=Paper=
{{Paper
|id=Vol-2055/paper8
|storemode=property
|title=Exploring the Potential of Game Audio for Wellbeing
|pdfUrl=https://ceur-ws.org/Vol-2055/paper8.pdf
|volume=Vol-2055
|authors=Katja Rogers,Lennart Nacke
|dblpUrl=https://dblp.org/rec/conf/chiplay/RogersN17
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==Exploring the Potential of Game Audio for Wellbeing==
https://ceur-ws.org/Vol-2055/paper8.pdf
Exploring the Potential of Game Audio for Wellbeing
Katja Rogers Lennart Nacke
Ulm University University of Waterloo
Ulm, Germany Waterloo, Canada
katja.rogers@uni-ulm.de len@uwaterloo.ca
ABSTRACT relating to the high stress environments they are performed in.
Music listening has long-standing ties to mental health, pos- For example, some professions like education or health care
itive affective states, and wellbeing. Even outside of clini- services feature environments with chronic imbalances in the
cal contexts, music is increasingly being explored as a cost- demands they place on individuals in comparison to resources
effective, ubiquitous way to support emotion regulation and provided to meet those demands [39]. Exposure to stress and
stress reduction in people’s everyday lives. Games have also related mental health issues in turn also predisposes people to
been shown to have the capability to improve player well-being physical illness such as cancer and cardiovascular disease; this
in certain contexts. However, the role of players’ exposure link between mental and physical health issues also leads to
to background music in games toward leveraging this effect significant economic consequences [39, 44]. The WHO have
has not been explored specifically. We explore the potential of emphasized the importance of prevention for achieving this
games to act as a tool for relaxation and stress reduction for goal [44]. The reduction of stress in everyday life is therefore a
the general public and discuss future research directions. good measure to improve the health of the general population
and support their wellbeing.
ACM Classification Keywords
Games are, ideally, fun and enjoyable. One of the main moti-
H.5.m. Information Interfaces and Presentation (e.g. HCI):
vations of players of digital games is escapism, that is, it facil-
Miscellaneous; K.8.0. Personal Computing: Games
itates relaxation through distraction from real life [61]. This
cognitive distraction is a positive and important way for indi-
Author Keywords
viduals to manage negative emotions [33]. While gameplay
wellbeing; games; audio; background music; positive gaming;
can also be linked to increased rage, this generally correlates
stress reduction.
with pathological use (that is, obsessive playing rather than
engaged playing) rather than merely with prolonged exposure
INTRODUCTION
to gameplay. Many types of gameplay are associated with
Mental health is described by the World Health Organization
short- and long-term positive effects on players’ affect and
(WHO) as a state of wellbeing in which individuals manage
wellbeing [33]. Further, games are relatively cheap, widely ac-
their lives productively and are able to contribute to soci-
cessible, and easy to use, particularly for generations that grew
ety [45]. The improvement of mental health is therefore im-
up with pervasive technology and video games. Given that
portant from both an individual perspective, as well as from a
cost factors are considered a systemic barrier stopping individ-
societal one. A large variety of demographic factors are corre-
uals from accessing mental health care, and that mental health
lated with an increased risk of mental health issues, including
issues are more likely to occur among younger individuals,
certain professions, minority groups, or individuals of lower
that is, under 30 years of age [11], this makes games a particu-
socio-economic status [44]. While mental health issues are
larly interesting candidate for assisting with the prevention of
stigmatized, they are highly prevalent. Further, a survey of
mental health issues in the general population.
the health system in Canada in 2015 found that a majority of
individuals with undiagnosed mental health issues ignore or Music is also linked to positive effects on mental health: the
self-medicate their conditions [11]. history of music as a therapeutic measure is extensive and
culturally comprehensive [4]. Many of these effects are as-
While some of the risk factors are genetic, exposure to stress
cribed to actively making music, for example, drumming to
in everyday life plays a significant role in increasing the likeli-
improve the mental health of individuals with post-traumatic
hood of individuals experiencing mental health issues, includ-
stress symptoms [2]. However, even passive music listening
ing but not limited to burnout and depression. Specific profes-
can lower the risk of mental health issues [36]. For example,
sions also carry increased risks of mental health issues, often
studies have shown that music listening after stressful experi-
ences increases individuals’ sense of wellbeing and decreases
depression [26]. Because of these effects, passive music listen-
ing is used in clinical settings to ease and control patients’ pain
and facilitate relaxation, where it shows a consistent positive
effect on psychological measures [4].
