Game-Based Biofeedback Increases Subjective Ratings of Interoceptive Awareness

Integrating human physiology into interactive computer environments, game-based biofeedback provides an intuitive platform to learn self-regulation through visualizing, monitoring, and modulating real-time biosignals. The present study presents a novel breath control biofeedback game aimed at enhancing interoceptive awareness–the ability to sense and appraise internal physiological signals–among adolescents and investigated potential differential effects between virtual reality (VR) and flat screen (FS) biofeedback. 45 participants experienced the biofeedback game to practice slow-paced breathing via VR and FS in a randomized order. Findings revealed significant increases in self-ratings of interoceptive awareness concerning the utility of bodily sensations, as well as interconnectedness of mental, emotional, and physiological processes for self-regulation. VR biofeedback may have conferred an added potential benefit through increases in attention regulation scores. While the effects of VR and FS biofeedback did not differ, the order of modality exposure influenced specific interoceptive outcomes. These findings demonstrate the potential of biofeedback games in enhancing interoceptive awareness, with clinical implications for improving emotion regulation and mental health.