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Luo J, Li F, Wu Y, Liu X, Zheng Q, Qi Y, Huang H, Xu G, Liu Z, He F, Zheng Y. A mobile device-based game prototype for ADHD: development and preliminary feasibility testing. Transl Psychiatry 2024; 14:251. [PMID: 38858375 PMCID: PMC11164876 DOI: 10.1038/s41398-024-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/13/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
This research aimed to devise and assess a mobile game therapy software for children with Attention-Deficit/Hyperactivity Disorder (ADHD), as well as evaluating its suitability and effectiveness in improving the cognitive ability of typically developing children. The study encompassed 55 children diagnosed with ADHD and 55 neurotypical children. Initial assessments involved ADHD-related scales, computerized tests for information processing, and physiological-psychological evaluations. After a 4-week home-based game intervention, participants underwent re-evaluation using baseline measures and provided feedback on treatment satisfaction. Considering the small proportion of study participants who dropped out, data was analyzed using both the Intention-to-Treat (ITT) analysis and the Per-protocol (PP) analysis. The trial was registered at ClinicalTrials.gov (NCT06181747). In ITT analysis, post-intervention analysis using linear mixed models indicated that the ADHD group improved significantly more than the neurotypical group particularly in Continuous Performance Test (CPT) accuracy (B = -23.92, p < 0.001) and reaction time (B = 86.08, p < 0.01), along with enhancements in anti-saccade (B = -10.65, p < 0.05) and delayed-saccade tasks (B = 0.34, p < 0.05). A reduction in parent-rated SNAP-IV scores was also observed (B = 0.43, p < 0.01). In PP analysis, paired-sample t-tests suggested that the ADHD group had significant changes pre- and post-intervention, in terms of CPT Accuracy (t = -7.62, p < 0.01), Anti-saccade task Correct Rate (t = -3.90, p < 0.01) and SNAP-IV scores (t = -4,64, p < 0.01). However, no significant changes post-intervention were observed in the neurotypical group. Survey feedback highlighted a strong interest in the games across both groups, though ADHD participants found the game more challenging. Parents of ADHD children reported perceived benefits and a willingness to continue the game therapy, unlike the neurotypical group's parents. The findings advocated for the integration of serious video games as a complementary tool in ADHD treatment strategies, demonstrating the potential to augment attentional abilities and alleviate clinical symptoms. However, a randomized controlled trial (RCT) is needed to further verify its efficacy.
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Affiliation(s)
- Jie Luo
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Fenghua Li
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yuanzhen Wu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Xuanang Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qingyi Zheng
- Department of Psychology and Human Development, Institute of Education, University College London, London, UK
| | - Yanjie Qi
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Huanhuan Huang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Gaoyang Xu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China
| | - Zhengkui Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Fan He
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China.
| | - Yi Zheng
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing Institute for Brain Disorders Capital Medical University, Beijing, People's Republic of China.
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Cregan SC, Toth AJ, Campbell MJ. Playing for keeps or just playing with emotion? Studying tilt and emotion regulation in video games. Front Psychol 2024; 15:1385242. [PMID: 38737959 PMCID: PMC11082399 DOI: 10.3389/fpsyg.2024.1385242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/05/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction In video gaming, tilt is thought to relate to poor emotional control and game performance. Despite widespread recognition of tilt in video gaming, there is a lack of research examining tilt empirically. Methods One thousand and seven gamers took part in our online study examining gamers experience of tilt, the factors which contribute to and protect against tilt, and the emotion regulation strategies gamers employ to deal with tilt. Results Gamers who reported playing for more competitive reasons, were at higher risk of experiencing tilt. Additional factors associated with an increased risk of experiencing tilt were increased anger and more hours spent playing. Protective factors against experiencing tilt were also identified, inclusive of a greater number of years gaming experience and engagement in adaptive emotion regulation strategies. Discussion This study provides an important starting point for creating a better understanding of tilt in gaming, equipping us with new knowledge to better support gamers to improve their emotion regulation during game play performance.
