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June 17, 2026Digital Health and Innovation0 citationsOpen Access

A Normative Analytics Approach to Functional Component Assessment: Identifying VR Efficacy Within the Video Game Therapy® Methodology

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MSMarcello SariniFBFrancesco Bocci

Key Result

Immersive 20-minute VR gaming sessions facilitated statistically significant changes in acute state anxiety and flow dimensions, moving the patient's profile toward healthy normative ranges.

Key Points

  • This study investigates the therapeutic potential of immersive VR gaming within the Video Game Therapy protocol.
  • Utilized a single-case normative analytics framework to measure individual responses.
  • Employed Crawford’s modified t-tests with longitudinal percentile tracking against a normative group (n=20).
  • Monitored state-anxiety, psychological well-being, and flow across three VR sessions.
  • Significant reduction in acute state anxiety post-VR sessions, exceeding measurement error boundaries.
  • Improvements observed in flow dynamics, indicating enhanced psychological engagement.
  • Patient's psychometric profile shifted towards healthy normative ranges.

Study Design

Type

Case Report (n=1)

Structured PICO

Does immersive Virtual Reality gaming improve acute state anxiety and psychological well-being in a single patient?

P
Population
A single-case study evaluating immersive VR gaming within Video Game Therapy, utilizing a normative reference group of 20 individuals.
I
Intervention
Immersive Virtual Reality (VR) gaming (20-min environment) within the Video Game Therapy (VGT) protocol
C
Comparator
Empirical normative reference group (n=20)
O
Outcome
Acute state-anxiety variations (STAI-Y1), psychological well-being (PGWBI), and flow dynamics across three distinct sessionspatient reported

The study demonstrates that a 20-minute immersive VR session can significantly improve acute state anxiety and flow dimensions in a single patient, validated using a Single-Case Normative Analytics framework.

Limitations

  • Focuses on individual, idiographic reactivity rather than general patterns across groups
  • Exploratory single-case nature
  • Focuses on individual, idiographic reactivity

Abstract

Background/Objectives: Single-case studies represent a sophisticated and rigorous methodological framework, widely established in clinical research for providing high-resolution data on individual functional responses. This study evaluates the clinical utility of integrating immersive Virtual Reality (VR) gaming as a novel “functional ingredient” within the Video Game Therapy (VGT) protocol. Given the exploratory single-case nature of this intervention, clinical state-modulations cannot be rigorously validated using standard aggregated group statistics. Therefore, the core objective of this paper is to investigate the therapeutic potential of the VR session on psychological state-modulation, introducing the Single-Case Normative Analytics (SCNA) framework as the mandatory statistical vehicle required to validate individual longitudinal shifts against normative data. Methods: The study treats individual VR exposures as independent, short-term clinical probes embedded within a real-world clinical journey. The SCNA framework was deployed by integrating Crawford’s modified t-tests with longitudinal percentile tracking against an empirical normative reference group (n = 20). Acute state-anxiety variations (STAI-Y1), psychological well-being (PGWBI), and flow dynamics were tracked across three distinct sessions to monitor the patient’s relative repositioning within the normative distribution. Results: The inferential analysis indicates that the immersive 20-min environment facilitated reliable, statistically significant changes in acute state anxiety and flow dimensions, systematically exceeding standard measurement error boundaries and successfully moving the patient’s psychometric profile toward healthy normative ranges. Conclusions: While these findings focus on individual, idiographic reactivity, they demonstrate the utility of the SCNA framework in providing clinicians with objective, evidence-based feedback on the clinical viability of specific VR-based functional units. This approach allows for a rigorous evaluation of standalone digital tools independently of a full, holistic VGT protocol, offering a structured alternative to traditional designs focused on identifying general patterns across groups.

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Cite This Study

Sarini et al. (2026) reported a case report. Immersive Virtual Reality (VR) gaming vs. Normative reference group was evaluated on Acute state-anxiety variations (STAI-Y1), psychological well-being (PGWBI), and flow dynamics. Immersive 20-minute VR gaming sessions facilitated statistically significant changes in acute state anxiety and flow dimensions, moving the patient's profile toward healthy normative ranges.

synapsesocial.com/papers/6a32623f8b0a6d04ea8e69e6https://doi.org/10.3390/dhi1010004
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