Positive Gaming: Workshop on Gamification and Games for Wellbeing With this paper, we explore the potential of games to act
A CHI PLAY ’17 Workshop as a preventative measure against stress in everyday life by
October 15, 2017, The Netherlands
©2017 Copyright held by the authors/owners.
facilitating relaxation and stress reduction, and in particular, with experiences of autonomy, and (when well-balanced) com-
the role of audio in this effect. We discuss future research petence. Social interaction in games fulfils the need for relat-
directions and two potential use cases for studies. edness; facilitation of social interaction is part of the reason for
the popularity of games [60]. Co-located co-playing correlates
RELATED WORK
with greater fun, challenge and perceived competence [19].
In this section we discuss related work on music listening and Johnson et al. [27] have proposed a model of videogames and
gaming in the context of improving wellbeing, and explore wellbeing, in which they discuss three determining factors for
games designed to be and perceived as being relaxing. positive effects of gameplay: player characteristics, game fea-
tures, and experience of play. Mandryk and Birk [37] explored
Music Listening for Wellbeing how some of these factors correlate with wellbeing in a sur-
Music has a long history of use in therapeutic settings due to vey, and found that people with depression or anxiety–despite
its positive influence on mental and social wellbeing [4, 36, activating behaviour being an issue with these conditions–still
57]. For example, group drumming has been used to combat played games a few times a week. Another online survey by
feelings of isolation and helplessness, and provide an outlet Reinecke [48] showed that players explicitly use games after
for negative emotions among soldiers diagnosed with combat stress in order to recover. Further, the importance of gameplay
stress reactions [2]. Group drumming has also been shown for stress recovery was increased for players with less social
to improve social development (e.g. self-esteem) and mental support. Reinecke also found that players who have a ten-
health of at-risk adolescents [59]. Of course, these effects may dency to cope with stress through emotional responses (e.g.,
also be linked to the social context in which group drumming distancing) are more likely to use games for stress relief than
occurs; social context of gameplay has similarly been shown participants who cope with stress through problem-focused
as a predictor of player wellbeing [58], and an important factor coping (e.g., pinpointing the problem and finding solutions).
in game enjoyment [60]. Overall, however, there is a clear link For our research question on the role of audio in gameplay
between music and the experience of flow [8, 12]. effects on wellbeing, this is particularly interesting given the
close connection of music to emotional responses.
Even passive music listening (as opposed to music making)
has been linked to improvements in wellbeing and a reduction In a subsequent study, Reinecke et al. [49] explored how partic-
of stress. For example, passive music listening has also been ipants reacted to different recovery options, that is, interactive
used as a therapeutic measure: a review on the effect of music or non-interactive media, after a stressful task. Their results
listening found that standard care practices for depression were show that media exposure in general, enjoyment, and interac-
improved through the addition of music therapy [38]. In edu- tivity are highly relevant factors for stress relief. In a study
cation for individuals with special needs, it is used to facilitate exploring psychosocial adjustment of youths aged 10 to 15,
relaxation, memory, and emotion regulation [17]. Listening to Przyblski [47] found that low levels (<1 hour) of electronic
music activates physiological and emotional responses, as well gaming per day was a key indicator of psychosocial adjust-
as regions of the brain that involve reward processing [6, 41]. ment, correlating with higher life satisfaction and prosocial
Individuals’ emotional responses to music depend on listeners’ behaviour compared to non-players. This effect was reversed
familiarity with it, their exposure to it, and its complexity [24]. for high levels of play (>3 hours). In a study on MMORPG
Even outside of clinical settings, individuals have been shown gameplay, Kirby et al. [29] found a small but significant nega-
to use music listening of their own initiative for emotional self- tive effect of gaming on psychological wellbeing. This effect
regulation [31, 51]. Similarly, a multi-method approach by was mediated through the type of use: obsessive play lowered
Västfjäll et al. [57] showed that music listening significantly psychological wellbeing (i.e., when playing adversely affected
lowers self-reported stress in everyday life. players’ lives), while engaged use did not. Overall, games
offer significant potential for facilitating stress reduction and
providing needs satisfaction, when not used pathologically.
Gameplay & Wellbeing
Playing games is also linked to wellbeing, and previous work
Many Facets of Zen Gaming
has pointed out that by providing relaxation and distraction,
games have the potential to help players manage negative It should be noted that there is a large diversity of opinions
emotions [33]. Similarly, a survey by Vella et al. [58] found regarding what kind of game is considered relaxing. There
positive effects of gameplay on wellbeing. According to Son- are some games that are explicitly designed to be particularly
nentag & Fritz, stress recovery is mediated by four aspects: engrossing and relaxing. A lot of these can be classified as
casual games, and feature simple mechanics and a calm or
psychological detachment, relaxation, mastery experiences,
player-controlled pace. For example, many of these games
and control [53]. Research on players’ motivations for playing
involve growing or raising virtual plants or animals, generally
has found escapism to be an important component, in the form
at a slow pace or in real time (e.g. Viridi [21] or Zen Koi [22],
of facilitating relaxation through distraction [52, 61].
in which players grow succulants or raise and breed koi fish,
The phenomenon of wellbeing through gameplay has been respectively). Similarly, casual farming games (’ville games)
linked to self-determination theory, which describes humans attract a significant amount of players, even though they do not
as trying to satisfy three psychological needs: autonomy, com- pose a great deal of challenge even for players with little game
petence, and relatedness [14]. When these needs are met, literacy [32]. A parody of these games led to the phenomenon
individuals experience enjoyment. Games provide players of clicker games, wherein players’ only mechanic consists of
wellbeing, we do not yet understand the role that game audio
plays in these effects on wellbeing.
Potentially, the background music of games that are perceived
as relaxing may be particularly well suited to improving well-
being through music listening alone, without the game. The
research based on self-determination theory, and stress re-
covery factors suggests that the influence of gameplay itself
should have the greater effect, as it satisfies these psychologi-
cal needs to a larger degree. However, we would like to spark
a discussion in the games user research community on the role
Figure 1. The game Stardew Valley is considered very relaxing due to that audio can perform in increasing the effects of gameplay
both game mechanics (which incorporate the pottering game pattern) on wellbeing. Further, how should game audio be designed in
and aesthetics. order to maximize the potential increase of this effect? In the
following we discuss potential research directions in this area.
clicking (e.g., Cow Clicker [5]). Nevertheless, this has sparked
Which Existing Games Cause Relaxation?
the development of a large number of similar clicking games.
As mentioned, some existing commercial games are known to
Other games that might be considered relaxing involve puzzles
be perceived as relaxing and engrossing by players. However,
– generally without a time limit, or with a non-timed mode.
there is little research on whether they have a measurable
Examples include Monument Valley [56], a puzzle game that
effect on people’s affective state and mental wellbeing. By
plays with M.C. Escher-style level layouts, using impossible
exploring how beneficial these games can be, research has
objects (e.g., Penrose triangles) for architectural design.
the opportunity to encourage gameplay with casual games for
However, there are also games that offer more extensive game stress relief as a cost-effective preventative way of reducing
worlds and mechanics, that are said to be particularly relax- mental health issues in the general population. As such, the
ing. One example is Stardew Valley [9], an open-ended role- games research community should consider exploring games
playing game in which players farm, forage, fish, and extract that players regard as particularly relaxing in more detail. For
resources while fighting monsters in the mines (see Figure 1). example, this approach might begin with player surveys or
Many game reviews have remarked on the game’s relaxing an analysis of blog reviews. By exploring which commercial
and absorbing qualities, pointing out the open world, simple games cause relaxation, the games research community will
mechanics, and continuous progress towards player-defined achieve an increased understanding of how this effect occurs.
goals [13, 46, 50]. Many of these also mention the background
music as playing a role in the relaxing effect. Effect of Game Genre
We previously discussed that the games and game elements
Lundgren & Björk [35] have also explored games that em-
that players consider relaxing may differ greatly, ranging from
ploy calm, arrangement-based game mechanics, which they
pottering games or puzzle games, reaction-based racing games,
name “pottering”. They describe the use of these pottering
to high-challenge games. Game audio performs different func-
mechanics in games such as Zoo Tycoon [20], Minecraft [42],
tions depending on game genre; this effect goes as far as to
The Sims [40], and FarmVille [63]. Among the patterns they
elicit highly divergent reactions when exploring player experi-
emphasize in these games is calm flow, which they describe as
ence upon the removal of audio in a strategy game compared
an almost meditative experience. In contrast, fast-paced games
to a stealth game [28]. We thus suggest that the effect of game
are also mentioned in the context of relaxation. For example,
audio on wellbeing may also differ depending on the game
racing games are considered relaxing by players partly due
genre. In particular, the effects of different audio types (e.g.,
to their challenge-based immersion. Taking flow theory to its
sound effects, voice/narration, and background music) may
limit, high but still manageable challenge in games leads to
also vary in their effects on wellbeing depending on game
a flow state, which for many players is rewarding, and some-
genre. By exploring how the different audio types and game
times even relaxing (even, for example, Dark Souls [18]).
genres can be combined to leverage a maximum increase in
subsequent wellbeing, the games research community could
LEVERAGING COMMERCIAL GAMES FOR WELLBEING provide guidelines for game developers to create game experi-
The related work shows that video games have the potential to ences that are ideal for stress relief and mental health.
induce a calming and relaxing effect on players by providing
a distraction from stress factors. This can be leveraged to Feedback Function of Audio
improve wellbeing and mental health in the general population. Audio performs a large variety of functions in games, among
Regardless of whether they are designed to provide relaxation them dramaturgic uses (i.e., affirming the visuals or providing
through pottering or reaction-based challenges, games are a counterpoint to it), stylization or emphasis, representations
generally designed to be engrossing and immersive. This and evocations of time, locations, or emotions, or providing
also includes their sound design, ranging from aesthetically a means of immersion [3]. Further, the effect of audio set to
pleasing sound effects and narration to suitable continuous media not one-sided; the visuals and story narrative inversely
background music. However, despite research on effects of also affect listeners’ music perception [23]. Finally, in in-
music listening and research on the effects of gameplay on teractive media such as games, audio also interacts with the
player: music can be used to comment on player decisions,
or influence future one [3]; interactivity is considered a key
difference between game and film music [15].
