoking situations in a safe and controlled
environment. VRET has shown promise in reducing anxiety symptoms in children by
gradually exposing them to anxiety-provoking situations in a customized virtual environ-
ment. In this section, we will explore how VRET can be used to create environments for
anxiety reduction in children.
One of the primary advantages of VRET is its ability to create customized virtual
environments that can simulate real-life situations that provoke anxiety in children. For
instance, children with social anxiety disorder can use VRET to simulate social inter-
actions in a virtual environment, allowing them to practice and learn coping skills that

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 Chapter 4

can help them reduce anxiety levels. By gradually increasing the intensity of exposure to
the virtual environment, therapists can help children learn to manage their anxiety levels
effectively.
Moreover, VRET can be used to create virtual environments that are specifically de-
signed to address the unique needs and preferences of each child. For example, children
with specific phobias, such as a fear of heights or spiders, can use VRET to simulate
exposure to these stimuli in a controlled and safe environment. This personalized ap-
proach can help children develop coping skills that are tailored to their specific fears and
anxieties, increasing the likelihood of successful outcomes.
Another advantage of VRET is its ability to provide a more engaging and immersive
experience for children than traditional therapies. By using VR technology, therapists
can create environments that are interactive, engaging, and more like real-life situations
than traditional therapies. This can enhance the child’s motivation and willingness to
participate in therapy, which can lead to better outcomes.
In addition to creating customized environments, VRET can be used to provide ex-
posure therapy that may be difficult or impossible to achieve in real life. For example,
children with post-traumatic stress disorder (PTSD) can use VRET to simulate trau-
matic events in a controlled environment, allowing them to learn coping skills and reduce
anxiety levels without being re-traumatized. This approach can be particularly useful
for children who have experienced traumatic events that are challenging or impossible to
replicate in real life.
However, there are also some limitations to using VRET for anxiety reduction in
children. One of the primary limitations is the cost of VR equipment, which can be
prohibitively expensive for some clinical settings. Additionally, the need for trained
therapists to deliver VRET can be a barrier to its widespread adoption. However, as the
technology becomes more accessible and the evidence base for VRET grows, it is likely
that these barriers will be addressed in the future.
In conclusion, VRET is a promising approach to creating environments for anxiety re-
duction in children. By creating customized and interactive virtual environments, VRET
can provide exposure therapy that is tailored to the unique needs and preferences of
each child. Although there are some limitations to its use, VRET has the potential to
improve outcomes for children with anxiety disorders and provide a more engaging and
immersive experience than traditional therapies. As the evidence base for VRET grows
and the technology becomes more accessible, it is likely that it will play an increasingly

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 Chapter 4

important role in anxiety reduction in children.

4.2.3 ARET for environment creation

Augmented Reality Exposure Therapy (ARET) is a type of therapy that uses augmented
reality technology to superimpose virtual stimuli onto the real-world environment. ARET
has shown promise in reducing anxiety symptoms in children by allowing them to face
their fears in naturalistic settings. In this section, we will explore how ARET can be used
to create environments for anxiety reduction in children.
One of the primary advantages of ARET is its ability to create virtual stimuli that
are superimposed onto the real-world environment. For example, a child with a fear
of dogs can use AR technology to see virtual dogs superimposed onto the real-world
environment, which can help them learn coping skills and gradually overcome their fears.
This personalized approach can help children develop coping skills that are tailored to
their specific fears and anxieties, increasing the likelihood of successful outcomes.
Moreover, ARET can be used to create naturalistic environments that are more sim-
ilar to real-life situations than traditional exposure therapy. By using AR technology,
therapists can create environments that are interactive and engaging, which can enhance
the child’s motivation and willingness to participate in therapy. Additionally, ARET can
provide a more cost-effective and accessible alternative to traditional exposure therapy,
as it does not require expensive VR equipment.
Another advantage of ARET is its ability to provide exposure therapy that is less
intrusive than traditional exposure therapy. For example, a child with a fear of public
speaking can use AR technology to practice their speech in front of a virtual audience,
which can help them learn coping skills and reduce anxiety levels without being in a
real-life public speaking situation. This approach can be particularly useful for children
who have severe anxiety or phobias that are difficult to replicate in real life.
However, there are also some limitations to using ARET for anxiety reduction in
children. One of the primary limitations is the need for accurate tracking of the real-world
environment to ensure that the virtual stimuli are superimposed correctly. Additionally,
the technology is still relatively new and may require further development to ensure its
efficacy and safety in clinical settings.
In conclusion, ARET is a promising approach to creating environments for anxiety
reduction in children. By superimposing virtual stimuli onto the real-world environment,

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 Chapter 4

ARET can provide exposure therapy that is tailored to the unique needs and preferences
of each child. Although there are some limitations to its use, ARET has the potential
to improve outcomes for children with anxiety disorders and provide a more naturalistic
and cost-effective alternative to traditional therapies. As the technology continues to
develop and its efficacy is further established, it is likely that it will play an increasingly
important role in anxiety reduction in children.

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Chapter 5

Results and Disscussion

In this section, evaluation of the performance and efficiency of our proposed machine
learning environments and compared it with the other environments. To realize the full
potential of machine learning and virtual reality in anxiety reduction, we considered we
investigate various machine learning classifiers used in our Virtual Reality (VR) system
for treating anxiety.

