Does a 360° VR nature environment augment relaxation during a MBSR breathing meditation?

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Saskia Seel, Katja Braun, Anne-Marie Frantz, Luna Wurr, Gregor Domes This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6954558/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study investigated whether immersive 360° virtual reality (VR) nature environments enhance the relaxation effects of a guided mindfulness-based stress reduction (MBSR) breathing meditation. In a randomized controlled trial, 100 healthy adults were assigned to one of three conditions: MBSR audio-only, MBSR with a 2D beach video (Display), or MBSR with a 360° VR beach video (VR). Psychophysiological indicators (heart rate, heart rate variability, skin conductance, respiration) and self-reported measures (affect, relaxation, presence, simulator sickness) were assessed before, during and after the intervention. While all groups exhibited the expected relaxation effects over time—characterized by increased parasympathetic activity, as indicated by a lower heart rate and skin conductance, and subjective relaxation—no significant additional benefit of the more immersive VR condition was observed. However, 360° VR was perceived as more immersive than 2D display, and exploratory analyses revealed unique interaction effects for sleepiness and heart rate variability indices in specific groups. The findings suggest that, although immersive VR reliably increases the sense of presence, it may not confer additional physiological relaxation benefits in mindfulness-experienced, low-stress populations. Future research should examine these effects in more diverse and clinically stressed cohorts, and test alternative VR content designs to optimize relaxation outcomes. Relaxation Mindfulness-Based Stress Reduction (MBSR) 360° video Immersion Autonomic nervous system Randomized trial Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 1. Introduction Chronic stress is a pervasive mental and physical health risk factor that has been shown to impact several functions of the central nervous system and markers of mental health (Mariotti, 2015 ; Schneiderman et al., 2005 ). Among others, general mood (McEwen, 2017 ), cardiovascular (Golbidi et al., 2015 ; Lucini et al., 2005 ) and immune function (Gouin, 2011 ; Webster Marketon and Glaser, 2008 ) have been shown to decline, while the risk of developing mental disorders (e. g. Hammen, 2005 ) is increased. Thus, clinical research has long since acknowledged the need for effective interventions that help mitigate harmful effects of chronic stress. Mindfulness-based stress reduction (MBSR) is a classic approach that roots in developing a mindset of benevolent acceptance of the status-quo without attachment to the outcome of a situation (Kabat-Zinn, 2003 ; Creswell & Lindsay, 2014 ). Meta-analyses have shown MBSR to promote mental health, quality of life, and recovery from mental health disorders such as depression and anxiety (Fjorback, 2011; Khoury et al., 2015 ). Physiologically, these effects could be attributed to MBSR-induced slow-paced breathing that has been hypothesized to shift the autonomic nervous system activity from a sympathetic dominant to a parasympathetic dominant state (Jerath et al., 2012 ). Psychologically, reduced repetitive negative thinking, alongside improved mindfulness, has been discussed as one of the significant mechanisms underlying the positive effects of MBSR (Gu et al., 2015 ). An equally classic approach to relaxation is nature exposure (NE) with the wide-spread observation that humans are inherently positively influenced by it due to an innate affinity for nature (e. g. Wilson, 1986 ; Ulrich, 2023 ). More recent studies have shown both physiological and psychological health benefits of green NE, such as enhanced general well-being, positive affect and recovery from mental fatigue, as well as shifting from sympathetic dominant to parasympathetic dominant ANS activity (Tsunetsugu et al., 2013 ; Berto, 2014 ). Urbanization and changes in life styles, however, contribute to consistently diminishing opportunities for casual NE (Hartig et al., 2014 ), which has supported growing experimental research interest around NE in virtual reality (Jerdan et al., 2018 ; Valmaggia et al., 2016 ). Virtual reality (VR) refers to an “inclusive, extensive, surrounding and vivid illusion of reality” (Slater and Wilbur, 1997 ; p. 605) in which the user feels present and active (Schubert et al., 2001 ). This is achieved by focusing the user’s attention on the VR setting, thus leading them to feel fully immersed into the experience. This immersion is maximized when the experience is as close to real life as possible with the VR environment addressing as many of the user’s senses as possible with relevant external stimuli (Schubert et al., 2001 ; Slater and Wilbur, 1997 ). VR is usually provided by utilizing a head-mounted display (HMD) with headphones to support immersion (Jerdan et al., 2018 ). VR environments are used in a great variety of experimental and therapeutic contexts to create situations that evoke psychological and physiological responses as comparable as possible to in vivo responses (Linnig et al., 2025 ; Zimmer and Domes, 2019 ; Zimmer et al, 2019 ; Felnhofer et al., 2025 ). In their systematic review on the feasibility, acceptability, and effectiveness of HMD-supported relaxation in the general population, Riches et al. ( 2021 ) presented VR relaxation via HMD as a safe tool to support mental health and wellbeing that induced significantly higher relaxation scores in the HMD conditions than in control conditions after a stressor. Comparing NE in VR and real-world NE with an indoor setting without NE, Browning et al. ( 2020 ) found that the NE conditions “were rated as equally restorative and both resulted in physiological arousal associated with positive affect”. Likewise, NE in VR was found to promote increase in positive affect and subjective recovery while also inducing decrease in negative affect when compared with VR city sceneries (Schutte et al., 2017 ; Yu et al., 2018 ). Lastly, when combining mindfulness audio interventions with NE in VR, independent studies reported NE in VR to support the significant increase in state mindfulness, positive affect and subjective relaxation (Navarro-Haro et al., 2017 ; Seabrook et al., 2020 ). However, it remains unclear if this combination also induces changes in physiological parameters of relaxation and improved mental and physical health associated with NE in VR and mindfulness alone. In this study, we investigated this question. Adapting and expanding Browning et al. ( 2020 )s study setup, we firstly assumed that adding on the presentation of a calm beach scene would augment the beneficial changes in positive mood, relaxation and parasympathetic tone associated with following a prerecorded MBSR breathing meditation audio. Secondly, we reasoned that the add-on effect of the beach scene would be stronger when the presentation induced high immersion for the user. Thus, we hypothesized that increasing levels of immersiveness during the mindfulness-based stress reduction (MBSR) breathing meditation would lead to stronger beneficial effects across psychological and physiological indicators. In particular, we expected that a 360° immersive virtual reality (VR) presentation would elicit stronger increases in state positive affect, relaxation, and heart rate variability, as well as stronger decreases in state negative affect, heart rate, and skin conductance level, compared to a standard 2D display presentation and an audio-only MBSR condition. Specifically, we anticipated (a) a greater increase in positive affect and (b) a stronger decrease in negative affect in more immersive conditions (360° VR > 2D Display > Audio). We also predicted (c) greater increases in subjective relaxation and (d) stronger decreases in heart rate, (e) increases in heart rate variability, and (f) decreases in skin conductance level, all scaling with the degree of immersiveness of the MBSR presentation. 2. Methods 2.1. Participants Based on an effect size of d = .31 derived from the mean reduction in negative affect of the control and VR group in a nature exposure study (Browning et al., 2020 ), the minimum sample size for a within-between interaction of three groups and four repeated measurements was estimated in G*power (Faul et al., 2009 ) at N = 102 ( f = .30; α = .05; 1-β = .80; correlation for repeated measures r = .30; no correction for non-sphericity). To compensate for possible dropouts, we aimed for a total sample of N = 106. Participants were recruited by on-campus advertisement. Interested individuals were included in the study if they were at least 18 years of age, and didn’t report on pronounced motion sickness in the past. Thus, a total of 106 adults were initially enrolled in the study. However, three individuals didn’t show up to the appointment and were no longer available for testing, and three individuals had to be excluded due to coffee consumption less than 30 minutes before the appointment. The remaining 100 participants completed the study (see 3. Results). The study was approved by the ethics committee at University of Trier (internal reference number 12/2024) and conducted in line with the Declaration of Helsinki. All participants gave informed written consent and could ask additional questions after finishing the study. Participation was rewarded either through monetary compensation of 15€, or with 1.5 hours of course credit. 2.2 Design We used a randomized, controlled, between- subjects design. Simple randomization was applied to assign participation to one of the three study groups (“Audio” vs. “Display” vs. “360° VR”) while equal distribution by self-reported gender was controlled. 2.3 Measures 2.3.1 Psychometric questionnaires Trait variables. Before the relaxation treatment, the Mini Symptom Checklist (Mini-SCL; Franke, 2017 ) and the Short Scale of the Trier Inventory for Chronic Stress (TICS-SSCS; Schulz et al., 2004 ) were used to assess recent psychological stress and potential pre-existing symptoms of psychiatric disorders, as well as the Mindful Attention and Awareness Scale (MAAS; Michalak et al., 2011 ) as a measure of mindfulness as a self-rated trait. State variables . Before and after the treatment, the Positive And Negative Affect Schedule (PANAS; Breyer and Bluemke, 2016 ) was used to track changes in positive and negative affect, while the Relaxation State Questionnaire (RSQ; Steghaus and Poth, 2022 ) was used to assess changes in psychophysiological relaxation, and the Simulator Sickness Questionnaire (SSQ; Kennedy et al., 1993 ) was used to track changes in motion sickness due to the experience of the digital environment. Furthermore, the Igroup Presence Questionnaire (IPQ; Schubert et al., 2001 ) and the subscale Immersion of the Technology Usage Inventory (TUI; Kothgassner et al., 2013 ) were used to assess immersion in the digital environment of the treatment groups “Display” and “360° VR” after the treatment. Further information about these questionnaires is available in the supplementary methods. 2.3.2 Physiological parameters of autonomic nervous system activity A 16-channel amplifier (V-Amp16, Brain Products, Gliching, Germany) was used in combination with the BrainVision Recorder (Brain Products GmbH, Gliching, Germany) to record the galvanic skin response (GSR), respiratory activity, and an electrocardiogram (ECG) at a sampling rate of 500Hz as parameters of ANS activity. The GSR (in micro-siemens) was measured with two electrodes (GSR Sensor Rev. 01; Brain Products, Gliching, Germany) that were attached to the index and ring fingers of the non-dominant hand using an isotonic GSR electrolyte gel (Neurospec, Stans, Switzerland) after skin preparation with isopropanol. The respiratory activity was assessed with the respiration belt transducer (Brain Products, Gliching, Germany). The ECG was recorded using single-use electrodes (P. J. Dahlhausen & Co. GmbH, Cologne, Germany) attached to the chest in a 3-lead configuration (modified Einthoven II). Respiratory activity was assessed and tested alongside the heart rate data to control for adherence to the MBSR meditation and effects induced by sinus arrythmia. 