This thesis consists of seven chapters supplemented by the bibliography and the appendix. While the first chapter introduces the topic and research questions, Chapter 2 provides the theoretical foundation and relevant work on stress, the four subsequent chapters present the results of ten research activities ranging from focus groups through experiments and real-world deployments up to user and diary studies. The concluding Chapter 7 presents the main findings of this work and answers the research questions ending with an outlook how future work could extend the presented research. Answering the ten research questions, this thesis is structured as follows:
Chapter 1 - Introduction The introductory chapter describes the relevance and the resulting motivation for researching stress responses in relation to digital technologies. Further, the research questions will be introduced and the research approach and methodology, as well as the research context in which this work has been carried out will be explained.
Chapter 2 - Background on Stress Responses In the second chapter, the theoretical background including theories and relevant work on previous and recent research embracing stress responses will be presented. Hereby, I focus on the theoretical foundations of stress, further addressing how stress responses can be detected using different measures. The sections lay the groundwork for my research and provide an overview over the most relevant work in the domain of research on the sources of stress.
Chapter 3 - Implications of Physiology-Aware Systems for Design Since reliable measurability is a basic prerequisite for developing and designing stress mitigating interventions, the laboratory study presented in Chapter 3 demonstrates that stress responses are physiologically measurable, which is validated by subjective data.
Chapter 4 - Clustering Limitations of Physiology-Aware Systems The fourth chapter is based on the findings considering implications of physiology-aware systems and thus, describes the investigation of their limitations from two different stakeholder perspectives. As a result the "Design Space for Physiology-Aware Systems" emerged, which summarizes and visualizes potential strengths and weaknesses of such hardware.
Chapter 5 - Exploring Tactile Feedback in Relation to Stress Envisioning the exploration of suitable stress mitigating techniques, the fifth chapter consists of two user studies which consecutively examine tactile feedback as a notifier about stress. While the first evaluation reveals that vibrotactile and pressure-based stimulation affect the users stress level similarly, thermal feedback is being regarded more favorable from a user perspective.
Chapter 6 - Manipulating Stressors in Interactive Systems Based on the findings from the first intervention exploration, I demonstrate how stressors can be manipulated in three different ways evaluating another approach to mitigate stress in Chapter 6. By examining the effects, particularly on the user him- or herself when (a) eliminating, (b) visualizing, and (c) self-adjusting sources of stress, I reveal that the pure preoccupation supports critical self-reflection even mutual consideration.
Chapter 7 - Conclusion and Outlook In the final chapter, a summary of the main research contributions will be provided by addressing the role of reflection and awareness. By answering the research questions posed in the beginning, the set of overall and concrete design recommendations will be introduced. In this context, the importance of privacy preservation is being highlighted when phrasing what should be considered when designing interactive systems. After acknowledging the limitations of the presented work, and outlook regarding future research challenges will be given.
Chapter 2
Background on Stress Responses
At large, there exist no single universally accepted definition of the complex construct of stress [97]. However, those situations that cause stress in organisms, and particularly humans have been examined in detailed and thus, in relevant literature there is a consensus on what such stressors can be, namely environmental conditions like extreme temperatures or noises, biological states like sleep deprivation, and cognitive events like time or social pressure, as well as prolonged work [23]. In contrast to these very precise examples of stressors, others referred broadly to stress as the "imposition or perception of environmental or physical change, either negative [...] or positive [...], elicits a spectrum of physiologic changes that can be construed as adaptive to the organism" [114]
(p.78). Given the ambiguity among the various definitions of stress, this thesis relies on the common understanding of stressors as "events that [...], challenge or threaten the wellbeing of an organism, increase its arousal or activation level, and deplete its resources" [23] (p.23).
In the course of research on affective responses, it has been found that a particular state works in a different manner than emotions. Through his experiments Selye [242] could show that individuals react differently when being exposed to aversive stimuli and consequently, called the resulting response pattern stress. In the following, three representatives of the most relevant theories on stress will be
presented, embracing the General Adaption Syndrom (GAS) [242], the concept of homeostasis [34], as well as theTransactional Model of Stress and Coping[152].
While the first two theories look at stress from a physiological perspective, the latter model introduces a more holistic view understanding stress as the interplay between an individual and the environment. The close connection between the perception of stressors and a change in body signals has been observed by various researchers at the beginning of the 20th century. However, the term
"fight-or-flight reaction" has been introduced by Cannon [34] referring to the release of the hormone adrenaline which triggers the physiological responses described under "Physiological Measures" in Section 2.3.
2.1 Theoretical Foundation of Stress
One milestone in the field of stress research represents the work of Hans Selye.
By his work "The Stress of Life" [242], he provided an extensive investigation of stress and was one of the first who mentioned the termstressandstressorsbefore it became popular in the following years. Observing the biological changes in animal experiments as consequences of presented stimuli, his definition refers to so-called "non-specifically caused changes" [242] (p.64) which elicit a certain response pattern that he called stress. Following on this, Selye splitted the resulting process in three different phases including the thealarm reaction, what is visible in the individual’s physiological signals; thestage of resistanceshowing signs that the individual has adapted to the particular stressful stimulus; finally thestage of exhaustionindicates that the individual cannot resist the aversive effect of the stressor and thus, thealarm reactions’ symptoms might repeat until the organism finally dies. This gradual biological program was named "General Adaption Syndrom" and corresponds to the concept of "homeostasis" [34], initially mentioned by Claude Bernard as the "milieu intérieur". By homeostasis it is meant the balanced state that is maintained and which faces continuous encounters with intrinsic or extrinsic challenging factors, such as stressors [42]. Since the each organism intuitively aims to be in this equilibrium, it is required to adapt to environmental changes permanently. This effort increases when the organism has to deal with stress because the recovery to go back into a homeostatic state might take enormous resources depending on the stressor’s disturbing impact.
The fact that stressors can lead to positive or negative outcomes was addressed by Selye [244] first and will be explained when referring to the concept of "eustress"
and "distress" in the following paragraph. Following on from this distinction,
Figure 2.1: Illustration of the Transactional Model of Stress and Coping [152] adapted from Guttmanna.
a ByPhilippGuttmann-Ownwork,CCBY-SA4.0,https:
//commons.wikimedia.org/w/index.php?curid=45616588
the so-calledChallenge-Hindrance Occupational Stress Modelby Cavanaugh et al. [36] assumes that stressors can be either perceived as challenges which trigger exceeding performances, or as hindrances that distract individuals from achieving their goals. In which of these two clusters a stressor is being allocated, depends on the individual’s appraisal. In this context, theTransactional Model of Stress and Coping by Lazarus and Folkmann [152] serves as a foundation for Cavanaugh et al.’s model. This approach refers to psychological stress and focuses on the interdependence of appraisal and coping as depicted in Figure 2.1. Hereby, appraisal plays a key role since according to their assumption, individuals decide on their future actions based on their evaluation whether the perceived stimulus is threatening, challenging, or harmful and consequently requires coping. This first appraisal follows the second appraisal phase referring to the individual’s estimation whether one’s own resources and so-calledcoping potentialare sufficient. Lastly, the individual approaches the final phase having to choose a suitable coping strategy, which is either problem-focused by adjusting
Figure 2.2:Simplified and commonly used illustration of the Yerkes-Dodson law [288] in the Hebbian version adapted from Diamond et al. [56]. Hereby, the lack of a negative impact on when performing simple task is neglected and therefore, simplifies the process.
the stressful stimulus or emotion-focused by re-considering one’s situation. As an alternative to the coping, a reappraisal can be applied.
Eustress and Distress and the Yerkes-Dodson Law As part of Selye’s research, he conceptualize the terms "eustress" and "distress" referring to the different positive and negative stress responses. Building upon his experiments, he inferred that the response to a stressor can either be perceived as an agreeable feeling, as it is for example, when athletes experience a high arousal shortly before a competition stars. On the other hand, whether an individual perceives as a stressor as disagreeable is also dependent on preliminary experiences and thus, external factors [243]. Accordingly, the distinction between these states is important, since as long as the individual is in control of the sensed stress, it’s homeostasis is challenged which is still perceived to be exciting. In contrast, when the situations gets out of control or unpleasant feelings arise, the positive eustress can turn into an averse experience, so-called distress.
In this context, the Yerkes-Dodson law [288] is notable, since it describes with the illustration of an inverted U-shaped curve how an individual’s performance relates to it’s perceived arousal. As can be seen in Figure 2.2, the performance is best, when the individual is neither under- or over-aroused and thus, maintains a equilibrium between both states.