5.0.1 Physiological Data in VR-Based Machine Learning Ap-

plications for Treating Phobias

Currently, VRET is seen as an efficient method for phobia treatment, both from a financial
and a comfort point of view. It offers flexibility, confidentiality and trust, encouraging
more people to seek treatment. As far as we know, the issue of classifying emotion levels
in VR conditions, meaning how intensely emotion is felt based on different factors, have
not been yet properly defined. In the proposed system, we focus our study on the ML
and DL methods, which automatically classify fear levels using physiological data. The
dataset has been acquired in direct relation to our acrophobia therapy application, more
specifically, by exposing the users to different heights in both the real-world and virtual
environment.

1. Emotion detection using ECG.

Figure 5.1 illustrates the ECG readings for recognising the phobia levels using
machine learning.

The electrocardiogram (ECG) is a diagnostic tool used to measure and record the
electrical activity of the heart. Recent research has suggested that the ECG signal

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 Chapter 5

Figure 5.1: Emotion detection using ECG.

is modulated by emotions, allowing researchers to use it as a tool for detecting

emotional states.

Changes in heart rate variability (HRV) can be used to analyze the impact of emo-
tions on the cardiovascular system. When someone experiences stress or anxiety,
their heart rate tends to increase and become more erratic. Conversely, when some-
one is relaxed or experiencing positive emotions, their heart rate tends to decrease
and become more regular.

By analyzing the HRV of an individual’s ECG signal, researchers can determine

their emotional state with a degree of accuracy. This has the potential to provide
new insights into how emotions affect our physiological responses, and could lead to
new diagnostic tools for mental health conditions such as anxiety and depression.

2. Desktop application for a GUI

Figure 5.2: Graphical user interface of the Windows desktop application.

Figure 5.2 illustrates the (A) Inputs—Machine learning algorithm (MLA) and sub-
ject, (B) On-line plots of HR and EDA, (C) Details of the selected algorithm, (D)
Calculated accuracy only considering the true classes, (E) On-line prediction status

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 Chapter 5

(blue line) and true class according to the labeled data (yellow bars).

a machine learning algorithm (MLA) being used to predict emotional states based
on heart rate (HR) and electrodermal activity (EDA) data. The inputs to the
algorithm would include the HR and EDA data as well as information about the
subject being studied.

On-line plots of HR and EDA would likely be used to visualize the physiological
data being collected in real-time, allowing researchers to monitor changes in the
signals and observe how they correspond to different emotional states.

The selected algorithm would likely involve a combination of techniques from ma-
chine learning and signal processing, designed to identify patterns in the data that
correspond to different emotions.

The calculated accuracy would indicate how well the algorithm is able to correctly
predict the true emotional state based on the physiological data, with a higher
accuracy indicating better performance.

The on-line prediction status and true class would be used to evaluate the perfor-
mance of the algorithm in real-time, with the blue line representing the algorithm’s
predicted emotional state and the yellow bars indicating the true emotional state
based on labeled data. Overall, the goal of this type of research is to develop more
accurate and reliable tools for detecting and diagnosing emotional states based on
physiological signals.

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 Chapter 5

5.0.2 Results based on different environment

The different environments will provide their respective accuracy ratings for the different
machine learning and biosignal device combined

1. Accuracy reading of the methodologies

Figure 5.3: Biosignal readings and accuracy.

A biosignal accuracy rating table is a way of summarizing the performance of a

machine learning algorithm or another computational tool that is used to analyze
biosignals such as an electrocardiogram (ECG) or electroencephalogram (EEG)
data. The table typically includes information about the algorithm’s sensitivity,
specificity, positive predictive value (PPV), negative predictive value (NPV), and
overall accuracy.

Sensitivity refers to the proportion of true positive results (i.e., correctly identify-
ing the presence of a particular condition or state), while specificity refers to the
proportion of true negative results (i.e., correctly identifying the absence of a par-
ticular condition or state). PPV and NPV represent the proportion of positive and
negative results, respectively, that are true positives or negatives.

An accurate and reliable biosignal accuracy rating table can be an important tool
for researchers and healthcare providers working with biosignals, as it can help them
evaluate the performance of different algorithms and choose the best approach for
a particular application.

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Chapter 6

Conclusion

Virtual reality (VR) and machine learning (ML) technologies have the potential to provide
effective and accessible interventions for anxiety and related mental health disorders. VR
can create immersive and interactive environments that simulate real-world situations,
allowing users to confront and overcome their fears and anxieties in a safe and controlled
way. ML can enhance the accuracy and personalization of VR-based treatments by ana-
lyzing user data and adapting the VR experience to their individual needs and preferences.
The combination of VR and ML can also enable real-time biofeedback and physiological
monitoring, such as using electroencephalography (EEG) or electrocardiography (ECG)
to measure and modulate user responses to stress and anxiety. However, there are still
technical and ethical challenges to be addressed in developing and deploying VR-ML sys-
tems for anxiety reduction, such as ensuring data privacy and security, avoiding bias and
discrimination, and maintaining user engagement and compliance. Ongoing research and
collaboration across various fields, including psychology, neuroscience, computer science,
and human-computer interaction, will be crucial to advance the potential of VR and ML
for mental health care and wellbeing. Ultimately, the successful integration of VR and
ML can offer a promising and innovative approach to addressing the burden of anxiety
and related disorders.

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References

[1] Ferraz-Torres, Marta, et al. ”Passive or interactive virtual reality? The effectiveness
for pain and anxiety reduction in pediatric patients.” Virtual Reality 26.4 (2022):
1307-1316.

[2] Ahmadpour, Naseem, et al. ”Virtual Reality interventions for acute and chronic pain
management.” The international journal of biochemistry cell biology 114 (2019):
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