Virtual Reality Adaptive Training for Personalized Stress Inoculation.

Objective: To evaluate a personalized adaptive training program designed for stress prevention using graduated stress exposure.

Background: Astronauts in the high-risk space mission environment are prone to performance-impairing stress responses, making preemptive stress inoculation essential for their training.

Methods: This work developed an adaptive virtual reality-based system that adjusts environmental stressors based on real-time stress indicators to optimize training stress levels. Sixty-five healthy subjects underwent task training in one of three groups: (no stressors), (prescheduled stressor changes), and . Psychological (subjective stress, task engagement, distress, worry, anxiety, and workload) and physiological (heart rate, heart rate variability, blood pressure, and electrodermal activity) responses were measured.

Results: The condition showed a significant decrease in heart rate and a decreasing trend in heart rate variability ratio, with no changes in the other training conditions. Distress showed a decreasing trend for the and conditions. Task engagement showed a significant increase for and a significant decrease for the condition. All training conditions showed a significant decrease in worry and anxiety and a significant increase in the other heart rate variability metrics.

Conclusion: Although all training conditions mitigated some stress, the preponderance of trial effects for the condition supports that it is more successful at decreasing stress.

Application: The integration of real-time personalized stress exposure within a VR-based training program not only prepares individuals for high-stress situations by preemptively mitigating stress but also customizes stressor levels to the crew member's current state, potentially enhancing resilience to future stressors.