Game-based peripheral biofeedback for stress assessment in children.
BACKGROUND
Peripheral biofeedback is considered to be an efficient method for assessment and stress mitigation in children. The aim of the present study was to assess the levels of stress and stress mitigation in healthy school children (HSC), in children with cystic fibrosis (CF), general anxiety (GA) and attention-deficit-hyperactivity disorder (ADHD).


METHODS
Each investigated group (HSC, CF, GA, ADHD) consisted of 30 school-aged children from both sexes. Psychological characteristics were evaluated on Eysenck Personality Questionnaire (EPQ). The lie scale was used to determine participant honesty. Four biofeedback games using a pulls detector were applied for assessment of the stress levels as well as to evaluate ability to relax.


RESULTS
EPQ found more psychopathological traits (P < 0.001) and less extroversion (P < 0.001) in children with GA and ADHD. In addition, high neurotic tendencies were found in children with CF (P < 0.01) and GA (P < 0.01). Unexpectedly, the lie scale was lower in ADHD children (P < 0.01) than in all other groups (HSC, CF, GA). The Magic blocks score was significantly different in relaxation levels between control and CF children (P < 0.05). Speed in the game Canal was significantly different in relaxation levels between healthy controls and all other groups, but no changes in pulls, as a relaxation measure, were found during the game. The CF group had much more commissions stemming from impulsivity (t= 5.71, P < 0.01), while the GA and ADHD children had more inattention omissions (P < 0.05). Strong negative correlation between age and pulls (r= 0.49, P= 0.003) and strong negative correlation between age and omissions (r=-0.86, P= 0.029) were found among all groups analyzed.


CONCLUSIONS
The ability to learn stress mediation is correlated with age. All three groups of children had significantly lower relaxation levels when compared to healthy controls. Relaxation was more difficult for children with GA or ADHD, and easier for children with CF.
Pop-Jordanova
Nada
N
Pediatric Clinic, Medical Faculty Skopje, Skopje, Macedonia. npopjordanova@gmail.com
Gucev
Zoran
Z
D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology*; D001676:Biofeedback, Psychology; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000523:psychology*; D030141:Feedback, Psychological; D005260:Female; D005717:Games, Experimental; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010552:Personality Assessment; D012016:Reference Values; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis*