STRESSmission as a new stress reduction and mood boosting tool: a proof of concept study

Introduction

According to the concept proposed by one of the pioneers of stress research, Hans Selye, stress is a natural physical and mental reaction to life experiences. It is part of daily life, essential for survival, and can be catalyst to take action – referred to as eustress or beneficial stress (Selye 1975). However, when it is persistent or chronic, stress can lead to the development of a range of somatic and psychiatric illnesses, including depression and post-traumatic stress disorder (PTSD) (Nestler and Russo 2024).
The recent pandemic of the virus SARS-CoV-2, causing the disease COVID-19, together with restrictions such as the social isolation experienced during lockdowns, has been identified as a significant contributing factor to the development of health problems (Meherali et al. 2021). Furthermore, the ongoing nature of the pandemic has resulted in chronic, unpredictable stress, which is recognized as a highly potent stressor (Gerván et al. 2022). Consequently, there is an urgent need to develop resilience to cope effectively with stressors in the post-COVID era.
Resilience is defined as the capacity of systems to absorb changes occurring under the influence of external factors and to maintain and control their functions (Jabareen 2013). The development of resilience is facilitated by various coping mechanisms (Nestler and Russo 2024). The psychological stress and coping theory proposed by Lazarus and Folkman (1984, p. 141) is predicated on the notion of “constantly changing (dynamic) cognitive and behavioural efforts to master certain external and internal requirements, assessed by an individual as overburdening or exceeding their resources”. The development of adaptation and flexible strategies may make such challenges more straightforward to cope with (Sivilli and Pace 2014). Failure to manage stress or not taking appropriate measures, in turn, leads to a decrease in general resilience, causing illness or even death (McEwen 1998). Thus, there is an urgent need to have available resources and techniques to be used in times of stress and challenges, and people have developed different strategies to deal with stressors.
Endler and Parker (1990) identified three styles of coping with stress: 1) task-focused style, 2) emotions-focused style, 3) avoidance-focused style, which relies on seeking social contacts and receiving support and engaging in alternative activities as a way to take one’s mind off the stressful situation to avoid thinking about problems (Endler and Parker 1994). In this study, we will focus on the task-oriented and the avoidance-focused style (e.g. Endler and Parker 1990; Schnider et al. 2007; Zeidner and Saklofske 1996). We implement task-focused styles in the game, by practising scientifically proven methods of coping with stress, as well as an avoidance-focused style used as a temporary “break away” from sources of stress (e.g. through entertainment, sports, meetings). However, we must remember here that during the COVID-19 pandemic, social relationships were very limited due to the lockdown. Moreover, during the pandemic, there was a notable increase in the time people spent in the virtual, digital world, in front of the TV, computers, and cell phones. We recognize an urgent need to return to spending more time with other people and engaging in activities that do not require electronic devices. That is why we propose the card game STRESSmission as a psychoeducational tool that teaches anti-stress techniques and helps improve mood while playing offline with other people.
Mood is defined as an involuntary affective state (Frijda 1999) that is characterized by moderate intensity (Lazarus 1999). Its duration can range from a few hours to several days, with an indistinct beginning and end and frequently an ambiguous underlying cause (Ekman 1999; Frijda 1999). Numerous studies indicate a strong correlation between stress and mood. For instance, a study by Bolger et al. (1989) of 166 married couples who maintained daily experience diaries over six weeks demonstrated that, in pooled within-person analyses, daily stressors accounted for up to 20% of the variance in mood. In a further study (van Eck et al. 1998) the relationship between stressful daily events and mood was investigated in a group of 85 office workers. Controlling for individual differences in mood levels, multilevel regression analyses demonstrated that events were followed by an increase in negative affect and arousal and a decrease in positive affect. The results indicate that perceived stress is associated with the frequency of reported events and more intense and prolonged mood responses. A more recent study (Nahum et al. 2023) with 144 stressed young adults during military combat training showed that psychological resilience is manifested in the daily relationship between control mechanisms and mood. The findings underscore the significance of resilience, including cognitive control, in coping with demanding life circumstances.
McCrae (1982) suggested that differences in coping strategies between younger and older people are due to differences in the problems they experience. Subsequent researchers have indicated that, except for those related to health, the number of daily stressors decreases with age (Aldwin et al. 1996a; Chiriboga 1997). Studies have shown that people over the age of sixty report fewer daily stressors than those in early and middle adulthood (Almeida and Horn 2004).
Learning effective and safe coping techniques and effectively reducing stress’s impact on the body are a vital social need. In response to these challenges, during regular online meetings of the group of people creating the game, consisting of scientists and practitioners gathered around SWPS University, we diagnosed the need to educate society on coping with stress; spontaneously formed an interdisciplinary team (psychologists, a sociologist, a neuroscientist, and a gaming expert), geographically dispersed and collaborating almost exclusively online; and created, planned, tested, and researched a social innovation – a psychoeducational tool for de-stressing and learning anti-stress techniques. All of it was performed in an attractive, engaging, and effective way over 4 years of voluntary work (2021-2025).
The literature on the health benefits of board games is still limited (Wanyama et al. 2012; Crawford and Wiltz 2015; Vita-Barrull et al. 2022). However, studies conducted during the COVID-19 pandemic showed that playing any type of modern board and card game (excluding games with a high influence of luck) could be beneficial for children at risk of social exclusion (Moya-Higueras et al. 2023). In addition, board and card games could be used as a cognitive intervention to maintain some cognitive functions in healthy older adults over the age of 65 (Estrada-Plana et al. 2021). Moreover, a study of older people found an association between higher levels of participation in leisure activities, including playing a board game, and a reduced risk of dementia such as Alzheimer’s disease and vascular dementia (Verghese et al. 2023). Several multidisciplinary studies performed by our group were conducted – there were psychological ones, marketing (qualitative and quantitative), and physiological (looking at changes in levels of the stress hormone cortisol) (Bonk et al. 2025). The ethics and psychological safety of the games were reviewed. The result was STRESSmission – a tool that comes in the two forms: a card game (described here), and a board game (Bonk et al. 2024; Bonk et al. 2025).
The card game comprises 54 task cards, which are grouped according to Aristotle’s triad of Soma, Psyche, and Polis and relating to the body (Soma), the psyche (Psyche), and social interactions (Polis). In addition, it includes 10 STRESSometer cards, which assist players in assessing their subjective stress levels before and after the game. The game also features 20 markers, a manual, a contract, and a convenient fabric bag (Fig. 1). The game is suitable for players over the age of 14. Further details can be found on the Polish webpage www.stresmisja.pl. The webpage contains a link to a booklet entitled “Stress Compendium” (“Kompendium wiedzy o stresie”), which can be downloaded from the webpage https://stresmisja.pl at no cost, and contains details anti-stress techniques employed in the game.
This article presents the results of preliminary research on this new card game as a possible tool that can be used to reduce stress and improve mood. The hypotheses described in the method sections were tested to assess perceived (subjective) stress and mood levels in the younger age group (students) and the older age group (seniors). As the stress response changes with age, addressing this variable was important in assessing the best-suited target group of customers (Novais et al. 2016). Additionally, a customized questionnaire with open-ended questions was developed, to assess the STRESSmission card game in terms of its attractiveness, the clarity of the game’s rules, the necessity for any changes to the game, the usefulness of the game’s tools, and the willingness to use the cards and to purchase the game.

