High Anxiety Sensitivity Research Articles

Predictors of Sexual Dysfunction, Associated Distress, and Sexual Satisfaction Among Male and Female Patients Living with Anxiety Disorders in Denmark

ABSTRACT Although previous studies have established links between anxiety disorders, sexual dysfunctions, and sexual satisfaction, there is relatively little research on the specific factors associated with living with an anxiety disorder that might contribute to these sexual health disparities. This study assessed the associations between anxiety, cognitive distractions, biased expectancies, and 1) sexual dysfunction (DSM-5 diagnostic criteria) 2) associated distress, and 3) sexual satisfaction while considering the role of pharmacological treatment-related sexual side effects and comorbid depressive symptoms. A large clinical population (N = 207) of people with anxiety diagnoses seeking treatment at 11 outpatient anxiety clinics in Denmark participated. Higher cognitive distraction levels were linked with a greater risk of sexual dysfunction, more sexual dysfunction-associated distress, and lower sexual satisfaction. Higher sexuality and anxiety biased expectancies were associated with an increased risk of sexual dysfunctions and associated distress and decreased sexual satisfaction. Higher anxiety symptom severity was only associated with lower sexual satisfaction among female respondents. Higher anxiety sensitivity was linked to a higher risk of sexual dysfunction, associated distress, and lower sexual satisfaction among female participants only.

Anxiety depression levels, anxiety sensitivity, and quality of life in children with chronic spontaneous urticaria: A cross-sectional study

Existing literature offers some insights into the prevalence of anxiety and depression in children with chronic spontaneous urticaria (CSU). However, the literature on anxiety sensitivity (AS) and quality of life (QoL) in these children remains poorly understood. This study aimed to evaluate psychiatric diagnoses, anxiety and depression levels, AS, and QoL in children with CSU compared to healthy controls. The CSU group consisted of 44 children aged 8 to 17 years who were diagnosed with CSU, while the control group consisted of 44 healthy children. A child psychiatrist conducted the psychiatric assessment of the children. The Revised Child Anxiety and Depression Scales (RCADS), the Childhood Anxiety Sensitivity Index (CASI), and the Children’s Dermatology Life Quality Index (CDLQI) were administered. Multiple linear regression analysis was conducted to identify independent predictors of QoL, considering several potential factors, including the urticaria activity score, duration of urticaria, presence of a psychiatric diagnosis, scores on the RCADS major depression disorder, RCADS-total anxiety, and total CASI. A significantly higher prevalence of psychiatric diagnoses and anxiety disorders was observed in the CSU group (P < .05). In the CSU group with a psychiatric diagnosis, CASI-total (0.011), CASI-physical (0.049), CASI-social (0.022), and CDLQI scores (P < .001) were significantly higher than those without a psychiatric diagnosis. In the multiple linear regression analysis, only the presence of a psychiatric diagnosis was found to be a significant predictor of CDLQI scores (OR, 5.918; 95% CI, 2.505–9.330; P: .001). This study indicated that children with CSU exhibited a higher prevalence of psychiatric diagnoses than controls. Additionally, children with psychopathology in the CSU group demonstrated higher AS and greater impairment of QoL than those without psychiatric diagnoses. Furthermore, the most significant predictor of a decline in QoL was the presence of a psychiatric diagnosis.

Caffeine Motives and Its Effects of High Anxiety Sensitivity on Individuals

This study investigates the relationship between motives of caffeine consumption, stress and anxiety among individuals in age ranging from 18 – 40 years. The study was done with a sample size of 100 individuals and the data was collected using an online google survey and the responses were recorded. Quantitative analysis was done and then these were graded according to Anxiety sensitivity index (ASI). Anxiety and caffeine are reported to have an association (p = 0.656). In this study it was found that individuals consume caffeine for habit, pleasure, social interaction, to enhance productivity and to wake up. Also, caffeine relation with respect to anxiety was made using anxiety sensitivity and positive correlation was found for the same but as such no significant main effect of anxiety and caffeine consumption was made.

Exploring Relations Between Unique Patient Characteristics and Virtual Reality Immersion Level on Anxiety and Pain in Patients Undergoing Venipuncture: Secondary Analysis of a Randomized Control Trial.

Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics and VR immersion level on the effectiveness of VR for managing pediatric pain and anxiety during venipuncture. The purpose of this study is to determine how specific patient characteristics and level of immersion during a VR intervention impact anxiety and pain levels for pediatric patients undergoing venipuncture procedures. This study is a secondary data analysis of 2 combined, previously published randomized control trials on 252 pediatric patients aged 10-21 years observed at Children's Hospital Los Angeles from April 12, 2017, to July 24, 2019. One randomized clinical trial was conducted in 3 clinical environments examining peripheral intravenous catheter placement (radiology and an infusion center) and blood draw (phlebotomy). Conditional process analysis was used to conduct moderation and mediation analyses to assess the impact of immersion level during the VR intervention. Significant moderation was found between the level of immersion and anxiety sensitivity when predicting postprocedural anxiety (P=.01). Patients exhibiting the highest anxiety sensitivity within the standard of care yielded a 1.9 (95% CI 0.9-2.8; P<.001)-point elevation in postprocedural anxiety relative to individuals with high immersion levels. No other significant factors were found to mediate or moderate the effect of immersion on either postprocedural anxiety or pain. VR is most effective for patients with higher anxiety sensitivity who report feeling highly immersed. Age, location of the procedure, and gender of the patient were not found to significantly impact VR's success in managing levels of postprocedural pain or anxiety, suggesting that immersive VR may be a beneficial intervention for a broad pediatric population. ClinicalTrials.gov NCT04268901; https://clinicaltrials.gov/study/NCT04268901.

Examining the Mediating Role of Resilience and Life Satisfaction in the Relationship Between Anxiety Sensitivity and Perceived Stress.

This study examines the mediation role of life satisfaction and resilience variables in the relationships between anxiety sensitivity and perceived stress. The data was collected with the Anxiety Sensitivity Index-3, Life Satisfaction Scale, Perceived Stress Scale, and Brief Psychological Resilience Scale from 347 university students (Mage = 23.15, SD = 5.15; 70% girls, 30% boys). The analyses were examined by structural equation modeling using AMOS 24. The findings suggest that students with high anxiety sensitivity and perceived stress have low resilience and life satisfaction levels. More importantly, resilience and life satisfaction were found to have partial mediation. As a result, it is seen that anxiety sensitivity has a significant effect on reducing perceived stress by increasing students' resilience and life satisfaction. Therefore, this situation facilitates decreased anxiety levels, greater satisfaction with life, and more robust mental health.

Efficacy and implementation of exercise-based smoking cessation treatment for adults with high anxiety sensitivity (STEP): Study protocol for a randomized controlled trial

Anxiety sensitivity (AS), reflecting the fear of bodily sensations, is a transdiagnostic vulnerability factor that underpins both affective psychopathology and smoking. Phase II research supports the efficacy of a 15-week community-based intervention (STEP) that combines high-intensity exercise offered by the YMCA with standard smoking cessation treatment (tobacco quitline and nicotine replacement therapy) for sedentary smokers with elevated AS. This Phase III study aims to enroll 360 adults to evaluate whether STEP efficacy for achieving smoking abstinence generalizes to Black and Hispanic smokers with elevated AS.

Anxiety Sensitivity and Distress Tolerance in Relation to Smoking Abstinence Expectancies Among Black Individuals Who Smoke.

Black individuals who smoke in the United States experience significant tobacco-related disparities. Although prior work has established that smoking abstinence expectancies play an important role in smoking-related outcomes, few studies have examined potential individual difference factors that may be relevant to smoking abstinence expectancies among Black individuals who smoke. The present study investigated anxiety sensitivity and distress tolerance in relation to smoking abstinence expectancies among a sample of Black individuals who smoke. Participants were 86 Black adults who smoke cigarettes daily (M age = 46.07 years, SD = 10.37; 26.7% female). Four separate linear regression analyses were conducted to evaluate the relation between anxiety sensitivity, distress tolerance, and their interaction with each of the four smoking abstinence expectancies (i.e., somatic symptoms, positive consequences, harmful consequences, and negative mood). Results indicated that higher anxiety sensitivity was related to higher somatic symptoms, harmful consequences, and negative mood abstinence expectancies, whereas distress tolerance was related to higher positive consequences. Further, anxiety sensitivity and distress tolerance interacted to confer greater expectancies for the positive consequences of quitting. The current findings are among the first to document that anxiety sensitivity and distress tolerance are clinically relevant factors to consider when tailoring smoking cessation treatments for Black individuals who smoke. Future research is needed to examine distress tolerance and anxiety sensitivity as longitudinal predictors of smoking abstinence expectancies among Black individuals who smoke.

Attentional Control Accounts for the Association Between Anxiety Sensitivity and Sleep Efficiency in Clinic-Referred Youth.