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Affiliation(s)
- Sarah C. Cregan
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Lero - Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
| | - Adam J. Toth
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Lero - Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
- Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
- Centre for Sport Leadership, Maties Sport, Stellenbosch University, Stellenbosch, South Africa
| | - Mark J. Campbell
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Lero - Science Foundation Ireland Research Centre for Software, University of Limerick, Limerick, Ireland
- Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
- Centre for Sport Leadership, Maties Sport, Stellenbosch University, Stellenbosch, South Africa
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Kim HK. Attraction and achievement as 2 attributes of gamification in healthcare: an evolutionary concept analysis. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2024; 21:10. [PMID: 38600768 PMCID: PMC11130557 DOI: 10.3352/jeehp.2024.21.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
This study conducted a conceptual analysis of gamification in healthcare utilizing Rogers’ evolutionary concept analysis methodology to identify its attributes and provide a method for its applications in the healthcare field. Gamification has recently been used as a health intervention and education method, but the concept is used inconsistently and confusingly. A literature review was conducted to derive definitions, surrogate terms, antecedents, influencing factors, attributes (characteristics with dimensions and features), related concepts, consequences, implications, and hypotheses from various academic fields. A total of 56 journal articles in English and Korean, published between August 2 and August 7, 2023, were extracted from databases such as PubMed Central, the Institute of Electrical and Electronics Engineers, the Association for Computing Machinery Digital Library, the Research Information Sharing Service, and the Korean Studies Information Service System, using the keywords “gamification” and “healthcare.” These articles were then analyzed. Gamification in healthcare is defined as the application of game elements in health-related contexts to improve health outcomes. The attributes of this concept were categorized into 2 main areas: attraction and achievement. These categories encompass various strategies for synchronization, enjoyable engagement, visual rewards, and goal-reinforcing frames. Through a multidisciplinary analysis of the concept’s attributes and influencing factors, this paper provides practical strategies for implementing gamification in health interventions. When developing a gamification strategy, healthcare providers can reference this analysis to ensure the game elements are used both appropriately and effectively.
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Affiliation(s)
- Hyun Kyoung Kim
- /Department of Nursing, Kongju National University, Gongju, Korea
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Eiland LS, Gildon BL. Diagnosis and Treatment of ADHD in the Pediatric Population. J Pediatr Pharmacol Ther 2024; 29:107-118. [PMID: 38596418 PMCID: PMC11001204 DOI: 10.5863/1551-6776-29.2.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/19/2023] [Indexed: 04/11/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood with approximately 6 million children (age 3 to 17 years) ever diagnosed based on data from 2016-2019. ADHD is characterized by a constant pattern of inattention and/or hyperactivity-impulsivity symptoms that interferes with development or functioning. Specific criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition Text Revision assist with the diagnosis with multiple guidelines available providing non-pharmacologic and pharmacologic recommendations for the treatment of ADHD in the pediatric population. While all guidelines similarly recommend behavioral and/or stimulant therapy as first-line therapy based on age, not all stimulant products are equal. Their differing pharmacokinetic profiles and formulations are essential to understand in order to optimize efficacy and safety for patients. Additionally, new stimulant products and non-stimulant medications continue to be approved for use of ADHD in the pediatric population and it is important to know their differences in formulation, efficacy, and safety to other products currently available. Lastly, due to drug shortages, it is important to understand product similarities and differences to select alternative therapy for patients.
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Affiliation(s)
- Lea S. Eiland
- Department of Pharmacy Practice (LSE), Auburn University Harrison College of Pharmacy
| | - Brooke L. Gildon
- Department of Pharmacy Practice (BLG), Southwestern Oklahoma State University College of Pharmacy
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Spies G, Huss J, Motswage O, Seedat S, Eichenberg C. Attitudes of patients and mental health professionals towards hypothetical use of serious games in psychotherapy. Health Informatics J 2024; 30:14604582241259343. [PMID: 38900576 DOI: 10.1177/14604582241259343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Serious games are increasingly being applied within healthcare, but their integration in psychotherapeutic settings is less documented. OBJECTIVES The present study sought to identify the attitudes of psychotherapists and patients towards the hypothetical use of serious games in psychotherapy in the South African context. METHODS Online surveys assessed acceptance, experience, and requirements for the utilisation of serious games in therapeutic contexts. Clients utilising mental health services (n = 209) and psychotherapists delivering mental health services (n = 156) in South Africa completed the online survey. RESULTS Knowledge about serious games is limited with only 15% of clients and 16% of therapists reporting knowledge of the existence and application of serious games. Use of serious games is even more infrequent with only 1% of therapists and 6% of clients currently using serious games as an intervention. Despite this, our findings highlight an apparent demand for their use, with 71% of therapists indicating that serious games would be a suitable adjunct treatment modality for their patients. Our results show a general openness toward the use of serious games in psychotherapy. CONCLUSION The use of serious games as an e-mental health treatment modality is conceivable for both patients and therapists, particularly as a complementary strategy to traditional face-to-face psychotherapy.