Material and methods

The studies were divided into: Study 1. Assessment of the effects of the STRESSmission card game on mood and stress level; and Study 2. Questionnaire – Assessment of STRESSmission card game – a customized questionnaire with open-ended questions.

Study 1. Assessment of the effects of the STRESSmission card game on mood and stress level

Participants
This pilot study was performed on 206 participants: 171 women (83%) and 35 men (17%). Two age groups were tested: SWPS students (age 23-24 years old), n = 102 (50.5%), and seniors (60-80 years old), n = 104 (49.5%). All participants in the study were functionally independent, and they did not report any mental health problems in the last three months. They also were not addicted to drugs, including nicotine, and did not suffer from any trauma in the last three months before the study started.
The study has been approved by the Ethical Committee at Poznan University of Medical Sciences, Poland (license number 395/22). All experiments were performed by relevant named guidelines and regulations. Informed consent was obtained from all participants.

Procedure
The study was conducted in 2 age groups – among students and seniors. The game was played once in groups of about 4-6 participants. The game elements were 56 cards (18 cards in each category: Soma, Psyche and Polis, Fig. 2), the STRESSometer (Fig. 3) and Mood Barometer (Fig. 4), a contract, and game instructions.
The cards contain short descriptions of anti-stress techniques that are based on scientific research. Tasks from the Soma category concern bodywork techniques (e.g. breathing), those from Psyche are cognitive techniques (e.g. mindfulness training), and those from Polis are linked to social relations (e.g. social support).
Before the game started, the rules were discussed and everyone read the contract. In the beginning, players marked their subjective level of stress and mood using markers. The game then began, and on average lasted about 45 minutes. Afterwards, the players indicated their stress levels and mood again.

Measures The study used 3 tools: the STRESSometer, the Mood Barometer, and a self-administered questionnaire containing questions about the attractiveness of the game, the comprehensibility of its rules, and the willingness to purchase the game.
The following hypotheses were tested:
1. The level of perceived (subjective) stress will decrease significantly after the game in the entire study group (regardless of age).
1a. The level of subjective (perceived) stress will decrease significantly after playing the game compared to before playing the game in the student group.
1b. The level of subjective (perceived) stress will be significantly lower after the game than before in the senior group.
2. The level of subjectively assessed mood will be significantly higher after participation in the game than before in the entire group of subjects (regardless of the age of the players).
2a. The level of subjectively assessed mood will be significantly higher after participation in the game than before in the student group.
2b. The level of subjectively assessed mood will be significantly higher after participation in the game than before in the seniors group.
3. Compared to the student group, seniors will report lower levels of stress and higher mood levels before and after the game.
4. The change in perceived stress and mood levels over time (before and after the game) will depend on the age of players.
The STRESSometer (Fig. 3) and Mood Barometer (Fig. 4) were prototypes developed as possible tools for a card version of the STRESSmission game. They were intended to raise awareness of current emotions and tensions, and whether the tasks performed during the game (anti-stress techniques) change the level of stress and mood experienced. The results can be discussed among the participants after the game.
STRESSometer – using this tool, the player reports a subjective feeling of stress level before (STRESSometer1) and after the game (STRESSometer2) on a scale from 0 (no stress) to 10 (maximum stress; Fig. 3).
Mood barometer – Subjective feeling of mood level before (Mood Barometer1) and after (Mood Barometer2) the game on a scale from –10 (very negative mood) to +10 (very positive mood). It helps to determine whether the tasks performed (anti-stress techniques) affect mood. The results can be discussed after the game among the participants (Fig. 4).
Please note that in the final product released to the market, we selected only the STRESSometer with its new graphic design (Fig. 1).

Study 2. Questionnaire – Assessment of STRESSmission card game – a customized questionnaire with open-ended questions

The respondents (n = 206) – seniors from the University of the Third Age in Gdansk (n = 104) and students (n = 102) from the University of Life Sciences in Poznan, the Higher School of Banking in Gdansk, and the University of Warsaw – additionally filled out a customized questionnaire on the attractiveness and purchase intention of the game.
The following questions are to be considered: the game’s attractiveness, the clarity of the game’s rules, the necessity for any changes to the game, the usefulness of the Mood Barometer (Barometr Nastroju – a proprietary tool used to visualize the current mood of the player), and the willingness to use the cards and to purchase the game.
The following questions were asked to participants (we asked questions to students and seniors):
• How do you rate the game’s attractiveness? (scale from 1 to 5; from not attractive to very attractive);
• How do you rate the understandability of the rules of the game? (scale from 1 to 5; from not understandable to very understandable);
• Do you want to change something in the STRESSmission game? (yes or no);
• How do you assess the usefulness of the STRESSometer? (scale from 1 to 5);
• Would you like to use the STRESSmission cards? (scale from 1 to 5);
• Would you feel like buying the STRESSmission game? (scale from 1 to 5).

Statistical analysis

Due to the non-normal distribution of variables, as indicated by the Kolmogorov-Smirnov test, nonparametric tests were applied (Wilcoxon Z, Mann-Whitney U). The conventional significance threshold of α = 0.05 was used. Data analysis was performed using IBM SPSS Statistics, version 29.