Youth with anxiety disorders report difficulty falling asleep and returning to sleep after sleep onset (i.e., poor sleep efficiency). Anxiety sensitivity, the excessive attention to physical symptoms of anxiety and their threatening interpretations, has been linked to poor sleep efficiency. We tested a conceptual model wherein attentional control, attentional focusing and attentional shifting would account for the relationship between anxiety sensitivity and poor sleep efficiency. 255 youths (6-17years old, 78% Hispanic/Latino) who presented to a university-based research clinic completed measures on anxiety sensitivity, sleep, and attentional control. Poorer sleep efficiency was significantly correlated with higher anxiety sensitivity and lower attentional control, attentional focusing, and attentional shifting. Higher anxiety sensitivity was significantly correlated with lower attentional control and attentional focusing. Attentional control and attentional focusing, not attentional shifting, accounted for the relationship between anxiety sensitivity and poor sleep efficiency. These findings identify attentional control and attentional focusing as variables that may explain the association between anxiety sensitivity and sleep efficiency in youth.

Influence of psychiatric symptom profiles of parents on sleep bruxism intensity of their children

Objective The objective of this study was to evaluate the effects of parental anxiety, depression levels and psychiatric symptom profiles of parents on the occurrence of sleep bruxism in children. Material & Methods This cross-sectional study was carried out with a sample of 94 children aged 6 to 12 years, divided into two groups: with sleep bruxism (bruxism group-BG) and without sleep bruxism (control group-CG). Beck Depression Inventory (BDI), Symptom Checklist (SCL-90-R), Symptom Checklist and Screen for Child Anxiety Related Emotional Disorders-Parent (SCARED-P) scale were used to assess anxiety and depression levels of parents. All questionnaires were filled out by parents of children. Intraoral and extraoral examinations were carried out of children in the clinic and sleep bruxism was determined. All stress conditions were investigated by logistic regression analysis. In the comparison of the qualitative data, chi-square and Fisher exact tests were used. Results The data revealed that participants whose mothers had high anxiety and interpersonal sensitivity scores, and participants whose fathers had a medium level of obsessive-compulsive disorder were more likely to have an SB problem (p < 0.05). According to the results of BDI, the fathers’ results between the BG and the CG were not statistically significant (p > 0.05). However, the mothers’ results between the BG and the CG were statistically significant (p < 0.05) When all subscales of SCARED-P were evaluated, the separation anxiety disorder subscore was statistically significant in the bruxism group. Conclusion The psychological status of parents is a significant risk factor associated with SB development in school-age children.

Anxiety sensitivity elevates the risk of mental health problems in employees with higher probability of contacting COVID-19 at work.

Individuals with increased risk of being in contact with COVID-19 cases at work have been reported to suffer from higher fear of infection and associated mental health problems. The present study examines whether this risk is further increased by higher anxiety sensitivity (AS, i.e., fear of bodily symptoms such as breathlessness, which also are core symptoms of COVID-19) that is also known to be associated with an increased risk of psychopathology. In spring 2020, 783 German health care and social workers participated in a cross-sectional online-survey, in which anxiety sensitivity, depression, anxiety, health anxiety, fear of a COVID-19 infection as well as panic symptoms were assessed. Of these participants, 28.7% affirmed contact with COVID-19 cases, which was associated with greater fear of the virus. Individuals with high AS reported more severe anxiety, health anxiety, depressive symptoms, as well as incident and recurrent panic symptoms. Moreover, the risk association of exposure to COVID-19 cases at work with health anxiety, general anxiety, and panic symptoms was further increased by higher levels of AS. These findings suggest that especially employees with contact to COVID-19 cases who also are high in AS might profit from targeted interventions to prevent excessive fear and associated mental health problems.

Relationship between Anxiety Sensitivity, Death Anxiety, and Resilience in the Age of Pandemics and Lifelong Learning

