Saturday, October 5, 2013

How playing casual games could help lead to better soldiers

PopCap-funded physiology studies lead to potential military applications.

Playing a casual game could let a researcher know whether this soldier is prepared to be in this position.
LCPL Alicia M. Anderson USMC, via Wikimedia Commons
When PopCap underwrote studies on the cognitive benefits of playing casual games with East Carolina University, it never imagined that the research would inspire the exploration of casual game projects for military use. But the principles PopCap helped examine in those studies are the basis for several projects which could lead to the development of new training aids and in-theater medical diagnostic tools for the United States Armed Forces. And it all began with a bit of fan appreciation.
Back in 2006, PopCap Senior Director of Public Relations Garth Chouteau decided to conduct an informal survey on why fans enjoyed PopCap games. “I started to receive the occasional e-mail or call from customers, and being the inquisitive PR person that I am, I would generally take that opportunity to ask them why they liked the games, what they liked about the games,” Chouteau told Ars. “After getting enough of those comments to the effect of ‘These games, they help me relax,’ ‘They seem to make my mind sharper,’ or ‘They provide some type of mental exercise,’ I said to myself, 'We need to understand if this is broadly true. We need a bigger sample.'”
So PopCap hired a company called Information Solutions Group to conduct a formal survey of just over 1,000 customers, asking if they derived any benefits aside from entertainment out of playing PopCap games. "Stress relief was something that three-quarters or more, I think it was 77 percent specifically, chose,” said Chouteau. “And I believe it was 81 percent who cited cognitive exercise.”
PopCap then reached out to departments at multiple universities in the hopes of sponsoring a more rigorous study to understand these effects. Dr. Carmen Russoniello, professor and director of the Psychophysiology and Biofeedback Lab at East Carolina University (ECU), gave the most enthusiastic response. “He had a lot of experience in various types of recreational therapy, and he was intrigued by the idea,” said Chouteau.

Having fun is healthy

Russoniello’s research is inspired by his experience as a recreational therapist. His dissertation was conducted at an inpatient alcoholic treatment facility, where he tested the hypothesis that stress-reduction ought to be measurable physiologically. To prove that hypothesis, experimental groups were assigned tasks that required different amounts of oxygen to perform.
“What we found was, not only psychologically did these people report that they felt better, but we could see biochemical changes that were significant between the groups,” he said. For example, the groups that conducted less strenuous activity had lower levels of cortisol, a hormone released in response to stress.
“I was looking for ways to measure these same kinds of activities, which led me to biofeedback, and it turns out that I could use it for intervention as well as to measure the effects of other things on people, which is one of its real benefits,” said Dr. Russoniello. “I can hook you up and see if it works. It really has an advantage of being able to quantify an outcome of a stimulus, like an activity.”
An activity like playing casual video games, for example.

Less stress, better mood

Enlarge / Take two games of Peggle and call me in the morning.
The first PopCap-sponsored study at ECU was titled “A Randomized, Controlled Study of the Effectiveness of PopCap Video Games in Reducing Stress and Improving Mood.” The researchers measured the heart rate variability (HRV) and alpha wave activity among experimental subjects who were given a choice of playing Peggle, Bejeweled, or Bookworm.
“HRV tells you about a thousand times more than your pulse,” said Russoniello. “One of the first things the students notice when someone’s hooked up to HRV is that their heart rate vacillates. Like when a nurse takes [a pulse] and says that it’s 72, it’s actually 72, 68, 80, 69, and that’s important, that variability.” According to Russoniello, heart rate variability can be predictive of depression, anorexia nervosa, and diabetes, among other conditions, and it can also be used to measure stress levels.
As for alpha waves, measuring their strength in both the left and right sides of the brain and measuring the level of synchrony between the hemispheres can measure mood variances such as depression or mania.
Analysis of alpha wave and HRV data from the experiment indicated that the experimental group that played the games exhibited fewer signs of depression or anxiety than a control group. Some of these variances were dependent upon the subject's gender or which game was chosen, suggesting to Russoniello the idea of prescribing specific games to specific patients in order to achieve desired results. The researchers determined that more study was needed.

Casual games as mental health prescription

In addition to another set of lab sessions, the experimental group was instructed to play a casual video game of their choice at home for at least 30 minutes three times per week, with at least 24 hours between each session, for a month. Their post-study scores on the standard nine-item depression scale of the Patient Health Questionnaire demonstrated statistically meaningful reductions in depression symptoms.
Subjects also took a self-administered psychological assessment of mood called the Profile of Mood States, which showed that anger, depression, fatigue, and confusion were all reduced by at least 50 percent in the experimental group. Anxiety levels were also reduced.
The third study being underwritten by PopCap is currently underway and will drill down further into the results of the second study by looking at how casual games might be used in combination with other therapies to combat clinical depression. ECU is also conducting studies into the effects of casual games that are separate from the PopCap-sponsored research. The preliminary results of one of these offshoot studies suggest that playing casual video games can improve a person’s ability to make decisions and respond quickly to a stimulus.
The sum total of the experimental results from all of these studies convinced Russoniello to move forward with proposals to the Department of Defense for military applications of casual game play (though he stressed that these are still just proposals and that there are no projects currently underway with the DOD).
The concept of using casual games for military training purposes is not new. One of Russoniello’s research partners, Dr. Vadim Pougatchev, was involved in just such an initiative in the Soviet Union.
“In the late 80s I was part of the project to develop a special computer program to provide neurocognitive assessment and training for high-risk operators,” Pougatchev told Ars. “This program was implemented in the form of a simple game called Captain Nemo. It appeared that this program was also used to train Soviet Air Force and Navy personnel. Later we found out that besides military pilots, candidates to cosmonauts were trained with it.”