Results

Study 1

Assessment of stress and mood levels by using STRESSometer and Mood Barometer in both students and seniors before and after playing the STRESSmission game
The research aimed to evaluate the effects of the STRESSmission card game on stress and mood across two age groups: young students and older adults (seniors). Overall, we found that the mean stress level before playing the STRESSmission game in both groups was M = 2.68, SD = 2.02, and after playing the game M = 1.54, SD = 1.83 (Z = –8.11, p < 0.001, r ≈ 0.57). Thus, hypothesis 1 was confirmed.
We also found an increase in mood. Overall, the mean mood level before playing the STRESSmission game was M = 3.22, SD = 1.05 and M = 6.24, SD = 3.06 after playing the game (Z = –11.05, p < 0.001, r ≈ 0.77). Furthermore, we assessed each age group’s stress and mood levels separately. Hypothesis 2 was confirmed.

Assessment of stress and mood levels using STRESSometer and Mood Barometer in students before and after playing the STRESSmission game
We found that the mean stress level (M) before playing the STRESSmission game was M = 3.56, SD = 1.76, and after playing the game M = 2.07, SD = 1.97 (Z = –6.46, p < 0.001, r ≈ 0.45). The obtained results confirmed Hypothesis 1a: Thus, the stress level was lower after playing the game.
We also found that the mean mood level (M) before playing the STRESSmission game was M = 2.76, SD = 3.85, and after playing the game M = 5.76, SD = 3.13 (Z = –7.78, p < 0.001, r ≈ 0.54). Thus, the results confirmed Hypothesis 2a: The mood level was higher after playing the game.

Assessment of stress and mood levels using STRESSometer and Mood Barometer in seniors before and after playing the STRESSmission game
We found that the mean stress level (M) before playing the STRESSmission game was M = 2.04, SD = 1.96, and after playing the game M = 1.16, SD = 1.64 (Z = –5.08, p < 0.001, r ≈ 0.35). Thus, Hypothesis 1b was confirmed: Playing the game reduced the stress level.
We also found that the mean mood level (M) before playing the STRESSmission game was M = 3.63, SD = 4.20, and after playing the game M = 6.68, SD = 2.94 (Z = –7.87, p < 0.001, r ≈ 0.55). The obtained results confirmed Hypothesis 2b: Thus, the game increased mood level.

Comparison of stress and mood levels between students and seniors before and after playing the STRESSmission game
Seniors reported significantly lower stress levels before the game (U = 2058, p < 0.001, r ≈ 0.38) compared to students. The same was observed after the game (U = 2651, p < 0.001, r ≈ 0.26).
Moreover, we found that seniors tended to rate their mood higher before the game (U = 4113, p = 0.04, r ≈ 0.14) and significantly higher after the game (U = 4008.5, p = 0.021, r ≈ 0.16) than students. Thus, Hypothesis 3 was confirmed.

Repeated measures analysis: Stress and mood levels before and after the playing the STRESSmission game across groups
The analysis revealed a significant difference in the change in stress level between students and seniors over time, U = 2843, p = 0.001, r ≈ 0.22, indicating a significant interaction between age group and time of stress measurement. Students experienced a more significant decrease in stress than seniors (a decrease of 1.49 vs. 0.88).
We found no significant interaction between mood measurement and age group (students, seniors), U = 4574.5, p = 0.361, r ≈ 0.06, indicating that the change in mood over time did not differ between seniors and students. Both college students and seniors experienced similar changes in mood – there is no evidence that time affected the mood of the two groups differently.
Hypothesis 4 was partially confirmed.

Study 2

Open-ended questions
Participants (n = 206: students n = 102, and seniors n = 104) were asked if they liked playing games. 167 respondents (81.1%) said they liked playing games, and 39 participants (18.9%) did not like playing games; the remaining people did not respond to this question.

