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Updated: Jul 6, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
Enhancing Mindfulness Training in Virtual Reality: A Randomized Trial of Biofeedback Integration
Ana Domingues1, Ana Beato2, Jorge Oliveira2
1Faculty of Psychology, Universidade de Lisboa, Lisbon, Portugal.
Abstract:
Virtual reality (VR) and biofeedback have emerged as promising tools for mindfulness training. However, their combined effectiveness, compared with Traditional Mindfulness formats, remains understudied. This study investigated the short-term effects of a brief mindfulness intervention delivered via VR, with and without biofeedback, on psychological and physiological outcomes. Seventy-two participants (64.7 percent women; aged 18-57 years, M = 24.0) were randomly assigned to one of three groups (n = 24 per group): mindfulness with VR and biofeedback, mindfulness with VR only, and traditional audio-guided mindfulness. Self-report measures assessed negative emotional symptoms, state anxiety, affect, and present-moment awareness before and after the intervention. Heart rate was recorded as a psychophysiological index of arousal. Results indicated significant reductions in stress, anxiety, and heart rate and an increase in positive affect across all groups. The VR + biofeedback group showed significantly greater improvements in receptive awareness and attentional focus compared with the other conditions. These findings support the use of VR-based mindfulness and suggest that integrating biofeedback may enhance present-moment engagement.

