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Do Video Games Reduce Or Induce Stress? the Effect of Challenge and Threat Appraisals on Stress and Aggression When Playing Violent and Nonviolent Video Games

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Do Video Games Reduce Or Induce Stress? the Effect of Challenge and Threat Appraisals on Stress and Aggression When Playing Violent and Nonviolent Video Games DO VIDEO GAMES REDUCE OR INDUCE STRESS? THE EFFECT OF CHALLENGE AND THREAT APPRAISALS ON STRESS AND AGGRESSION WHEN PLAYING VIOLENT AND NONVIOLENT VIDEO GAMES by Anne Marie Porter A dissertation submitted to the faculty of The University of North Carolina at Charlotte in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Psychology Charlotte 2017 Approved by: ______________________________ Dr. Paula Goolkasian ______________________________ Dr. Charlie Reeve ______________________________ Dr. Sara Levens ______________________________ Dr. Zachary Wartell ii ©2017 Anne Marie Porter ALL RIGHTS RESERVED iii ABSTRACT ANNE MARIE PORTER. Do video games reduce or induce stress? The effect of challenge and threat appraisals on stress and aggression when playing violent and nonviolent video games. (Under the direction of DR. PAULA GOOLKASIAN) Video game players report using video games for stress reduction, but previous studies have found mixed results when examining stress and video games, and fail to comprehensively measure all relevant psychological, emotional, and physiological stress indicators. The current study used the Biopsychosocial Model of Challenge and Threat (Blascovich & Tomaka, 1996) to examine the effects of stress appraisals and video game content on emotions and cardiovascular activity. The study also examined how appraisals and game content affect aggressive cognitions. In a 2 x 2 factorial design, participants received challenging or threatening appraisal instructions, and played a violent or nonviolent game. Results indicated that threat appraisal instructions increased negative emotion ratings and heart rate, but not blood pressure. Violent gameplay increased heart rate and blood pressure, but violent players also had higher positive emotion ratings than nonviolent players. Stress appraisals and game content had no effect on aggressive cognitions. In conclusion, emotional and physiological stress outcomes showed different results, and violent gameplay predicted a physiological stress response while also inducing more positive emotions. Video games may produce different stress effects compared to stressors used in previous studies, and future research should investigate the longitudinal health and emotional consequences of violent gameplay. iv DEDICATION I dedicate this dissertation to the developers, members, and researchers of the video game community, who inspired me to pursue my research and follow my passions. I also dedicate this dissertation to my parents, Shelley and David Porter, whose support helped turn my passions into reality. v ACKNOWLEDGEMENTS I extend my deepest gratitude to my advisor and mentor, Dr. Paula Goolkasian, who has always supported my research interests, advocated for me in times of need, and taught me invaluable lessons in both teaching and research. I also extend my thanks to my other dissertation committee members: Dr. Chuck Reeve, Dr. Sara Levens, and Dr. Zachary Wartell, whose insightful advice and positive support reappraised my potentially stressful dissertation experience into a fulfilling and exciting challenge. I extend my gratitude to the Health Psychology Ph.D. Program for granting me the opportunity to follow my passions and begin my research career. I am especially grateful to our program director, Dr. Virginia Gil-Rivas, for her unwavering support of the students within this program, and teaching me to approach health as a biopsychosocial state of well-being. I also extend my gratitude to the Graduate School at the University of North Carolina at Charlotte, the Health Psychology Ph.D. Program, the Department of Psychological Science, the School of Social Work, and Shaping the Message for their financial support through the Graduate Assistant Support Plan (GASP), graduate assistantships, research funds, and travel funds during my graduate career. Lastly, I extend my deepest gratitude to my loving parents and supportive family, my fellow graduate students and friends, and my little dog, Kairi, whose kindness, warmth, and encouragement supported me during my lowest moments, and made this journey through graduate school possible. vi TABLE OF CONTENTS LIST OF TABLES ix LIST OF FIGURES x LIST OF ABBREVIATIONS xii INTRODUCTION 1 LITERATURE REVIEW 4 Stress Overview 4 Stress and Health 7 Stress Measurement 9 Video Games and Stress 10 Biopsychosocial Model of Challenge and Threat 10 Physiological Outcomes 13 Behavioral and Emotional Outcomes 15 Anger and the Biopsychosocial Model 16 Stress Appraisal Measurement 19 THE CURRENT STUDY 21 METHOD 23 Participants 23 