Attractiveness of the game
The attractiveness of the game was rated on a scale from 1 to 5, where 1 = “I really don’t like it”, 2 = “I don’t like it”, 3 = “Neither yes nor no”, 4 = “I like it”, and 5 = “I like it very much”. Among the 206 participants, 1% of respondents rated the game as 1, 1.5% as 2, 16% as 3, 59.7% as 4, and 21.8% as 5.
/>Clarity of the rules of the game
The results of the clarity of the rules of the STRESSmission card game show that most participants found the rules to be understandable. One participant rated the rules as “not understandable” at all (0.5%), 1% of participants rated them as “somewhat unclear”, and 6.3% rated them as “moderately understandable”. Additionally, 35.9% of participants rated the rules as “mostly understandable”, and 5.3% rated them as “completely understandable”, while 1% did not answer this question.
/>Need for changes in STRESSmission
The results regarding whether any changes should be made to the STRESSmission game show that the most of participants (77.7%) did not think any changes were necessary. In contrast, only 21.3% of participants believed changes were needed (1% did not answer this question).

>Usefulness of the Mood Barometer Tool
The results regarding the usefulness of the subjective mood tool (Mood Barometer) indicate that most participants found the tool useful to assess perceived stress level. 1% of participants rated it as “totally useless”, 2.9% rated it as “useless”, 22.3% considered it as “neither useful nor useless”, 51% rated it as “useful”, and 22.3% rated it as “very useful” (0.5% of participants did not answer this question).

Willingness to use the STRESSmission cards again
The results regarding participants’ willingness to use the STRESSmission cards again show that most would be open to using the game again. 1.5% of participants answered “definitely not”, 6.8% answered “probably not”, and 10.1% answered “no opinion”. Additionally, 46.6% of participants answered “probably yes”, and 35% answered “definitely yes”.
<br/>Willingness to purchase the STRESSmission cards
The results regarding participants’ willingness to purchase the STRESSmission cards show that the majority expressed a positive inclination. 2.9% of participants answered “definitely not”, 19.4% answered “probably not”, and 19.4% answered “no opinion”. Additionally, 43.7% of participants answered “probably yes”, and 14.6% answered “definitely yes”.
When we compared the answers of students and seniors, the major findings were as follows:
More students stated that they like playing games compared to seniors (U = 4242, p < 0.001, r ≈ –0.26, indicating a medium effect size).
More students stated that the Mood Barometer tool was useful while playing games compared to seniors (U = 3945.5, p < 0.001, r ≈ –0.234, indicating a medium effect size).
Students were more critical and more likely to answer that there is a need to change something in the STRESSmission game compared to seniors (U = 4544, p = 0.029, r ≈ –0.152, small-to-medium effect size).
Students are more likely to use the cards again compared to seniors (U = 4536.5 p = 0.052, r ≈ –0.135, small-to-medium effect size).
Students tend to state that it is more likely that they would buy the game compared to seniors (U = 4568.5, p = 0.070, r ≈ –0.126, small-to-medium effect size).
Respondents who completed the questionnaire on the attractiveness of the game were asked (by means of open questions in the authors’ questionnaire) what made playing STRESSmission worthwhile. They mainly pointed to the psycho-educational dimension – the opportunity to get to know themselves and other players better. There were responses such as ‘the opportunity to get to know your personality’ and ‘to really get to know yourself and others’, ‘to get to know the needs of people close to you’, ‘to become aware of different (psychological) mechanisms’ and thus ‘to break down barriers’ and ‘to get closer to another person’. Some players saw it as an opportunity to get to know people who were already important to them in a deeper way (‘I would like to play with someone close to me, and I am curious about their reactions’). For some audiences, the game could also start of an “interesting conversation” on topics usually neglected in superficial exchanges.
As intended by the developers, there were frequent references to STRESSmission ‘improving mood and reducing stress’, ‘relaxing’ and ‘de-stressing’, ‘relaxing and calming down’ and ‘teaching anti-stress techniques in a fun way’.
Players also thought that the game was simply ‘interesting’ and suitable for an interesting, even ‘great’, ‘fruitful’ time-filler, ‘to kill boredom’.
In terms of where the testers see the game taking place, it is most often in the comfort of their own homes, but also outdoors – in the open air, around a campfire, in the park, anywhere you can find a moment of leisure. The place, not necessarily in the geographical sense, must be “safe”, and therefore the players should be non-accidental people, people we trust – acquaintances, friends, a beloved boyfriend or girlfriend.
However, STRESSmission is not for everyone and “not for every occasion”. Apart from the need to choose the right playmates, for some respondents the game itself requires too much openness and honesty, especially if the person “doesn’t like to talk about himself” or “doesn’t need to open up that much”. For such people, playing STRESSmission can be uncomfortable and even contribute to increased stress.