2.4 VR equipment For the “360° VR” condition, an HMD (VIVE PRO, HTC Corporation, Taoyuan, Taiwan) with integrated headphones was connected to a computer (Windows 10, Intel (R) Core (TM) i9-10940X CPU 3.3GHz, 64 bits, NVIDIA RTX A5000, 64 GB Ram). For the “Display” condition, a desktop PC monitor (Philips QHD-LCD-Monitor 272B8Q) was connected to the same computer and set up at 120cm from the seat of the participant at eye level. For both the “Display” and “Audio” conditions, over-ear headphones (AKG K52) were connected to the same computer to maintain stable sound quality. Based on Anderson et al. ( 2017 ), we used a monoscopic 360° beach video ( https://www.atmosphaeres.com/video/895L/Sunset+On+Beach+-+Long+Version ) showing waves in the sunset, accompanied with ocean sounds (see Fig. 1 for a screenshot approximating the point of view shown in the “Display” condition). The video lasted 14 minutes and had no scene changes. It was played, starting at 00:00, either via the HMD or via the PC screen, depending on the condition, and stopped shortly after the end of the MBSR audio. 2.5 Procedure On the day before the assessment, the participants were instructed not to consume any alcohol, drugs, or medication 24 hours before the study, and to refrain from engaging in strenuous physical activities. They were also instructed not to consume any caffeinated drinks for at least 6 hours before participation. Specific time frames and additional information are provided in Fig. 2 . Upon entering the laboratory, participants gave written informed consent and provided demographic data, including information about potential confounding variables. Then electrodes and respiratory belt were attached and the recording was started. After filling out the pre-treatment questionnaires (Mini-SCL, MAAS, TICS-SSCS, SSQ, RSQ, and PANAS), a three-minute baseline was obtained. Participants were then randomly assigned to one of the three experimental conditions and prepared: participants in the “Audio” and “Display” conditions were given headphones and waited, while the HMD was fitted to those in the “360° VR” group and adjusted to their specific visual needs. After an additional minute to account for potential orientation reactions to the VR setting, the treatment was started: the “Audio” group received a 10 minute long guided MSBR breathing exercise audio over headphones, while the “Display” group also watched the video of a beach on screen, and the “360° VR” group watched the same video, but in a 360° version enabled by the HMD. All groups were instructed to keep their eyes open during the treatment. After the treatment and a short waiting period to account for the removal of the HMD, participants were asked to fill out the post-treatment questionnaires (SSQ, RSQ, PANAS, TUI, and IPQ). They were disconnected from the V-AMP, could ask questions, and were compensated. 2.6 Data preprocessing All data preprocessing was handled blindly. Scale scores and, if existing, T-values were calculated for all questionnaires used. The physiological data was preprocessed in BrainVision Analyzer (2.3.0; Brain Products, Gliching, Germany) and Matlab (Version R2024a; Mathworks, Natick, Massachusetts, USA), respectively. The data was then segmented into a 3-min baseline and three 3-minute segments covering the relaxation phase for further statistical analyses (see Fig. 2 ). For the calculation of skin conductance levels (SCL), the GSR raw data was low-pass filtered (0.03 Hz, Butterworth, 8th order) in Matlab. For the assessment of breathing rate, the respiration data was filtered (low-pass: 0.12 Hz, 4th order and high-pass: 0.4 Hz, 4th order) and down-sampled to 10 Hz. Movement artifacts were then detected semi-automatically; contaminated recording sections were removed. Peaks were then counted and calculated into a corrected mean breaths per minute value. For heart rate and HRV analyses, the ECG data was filtered in a first step applying a low-pass filter (5 Hz, 4th order), a high-pass filter (45 Hz, 4th order) and a notch filter (50 Hz). Then R-peaks were detected using the “ECG markers” function of the BrainVision Analyzer and manually corrected if necessary. Artifacts (e. g. sections where no clear R-peaks could be identified) then were removed semi-automatically with the Artifact Rejection function. The resulting inter-beat-intervals (IBIs) were further processed in Matlab to calculate corrected values for the heart rate (HR, in bpm), root mean square of successive differences (RMSSD in ms) and the percentage of successive Normal-to-Normal intervals that differed by more than 50 milliseconds (pNN50 in %), as these measures have been listed in the review of Shaffer and Ginsberg ( 2017 ) as suitable for recording lengths of less than 180 seconds. In general, if more than 1/3 of psychophysiological data derived from GSR, respiratory activity, and ECG (baseline and the three-minute segments of the treatment) was removed during the artifact rejection per phase, that phase was deemed too poor in quality and thus removed from further analyses. If more than two phases were removed this way, the whole GSR, ECG or respiratory activity dataset was removed from the analyses. Detailed information is reported below (see 3.2 and Tables S7-S9). 2.7 Statistical analyses Fisher's exact and Chi² tests were used for the statistical comparison of the frequency distributions. Mixed repeated-measure ANOVAs were conducted to test for differences in subjective relaxation, heartrate, heartrate variability, skin conductance level, and respiratory rate in the three experimental groups (between factor) over the measurement points (within factor). In case of non-sphericity, Greenhouse-Geisser corrected results and ε are reported. Effect sizes for ANOVAs are reported as η p 2 . Pairwise comparisons were Bonferroni-corrected. All statistical analysis were done in RStudio version 2024.04.1 with R version 4.4.0 (R Core Team, 2024 ). For analyses of variance (ANOVA) we used the package rstatix 0.7.2 (Kassambara, 2023 ). In case of robust ANOVAs, we used the package WSR2 1.1.6 (Mair and Wilcox, 2019 ) and calculated η p 2 as discussed by Haiyang ( 2020 ). All figures were created with GraphPad Prism version 10.4.2 for Windows (GraphPad Software, Boston, Massachusetts USA). The level of significance was set to p < 0.05. 3. Results One hundred adults (74 cisgender women, 25 cisgender men, 1 non-binary) adults between the ages of 19 and 61 years ( N = 99; M = 26.6, SD = 8.7) completed the study. 91% were native German speakers and 84% currently attended university. 81% of participants reported experience in at least one relaxation technique (63% in meditation, 51% in imaginative exercises, 50% in yoga, 41% in progressive muscle relaxation) prior to taking part in the study. In terms of factors that could influence a participant’s relaxation experience, they reported on the following aspects: 22% had been in psychotherapy before the study (time since: 3.73 ± 3.64 years; 6% in active therapy), 8% had consumed coffee up to six hours before the study, 6% had been significantly physically active in the last 24 hours, 5% reported on being smokers, 2% had a known cardiovascular disease, and 1% reported on recreational drug use. 33.8% of female participants reported contraceptive use. There were no significant differences between the experimental groups any of the factor listed above (see Tab. S1 & S2). There were also no significant differences between the groups regarding symptoms of simulator sickness, positive and negative affect, and relaxation indicators before the treatment (see Tab. S3). 3.1 Self-reported state variables: Immersiveness, Affect and Relaxation During the analyses, we detected no extreme outliers in any of the self-reported questionnaire data and chose not to correct for regular outliers to preserve data variance. Corresponding mean group values are in Table S5. First, we tested our base assumption that the beach scene presented in 360° VR would be rated as significantly more immersive than the same scene presented on a 2D Display. As expected, the ”360° VR” group consistently reported significantly higher values in all subscales of the IPQ and the TUI Immersion subscale than the “Display” group, indicating higher immersion and feeling of presence with medium to large effect sizes (see Tab. S4, all p < .05). For positive affect, there were no significant effects of time, condition , or their interaction. While we found a significant main effect of time on negative affect with lower scores over time, there were no significant effects for condition or the time × condition interaction (see Table 1 ). When examining relaxation, we considered all subscales of the RSQ separately. For each muscular, cardiovascular and general relaxation, a significant main effect of time was observed, but no effects of condition or the interaction were found. For the subscale Sleepiness however, post-relaxation showed a significant main effect of time and a significant interaction between time and condition , although there was no main effect of condition (see Table 1 ). Pairwise comparisons indicated a significant change in sleepiness in the “Display” condition ( p < .001), but no such change was observed in the “360° VR” or “Audio” conditions (see Fig. 3 ). 3.2 Physiological indicators of parasympathetic tone After data preprocessing, a total of 5.8% of the respiratory belt data, 17.7% of the ECG data, and 4.0% of galvanic skin response data had to be excluded from the analyses due to insufficient data quality and movement artifacts; a comprehensive overview of missing data is displayed in Table S8. An overview of average group values is in Table S9. In summary, we excluded a total of n respiration =6, n ECG =25 and n GSR =8 participants respectively from analysis due to extreme outliers or data loss due to technical errors. Additionally, for RMSSD as a HRV index, we excluded n RMSSD =5 participants from analysis due to extreme outliers (see Tab. S7). For respiratory rate, heart rate, pNN50, and skin conductance level, we found a significant main effect of time with lower respiratory rate, heart rate, and skin conductance level, as well as higher pNN50 over time, but there were no significant effects for condition or the time × condition interaction (see Table 2 and Fig. 4 ). In Bonferroni-corrected pair-wise post-hoc tests, we found the breathing rate in all conditions at baseline to differ significantly from each of the relaxation segments (all p .05). For RMSSD as a parameter of heart rate variability, we found the same pattern of a significant main effect of time with an increase in all parameters over time as well as a significant time × condition interaction, but no significant effect for condition (see Table 2 and Fig. 4 ). In Bonferroni-corrected pair-wise post-hoc tests, however, we found no significant differences between the four phases or interactions for RMSSD (all p > .05). Table 1 Results of mixed repeated measures ANOVAs for self-reported state variables. Source PANAS: positive affect PANAS: negative affect 1 RSQ: General relaxation df F p η p 2 df F p η p 2 df F p η p 2 Between-subjects effects Condition 2, 97 0.264 .769 .005 2, 38.21 0.147 .864 .008 2, 97 .564 .571 .011 Within-subjects effects Time 1, 97 2.875 .093 .029 1, 51.85 13.295 < .001 .204 1, 97 23.820 < .0001 .197 Condition x Time 2, 97 0.071 .932 .001 2, 38.23 1.614 .212 .078 2, 97 1.745 .180 .035 Source RSQ: Muscular relaxation RSQ Cardiovascular relaxation RSQ Sleepiness df F p η p 2 df F p η p 2 df F p η p 2 Between-subjects effects Condition 2, 97 0.716 .491 .015 2, 97 0.701 .498 .014 2, 97 0.625 .538 .013 Within-subjects effects Time 1, 97 20.729 < .0001 .176 1, 97 9.294 .003 .087 1, 97 16.739 < .0001 .147 Condition x Time 2, 97 1.256 .289 .025 2, 97 0.263 .770 .005 2, 97 4.490 .014 .085 Table 2 Results of mixed repeated measures ANOVAs for psychophysiological parameters of ANS activity. Source Respiratory frequency Skin conductance level Heart rate df F p η p 2 df F p η p 2 df F p η p 2 Between-subjects effects Condition 2, 91 1.444 .323 .025 2, 89 2.380 .098 .051 2, 72 0.997 .374 .027 Within-subjects effects Time 1.67, 151.90 156.770 < .0001 .633 1.69, 150.73 28.983 < .0001 .246 2.15, 154.72 42.733 < .0001 .372 Condition x Time 3.34, 151.90 1.652 .174 .035 3.39, 150.73 1.553 .198 .034 4.30, 154.72 0.633 .651 .017 Source RMSSD pNN50 df F p η p 2 df F p η p 2 Between-subjects effects Condition 2, 68 0.319 .728 .009 2, 72 0.076 .927 .002 Within-subjects effects Time 2.07, 141.10 15.117 < .0001 .182 2.37, 170.69 10.107 < .0001 .123 Condition x Time 4.15, 141.10 2.505 .043 .069 4.74, 170.69 2.255 .054 .059 Note . 