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Updated: May 23, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
Applying Virtual Reality in Mindfulness Exercises for Emotion Regulation and Mental Health Among Inpatients With
1Department of Environmental and Occupational Health, Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station, TX, USA.
Abstract:
PurposeThis study evaluated the feasibility of incorporating Virtual Reality (VR) technology into meditation exercises and using Electrocardiogram (ECG) devices for emotion regulation assessment. It also explored changes in emotion regulation, depression, and anxiety among participants.DesignA single-arm feasibility study.SubjectsPsychiatric hospital inpatients diagnosed by physicians with major depressive disorder or generalized anxiety disorder in the Midwestern United States (n = 25).InterventionVR meditation exercises 3 times weekly for 10 weeks.MeasuresPhysiological coherence, as an indicator of regulated emotional state, was assessed using ECGs, while depression and anxiety were measured through survey questionnaires.AnalysisPaired t-tests were employed to analyze changes in emotion regulation, depression, and anxiety.ResultsAfter 10 weeks, significant increases were observed in physiological coherence, suggesting more regulated emotional states (M = -35.25, SD = 22.25, 95% CI [-40.63, -29.86], Cohen's d = -1.58). Reductions were also noted in depression (M = 3.48, SD = 3.29, 95% CI [1.84, 7.51], Cohen's d = 1.06) and anxiety (M = 3.12, SD = 4.03, 95% CI [1.45, 4.78], Cohen's d = 0.77).ConclusionsVR is a feasible technology for meditation exercises, with observed associations with more stable emotional states, and reductions in depression and anxiety symptoms, while the application of ECG-based assessment further addresses methodological shortfalls in this population. These results highlight the potential of applying VR technology in mindfulness exercises to leverage inherent digital healthcare strengths, such as user-centered care and tailored treatment.