Discussion

This pilot study confirmed the impact of playing the STRESSmission game on lowering perceived stress and improving mood levels in student and senior groups.
Using subjective self-report measures (the STRESSometer and the Mood Barometer), we observed significant reductions in stress and notable improvements in mood in both groups after playing the game. Overall, the STRESSmission game led to a statistically significant reduction in perceived stress and a statistically significant improvement in mood for all participants. These findings provide preliminary evidence that structured, playful interventions such as STRESSmission may serve as effective short-term strategies for improving emotional well-being, regardless of age.
When the two age groups were analysed separately, both students and seniors benefited from the intervention, although the extent of the change varied. Students showed a greater reduction in stress levels than seniors. This was also reflected in the results of the repeated measures ANOVA, which showed a significant interaction effect between time and age group for stress levels. Specifically, students experienced a greater reduction in stress than seniors. These results suggest that the effect of STRESSmission on subjective stress levels may be moderated by age. One possible explanation is that younger people may be more responsive to interventions with gamified elements, possibly due to greater openness to playful experiences or greater familiarity with game-based strategies (Hamari et al. 2014; Sailer et al. 2017).
In contrast, there was no significant interaction between time and age group for mood levels. This suggests that the improvement in mood following the game was comparable for both students and seniors. In other words, age did not moderate the effect of the STRESSmission game on mood. Both groups experienced a significant improvement in mood, reinforcing the idea that simple, engaging activities such as analogue card games can have a universally positive effect on emotional well-being. Similar results have shown a shift from negative to positive mood during the use of the board game for training in adult learning settings (Wait and Frazer 2018).
Taken together, these findings support the use of offline analogue games as an accessible and effective tool for promoting mental health and emotional well-being in diverse populations. However, we did not test the online version of the game, but especially in the post-COVID-19 era, spending time offline is very beneficial in building social support, which could help reduce stress and improve mood levels. Moreover, the differences in stress reduction highlight the importance of considering age-related factors when designing or selecting interventions. Future research could explore how specific elements of gamification or game mechanics could be optimised to meet the needs of different demographic groups.
The game was played in a controlled setting in our studies. But, interestingly, when asked about the location of the game, the majority of respondents said that they most often played the game in the comfort of their own home. However, a significant minority also reported that they experienced it away from home, in places such as the open air, around a campfire, in parks and other outdoor spaces, at any time during their free time. The location, however, and not necessarily in a purely geographical sense, must be ‘safe’, and therefore the participants should be non-accidental, trusted people – acquaintances, friends, a beloved boyfriend or girlfriend, accidental people. Therefore, STRESSmission may not be universally suitable across situations. In addition to the need to choose appropriate playmates, the game itself may require an excessive degree of openness and honesty from some people, which was seen especially when performing tasks from Psyche category, particularly those who are reluctant to talk about themselves or who do not feel the need to reveal their innermost feelings. This could be seen as a limitation of the game. For such individuals, participation in STRESSmission may cause feelings of discomfort and possibly increase stress levels.
We also tested the usefulness of the STRESSometer and the Mood Barometer, and based on the results, we decided to use the STRESSometer in the product we are launching. Based on the results of this pilot study together with other unpublished data (Bonk et al. 2025) we suggest that STRESSmission could serve as psychoeducation tool for teaching anti-stress techniques. However, further studies are needed to test this in depth. Secondly, it could be a useful tool for teaching anti-stress techniques to people dealing with stress. However, further studies are needed to better address the needs of different age groups, such as children and adolescents.
Our results also confirm the attractiveness of the game and the clarity of the rules. When we analysed two age groups, the games appeared to be more suitable for students. We found that more students said they liked playing the game, were likely to use the cards again, and would buy the game compared to seniors.
