The hedonic evaluation of neurofeedback stimuli is fast, automatic and implicit An ERP study on stimulus design

Introduction - Neurofeedback (NFB) has demonstrated efficacy in treating various disorders, often achieving substantial symptom reductions. Despite its effectiveness, a significant percentage of users (non-responders), fail to benefit from NFB. Addressing this issue, the study at hand investigates the role of NFB design on neuro-physiological responses. Method - event related potentials (ERPs) are examined in response to the application of different aesthetic principles in the context of NFB stimulus design. Drawing from Self-Determination Theory and ERP studies in the field of web design, 16 feedback stimuli were developed according to specific design principles. Stimulus design effects were inspected by means of ERPs allowing for the assessment of implicit and fast electroencephalogram (EEG) reactions. Results of n = 38 participants indicated distinct ERP response patterns at time window of interest 1 (TWOI-1; 100-200 ms) and TWOI-2 (200-300 ms), predicted by beholder-based liking and complexity of stimuli. The findings align with the proposed hypotheses suggesting that aesthetic evaluation of NFB stimuli occurs rapidly and implicitly. In response to the aesthetic vs. non-aesthetic categories, the findings were mixed. The results underscore the importance of further exploration of aesthetic design guidelines in the context of NFB applications. It is discussed how NFB aesthetics relate to Processing Fluency and Affective Prediction Error Theory, while the theoretical methodological issue of the Fixed Effect Fallacy is taken into consideration. The study contributes to the broader understanding of how design elements can affect therapeutic efficacy and engagement in NFB and Human Computer Interaction in therapeutic contexts in general.