Game audio is said to support cognitive appraisal, in that
it supports perceived realism, hides the game medium, and
heightening emotional responses [15]. A study by Nacke et
al. [43] reported highest flow values for gameplay with sound
effects but no background music; this emphasizes the role of
audio for providing feedback to the player. As the effect of
gameplay on wellbeing is linked to the fulfilment of psycho-
logical needs including mastery experiences and competence,
the feedback function of audio is particularly important for
supporting and communicating players’ successful actions.
The Role of Game Background Music Figure 2. The game Monument Valley is widely described as a relaxing
As discussed, research on music listening has shown strong puzzle game due to both game mechanics with a calm pace, and calming
ties to improved wellbeing. Given that certain games are con- background music.
sidered particularly relaxing, how much of a role does the back-
ground music play in these specific games? Related work has
shown that the presence of background music can affect play- The game has received high praise for its game mechanics, but
ers’ perception of a game, and increases immersion [34, 62]. is also described as relaxing and “actively soothing” due to its
Further, the tempo of background music influences player be- background music [16]. With its game duration of roughly 2
haviour, and there is evidence that allowing players to choose hours overall [55], and the potential to present players with
their own custom background music increases enjoyment [7]. specific levels without requiring lengthy tutorials, it would be
well suited to an in-lab study setting.
Some game soundtracks are designed explicitly to be absorb-
ing and soothing, and many game soundtracks are sold inde-
Stardew Valley
pendently of the game (e.g., the Bastion [30] or Monument
Playing Stardew Valley is considered relaxing by many
Valley [54] soundtracks). However, there has been no research
fans [13, 25, 50]. The game showcases many pottering game
on whether the background music might already be well suited
patterns as described by Lundgren and Björk [35]: construc-
for music listening for the purpose of stress relief. The games
tion by allowing the player to arrange their farm, nurturing
research community should explore how much of the relaxing
(for example through the farming elements), value of effort
effect of games is mediated through the games’ background
through facilitating long-term goals (e.g., re-building the com-
music. How much of it is caused by the audio itself, and
munity center), calm flow (even the combat mechanics are not
how much is caused by the combination of audio and game
fast paced), and framed freedom through the game mechan-
mechanics, through satisfaction of psychological needs?
ics of farming, foraging, fishing, and fighting monsters while
extracting resources from the mines.
Potential Benefits of Exploring These Questions
By exploring these research questions, the games research The soundtrack of Stardew Valley has very positive ratings on
community will be able to design games that leverage their Steam [1]. It has also been mentioned in reviews specifically as
potential for stress relief to the greatest degree possible. This being relaxing [25], and also in the context of being crucial to
will help to improve players’ everyday life as a preventative achieving a stress-free combat system [46]. Due to these player
measure against mental health issues. Further, this will also responses, as well as an easy learning curve for beginners, it
potentially open up research directions towards stress manage- is also well suited to a study exploring the relaxing effect of
ment for people already diagnosed with mental health issues music in gameplay on wellbeing.
such as depression or post-traumatic stress symptoms, and
shift the focus of games research for wellbeing from only CONCLUSION
preventative to include therapeutic applications. Mental health is an issue of increasing societal and financial
importance, and prevention strategies include helping individ-
USE CASES: POTENTIAL GAMES uals to reduce and manage stress in everyday life. In this paper,
In this final section, we discuss two potential use cases in the we elaborate on research areas exploring the effects on well-
form of games which are generally considered relaxing, and being of music listening and playing games, respectively. We
which may be a starting point for research. further discuss games which are considered relaxing and point
out research directions for exploring the role of game audio in
Monument Valley improving player wellbeing, and through stress reduction, also
This puzzle game by ustwo consists of M. C. Escher-style helping to prevent mental health issues. With this paper, we
level designs (see Figure 2), which the player can rotate in hope to spark a discussion and on the role of audio in game de-
three dimensions while the camera remains fixed in a two- sign for wellbeing, as well as prompt potential collaborations
dimensional perspective (which are reminiscent of Fez [10]). to further this research direction.
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