Hitting “the zone”

One of the offshoot projects from the PopCap studies involved modifying a version of Bejeweled to provide background visual and auditory prompts that the player could use to modify their breathing patterns and promote cardio respiratory synchrony. That's the state in which heartbeat and respiration are in sync, and it correlates with increased relaxation, according to Dr. Russoniello.
This kind of synchrony is often colloquially referred to as “the zone,” and on average it happens when the user is at a rate of six breaths per minute. This is where the military wants its soldiers when going through military training like firing range exercises and what ECU is currently studying with some ROTC students.
“Snipers get this,” Russoniello said. “When they train, they know that when you squeeze the trigger is when your heart rate is at its lowest point, right before it accelerates again. When you breathe in, your heart rate goes up. When you breathe out, it goes down. So right at the end of the exhale is when they squeeze the trigger.”
“What happens is, with HRV, they can literally see this on a screen,” he continued. “They learn to get into the zone, and when they’re in the zone they quiet themselves, and they’re much more accurate... You measure one group that trains and one that doesn’t, and we believe [the group with HRV training] will be better.”
Using casual games to take HRV measurements could also be used to decide who ought to be admitted into the armed forces in the first place. This hypothetical application imagines a casual game that could be used to take a quick HRV measurement for a recruit. A library of this data could be used predictively to help determine which recruits will wash out of boot camp, and it could save money that otherwise might be used to train someone who is not right for the service.
“You start taking profiles of guys when they all come into boot camp. You start linking the ones that are really successful with the ones that are not and look at their HRV, and pretty soon you go, 'Wow, these guys in this range right now don’t do so well in the Marine Corps,'” said Russoniello.

Casual games as diagnostic assessments

Russoniello was a machine gunner in the Marine Corps during the Vietnam War, so he understands the importance of monitoring battle fatigue. “I was in battle. You lose 20 percent of the guys; they just fucking lose it, man. You can’t take that kind of stress for a year straight,” he said.
Measurements of autonomic system function like HRV could also be used to make decisions about whether or not a soldier was fit to be deployed or remain on the line. “This is the number one priority of the Department of Defense," Russoniello said. "They want to know when a guy is ready to go into battle and when he should be taken out.”
This theoretical application of ECU’s casual game research imagines a corpsman equipped with casual game-like software on a portable device. A soldier would play the game in theater to generate HRV data, which would then be uploaded to a location where a specialist could review the information. If the specialist decided that the soldier in question was no longer in a state where he or she could perform effectively, the corpsman could send that soldier to the rear.
Casual games could also be used to assess traumatic brain injury in the field. When someone joins the military, they take Automated Neuropsychological Assessment Metrics (ANAM) testing, which establishes baseline data for the subject. Russoniello described ANAM testing as “long, arduous, and pretty mundane.”
“A major problem with neurocognitive assessments is you go to a psychologist to be tested, and you’re scared out of your freaking mind. It hinders your performance,” Russoniello said. If an assessment could be incorporated into a casual game instead, a soldier could be asked to play the game and establish baseline data without the performance stress, because the diagnostics would be hidden behind the game.
The same casual game could then be used to diagnose traumatic brain injury in the theater. These kinds of injuries happen often due to backblast, where a soldier gets hit by an explosion after firing heavy artillery from a too-close range. “I’m talking to Marines, and I ask them about backblasts, and they kind of look at me funny,... [but] it’s more common than one might imagine,” Russoniello said.
By having a soldier play the casual game again after such a backblast, a corpsman could gather information about reaction time, divided and sustained attention, and memory and make a diagnosis as to whether any brain injury may have occurred. “To be able to get a guy that’s a little dingy or something, and [he] can’t play the game anymore, there’s probably something wrong,” said Russoniello.

Happy to be an inspiration

While PopCap Games isn't directly connected to any of these potential military projects, and their games won't be used in those projects should they be approved, PopCap's Chouteau said he was happy that the company-sponsored research helped elucidate the principles that inspired these proposals for military use of casual games.
“We’re very pleasantly surprised and gratified at the prospect of the research we originally commissioned with ECU being applied more broadly and having positive effects for various types of people in different lines of work, capacities, and states of mind,” Chouteau said. “We were curious about certain aspects of our games and whether those things were true more broadly of video games or casual video games in general, but we certainly never in our wildest dreams saw that original research extending and expanding out into all these different areas.”
Dennis Scimeca is a freelance writer from Boston, Massachusetts.

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