Epidemics bring along many pathologies and become a threat for ill individuals because of an outbreak and those exposed to the outbreak process. Many negative psychological and educational results can be encountered following the COVID-19 process when previous studies were considered together with these threats. In this context, this research aimed to examine the effect of the COVID-19 on anxiety sensitivity, death anxiety, and resilience. In addition, examining anxiety sensitivity in terms of some personal variables (gender, physical health, marital status, and working status). The study has been conducted on a relational survey method. The participants consisted of 955 individuals aged between 18-68, of which 281 were males, and 662 were females. In this study, Anxiety Sensitivity Index-3, Death Anxiety Scale, and Brief Resilience Scale were used to collect data. The data were analyzed with Pearson correlation coefficient, regression, independent samples t-test, and ANOVA. The result of analyses showed a positive correlation between anxiety sensitivity and death anxiety; however, there is a negative correlation between resilience and anxiety sensitivity. Furthermore, resilience and anxiety sensitivity differed significantly according to gender, marital status, and working status (student, unemployed, employed, retired); however, the level of death anxiety did not differ according to gender and marital status. Anxiety sensitivity, death anxiety, and resilience did not differ significantly in terms of physical health. When considering the finding obtained in the present study, individuals with high anxiety sensitivity levels were affected more by the COVID -19 pandemic, but those with high resilience levels were affected less.

Caffeine Motives and Expectancies for Individuals with High Anxiety Sensitivity

Background: Anxiety Sensitivity (AS) is a transdiagnostic risk factor that includes fear of the potential physical and psychological consequences of anxiety-related symptoms. Caffeine consumption in high amounts is associated with symptoms of anxiety. Research on the relationship between AS and caffeine consumption has yielded inconsistent results. Objectives: In this study, we conducted an exploratory analysis to examine whether caffeine motives moderated the relationship between AS and high caffeine consumption. We also examined whether caffeine expectancies moderated the relationship between AS and high caffeine consumption. In addition, we assessed the bivariate relationships between AS and caffeine motives and between AS and caffeine expectancies. N = 317 participants completed an online survey using Amazon Mechanical Turk. Results: Results revealed that neither expectancies nor motives interacted with AS to predict high caffeine consumption. There was also no significant main effect of AS on high caffeine consumption. The only significant main effect in the prediction of high caffeine consumption was the use of caffeine for symptom management motives. In our follow-up analyses, high AS participants in the study expected that caffeine consumption would provoke anxiety. They also reported using caffeine for symptom management, taste, and social reasons. Conclusions: These findings suggest that the utility of AS as a predictor or foundation for higher amounts of substance use is not uniform across substances but rather depends on the type of substance in question.

Mediating Role of Emotional Intelligence in the Relationship between Anxiety Sensitivity and Academic Burnout in Adolescents.

(1) Background: Increased stress and study overload during adolescence could be related to academic burnout. Anxiety sensitivity of students seems to affect burnout levels, while emotional intelligence enables emotion management under stressful conditions. The objective of this study is to analyze the roles of anxiety sensitivity and emotional intelligence in academic burnout. (2) Methods: In this quantitative cross-sectional study conducted in Spain, the sample comprised 1287 high school students aged 14 to 18 who filled out the Maslach Burnout Inventory-General Survey, the Spanish version adapted for high school students of the Anxiety Sensitivity Index-3, and Brief Emotional Intelligence Inventory. (3) Results: Anxiety sensitivity was significantly higher in cynicism and emotional exhaustion. Furthermore, the mediation analysis showed that high anxiety sensitivity directly affected student exhaustion, cynicism, and efficacy levels. These effects were mediated mainly through stress management but also through the effect of stress management on mood, both emotional intelligence factors. (4) Conclusions: The academic changes that occur during high school hinder engagement and performance. Promoting the development of emotional skills would enable young people to manage their emotions when they become overwhelming and diminish their lack of interest and exhaustion in the classroom.

Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample

BackgroundPrevious research suggests that high anxiety sensitivity (AS) – a fear of arousal-related body sensations – may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model. MethodParticipants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis. ResultsResults revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators. LimitationsResults are limited by the cross-sectional nature of the data. ConclusionsThe present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.

Using latent profile analysis to uncover the combined role of anxiety sensitivity and test anxiety in students' state anxiety.

