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Updated: Jan 29, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
An Experimental Exploration of Cognitive Workload and Situational Awareness in Virtual Reality: Implications for
Fabiha Islam1, Zipporah Bright1, Liang Zhan2
1School of Systems Science and Industrial Engineering, Binghamton University, Binghamton, New York, USA.
Objectives:
Many people face emotional challenges without meeting the criteria for clinical mental disorders. Virtual Reality (VR) has become popular in psychotherapy due to accessibility, but it can sometimes increase cognitive workload (CWL) and decrease situational awareness (SA). This study addresses the need for continuous user monitoring by assessing CWL and SA in real-time using eye-tracking.
Methods:
Twenty-one participants performed cognitive tasks of varying difficulty in both virtual and real-world environments, allowing direct comparison of the same task difficulty across the two environments. Pupil diameter, fixation, and saccade duration data were collected.
Results:
Pupil diameter results showed that VR environment may be associated with a reduced effect of high task difficulty on participants' CWL. Fixation and saccade durations results indicated that participants could maintain the same level of SA and engagement in the VR environment regardless of the task difficulty.
Conclusion:
These findings provide insights into the effects of VR on CWL and SA, which may inform future research exploring VR's potential in clinical populations.
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