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Affiliation(s)
- Georgina Spies
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African PTSD Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Jessica Huss
- Department of Psychology, University of Kassel, Kassel, Germany
| | - Oscar Motswage
- Department of Psychology, College of Human Sciences, University of South Africa, Pretoria, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Christiane Eichenberg
- Medical Faculty, Institute of Psychosomatic, Sigmund Freud Private University, Austria
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Martin-Moratinos M, Bella-Fernández M, Rodrigo-Yanguas M, González-Tardón C, Sújar A, Li C, Wang P, Royuela A, Lopez-Garcia P, Blasco-Fontecilla H. Effectiveness of a Serious Video Game (MOON) for Attention Deficit Hyperactivity Disorder: Protocol for a Randomized Clinical Trial. JMIR Res Protoc 2024; 13:e53191. [PMID: 38393773 PMCID: PMC10924267 DOI: 10.2196/53191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/20/2023] [Accepted: 01/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood and adolescence, with a prevalence of 5% and associated difficulties and worse prognosis if undetected. Multimodal treatment is the treatment of choice. However, sometimes treatment can be insufficient or have drawbacks. OBJECTIVE This study protocol aims to demonstrate the effectiveness of cognitive training through the serious video game The Secret Trail of Moon (MOON) in improving emotional regulation in people with ADHD. METHODS This is a prospective, unicenter, randomized, unblinded, pre- and postintervention study. The groups will be randomized (MOON vs control) via an electronic case report form. The MOON intervention will be performed 2 times per week for 10 weeks (30 minutes per session). The first 5 weeks (10 sessions) will be conducted face-to-face at the Puerta de Hierro University Hospital, and the remaining weeks will be conducted via the internet at the participants' homes. The total sample consists of 152 patients aged between 7 and 18 years. All participants have a clinical diagnosis of ADHD under pharmacological treatment. Data collection will be used to obtain demographic and clinical data. The data will be recorded using REDCap. Measures will be made through clinical scales for parents and objective tests of cognitive functioning in patients. Additional information on academic performance will be collected. The study has a power greater than 80% to detect differences. Student t test, 2-factor analysis of variance (ANOVA), and Mann-Whitney analyses will be performed according to each variable's characteristics. RESULTS The study was approved by the Research Ethics Committee of the Puerta de Hierro University Hospital on December 14, 2022. As of September 26, 2023, we have enrolled 62 participants, and 31 participants have completed the study. This clinical trial was funded by the Comunidad de Madrid (IND2020/BMD-17544). The approximate completion date is March 2024. CONCLUSIONS Serious video games such as MOON can be motivational tools that complement multimodal treatment for ADHD. TRIAL REGISTRATION ClinicalTrials.gov; NCT06006871; https://clinicaltrials.gov/study/NCT06006871. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53191.
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Affiliation(s)
- Marina Martin-Moratinos
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain, Spain
- Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - Marcos Bella-Fernández
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain, Spain
- Faculty of Psychology, Autonoma University of Madrid, Madrid, Spain
- Department of Psychology, Pontifical University of Comillas, Madrid, Spain
| | | | | | - Aaron Sújar
- Department of Computer Engineering, Universidad Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Chao Li
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain, Spain
- Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - Ping Wang
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain, Spain
- Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
| | - Ana Royuela
- Clinical Biostatistics Unit, Consortium for Biomedical Research Network in Epidemiology and Public Health, Madrid, Spain
| | - Pilar Lopez-Garcia
- Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
- Spain Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, Spain, Spain
- Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
- Spain Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
- ITA Center Mental Health Specialists, Madrid, Spain
- Health Sciences School and Medical Center, Universidad Internacional de La Rioja, Madrid, Spain
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Wong RS, Tung KTS, Ho FKW, Wong WHS, Chow CB, Chan KL, Fu KW, Ip P. Effect of a Mobile Game-Based Intervention to Enhance Child Safety: Randomized Controlled Trial. J Med Internet Res 2024; 26:e51908. [PMID: 38354042 PMCID: PMC10902767 DOI: 10.2196/51908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Evidence supports the effectiveness of serious games in health education, but little is known about their effects on the psychosocial well-being of children in the general population. OBJECTIVE This study aimed to investigate the potential of a mobile game-based safety education program in improving children's safety and psychosocial outcomes. METHODS Safe City is a mobile roleplaying game specifically designed to educate children in Hong Kong about safety. This randomized controlled trial included 340 children in grades 4 through 6. Intervention arm participants (n=170) were instructed to play the Safe City mobile game for 4 weeks, whereas control arm participants (n=170) received a safety booklet. All participants completed a survey on safety knowledge and behaviors and psychosocial problems at baseline (T1), 1 month postintervention (T2), and 3 months postintervention (T3). Cumulative game scores and mini-game performance were analyzed as a proxy for the extent of exposure to the game. Outcome data were analyzed using 2-sample 2-tailed t tests to compare mean change from T1 to T2 and to T3 for intervention versus control arm participants. The association of game use with outcome changes postintervention was analyzed using generalized additive models. RESULTS No significant differences were found in mean changes between the intervention and control arms. However, use analyses showed that higher game scores were associated with improvements in safe behavior (P=.03) and internalizing problems (P=.01) at T3. Matching and Spot the Danger mini-game performance significantly predicted improvements in safety knowledge at T2 and T3. CONCLUSIONS Analysis of use has shown that playing the Safe City mobile game can result in significant improvements in safety knowledge and reductions in unsafe behavior and internalizing problems. These findings provide evidence for the positive impact of serious games on psychological and social well-being, highlighting the potential of technology-driven interventions to assist children in learning about safety and preventing injuries. TRIAL REGISTRATION ClinicalTrials.org NCT04096196; https://clinicaltrials.gov/show/NCT04096196. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/17756.