1 This was calculated using robust ANOVA, resulting in no effect size measure. 3.3 Change in simulator sickness symptoms Because of potential increases in simulator sickness symptoms due to incongruences between the visual input and the head movement-based feedback of the vestibular nerve, we tested changes in the SSQ via exploratory analyses. We assumed to find bigger changes in nausea, oculomotor, and disorientation symptoms in the “360° VR” condition compared to both the “Audio” and “Display” conditions after treatment. For SSQ Disorientation only, we detected 17 extreme outliers in pre and post treatment measurements ( n Participant =12). Again, we chose not to exclude regular outliers to preserve data variance. However, we calculated two models, one without and one with excluding the extreme outliers, to assess their impact. Corresponding mean group values are in Table S5. In summary, the results of our analyses did not completely support our assumptions (see Tab. S6 and Fig. 5 ). While we found a significant main effect of time on nausea symptoms with reduced symptom ratings over time, there were no significant effects for condition or the time × condition interaction. For symptoms of eye strain measured by the SSQ Oculomotor in contrast, we found a significant main effect of time with increased symptom ratings over time, as well as a significant interaction effect of time × condition , which did not survive in Bonferroni-corrected post-hoc tests (all p > .05). Lastly, while a robust rmANOVA found a significant main effect of condition on disorientation symptoms assessed by SSQ Disorientation for both variants (with and without exclusion), robust post-hoc tests found no significant differences between the conditions ( p > .05). 4. Discussion The aim of this study was to investigate potential relaxation-enhancing effects of immersive virtual NE on a prerecorded MBSR breathing meditation audio. We assumed to find effects of relaxation on self-reported mood and relaxation, as well as parameters of ANS activity over time, with the magnitude of the effect depending on the immersiveness of the virtual nature exposure: largest effects were to be found in the more immersive “360° VR” condition vs. the less immersive “Display” and “Audio” conditions. Like expected, participants generally rated the “360° VR” condition as significantly more immersive than the “Display” condition. Furthermore, they followed the instructions given in the MBSR relaxation meditation, as indicated by the decrease in breathing frequency over time in all treatment groups. All psychophysiological parameters we assessed followed the known pattern in MBSR interventions: negative affect, respiratory rate and heart rate decreased over time, while relaxation indices, RMSSD and pNN50 increased over time. In terms of condition and interaction effects however, the results did not align with our assumptions. 4.1 No condition effects We found no condition effects in any parameter we assessed. This indicates that, for this group of participants at least, the digital NE did not augment the effects of the MBSR relaxation meditation. This could be based on several factors, of which we aim to discuss a few. First, the simultaneous presentation of the MBSR breathing meditation and the virtual nature exposure, which involved both sound and visual stimulation, could have caused interference effects. More specifically, the combination of the voice lines from the meditation and the ocean sounds of the virtual nature video could have caused cognitive or attentional overload, which would make it harder for participants to maintain focus on both the meditation and the nature scene, resulting in smaller add-on effects (Clark & Boz, 2025 ; Ersin et al, 2021 ; Smucny et al., 2013 ). Second, individual-centric ceiling effects regarding relaxation and effectiveness of mindfulness may have limited the potential add-on effects of the virtual NE, especially without a stressor before the treatment. Relaxation practices like meditation often lead to improvements over time due to learning effects (e. g. Solhaug et al., 2019 ). Our participants who were already experienced in relaxation as a skill (74–90% per condition) might have reached a point in mindfulness effectiveness where the assumed added relaxation effect of the virtual NE would not significantly enhance their psychophysiological relaxation response (Jo et al., 2024 ). Likewise, it can also be argued that this sample, as indicated by the SSCS of the Trier Chronic Stress Scale, generally experienced a tolerable amount of stress prior to the intervention. Since mindfulness seems to exhibit strongest effects in highly distressed populations (Cresswell & Lindsay, 2014), this moderate burden would limit how pronounced the effect of the mindfulness intervention and, in turn, the digital NE could be in this study. This argument is supported by the fact that most studies mentioned in Riches et al. ( 2021 )s systematic review (e.g., Anderson et al., 2017 ) used an additional stress induction before their MBSR treatments, while our setup avoided this to increase external validity. It seems plausible to assume that we could have found condition effects, too, if the baseline of our participants was more distressed. Third, the scenery used for the NE in VR could be non-ideal for the intended relaxation effect in this study. Comparing our NE material, a calm beach view, with studies included in Browning et al. ( 2020 ) and Liang et al. ( 2024 )s meta-analyses on virtual NE, our video is an outlier without greenery, trees or plants in general. Going back to the underlying hypotheses for why NE in general works (see Wilson, 1986 ; Kaplan, 1995; Ulrich, 2023 , 1983, 1979), there can be reasoned that some greenery could be inherently important for the relaxing effect of NE in VR (see Li et al., 2021 ). 4.2 Sleepiness interaction Despite the lack of condition effects in all measures, an interaction effect emerged during analysis and remained significant after post-hoc testing: only participants of the “Display” condition reported feeling significantly sleepier after the intervention. This was surprising, since we had assumed that the visual stimulation would keep participants in both virtual NE conditions engaged and alert. Furthermore, we reasoned to find increased sleepiness, if at all, in the “Audio” condition due to the lack of external stimulation and instruction to keep one’s eyes open. Prolonged exposure to digital displays increases eye strain and sleepiness; at this point, this can be considered common knowledge. However, explaining the rise in sleepiness just with the use of digital displays in this experimental setup is lacking. Since we found a descriptive rise in eye strain for participants in both “360° VR” and “Display” conditions (see 3.3), in that line of thought, we would have expected to find a significant increase in sleepiness in both conditions as well. However, it was confirmed in our analysis for the “Display” condition only. Possibly, a more likely explanation is the experience of immersion and presence. Both were significantly higher in the “360° VR” condition when compared with the “Display” condition (see 3.1). When compared with desktop users, participants experiencing a more real-life virtual environment can report on increased alertness and show better task performance (Kumar et al.,2017). 4.3 Limitations and outlook NE in VR is a promising new way of augmenting relaxation by itself and in combination with an MBSR relaxation meditation – multiple reviews (e. g. Ma et al.; 2023 ; Spano et al., 2023 ) support this hypothesis, but so far for mood, attention restoration and self-rated relaxation only. This study was the, to our knowledge, first one to assess potential changes in physiological indicators of stress reduction, namely cardiovascular function and electrodermal activity, while also altering the level of immersion during the virtual NE and avoiding a stress induction beforehand. We were able to replicate time-based effects, but could not confirm immersion-based advantages of concurrent digital NE. Aside from the reasons discussed so far, this could also be due to study specifics. We assessed a predominantly young, female, healthy and relaxation-experienced sample of psychology students in a single-session design. Our results are, hence, not representative for the greater public and need to be replicated with a bigger representative sample. Our design, on top of that, was incomplete due to lacking a non-stimulated control and groups with digital NE only. Future and follow-up studies should incorporate these additional passive and visual stimulation-only control groups, as well as a NE in VR using a green nature scenery as a comparison to a non-green nature scene. Furthermore, adding less relaxation-experienced and clinical groups will add the needed variance and representativeness to understand the impact of potential interference and ceiling effects on subjective and physiological relaxation parameters. This, ultimately, will further our evaluation and understanding of the benefits of NE in VR. 5. Conclusion Overall, our present study suggests that experienced participants taking part in a MBSR relaxation mediation do not necessarily benefit from an added NE in VR. Some subtle differences hint at a benefit, however, the relationship remains unclear so far. Further research is needed to justify the added costs of providing NE in VR. However, the rapid and extensive growth of VR technology, as well as the technological pull-effect could potentially be used to make NE-supported relaxation more impactful and beneficial, more accessible and attractive to mobility-impacted groups and relaxation-novices, potentially acting as a gateway-treatment for proven, effective methods such as mindfulness. Declarations Conflict of interest The authors declare that they have no conflict of interest. Consent to participate All participants provided signed informed consent prior to their participation. Their privacy rights have been observed carefully. The study was conducted anonymously. There was no deception in any way. The participants were given the opportunity to withdraw their consent at any time and terminate their participation. Consent for publication All participants provided signed informed consent that the anonymized results can be published. Ethics approval The present study was carried out in accordance with the APA Guidelines for Ethical Conduct of Behavioral Projects Involving Human Participants and The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans. Ethical review and approval were given by the Ethics Committee of the University of Trier (internal reference number #12/2024). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third-party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copy-right holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ . Funding This work was supported by the University Research Priority Program “Psychobiology of Stress” funded by the State Rhineland-Palatinate. Author Contribution S.S. wrote the original draft, conducted formal analysis, prepared the visualizations, curated the data, supervised the project, and contributed to the conceptualization. K.B., A.-M.F., and L.W. contributed to the conceptualization, investigation, and review and editing of the manuscript. G.D. acquired funding, provided project administration and supervision, and contributed to the conceptualization, methodology, resources, and manuscript review and editing. All authors reviewed and approved the final manuscript Acknowledgement The study hypotheses and methods were preregistered at OSF: https://osf.io/awbkn. Data Availability The datasets generated for this study, the codebook, and the R code used for the reported analyses will be available on OSF (https://osf.io/pzyeb/) after publication. References Anderson, A. P., Mayer, M. D., Fellows, A. M., Cowan, D. R., Hegel, M. T., Buckey, J. C. (2017). Relaxation with immersive natural scenes presented using virtual reality. Aerosp. Med. Hum. Perform. 88 , 520–526. https://doi.org/10.3357/AMHP.4747.2017 Berto, R., 2014. The role of nature in coping with psycho-physiological stress: a literature review on restorativeness. Behav. Sci. 4 , 394–409. https://doi.org/10.3390/bs4040394 Breyer, B., Bluemke, M. (2016). Deutsche Version der Positive and Negative Affect Schedule PANAS (GESIS Panel) [German version of the Positive and Negative Affect Schedule] . Zusammenstellung sozialwiss. 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MAAS - Mindful Attention and Awareness Scale - deutsche Version . https://doi.org/10.23668/PSYCHARCHIVES.6555 Navarro-Haro, M. V., López-del-Hoyo, Y., Campos, D., Linehan, M. M., Hoffman, H. G., García-Palacios, A., ..., García-Campayo, J. (2017). Meditation experts try Virtual Reality Mindfulness: A pilot study evaluation of the feasibility and acceptability of Virtual Reality to facilitate mindfulness practice in people attending a Mindfulness conference. PloS one , 12 (11), e0187777. https://doi.org/10.1371/journal.pone.0187777 R Core Team (2024). R: A language and environment for statistical computing (version 4.4.0). R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/. Riches, S., Azevedo, L., Bird, L., Pisani, S., Valmaggia, L. (2021). Virtual reality relaxation for the general population: a systematic review. Soc. Psychiatry Psychiatr. 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Routledge, New York, NY, USA, pp. 143–146. https://doi.org/10.4324/9781003382904 Valmaggia, L. R., Latif, L., Kempton, M. J., Rus-Calafell, M. (2016). Virtual reality in the psychological treatment for mental health problems: An systematic review of recent evidence. Psychiatry Res. 236 , 189–195. https://doi.org/10.1016/j.psychres.2016.01.015 Webster Marketon, J. I., Glaser, R. (2008). Stress hormones and immune function. Cell. Immunol., 252 , 16–26. https://doi.org/10.1016/j.cellimm.2007.09.006 Wilson, E.O. (1986). Biophilia. Harvard University Press. Yu, C. P., Lee, H. Y., Luo, X. Y. (2018). The effect of virtual reality forest and urban environments on physiological and psychological responses. Urban For. Urban Green. , 35 , 106-114. https://doi.org/10.1016/j.ufug.2018.08.013 Zimmer, P., Domes, G. (2019). Same same but different? Replicating the real surroundings in a virtual Trier Social Stress Test does not affect psychophysiological stress response. Psychoneuroendocrinology , 107 , 9. https://doi.org/10.1016/j.psyneuen.2019.07.022 Zimmer, P., Wu, C. C., Domes, G. (2019). Same same but different? Replicating the real surroundings in a virtual trier social stress test (TSST-VR) does not enhance presence or the psychophysiological stress response. Physiol. Behav. , 212 , 112690. https://doi.org/10.1016/j.physbeh.2019.112690 Additional Declarations No competing interests reported. Supplementary Files SeeletalRelaxationSupplements20250623clean.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6954558","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475897433,"identity":"83554106-50aa-4207-a39f-14857e542838","order_by":0,"name":"Saskia Seel","email":"","orcid":"","institution":"Johannes Gutenberg- University Mainz","correspondingAuthor":false,"prefix":"","firstName":"Saskia","middleName":"","lastName":"Seel","suffix":""},{"id":475897434,"identity":"00940871-6b66-4e20-8d27-5f07eb4c58a8","order_by":1,"name":"Katja Braun","email":"","orcid":"","institution":"University of Trier","correspondingAuthor":false,"prefix":"","firstName":"Katja","middleName":"","lastName":"Braun","suffix":""},{"id":475897435,"identity":"2084440e-2813-4221-b950-6558e88e85ee","order_by":2,"name":"Anne-Marie Frantz","email":"","orcid":"","institution":"University of Trier","correspondingAuthor":false,"prefix":"","firstName":"Anne-Marie","middleName":"","lastName":"Frantz","suffix":""},{"id":475897436,"identity":"c94b161f-e2fe-407e-8dc5-f165c257883a","order_by":3,"name":"Luna Wurr","email":"","orcid":"","institution":"University of Trier","correspondingAuthor":false,"prefix":"","firstName":"Luna","middleName":"","lastName":"Wurr","suffix":""},{"id":475897437,"identity":"008f024a-a4a3-4220-842b-5df155c5fc62","order_by":4,"name":"Gregor Domes","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYDCCAyCigoGBDUQnwEUIajkD0sJMihbGNhCLGdkQPIDveHfiw5/zDufxMfAf+/Cg4h5QpAG/FskzZzcb8247XAx0GPOMhDPFQBEC1hjcyN0mzbjtcGKb/GNmhsS2BKBIAkEt23/+nAPUArSFIfEfUMv9B4RtYeBtgGlpANmCXwfYL9I8x9JBWowZEo4l8EieIeAwvuO9Gz/+qLFOnN/A+JjxR02CHN/xAwSsQQc8JKofBaNgFIyCUYANAABD9kXbN13aQgAAAABJRU5ErkJggg==","orcid":"","institution":"University of Trier","correspondingAuthor":true,"prefix":"","firstName":"Gregor","middleName":"","lastName":"Domes","suffix":""}],"badges":[],"createdAt":"2025-06-23 08:38:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6954558/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6954558/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87007154,"identity":"8f4d9ee5-f8e0-4c0c-b19f-db8f1c401aa9","added_by":"auto","created_at":"2025-07-18 08:38:08","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":604125,"visible":true,"origin":"","legend":"\u003cp\u003eScreenshot from “Sunset on Beach – Long Version” (permission granted from \u003cem\u003eAtmosphaeres\u003c/em\u003e)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6954558/v1/5c4ebf2bae752086629c71c6.png"},{"id":87007158,"identity":"32d6652b-05ca-4c26-8a99-2f2f6853a610","added_by":"auto","created_at":"2025-07-18 08:38:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":83097,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic experimental procedure. 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Introduction","content":"\u003cp\u003eChronic stress is a pervasive mental and physical health risk factor that has been shown to impact several functions of the central nervous system and markers of mental health (Mariotti, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Schneiderman et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Among others, general mood (McEwen, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), cardiovascular (Golbidi et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Lucini et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) and immune function (Gouin, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Webster Marketon and Glaser, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2008\u003c/span\u003e) have been shown to decline, while the risk of developing mental disorders (e. g. Hammen, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) is increased. Thus, clinical research has long since acknowledged the need for effective interventions that help mitigate harmful effects of chronic stress.\u003c/p\u003e\u003cp\u003eMindfulness-based stress reduction (MBSR) is a classic approach that roots in developing a mindset of benevolent acceptance of the status-quo without attachment to the outcome of a situation (Kabat-Zinn, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Creswell \u0026amp; Lindsay, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Meta-analyses have shown MBSR to promote mental health, quality of life, and recovery from mental health disorders such as depression and anxiety (Fjorback, 2011; Khoury et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Physiologically, these effects could be attributed to MBSR-induced slow-paced breathing that has been hypothesized to shift the autonomic nervous system activity from a sympathetic dominant to a parasympathetic dominant state (Jerath et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Psychologically, reduced repetitive negative thinking, alongside improved mindfulness, has been discussed as one of the significant mechanisms underlying the positive effects of MBSR (Gu et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAn equally classic approach to relaxation is nature exposure (NE) with the wide-spread observation that humans are inherently positively influenced by it due to an innate affinity for nature (e. g. Wilson, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e1986\u003c/span\u003e; Ulrich, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). More recent studies have shown both physiological and psychological health benefits of green NE, such as enhanced general well-being, positive affect and recovery from mental fatigue, as well as shifting from sympathetic dominant to parasympathetic dominant ANS activity (Tsunetsugu et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Berto, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Urbanization and changes in life styles, however, contribute to consistently diminishing opportunities for casual NE (Hartig et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), which has supported growing experimental research interest around NE in virtual reality (Jerdan et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Valmaggia et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eVirtual reality (VR) refers to an \u0026ldquo;inclusive, extensive, surrounding and vivid illusion of reality\u0026rdquo; (Slater and Wilbur, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e1997\u003c/span\u003e; p. 605) in which the user feels present and active (Schubert et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). This is achieved by focusing the user\u0026rsquo;s attention on the VR setting, thus leading them to feel fully immersed into the experience. This immersion is maximized when the experience is as close to real life as possible with the VR environment addressing as many of the user\u0026rsquo;s senses as possible with relevant external stimuli (Schubert et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2001\u003c/span\u003e; Slater and Wilbur, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e1997\u003c/span\u003e). VR is usually provided by utilizing a head-mounted display (HMD) with headphones to support immersion (Jerdan et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). VR environments are used in a great variety of experimental and therapeutic contexts to create situations that evoke psychological and physiological responses as comparable as possible to in vivo responses (Linnig et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Zimmer and Domes, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Zimmer et al, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Felnhofer et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn their systematic review on the feasibility, acceptability, and effectiveness of HMD-supported relaxation in the general population, Riches et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) presented VR relaxation via HMD as a safe tool to support mental health and wellbeing that induced significantly higher relaxation scores in the HMD conditions than in control conditions after a stressor. Comparing NE in VR and real-world NE with an indoor setting without NE, Browning et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) found that the NE conditions \u0026ldquo;were rated as equally restorative and both resulted in physiological arousal associated with positive affect\u0026rdquo;. Likewise, NE in VR was found to promote increase in positive affect and subjective recovery while also inducing decrease in negative affect when compared with VR city sceneries (Schutte et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Yu et al., \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Lastly, when combining mindfulness audio interventions with NE in VR, independent studies reported NE in VR to support the significant increase in state mindfulness, positive affect and subjective relaxation (Navarro-Haro et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Seabrook et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, it remains unclear if this combination also induces changes in physiological parameters of relaxation and improved mental and physical health associated with NE in VR and mindfulness alone.