There are several advantages of playing STRESSmission. Firstly, although the use of modern board games has increased in recent years in education, research, and mental health care (Vita-Barrul 2022), there is a lack of comprehensive experiments on using them as a psychoeducational tool helping in learning stress coping strategies. Our data (Bonk et al. 2025), indicating that the game reduced subjective (based on psychological tests) and objective (based on physiological tests measuring levels of the stress hormone cortisol), is the first – according to our best knowledge – to test scientifically stress management techniques employed in the STRESSmission game as a potential psychoeducational tool. Moreover, this preliminary study, where the card game prototypes were tested, indicates stress reduction and mood improvement of the game.
Secondly, we believe that the STRESSmission card game could be used as a digital detox tool. The game, due to its analogue nature, allows one to spend time away from electronic devices and focus on being ‘here and now’ offline by practising mindfulness. However, there are examples of beneficial effects of computer games, such as teaching strategies to reduce intrusive memories of trauma (Gamble et al. 2021) or the ability to cope with danger (Andersson et al. 2018). On the other hand, studies suggest that these games can lead to long-term changes in the reward circuitry that resemble the effects of substance dependence (Weinstein 2010).
Thirdly, our results also suggest that the game creates a space to talk about situations related to stress and coping, as well as providing an opportunity to release emotions. Thus, the cooperative nature of the game and the conversation-oriented tasks (Polis category) are combined with one of the forms of this strategy, which is the search for support and social contact. The STRESSmission game thus promotes social support in addition to relaxation and integration. Indeed, numerous studies indicate that prosocial behaviour has protective effects on health and adaptation to stress (Kropotkin 1972; Bullinger et al. 2011; Tomasello 2009).
Moreover, the game allows players to disengage from daily life’s demands, offering a pleasurable and relaxing experience, detachment from everyday problems, promoting health and wellbeing, and increasing awareness about mental health.
Despite the benefits of playing this card game that have been revealed by our studies, there are also limitations of the current studies. One of the limitations of the present studies is that they were performed on cohorts of relatively healthy students and seniors. However, in view of the other results discussed above, it is conceivable that this card game could also be successfully used in patients suffering from trauma, anxiety, depression, and other disorders. >Moreover, further studies are planned to test this game on children. It would also be interesting to compare the analogue and digital versions of the game as well as to provide an English version of it. In the course of our work on STRESSmission, we have given full consideration to this further application of the game for people with mental health problems, designing the tasks with meticulous care and employing psychological knowledge. Consequently, the aforementioned studies reveal a wide range of potential applications for games such as STRESSmission. These include its use as a psychoeducational tool to teach anti-stress techniques, as well as its possible future application as a therapeutic target for fear and anxiety disorders, and illnesses related to trauma and stress. However, it is imperative to conduct additional testing and to select suitable card tasks. A further limitation of the study is the over-representation of women (83%) in comparison to men (17%). Consequently, further research is warranted, encompassing larger samples of male subjects. Moreover, further studies should encompass additional target age groups, such as children and adolescents, who frequently experience elevated stress levels and emotional volatility. These groups necessitate psychoeducational interventions, which the current game does not cater to, as it is exclusively designed for individuals over the age of 14.
To summarize, the findings of both qualitative and quantitative studies conducted on two distinct age groups (student and senior) have demonstrated that the STRESSmission card game has the potential to function as a stress-relieving tool and as a medium for learning, thereby assisting individuals in managing stressors. Furthermore, the efficacy of the tool in enhancing players’ mood levels has been demonstrated. The preliminary findings suggest that this tool could be helpful to reduce the stress response and increase mood level.

Acknowledgements

The game’s development was funded by a project entitled ‘The Innovation Incubator 4.0’ (‘Inkubator Innowacyjności 4.0’), which was funded by the European Union.
We would like to express our gratitude for the Silver Medal awarded to STRESSmission, the game developed by INTARG, at the 16th International Trade Fair for Inventions and Innovations in Katowice in 2023 (Międzynarodowe Targi Wynalazków i Innowacji).
We would like to extend our gratitude to other team members for their cooperation in the creation of the game: Katarzyna Barcińska, Patrycja Sawicka-Sikora, Jakub Felczak as well as a previous team member, Dr Dominika Winogrodzka. We would also like to thank the students and seniors who participated in the study.

Disclosures

The study was funded by the European Union grant from “The Innovation Incubator 4.0” (“Inkubator Innowacyjności 4.0”).
The study was approved by the Bioethics Committee of the Poznan University of Medical Sciences (Approval No. 395/22).
The authors declare no conflict of interest.

References