Materials 23 Measures 24 Stress Appraisal Outcomes 24 Physiological Outcomes 24 Behavioral and Emotional Outcomes 25 vii Aggression Outcomes 26 Video Game Outcomes 27 Procedure 28 Data Analysis 31 RESULTS 33 Participant Characteristics 33 Group Comparisons 34 Manipulation Checks 36 Stress Appraisal 36 Game Characteristics 39 Study Outcomes 40 Heart Rate and Heart Rate Variability 41 Blood Pressure 45 Game Performance 47 Emotion Ratings 48 Aggressive Cognition 53 DISCUSSION 56 Stress Appraisal 57 Video Game Content 59 Aggression 63 Conclusions 64 REFERENCES 66 APPENDIX A: APPRAISAL INSTRUCTIONS 75 viii APPENDIX B: SURVEY MATERIALS 77 APPENDIX C: LEXICAL DECISION TASK 82 ix LIST OF TABLES TABLE 1: Cronbach Reliability Analyses for Emotion Subscales 26 TABLE 2: Outcome Measurement Time Points 29 TABLE 3: Participant Characteristic Mean (SD) Comparisons across Groups 34 TABLE 4: Participant Characteristic Frequency Comparisons across Groups 35 TABLE 5: Baseline Measure Mean (SD) Comparisons across Groups 35 TABLE 6: Means (SD) and Main Effects of Blood Pressure and Emotions over 40 Time TABLE 7: Means (SD) and Main Effects of Heart Rate and HRV over Time 41 TABLE 8: Number of Errors and Mean (SD) Reaction Times in the Lexical 54 Decision Task x LIST OF FIGURES FIGURE 1: Pathways in the Biopsychosocial Model of Challenge and Threat 12 FIGURE 2: Significant main effects and interaction effect of appraisal instructions 37 on primary demand appraisals over time FIGURE 3: Significant main effects and interaction effect of appraisal instructions 38 on secondary skill appraisals over time FIGURE 4: Significant interaction effect of game content on secondary skill 39 appraisals over time FIGURE 5: Significant interaction effect of appraisal instructions on heart rate over 42 time FIGURE 6: Significant interaction effect of appraisal instructions on heart rate 43 variability over time FIGURE 7: Significant interaction effect of game content on heart rate over time 44 FIGURE 8: Significant interaction effect of game content on heart rate variability 45 over time FIGURE 9: Significant interaction effect of game content on systolic blood pressure 46 over time FIGURE 10: Significant interaction effect of game content on diastolic blood 47 pressure over time FIGURE 11: Significant main effects and interaction effect of appraisal instructions 49 on threat emotions over time. FIGURE 12: Significant main effects and interaction effect of appraisal instructions 49 on challenge emotions over time FIGURE 13: Significant interaction effect of appraisal instructions on harm emotions 50 over time FIGURE 14: Significant main effects and interaction effect of appraisal instructions 50 on benefit emotions over time FIGURE 15: Significant main effects and interaction effect of game content on 52 challenge emotions over time xi FIGURE 16: Significant main effects and interaction effect of game content on harm 52 emotions over time FIGURE 17: Significant main effects of game content on benefit emotions 53 xii LIST OF ABBREVIATIONS HR Heart Rate HRV Heart Rate Variability BP Blood Pressure TPR Total Peripheral Resistance CO Cardiac Output CV Cardiovascular SNS Sympathetic Nervous System PNS Parasympathetic Nervous System SAM Sympathetic Adrenal Medullary Axis HPA Hypothalamus Pituitary Adrenal Axis BMI Body Mass Index BPS Biopsychosocial GAM General Aggression Model RT Reaction Time ESRB Entertainment Software Rating Board ANOVA Analysis of Variance SD Standard Deviation 1 INTRODUCTION Research shows that playing video games can lead to both positive and negative health consequences (Anderson, Zimand, Hodges, & Rothbaum, 2005; Carnagey & Anderson, 2005; Green & Bavelier, 2003; Kuss & Griffiths, 2012; Merry et al., 2012; O’Neal, Patterson, Soltani, Teeley, & Jensen, 2008; Peng, Lin, & Crouse, 2011), but previous studies have not concluded whether video games have positive or negative effects on stress. Stress is a predictor of long term mental and physical health. Chronic stress over time influences cardiovascular, metabolic, and immunological dysfunction, and contributes to the progression and exacerbation of multiple health problems including coronary heart disease, autoimmune disease, and diabetes (Harbuz, Chover-Gonzales, & Jessop, 2003; Pasquali, Vicennati, Cacciari, & Pagotto, 2006; Steptoe & Kivimaki, 2012). Forty-two percent of people play games on a regular basis of three hours a week or more (Entertainment Software Association, 2015), and if playing video games induces stress, regular video game players may be at risk for chronic stress and the resulting negative health consequences. The current study is centered around the following questions: 1) Are video games stress-inducing? 2) Do stress outcomes depend on video game content? Current research on video games and stress is mixed. Several studies claim that playing video games can be a stress relieving, recovery experience. Playing video games allows
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