\u003c/p\u003e\u003cp\u003eIn this study, we investigated this question. Adapting and expanding Browning et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e)s study setup, we firstly assumed that adding on the presentation of a calm beach scene would augment the beneficial changes in positive mood, relaxation and parasympathetic tone associated with following a prerecorded MBSR breathing meditation audio. Secondly, we reasoned that the add-on effect of the beach scene would be stronger when the presentation induced high immersion for the user. Thus, we hypothesized that increasing levels of immersiveness during the mindfulness-based stress reduction (MBSR) breathing meditation would lead to stronger beneficial effects across psychological and physiological indicators. In particular, we expected that a 360\u0026deg; immersive virtual reality (VR) presentation would elicit stronger increases in state positive affect, relaxation, and heart rate variability, as well as stronger decreases in state negative affect, heart rate, and skin conductance level, compared to a standard 2D display presentation and an audio-only MBSR condition. Specifically, we anticipated (a) a greater increase in positive affect and (b) a stronger decrease in negative affect in more immersive conditions (360\u0026deg; VR\u0026thinsp;\u0026gt;\u0026thinsp;2D Display\u0026thinsp;\u0026gt;\u0026thinsp;Audio). We also predicted (c) greater increases in subjective relaxation and (d) stronger decreases in heart rate, (e) increases in heart rate variability, and (f) decreases in skin conductance level, all scaling with the degree of immersiveness of the MBSR presentation.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Participants\u003c/h2\u003e\u003cp\u003eBased on an effect size of \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.31 derived from the mean reduction in negative affect of the control and VR group in a nature exposure study (Browning et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), the minimum sample size for a within-between interaction of three groups and four repeated measurements was estimated in G*power (Faul et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2009\u003c/span\u003e) at \u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;102 (\u003cem\u003ef\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.30; α\u0026thinsp;=\u0026thinsp;.05; 1-β\u0026thinsp;=\u0026thinsp;.80; correlation for repeated measures \u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.30; no correction for non-sphericity). To compensate for possible dropouts, we aimed for a total sample of \u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;106. Participants were recruited by on-campus advertisement. Interested individuals were included in the study if they were at least 18 years of age, and didn\u0026rsquo;t report on pronounced motion sickness in the past.\u003c/p\u003e\u003cp\u003eThus, a total of 106 adults were initially enrolled in the study. However, three individuals didn\u0026rsquo;t show up to the appointment and were no longer available for testing, and three individuals had to be excluded due to coffee consumption less than 30 minutes before the appointment. The remaining 100 participants completed the study (see 3. Results).\u003c/p\u003e\u003cp\u003e The study was approved by the ethics committee at University of Trier (internal reference number 12/2024) and conducted in line with the Declaration of Helsinki. All participants gave informed written consent and could ask additional questions after finishing the study. Participation was rewarded either through monetary compensation of 15\u0026euro;, or with 1.5 hours of course credit.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Design\u003c/h2\u003e\u003cp\u003eWe used a randomized, controlled, between- subjects design. Simple randomization was applied to assign participation to one of the three study groups (\u0026ldquo;Audio\u0026rdquo; vs. \u0026ldquo;Display\u0026rdquo; vs. \u0026ldquo;360\u0026deg; VR\u0026rdquo;) while equal distribution by self-reported gender was controlled.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Measures\u003c/h2\u003e\u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\u003ch2\u003e2.3.1 Psychometric questionnaires\u003c/h2\u003e\u003cp\u003e\u003cem\u003eTrait variables.\u003c/em\u003e Before the relaxation treatment, the Mini Symptom Checklist (Mini-SCL; Franke, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) and the Short Scale of the Trier Inventory for Chronic Stress (TICS-SSCS; Schulz et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2004\u003c/span\u003e) were used to assess recent psychological stress and potential pre-existing symptoms of psychiatric disorders, as well as the Mindful Attention and Awareness Scale (MAAS; Michalak et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) as a measure of mindfulness as a self-rated trait.\u003c/p\u003e\u003cp\u003e\u003cem\u003eState variables\u003c/em\u003e. Before and after the treatment, the Positive And Negative Affect Schedule (PANAS; Breyer and Bluemke, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) was used to track changes in positive and negative affect, while the Relaxation State Questionnaire (RSQ; Steghaus and Poth, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) was used to assess changes in psychophysiological relaxation, and the Simulator Sickness Questionnaire (SSQ; Kennedy et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e1993\u003c/span\u003e) was used to track changes in motion sickness due to the experience of the digital environment. Furthermore, the Igroup Presence Questionnaire (IPQ; Schubert et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2001\u003c/span\u003e) and the subscale \u003cem\u003eImmersion\u003c/em\u003e of the Technology Usage Inventory (TUI; Kothgassner et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) were used to assess immersion in the digital environment of the treatment groups \u0026ldquo;Display\u0026rdquo; and \u0026ldquo;360\u0026deg; VR\u0026rdquo; after the treatment.\u003c/p\u003e\u003cp\u003eFurther information about these questionnaires is available in the supplementary methods.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\u003ch2\u003e2.3.2 Physiological parameters of autonomic nervous system activity\u003c/h2\u003e\u003cp\u003eA 16-channel amplifier (V-Amp16, Brain Products, Gliching, Germany) was used in combination with the BrainVision Recorder (Brain Products GmbH, Gliching, Germany) to record the galvanic skin response (GSR), respiratory activity, and an electrocardiogram (ECG) at a sampling rate of 500Hz as parameters of ANS activity. The GSR (in micro-siemens) was measured with two electrodes (GSR Sensor Rev. 01; Brain Products, Gliching, Germany) that were attached to the index and ring fingers of the non-dominant hand using an isotonic GSR electrolyte gel (Neurospec, Stans, Switzerland) after skin preparation with isopropanol. The respiratory activity was assessed with the respiration belt transducer (Brain Products, Gliching, Germany). The ECG was recorded using single-use electrodes (P. J. Dahlhausen \u0026amp; Co. GmbH, Cologne, Germany) attached to the chest in a 3-lead configuration (modified Einthoven II). Respiratory activity was assessed and tested alongside the heart rate data to control for adherence to the MBSR meditation and effects induced by sinus arrythmia.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.4 VR equipment\u003c/h2\u003e\u003cp\u003eFor the \u0026ldquo;360\u0026deg; VR\u0026rdquo; condition, an HMD (VIVE PRO, HTC Corporation, Taoyuan, Taiwan) with integrated headphones was connected to a computer (Windows 10, Intel (R) Core (TM) i9-10940X CPU 3.3GHz, 64 bits, NVIDIA RTX A5000, 64 GB Ram). For the \u0026ldquo;Display\u0026rdquo; condition, a desktop PC monitor (Philips QHD-LCD-Monitor 272B8Q) was connected to the same computer and set up at 120cm from the seat of the participant at eye level. For both the \u0026ldquo;Display\u0026rdquo; and \u0026ldquo;Audio\u0026rdquo; conditions, over-ear headphones (AKG K52) were connected to the same computer to maintain stable sound quality.\u003c/p\u003e\u003cp\u003eBased on Anderson et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), we used a monoscopic 360\u0026deg; beach video (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.atmosphaeres.com/video/895L/Sunset+On+Beach+-+Long+Version\u003c/span\u003e\u003cspan address=\"https://www.atmosphaeres.com/video/895L/Sunset+On+Beach+-+Long+Version\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) showing waves in the sunset, accompanied with ocean sounds (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e for a screenshot approximating the point of view shown in the \u0026ldquo;Display\u0026rdquo; condition). The video lasted 14 minutes and had no scene changes. It was played, starting at 00:00, either via the HMD or via the PC screen, depending on the condition, and stopped shortly after the end of the MBSR audio.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Procedure\u003c/h2\u003e\u003cp\u003eOn the day before the assessment, the participants were instructed not to consume any alcohol, drugs, or medication 24 hours before the study, and to refrain from engaging in strenuous physical activities. They were also instructed not to consume any caffeinated drinks for at least 6 hours before participation. Specific time frames and additional information are provided in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e Upon entering the laboratory, participants gave written informed consent and provided demographic data, including information about potential confounding variables. Then electrodes and respiratory belt were attached and the recording was started. After filling out the pre-treatment questionnaires (Mini-SCL, MAAS, TICS-SSCS, SSQ, RSQ, and PANAS), a three-minute baseline was obtained. Participants were then randomly assigned to one of the three experimental conditions and prepared: participants in the \u0026ldquo;Audio\u0026rdquo; and \u0026ldquo;Display\u0026rdquo; conditions were given headphones and waited, while the HMD was fitted to those in the \u0026ldquo;360\u0026deg; VR\u0026rdquo; group and adjusted to their specific visual needs. After an additional minute to account for potential orientation reactions to the VR setting, the treatment was started: the \u0026ldquo;Audio\u0026rdquo; group received a 10 minute long guided MSBR breathing exercise audio over headphones, while the \u0026ldquo;Display\u0026rdquo; group also watched the video of a beach on screen, and the \u0026ldquo;360\u0026deg; VR\u0026rdquo; group watched the same video, but in a 360\u0026deg; version enabled by the HMD. All groups were instructed to keep their eyes open during the treatment.