Studies report a growing tendency for students to experience state anxiety in schools. However, the combination of individual susceptibilities likely to trigger students' anxious states remains unclear. This study examined whether distinct profiles of students emerge regarding their susceptibility to anxiety sensitivity and/or test anxiety and evaluated whether students' profile predicted anxious states. We also verified whether susceptibility profiles varied across gender, school level, and school type. In total, 1,404 Canadian students in Grades 5 and 10 (589 boys; M age = 15.2, SD = 2.1) from 13 public and private schools completed self-reported measures of state/trait anxiety, anxiety sensitivity, and test anxiety. Latent profile analyses identified four susceptibility profiles: (1) Double-susceptibility: highest anxiety sensitivity and test anxiety scores; (2) Unique-susceptibility to test anxiety: high test anxiety score and low anxiety sensitivity score; (3) Unique-susceptibility to anxiety sensitivity: high anxiety sensitivity score and low test anxiety score; and (4) No-susceptibility: lowest anxiety sensitivity and test anxiety scores. The profiles comprised 12, 9, 6, and 73% of the sample, respectively, and their membership varied across gender and school type, but not across school levels. A linear mixed-effect model showed that state anxiety varied significantly between profiles, where the Double-susceptibility profile predicted the highest state anxiety scores, followed by the two Unique-susceptibility profiles (indifferently), and the No-susceptibility profile. Beyond their theoretical contribution to the state-trait anxiety literature, these findings suggest that selective interventions designed more specifically for students with the Double-susceptibility profile may be worthwhile. Results also highlight the high proportion of students with the No-susceptibility profile and shed light on the reassuring portrait regarding students' anxiety.

Is Anxiety Sensitivity Associated with COVID-19 Related Distress and Adherence among Emerging Adults?

We investigated whether anxiety sensitivity (AS) is associated with increased distress and adherence to public health guidelines during the COVID-19 pandemic among undergraduates, and whether increased distress mediates the relationship between AS and increased adherence. An online cross-sectional survey was conducted with 1318 first- and second-year undergraduates (mean age of 19.2 years; 79.5% females) from five Canadian universities. Relevant subscales of the Substance Use Risk Profile Scale (SURPS) and the Big Five Inventory-10 (BFI-10) were used to assess AS and neuroticism. Three measures tapped distress: the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, and the Brief COVID-19 Stress Scales (CSS-B) for COVID-19-specific distress. The COVID-19 Adherence scale (CAD) assessed adherence to COVID-19 containment measures. AS was significantly independently associated with higher general distress (both anxiety and depressive symptoms) and higher COVID-19-specific distress, after controlling age, sex, study site, and neuroticism. Moreover, AS indirectly predicted greater adherence to COVID-19 preventive measures through higher COVID-19-specific distress. Interventions targeting higher AS might be helpful for decreasing both general and COVID-19-specific distress, whereas interventions targeting lower AS might be helpful for increasing adherence to public health containment strategies, in undergraduates.

Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance

ABSTRACT Background and Objectives Anxiety sensitivity (AS) is the fear of consequences of anxiety-related sensations, and has been linked to the development of panic symptoms. Distress tolerance (DT) encompasses one’s behavioral or self-perceived ability to handle aversive states. We examined whether higher DT buffers the relationship between AS and changes in panic symptoms across two timepoints, spaced ∼three weeks apart. Design and Methods At Time 1, 208 participants completed questionnaires and a physical DT task (breath-holding duration), a cognitive DT task (anagram persistence), and a self-report measure of DT (perceived DT). Panic symptoms were assessed at both timepoints. Structural equation modeling was used to evaluate two models in which AS and DT predicted changes in panic. Results Contrary to hypotheses, for those with longer breath-holding duration (higher physical DT), higher fears of physical anxiety-related sensations (higher physical AS) were associated with worse panic outcomes over time. Conclusions Findings suggest that those with lower physical DT may have been less willing to engage with difficult tasks in the short-term. Although disengagement in the short-term may provide temporary relief, it is possible that averse psychopathological consequences stemming from rigid or habitual avoidance of distressing states may develop over longer periods of time.

Relations Between Anxiety Sensitivity and Attachment in Outpatients With Borderline Personality Disorder.

Borderline personality disorder (BPD) is characterized by dysregulated emotion, interpersonal relationships, and impulsivity, and is putatively linked to a known transdiagnostic risk factor, anxiety sensitivity (AS). AS is a dispositional fear of the physical, cognitive, and/or social consequences of arousal-related somatic sensations. Gratz et al. (2008) demonstrated significantly higher AS in outpatients with BPD and a predictive value of AS over and above emotion dysregulation and impulsivity. The present study sought to extend these findings with a larger sample of outpatients with BPD by investigating predictive value of AS dimensions; relations between AS and attachment style; and impact of BPD treatment on AS. Participants completed measures at three time points: pretreatment and 6 and 12 months posttreatment. AS social was the best predictor; attachment anxiety correlated positively with AS global and AS physical. AS levels significantly decreased from pretreatment to 6 months posttreatment. Clinical implications discussed include targeting AS in BPD treatment.