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Affiliation(s)
- Rosa S Wong
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Keith T S Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Frederick K W Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Chun Bong Chow
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - King Wa Fu
- Journalism and Media Studies Centre, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Jaiswal A, Kruiper R, Rasool A, Nandkeolyar A, Wall DP, Washington P. Digitally Diagnosing Multiple Developmental Delays Using Crowdsourcing Fused With Machine Learning: Protocol for a Human-in-the-Loop Machine Learning Study. JMIR Res Protoc 2024; 13:e52205. [PMID: 38329783 PMCID: PMC10884895 DOI: 10.2196/52205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/17/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND A considerable number of minors in the United States are diagnosed with developmental or psychiatric conditions, potentially influenced by underdiagnosis factors such as cost, distance, and clinician availability. Despite the potential of digital phenotyping tools with machine learning (ML) approaches to expedite diagnoses and enhance diagnostic services for pediatric psychiatric conditions, existing methods face limitations because they use a limited set of social features for prediction tasks and focus on a single binary prediction, resulting in uncertain accuracies. OBJECTIVE This study aims to propose the development of a gamified web system for data collection, followed by a fusion of novel crowdsourcing algorithms with ML behavioral feature extraction approaches to simultaneously predict diagnoses of autism spectrum disorder and attention-deficit/hyperactivity disorder in a precise and specific manner. METHODS The proposed pipeline will consist of (1) gamified web applications to curate videos of social interactions adaptively based on the needs of the diagnostic system, (2) behavioral feature extraction techniques consisting of automated ML methods and novel crowdsourcing algorithms, and (3) the development of ML models that classify several conditions simultaneously and that adaptively request additional information based on uncertainties about the data. RESULTS A preliminary version of the web interface has been implemented, and a prior feature selection method has highlighted a core set of behavioral features that can be targeted through the proposed gamified approach. CONCLUSIONS The prospect for high reward stems from the possibility of creating the first artificial intelligence-powered tool that can identify complex social behaviors well enough to distinguish conditions with nuanced differentiators such as autism spectrum disorder and attention-deficit/hyperactivity disorder. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52205.
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Affiliation(s)
- Aditi Jaiswal
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Ruben Kruiper
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Abdur Rasool
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Aayush Nandkeolyar
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Dennis P Wall
- Department of Pediatrics (Systems Medicine), Stanford University School of Medicine, Stanford, CA, United States
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Peter Washington
- Department of Information and Computer Sciences, University of Hawaii at Manoa, Honolulu, HI, United States
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Oh S, Choi J, Han DH, Kim E. Effects of game-based digital therapeutics on attention deficit hyperactivity disorder in children and adolescents as assessed by parents or teachers: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024; 33:481-493. [PMID: 36862162 DOI: 10.1007/s00787-023-02174-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/16/2023] [Indexed: 03/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset disorder characterized by pharmacological and non-pharmacological interventions. Despite the available treatment options and prevention measures, conventional treatments have several limitations. Digital therapeutics (DTx) like EndeavorRx® is an emerging alternative to overcome these limitations. EndeavorRx® is the first FDA-approved, game-based DTx approved for the treatment of pediatric ADHD. We investigated the effects of game-based DTx in randomised controlled trials (RCTs) on children and adolescents with ADHD. In this systematic review and meta-analysis, we searched PubMed, Embase, and PsycINFO databases up to January 2022. The protocol was registered (CRD42022299866). The assessor was defined as parents and teachers. The primary outcome was differences in inattention reported by the assessor, and the secondary outcome was differences in hyperactivity and hyperactivity/impulsivity reported by the assessor and the relative comparisons between game-based DTx, medicine, and control with indirect meta-analysis. Game-based DTx improved inattention more than the control upon assessment by assessors (standard mean difference (SMD) 0.28, 95% confidence interval (CI) 0.14-0.41; SMD 0.21, 95% CI 0.03-0.39, respectively), while medication improved inattention more than game-based DTx (SMD - 0·62, 95% CI - 1·04 to - 0·20) upon assessment by the teacher. Game-based DTx improved hyperactivity/impulsivity than the control upon assessment by assessors (SMD 0.28, 95% CI 0.03-0.53; SMD 0.30, 95% CI 0.05-0.55, respectively), and medication improved hyperactivity/impulsivity significantly than game-based DTx upon assessment by the teacher. Hyperactivity has not been reported extensively. As a result, game-based DTx had a more significant effect than the control, however medication was more effective.
