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- Title
Mental Health Outcomes of an Applied Game for Children with Elevated Anxiety Symptoms: A Randomized Controlled Non-inferiority Trial.
- Authors
Schoneveld, Elke A.; Wols, Aniek; Lichtwarck-Aschoff, Anna; Otten, Roy; Granic, Isabela
- Abstract
Anxiety disorders are the most prevalent mental health problems in childhood. Engaging, adequate, and appropriate prevention programs are needed. Applied games form a potential alternative delivery model and recent evidence suggests that they could be effective. The present randomized controlled non-inferiority trial investigated the beneficial effects of the applied game MindLight compared to cognitive behavioral therapy (CBT) on mental health outcomes associated with anxiety symptoms: internalizing problems, externalizing problems, and self-efficacy. In addition, we examined who benefitted most from both programs and analyzed baseline levels of anxiety, maternal mental health problems, and self-efficacy as predictors of changes in anxiety symptoms. After being screened for elevated anxiety, 174 selected children (8–12-year-old) were randomized to play MindLight or to receive a prevention program based on CBT. Study variables were assessed before and after the intervention, and at 3- and 6-months follow-up. Intention-to-treat analyses showed a significant reduction in mother-reported internalizing and externalizing problems and an increase in self-efficacy. Importantly, the magnitude of change did not differ between intervention groups. Non-inferiority analyses showed that MindLight was as effective as CBT in affecting internalizing problems and self-efficacy. However, CBT was more effective in decreasing externalizing symptoms than MindLight. Furthermore, baseline anxiety levels, maternal mental health problems, and self-efficacy did not influence the change of anxiety symptoms over time. Applied games, specifically theory-based games such as MindLight, hold potential as effective interventions for not only targeting anxiety symptoms, but also more general mental health outcomes. Highlights: Applied games form an alternative delivery model of therapeutic techniques. The applied game MindLight was as effective as CBT in improving youth mental health. In both groups, internalizing and externalizing problems and self-efficacy improved. Differences in baseline mental health were unrelated to intervention outcomes.
- Subjects
ANXIETY disorders treatment; ANXIETY; CHILD behavior; COGNITIVE therapy; INTENTION; MOTHERS; SELF-efficacy; VIDEO games; RANDOMIZED controlled trials; TREATMENT effectiveness; CHILDREN
- Publication
Journal of Child & Family Studies, 2020, Vol 29, Issue 8, p2169
- ISSN
1062-1024
- Publication type
Article
- DOI
10.1007/s10826-020-01728-y