Meta-analysis of digital game and study characteristics eliciting physiological stress responses.

Digital games have been used as stressors in a range of disciplines for decades. Nonetheless, the underlying characteristics of these stressors and the study in which the stressor was applied are generally not recognized for their moderating effect on the measured physiological stress responses. We have therefore conducted a meta-analysis that analyzes the effects of characteristics of digital game stressors and study design on heart rate, systolic and diastolic blood pressure, in studies carried out from 1976 to 2012. In order to assess the differing quality between study designs, a new scale is developed and presented, coined reliability of effect size. The results show specific and consistent moderating functions of both game and study characteristics, on average accounting for around 43%, and in certain cases up to 57% of the variance found in physiological stress responses. Possible cognitive and physiological processes underlying these moderating functions are discussed, and a new model integrating these processes with the moderating functions is presented. These findings indicate that a digital game stressor does not act as a stressor by virtue of being a game, but rather derives its stressor function from its characteristics and the methodology in which it is used. This finding, together with the size of the associated moderations, indicates the need for a standardization of digital game stressors.