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      A calming hug: Design and validation of a tactile aid to ease anxiety

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          Abstract

          Anxiety disorders affect approximately one third of people during their lifetimes and are the ninth leading cause of global disability. Current treatments focus on therapy and pharmacological interventions. However, therapy is costly and pharmacological interventions often have undesirable side-effects. Healthy people also regularly suffer periods of anxiety. Therefore, a non-pharmacological, intuitive, home intervention would be complementary to other treatments and beneficial for non-clinical groups. Existing at-home anxiety aids, such as guided meditations, typically employ visual and/or audio stimuli to guide the user into a calmer state. However, the tactile sense has the potential to be a more natural modality to target in an anxiety-calming device. The tactile domain is relatively under-explored, but we suggest that there are manifold physiological and affective qualities of touch that lend it to the task. In this study we demonstrate that haptic technology can offer an enjoyable, effective and widely accessible alternative for easing state anxiety. We describe a novel huggable haptic interface that pneumatically simulates slow breathing. We discuss the development of this interface through a focus group evaluating five prototypes with embedded behaviours (‘breathing’, ‘purring’, ‘heartbeat’ and ‘illumination’). Ratings indicated that the ‘breathing’ prototype was most pleasant to interact with and participants described this prototype as ‘calming’ and ‘soothing’, reminding them of a person breathing. This prototype was developed into an ergonomic huggable cushion containing a pneumatic chamber powered by an external pump allowing the cushion to ‘breathe’. A mixed-design experiment (n = 129) inducing anxiety through a group mathematics test found that the device was effective at reducing pre-test anxiety compared to a control (no intervention) condition and that this reduction in anxiety was indistinguishable from that of a guided meditation. Our findings highlight the efficacy of this interface, demonstrating that haptic technologies can be effective at easing anxiety. We suggest that the field should be explored in more depth to capture the nuances of different modalities in relation to specific situations and trait characteristics.

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          Most cited references95

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          The brief resilience scale: assessing the ability to bounce back.

          While resilience has been defined as resistance to illness, adaptation, and thriving, the ability to bounce back or recover from stress is closest to its original meaning. Previous resilience measures assess resources that may promote resilience rather than recovery, resistance, adaptation, or thriving. To test a new brief resilience scale. The brief resilience scale (BRS) was created to assess the ability to bounce back or recover from stress. Its psychometric characteristics were examined in four samples, including two student samples and samples with cardiac and chronic pain patients. The BRS was reliable and measured as a unitary construct. It was predictably related to personal characteristics, social relations, coping, and health in all samples. It was negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality (high negative affect and high social inhibition) were controlled. There were large differences in BRS scores between cardiac patients with and without Type D and women with and without fibromyalgia. The BRS is a reliable means of assessing resilience as the ability to bounce back or recover from stress and may provide unique and important information about people coping with health-related stressors.
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            Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being.

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              The ‘Trier Social Stress Test’ – A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting

              This paper describes a protocol for induction of moderate psychological stress in a laboratory setting and evaluates its effects on physiological responses. The 'Trier Social Stress Test' (TSST) mainly consists of an anticipation period (10 min) and a test period (10 min) in which the subjects have to deliver a free speech and perform mental arithmetic in front of an audience. In six independent studies this protocol has been found to induce considerable changes in the concentration of ACTH, cortisol (serum and saliva), GH, prolactin as well as significant increases in heart rate. As for salivary cortisol levels, the TSST reliably led to 2- to 4-fold elevations above baseline with similar peak cortisol concentrations. Studies are summarized in which TSST-induced cortisol increases elucidated some of the multiple variables contributing to the interindividual variation in adrenocortical stress responses. The results suggest that gender, genetics and nicotine consumption can influence the individual's stress responsiveness to psychological stress while personality traits showed no correlation with cortisol responses to TSST stimulation. From these data we conclude that the TSST can serve as a tool for psychobiological research.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: Resources
                Role: InvestigationRole: Methodology
                Role: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2022
                9 March 2022
                : 17
                : 3
                : e0259838
                Affiliations
                [1 ] Engineering Mathematics Department, University of Bristol, Bristol, United Kingdom
                [2 ] Soft Robotics Group, Bristol Robotics Laboratory, Bristol, United Kingdom
                [3 ] Bonnie Binary Ltd, Bristol, United Kingdom
                [4 ] Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
                [5 ] School of Psychological Science, University of Bristol, Bristol, United Kingdom
                University of Pennsylvania Perelman School of Medicine, UNITED STATES
                Author notes

                Competing Interests: The commercial affiliation with Bonnie Binary does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

                ‡ACH, JMR and CK are primary authors of this work. ACH, AL and JMR authors developed the prototypes and hardware for this study. JLF and CK authors were primary supervisors for the experiment in this study.

                Author information
                https://orcid.org/0000-0003-2146-6902
                https://orcid.org/0000-0001-8265-7791
                https://orcid.org/0000-0002-0950-4788
                Article
                PONE-D-21-05514
                10.1371/journal.pone.0259838
                8906645
                35263344
                04ddbd3c-5cd2-4989-ac7a-0b34f185fb45
                © 2022 Haynes et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 18 February 2021
                : 27 October 2021
                Page count
                Figures: 6, Tables: 1, Pages: 26
                Funding
                Funded by: Brigstow Institute
                Award ID: Seedcorn
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/N509619/1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/M020460/1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/R02961X/1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/S026096/1
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000266, Engineering and Physical Sciences Research Council;
                Award ID: EP/T020792/1
                Award Recipient :
                The prototype development was funded by a seedcorn grant from the Brigstow Institute, University of Bristol, UK which also supported author A.L. in the form of consultation fees. A.H is supported through the EPSRC Doctoral Training Partnership (EP/N509619/1). J.R. is supported by the Royal Academy of Engineering as a Chair in Emerging Technologies and by the EPSRC (grants EP/M020460/1, EP/R02961X/1, EP/S026096/1 and EP/T020792/1). A.L. received a salary from Bonnie Binary during the timeframe of this project. The specific role of the author is articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Respiration
                Breathing
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Engineering and Technology
                Technology Development
                Prototypes
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Medicine and Health Sciences
                Cardiology
                Heart Rate
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Perception
                Sensory Perception
                Touch
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Touch
                Social Sciences
                Psychology
                Cognitive Psychology
                Perception
                Sensory Perception
                Touch
                Biology and Life Sciences
                Neuroscience
                Sensory Perception
                Touch
                Biology and Life Sciences
                Physiology
                Sensory Physiology
                Custom metadata
                Data to support this paper is available from the Research Data Repository of University of Bristol at DOI: 10.5523/bris.3cyviafgeukvg2b7umuuxo6639, under access restrictions, to bona fide researchers. The data restriction is imposed by our University ethics committee since the data contains potentially sensitive information. The participants of the experiments presented in this paper gave consent for their data to be used for no purpose other than research.

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