The benefits of physical exercise on state anxiety: Exploring possible mechanisms

Although several studies have shown that one acute bout of physical exercise can reduce state anxiety in healthy samples, studies that examine this effect in subclinical and clinical samples are still rare and have found mixed results. In the present study, we investigated the effect of a single session of acute exercise on state anxiety in a subclinical sample with moderate to high anxiety sensitivity. Potential mediators, including self-efficacy, self-esteem, mindfulness, subjective vitality, rumination and emotional competencies were explored. Participants (N = 88) with moderate to high anxiety sensitivity were assigned randomly to either an active group (n = 44) or a control group (n = 44). State anxiety and the mediator variables were assessed before and after the intervention. State anxiety was reduced from baseline to post-intervention, but no difference was found between groups. Exploratory analyses suggested that in the active intervention condition, a reduction in state anxiety was partly mediated by an increase in positive affect and mediated by an increase in subjective vitality. One acute bout of exercise might not be enough to decrease state anxiety in subclinical individuals with moderate to high anxiety sensitivity. However, the results of this study suggest that positive affect and subjective vitality could be two mechanisms that might explain the beneficial effect of exercise on anxiety. This should be further investigated in future studies.

A STUDY ON PHYSIOLOGICAL AND EMOTIONAL BEHAVIOR CHANGES OF EMOTIONAL INTERACTION IN SERIOUS GAMES

BackgroundIn recent years, researchers have extensively explored the potential of computer games in the development of educational and entertainment content and services. In order to supplement the existing demonstrations and create an unforgettable and pleasant learning experience, computer games are used in the current educational practice. They provide educators with the opportunity to reorganize and conceptualize abstract, complex and technical information or knowledge for young students. In order to demonstrate and evaluate how a serious game can promote learning activities in a more constructive and meaningful way, we chose a computer game on waste recycling for user research and investigated the teaching effect of the game. The psychological evaluation of students in serious game education has also become a problem worthy of attention.Subjects and MethodsWhen designing this user study, we paid special attention to the relationship between gameplay and player's physiological state, so as to measure his performance. Quantitative and qualitative data were collected during the study. The results show that this game can really help learners understand the important knowledge of waste recycling. The research also shows that physiological signals can be used as an index of players' psychological state to a certain extent. A further direction is to add other physiological measurements, such as heart rate, during user research. SPSS 22.0 software was used for data statistical analysis. The measurement data were expressed as mean ± standard deviation (x ± s). The statistical method was as follows: descriptive statistics was used for general demographic characteristics, t-test was used for the comparison of the mean of two independent samples, nonparametric Kruskal Wallis test was used for ordered classification data, and regression analysis was used to verify the mediating effect of RS between as and mental health level according to the mediating effect test model. P < 0.05 was statistically significant.ResultsRecord the total time spent and scores obtained by each player at each level in the game. The total time spent at the first level is significantly higher at the second and third levels. The results of internal analysis of subjects showed that there were significant differences among the three levels in terms of game time (DF = 2, f = 17.291, P = 0.00 < 0.02). The total score of level 3 is significantly lower in level 1 and level 2. The results of intra subject analysis showed that there were also significant differences among the three levels in terms of scores obtained (DF = 2, f = 154.739, P = 0.00 < 0.02). In addition, we investigated whether there was any correlation between game time and task performance of all players at each level. In the first stage of the game, there is a correlation between the game time and the score. In addition, there is a correlation between the game time and the score of the third level. In this experiment, we collected three types of measurements using the neurosky thinking mode device: raw EEG signals, attention and meditation values. One way ANOVA showed that there were significant differences in the variance and standard deviation of meditation among the three game levels (fvariance_meditation = 4.11, P = 0.02 < 0.05; fstd_meditation = 3856, P = 0.026 < 0.05). The results showed that there were significant differences in students' academic performance (P < 0.05). Students with better academic performance had higher anxiety sensitivity; However, students with poor academic performance have better psychological elasticity.ConclusionsWe present our research aimed at investigating how a serious game promotes knowledge transfer. A specific educational scene is embedded in the game, and players are required to play roles and complete well-designed teaching tasks. Subjects were invited to experience the game in order to measure the teaching effect. The results show that playing this game can really help players learn about waste recycling. Players' game experience can have a positive impact on their performance in terms of game time. Due to the different difficulty, the three game levels have significant differences in game time and score. In addition, there is a direct correlation between game time and game performance, which shows that the teaching effect of learning games increases with the increase of game time. From this, we preliminarily come to the conclusion that academic performance has little impact on the evaluation of students' learning.