\u003c/p\u003e\u003cp\u003eAfter the treatment and a short waiting period to account for the removal of the HMD, participants were asked to fill out the post-treatment questionnaires (SSQ, RSQ, PANAS, TUI, and IPQ). They were disconnected from the V-AMP, could ask questions, and were compensated.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Data preprocessing\u003c/h2\u003e\u003cp\u003eAll data preprocessing was handled blindly. Scale scores and, if existing, T-values were calculated for all questionnaires used. The physiological data was preprocessed in BrainVision Analyzer (2.3.0; Brain Products, Gliching, Germany) and Matlab (Version R2024a; Mathworks, Natick, Massachusetts, USA), respectively. The data was then segmented into a 3-min baseline and three 3-minute segments covering the relaxation phase for further statistical analyses (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFor the calculation of skin conductance levels (SCL), the GSR raw data was low-pass filtered (0.03 Hz, Butterworth, 8th order) in Matlab. For the assessment of breathing rate, the respiration data was filtered (low-pass: 0.12 Hz, 4th order and high-pass: 0.4 Hz, 4th order) and down-sampled to 10 Hz. Movement artifacts were then detected semi-automatically; contaminated recording sections were removed. Peaks were then counted and calculated into a corrected mean breaths per minute value. For heart rate and HRV analyses, the ECG data was filtered in a first step applying a low-pass filter (5 Hz, 4th order), a high-pass filter (45 Hz, 4th order) and a notch filter (50 Hz). Then R-peaks were detected using the \u0026ldquo;ECG markers\u0026rdquo; function of the BrainVision Analyzer and manually corrected if necessary. Artifacts (e. g. sections where no clear R-peaks could be identified) then were removed semi-automatically with the \u003cem\u003eArtifact Rejection\u003c/em\u003e function. The resulting inter-beat-intervals (IBIs) were further processed in Matlab to calculate corrected values for the heart rate (HR, in bpm), root mean square of successive differences (RMSSD in ms) and the percentage of successive Normal-to-Normal intervals that differed by more than 50 milliseconds (pNN50 in %), as these measures have been listed in the review of Shaffer and Ginsberg (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) as suitable for recording lengths of less than 180 seconds.\u003c/p\u003e\u003cp\u003eIn general, if more than 1/3 of psychophysiological data derived from GSR, respiratory activity, and ECG (baseline and the three-minute segments of the treatment) was removed during the artifact rejection per phase, that phase was deemed too poor in quality and thus removed from further analyses. If more than two phases were removed this way, the whole GSR, ECG or respiratory activity dataset was removed from the analyses. Detailed information is reported below (see 3.2 and Tables S7-S9).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e2.7 Statistical analyses\u003c/h2\u003e\u003cp\u003eFisher's exact and Chi\u0026sup2; tests were used for the statistical comparison of the frequency distributions. Mixed repeated-measure ANOVAs were conducted to test for differences in subjective relaxation, heartrate, heartrate variability, skin conductance level, and respiratory rate in the three experimental groups (between factor) over the measurement points (within factor). In case of non-sphericity, Greenhouse-Geisser corrected results and ε are reported. Effect sizes for ANOVAs are reported as η\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e. Pairwise comparisons were Bonferroni-corrected.\u003c/p\u003e\u003cp\u003eAll statistical analysis were done in RStudio version 2024.04.1 with R version 4.4.0 (R Core Team, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). For analyses of variance (ANOVA) we used the package rstatix 0.7.2 (Kassambara, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In case of robust ANOVAs, we used the package WSR2 1.1.6 (Mair and Wilcox, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and calculated η\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e as discussed by Haiyang (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). All figures were created with GraphPad Prism version 10.4.2 for Windows (GraphPad Software, Boston, Massachusetts USA). The level of significance was set to \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eOne hundred adults (74 cisgender women, 25 cisgender men, 1 non-binary) adults between the ages of 19 and 61 years (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;99; \u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;26.6, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8.7) completed the study. 91% were native German speakers and 84% currently attended university. 81% of participants reported experience in at least one relaxation technique (63% in meditation, 51% in imaginative exercises, 50% in yoga, 41% in progressive muscle relaxation) prior to taking part in the study. In terms of factors that could influence a participant\u0026rsquo;s relaxation experience, they reported on the following aspects: 22% had been in psychotherapy before the study (time since: 3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;3.64 years; 6% in active therapy), 8% had consumed coffee up to six hours before the study, 6% had been significantly physically active in the last 24 hours, 5% reported on being smokers, 2% had a known cardiovascular disease, and 1% reported on recreational drug use. 33.8% of female participants reported contraceptive use.\u003c/p\u003e\u003cp\u003eThere were no significant differences between the experimental groups any of the factor listed above (see Tab. S1 \u0026amp; S2). There were also no significant differences between the groups regarding symptoms of simulator sickness, positive and negative affect, and relaxation indicators before the treatment (see Tab. S3).\u003c/p\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Self-reported state variables: Immersiveness, Affect and Relaxation\u003c/h2\u003e\u003cp\u003eDuring the analyses, we detected no extreme outliers in any of the self-reported questionnaire data and chose not to correct for regular outliers to preserve data variance. Corresponding mean group values are in Table S5.\u003c/p\u003e\u003cp\u003eFirst, we tested our base assumption that the beach scene presented in 360\u0026deg; VR would be rated as significantly more immersive than the same scene presented on a 2D Display. As expected, the \u0026rdquo;360\u0026deg; VR\u0026rdquo; group consistently reported significantly higher values in all subscales of the IPQ and the TUI Immersion subscale than the \u0026ldquo;Display\u0026rdquo; group, indicating higher immersion and feeling of presence with medium to large effect sizes (see Tab. S4, all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05).\u003c/p\u003e\u003cp\u003eFor positive affect, there were no significant effects of \u003cem\u003etime, condition\u003c/em\u003e, or their interaction. While we found a significant main effect of \u003cem\u003etime\u003c/em\u003e on negative affect with lower scores over time, there were no significant effects for \u003cem\u003econdition\u003c/em\u003e or the \u003cem\u003etime \u0026times; condition\u003c/em\u003e interaction (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhen examining relaxation, we considered all subscales of the RSQ separately. For each muscular, cardiovascular and general relaxation, a significant main effect of \u003cem\u003etime\u003c/em\u003e was observed, but no effects of \u003cem\u003econdition\u003c/em\u003e or the interaction were found. For the subscale Sleepiness however, post-relaxation showed a significant main effect of \u003cem\u003etime\u003c/em\u003e and a significant interaction between \u003cem\u003etime\u003c/em\u003e and \u003cem\u003econdition\u003c/em\u003e, although there was no main effect of \u003cem\u003econdition\u003c/em\u003e (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Pairwise comparisons indicated a significant change in sleepiness in the \u0026ldquo;Display\u0026rdquo; condition (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), but no such change was observed in the \u0026ldquo;360\u0026deg; VR\u0026rdquo; or \u0026ldquo;Audio\u0026rdquo; conditions (see Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Physiological indicators of parasympathetic tone\u003c/h2\u003e\u003cp\u003eAfter data preprocessing, a total of 5.8% of the respiratory belt data, 17.7% of the ECG data, and 4.0% of galvanic skin response data had to be excluded from the analyses due to insufficient data quality and movement artifacts; a comprehensive overview of missing data is displayed in Table S8. An overview of average group values is in Table S9. In summary, we excluded a total of \u003cem\u003en\u003c/em\u003e\u003csub\u003erespiration\u003c/sub\u003e=6, \u003cem\u003en\u003c/em\u003e\u003csub\u003eECG\u003c/sub\u003e=25 and \u003cem\u003en\u003c/em\u003e\u003csub\u003eGSR\u003c/sub\u003e=8 participants respectively from analysis due to extreme outliers or data loss due to technical errors. Additionally, for RMSSD as a HRV index, we excluded \u003cem\u003en\u003c/em\u003e\u003csub\u003eRMSSD\u003c/sub\u003e=5 participants from analysis due to extreme outliers (see Tab. S7).\u003c/p\u003e\u003cp\u003eFor respiratory rate, heart rate, pNN50, and skin conductance level, we found a significant main effect of \u003cem\u003etime\u003c/em\u003e with lower respiratory rate, heart rate, and skin conductance level, as well as higher pNN50 over time, but there were no significant effects for \u003cem\u003econdition\u003c/em\u003e or the \u003cem\u003etime \u0026times; condition\u003c/em\u003e interaction (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). In Bonferroni-corrected pair-wise post-hoc tests, we found the breathing rate in all conditions at baseline to differ significantly from each of the relaxation segments (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.0001), while heart rate, pNN50 and skin conductance level were not significantly different between the four phases (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.05).\u003c/p\u003e\u003cp\u003eFor RMSSD as a parameter of heart rate variability, we found the same pattern of a significant main effect of \u003cem\u003etime\u003c/em\u003e with an increase in all parameters over time as well as a significant \u003cem\u003etime \u0026times; condition\u003c/em\u003e interaction, but no significant effect for \u003cem\u003econdition\u003c/em\u003e (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). In Bonferroni-corrected pair-wise post-hoc tests, however, we found no significant differences between the four phases or interactions for RMSSD (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.05).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of mixed repeated measures ANOVAs for self-reported state variables.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"15\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eSource\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003ePANAS: positive affect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003ePANAS: negative affect\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c15\" namest=\"c11\"\u003e\u003cp\u003eRSQ: General relaxation\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eBetween-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.769\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 38.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.864\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e.564\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.571\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eWithin-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.875\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.029\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1, 51.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e13.295\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e23.820\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition x Time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.932\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 38.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.614\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.212\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.078\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.745\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eSource\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eRSQ: Muscular relaxation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003eRSQ Cardiovascular relaxation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c15\" namest=\"c11\"\u003e\u003cp\u003eRSQ Sleepiness\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eBetween-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.716\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.491\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.701\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.498\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.625\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.538\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.013\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eWithin-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.729\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.176\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e9.294\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e16.739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition x Time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.256\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.289\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.263\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.770\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2, 97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e4.490\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of mixed repeated measures ANOVAs for psychophysiological parameters of ANS activity.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"15\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eSource\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eRespiratory frequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003eSkin conductance level\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c14\" namest=\"c11\"\u003e\u003cp\u003eHeart rate\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eBetween-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.444\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.323\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2.380\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.098\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2, 72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.997\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.374\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eWithin-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.67, 151.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e156.770\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.633\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.69, 150.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e28.983\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.246\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2.15, 154.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e42.733\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.372\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition x Time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.34, 151.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.652\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.39, 150.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.553\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e4.30, 154.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.633\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e.651\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eSource\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eRMSSD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e\u003cp\u003epNN50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c14\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eBetween-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2, 68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.319\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.728\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.009\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2, 72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.076\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.927\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eWithin-subjects effects\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.07, 141.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.117\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.37, 170.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e10.107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCondition x Time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.15, 141.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.505\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.043\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.069\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.74, 170.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2.255\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.054\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e.059\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c15\" namest=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"15\"\u003e\u003cem\u003eNote\u003c/em\u003e. \u003csup\u003e1\u003c/sup\u003eThis was calculated using robust ANOVA, resulting in no effect size measure.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Change in simulator sickness symptoms\u003c/h2\u003e\u003cp\u003eBecause of potential increases in simulator sickness symptoms due to incongruences between the visual input and the head movement-based feedback of the vestibular nerve, we tested changes in the SSQ via exploratory analyses. We assumed to find bigger changes in nausea, oculomotor, and disorientation symptoms in the \u0026ldquo;360\u0026deg; VR\u0026rdquo; condition compared to both the \u0026ldquo;Audio\u0026rdquo; and \u0026ldquo;Display\u0026rdquo; conditions after treatment.\u003c/p\u003e\u003cp\u003eFor SSQ Disorientation only, we detected 17 extreme outliers in pre and post treatment measurements (\u003cem\u003en\u003c/em\u003e\u003csub\u003e\u003cem\u003eParticipant\u003c/em\u003e\u003c/sub\u003e=12). Again, we chose not to exclude regular outliers to preserve data variance. However, we calculated two models, one without and one with excluding the extreme outliers, to assess their impact. Corresponding mean group values are in Table S5. In summary, the results of our analyses did not completely support our assumptions (see Tab. S6 and Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile we found a significant main effect of \u003cem\u003etime\u003c/em\u003e on nausea symptoms with reduced symptom ratings over time, there were no significant effects for \u003cem\u003econdition\u003c/em\u003e or the \u003cem\u003etime \u0026times; condition\u003c/em\u003e interaction. For symptoms of eye strain measured by the SSQ Oculomotor in contrast, we found a significant main effect of \u003cem\u003etime\u003c/em\u003e with increased symptom ratings over time, as well as a significant interaction effect of \u003cem\u003etime \u0026times; condition\u003c/em\u003e, which did not survive in Bonferroni-corrected post-hoc tests (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.05). Lastly, while a robust rmANOVA found a significant main effect of \u003cem\u003econdition\u003c/em\u003e on disorientation symptoms assessed by SSQ Disorientation for both variants (with and without exclusion), robust post-hoc tests found no significant differences between the conditions (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;.05).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe aim of this study was to investigate potential relaxation-enhancing effects of immersive virtual NE on a prerecorded MBSR breathing meditation audio. We assumed to find effects of relaxation on self-reported mood and relaxation, as well as parameters of ANS activity over time, with the magnitude of the effect depending on the immersiveness of the virtual nature exposure: largest effects were to be found in the more immersive \u0026ldquo;360\u0026deg; VR\u0026rdquo; condition vs. the less immersive \u0026ldquo;Display\u0026rdquo; and \u0026ldquo;Audio\u0026rdquo; conditions.\u003c/p\u003e\u003cp\u003eLike expected, participants generally rated the \u0026ldquo;360\u0026deg; VR\u0026rdquo; condition as significantly more immersive than the \u0026ldquo;Display\u0026rdquo; condition. Furthermore, they followed the instructions given in the MBSR relaxation meditation, as indicated by the decrease in breathing frequency over time in all treatment groups. All psychophysiological parameters we assessed followed the known pattern in MBSR interventions: negative affect, respiratory rate and heart rate decreased over time, while relaxation indices, RMSSD and pNN50 increased over time. In terms of condition and interaction effects however, the results did not align with our assumptions.\u003c/p\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003e4.1 No condition effects\u003c/h2\u003e\u003cp\u003eWe found no condition effects in any parameter we assessed. This indicates that, for this group of participants at least, the digital NE did not augment the effects of the MBSR relaxation meditation. This could be based on several factors, of which we aim to discuss a few.\u003c/p\u003e\u003cp\u003eFirst, the simultaneous presentation of the MBSR breathing meditation and the virtual nature exposure, which involved both sound and visual stimulation, could have caused interference effects. More specifically, the combination of the voice lines from the meditation and the ocean sounds of the virtual nature video could have caused cognitive or attentional overload, which would make it harder for participants to maintain focus on both the meditation and the nature scene, resulting in smaller add-on effects (Clark \u0026amp; Boz, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Ersin et al, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Smucny et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSecond, individual-centric ceiling effects regarding relaxation and effectiveness of mindfulness may have limited the potential add-on effects of the virtual NE, especially without a stressor before the treatment. Relaxation practices like meditation often lead to improvements over time due to learning effects (e. g. Solhaug et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Our participants who were already experienced in relaxation as a skill (74\u0026ndash;90% per condition) might have reached a point in mindfulness effectiveness where the assumed added relaxation effect of the virtual NE would not significantly enhance their psychophysiological relaxation response (Jo et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Likewise, it can also be argued that this sample, as indicated by the SSCS of the Trier Chronic Stress Scale, generally experienced a tolerable amount of stress prior to the intervention. Since mindfulness seems to exhibit strongest effects in highly distressed populations (Cresswell \u0026amp; Lindsay, 2014), this moderate burden would limit how pronounced the effect of the mindfulness intervention and, in turn, the digital NE could be in this study. This argument is supported by the fact that most studies mentioned in Riches et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)s systematic review (e.g., Anderson et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) used an additional stress induction before their MBSR treatments, while our setup avoided this to increase external validity. It seems plausible to assume that we could have found condition effects, too, if the baseline of our participants was more distressed.\u003c/p\u003e\u003cp\u003eThird, the scenery used for the NE in VR could be non-ideal for the intended relaxation effect in this study. Comparing our NE material, a calm beach view, with studies included in Browning et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) and Liang et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2024\u003c/span\u003e)s meta-analyses on virtual NE, our video is an outlier without greenery, trees or plants in general. Going back to the underlying hypotheses for why NE in general works (see Wilson, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e1986\u003c/span\u003e; Kaplan, 1995; Ulrich, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2023\u003c/span\u003e, 1983, 1979), there can be reasoned that some greenery could be inherently important for the relaxing effect of NE in VR (see Li et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003e4.2 Sleepiness interaction\u003c/h2\u003e\u003cp\u003eDespite the lack of condition effects in all measures, an interaction effect emerged during analysis and remained significant after post-hoc testing: only participants of the \u0026ldquo;Display\u0026rdquo; condition reported feeling significantly sleepier after the intervention. This was surprising, since we had assumed that the visual stimulation would keep participants in both virtual NE conditions engaged and alert. Furthermore, we reasoned to find increased sleepiness, if at all, in the \u0026ldquo;Audio\u0026rdquo; condition due to the lack of external stimulation and instruction to keep one\u0026rsquo;s eyes open.\u003c/p\u003e\u003cp\u003eProlonged exposure to digital displays increases eye strain and sleepiness; at this point, this can be considered common knowledge. However, explaining the rise in sleepiness just with the use of digital displays in this experimental setup is lacking. Since we found a descriptive rise in eye strain for participants in both \u0026ldquo;360\u0026deg; VR\u0026rdquo; and \u0026ldquo;Display\u0026rdquo; conditions (see 3.3), in that line of thought, we would have expected to find a significant increase in sleepiness in both conditions as well. However, it was confirmed in our analysis for the \u0026ldquo;Display\u0026rdquo; condition only. Possibly, a more likely explanation is the experience of immersion and presence. Both were significantly higher in the \u0026ldquo;360\u0026deg; VR\u0026rdquo; condition when compared with the \u0026ldquo;Display\u0026rdquo; condition (see 3.1). When compared with desktop users, participants experiencing a more real-life virtual environment can report on increased alertness and show better task performance (Kumar et al.,2017).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003e4.3 Limitations and outlook\u003c/h2\u003e\u003cp\u003eNE in VR is a promising new way of augmenting relaxation by itself and in combination with an MBSR relaxation meditation \u0026ndash; multiple reviews (e. g. Ma et al.; \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Spano et al., \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) support this hypothesis, but so far for mood, attention restoration and self-rated relaxation only. This study was the, to our knowledge, first one to assess potential changes in physiological indicators of stress reduction, namely cardiovascular function and electrodermal activity, while also altering the level of immersion during the virtual NE and avoiding a stress induction beforehand. We were able to replicate time-based effects, but could not confirm immersion-based advantages of concurrent digital NE.\u003c/p\u003e\u003cp\u003eAside from the reasons discussed so far, this could also be due to study specifics. We assessed a predominantly young, female, healthy and relaxation-experienced sample of psychology students in a single-session design. Our results are, hence, not representative for the greater public and need to be replicated with a bigger representative sample. Our design, on top of that, was incomplete due to lacking a non-stimulated control and groups with digital NE only.\u003c/p\u003e\u003cp\u003eFuture and follow-up studies should incorporate these additional passive and visual stimulation-only control groups, as well as a NE in VR using a green nature scenery as a comparison to a non-green nature scene. Furthermore, adding less relaxation-experienced and clinical groups will add the needed variance and representativeness to understand the impact of potential interference and ceiling effects on subjective and physiological relaxation parameters. This, ultimately, will further our evaluation and understanding of the benefits of NE in VR.\u003c/p\u003e\u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eOverall, our present study suggests that experienced participants taking part in a MBSR relaxation mediation do not necessarily benefit from an added NE in VR. Some subtle differences hint at a benefit, however, the relationship remains unclear so far. Further research is needed to justify the added costs of providing NE in VR. However, the rapid and extensive growth of VR technology, as well as the technological pull-effect could potentially be used to make NE-supported relaxation more impactful and beneficial, more accessible and attractive to mobility-impacted groups and relaxation-novices, potentially acting as a gateway-treatment for proven, effective methods such as mindfulness.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided signed informed consent prior to their participation. Their privacy rights have been observed carefully. The study was conducted anonymously. There was no deception in any way. The participants were given the opportunity to withdraw their consent at any time and terminate their participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided signed informed consent that the anonymized results can be published.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study was carried out in accordance with the APA Guidelines for Ethical Conduct of Behavioral Projects Involving Human Participants and The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans. Ethical review and approval were given by the Ethics Committee of the University of Trier (internal reference number #12/2024).\u003c/p\u003e\n\u003ch2\u003eOpen Access\u003c/h2\u003e\n\u003cp\u003eThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third-party material in this article are included in the article\u0026rsquo;s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article\u0026rsquo;s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copy-right holder. To view a copy of this license, visit \u003cspan\u003e\u003cspan\u003ehttp://creativecommons.org/licenses/by/4.0/\u003c/span\u003e\u003c/span\u003e.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis work was supported by the University Research Priority Program \u0026ldquo;Psychobiology of Stress\u0026rdquo; funded by the State Rhineland-Palatinate.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eS.S. wrote the original draft, conducted formal analysis, prepared the visualizations, curated the data, supervised the project, and contributed to the conceptualization. K.B., A.-M.F., and L.W. contributed to the conceptualization, investigation, and review and editing of the manuscript. G.D. acquired funding, provided project administration and supervision, and contributed to the conceptualization, methodology, resources, and manuscript review and editing. All authors reviewed and approved the final manuscript\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eThe study hypotheses and methods were preregistered at OSF: https://osf.io/awbkn.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets generated for this study, the codebook, and the R code used for the reported analyses will be available on OSF (https://osf.io/pzyeb/) after publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAnderson, A. P., Mayer, M. D., Fellows, A. M., Cowan, D. R., Hegel, M. T., Buckey, J. C. (2017). Relaxation with immersive natural scenes presented using virtual reality. \u003cem\u003eAerosp. Med. Hum. Perform. 88\u003c/em\u003e, 520\u0026ndash;526. https://doi.org/10.3357/AMHP.4747.2017\u003c/li\u003e\n\u003cli\u003eBerto, R., 2014. The role of nature in coping with psycho-physiological stress: a literature review on restorativeness.\u003cem\u003e Behav. 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Behav.\u003c/em\u003e, \u003cem\u003e212\u003c/em\u003e, 112690.\u003cs\u003e \u003c/s\u003ehttps://doi.org/10.1016/j.physbeh.2019.112690\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Relaxation, Mindfulness-Based Stress Reduction (MBSR), 360° video, Immersion, Autonomic nervous system, Randomized trial","lastPublishedDoi":"10.21203/rs.3.rs-6954558/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6954558/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study investigated whether immersive 360\u0026deg; virtual reality (VR) nature environments enhance the relaxation effects of a guided mindfulness-based stress reduction (MBSR) breathing meditation. In a randomized controlled trial, 100 healthy adults were assigned to one of three conditions: MBSR audio-only, MBSR with a 2D beach video (Display), or MBSR with a 360\u0026deg; VR beach video (VR). Psychophysiological indicators (heart rate, heart rate variability, skin conductance, respiration) and self-reported measures (affect, relaxation, presence, simulator sickness) were assessed before, during and after the intervention. While all groups exhibited the expected relaxation effects over time\u0026mdash;characterized by increased parasympathetic activity, as indicated by a lower heart rate and skin conductance, and subjective relaxation\u0026mdash;no significant additional benefit of the more immersive VR condition was observed. However, 360\u0026deg; VR was perceived as more immersive than 2D display, and exploratory analyses revealed unique interaction effects for sleepiness and heart rate variability indices in specific groups. The findings suggest that, although immersive VR reliably increases the sense of presence, it may not confer additional physiological relaxation benefits in mindfulness-experienced, low-stress populations. Future research should examine these effects in more diverse and clinically stressed cohorts, and test alternative VR content designs to optimize relaxation outcomes.\u003c/p\u003e","manuscriptTitle":"Does a 360° VR nature environment augment relaxation during a MBSR breathing meditation?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 08:38:04","doi":"10.21203/rs.3.rs-6954558/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b9494bd6-d2b4-4570-b279-eccec25ffbf0","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-30T12:09:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 08:38:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6954558","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6954558","identity":"rs-6954558","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}