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Affiliation(s)
- SuA Oh
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Jina Choi
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung Ang University Hospital, Seoul, 06974, Republic of Korea
| | - EunYoung Kim
- Data Science, Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea.
- Regulatory Science, Pharmaceutical Industry, College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
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Alonso-Campuzano C, Iandolo G, Filosofi F, Tardivo A, Sosa-González N, Pasqualotto A, Venuti P. Tangible digital collaborative storytelling in adolescents with intellectual disability and neurodevelopmental disorders. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13159. [PMID: 37752789 DOI: 10.1111/jar.13159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/14/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Collaborative storytelling can be a helpful tool to promote cognitive and social skills in adolescents with neurodevelopmental disorders. AIMS The current study aimed to explore the benefits of collaborative storytelling using traditional (TST), digital (DST), and tangible digital (TDST) methodologies. MATERIALS AND METHODS Fourteen Spanish students with mild to moderate intellectual disability and other neurodevelopmental comorbid disorders participated in collaborative storytelling sessions in the classroom, following an experimental, mixed, and cross-sectional design. The study comprised three individual assessments of narrative skills and eight collaborative storytelling sessions using different storytelling methodologies. Individual and collaborative stories were videotaped, transcribed verbatim, and analysed for formal and content characteristics. Behaviours and interactions during the collaborative storytelling were analysed for each group and session. RESULTS The results show a positive effect of collaboration on students' stories, compared to individual performance, regardless of the methodology used. CONCLUSION Collaboration, technological device handling, and shared storytelling did not present a barrier for the participants.
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Affiliation(s)
- Cristina Alonso-Campuzano
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain
| | - Giuseppe Iandolo
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain
| | - Fabio Filosofi
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Angela Tardivo
- Observation and Functional Diagnosis Division, PSISE Clinical and Developmental Psychological Service, Madrid, Spain
| | - Noelia Sosa-González
- Observation and Functional Diagnosis Division, PSISE Clinical and Developmental Psychological Service, Madrid, Spain
| | - Angela Pasqualotto
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
- Department of Education and Learning, University of Applied Sciences and Arts of Southern Switzerland, Locarno, Switzerland
| | - Paola Venuti
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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Sylvester CM, Luby JL, Pine DS. Novel mechanism-based treatments for pediatric anxiety and depressive disorders. Neuropsychopharmacology 2024; 49:262-275. [PMID: 37608220 PMCID: PMC10700626 DOI: 10.1038/s41386-023-01709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
Pediatric anxiety and depressive disorders are common, can be highly impairing, and can persist despite the best available treatments. Here, we review research into novel treatments for childhood anxiety and depressive disorders designed to target underlying cognitive, emotional, and neural circuit mechanisms. We highlight three novel treatments lying along a continuum relating to clinical impact of the disorder and the intensity of clinical management required. We review cognitive training, which involves the lowest risk and may be applicable for problems with mild to moderate impact; psychotherapy, which includes a higher level of clinical involvement and may be sufficient for problems with moderate impact; and brain stimulation, which has the highest potential risks and is therefore most appropriate for problems with high impact. For each treatment, we review the specific underlying cognitive, emotional, and brain circuit mechanisms that are being targeted, whether treatments modify those underlying mechanisms, and efficacy in reducing symptoms. We conclude by highlighting future directions, including the importance of work that leverages developmental windows of high brain plasticity to time interventions to the specific epochs in childhood that have the largest and most enduring life-long impact.
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Affiliation(s)
- Chad M Sylvester
- Washington University Department of Psychiatry, St. Louis, MO, USA.
- Washington University Department of Radiology, St. Louis, MO, USA.
| | - Joan L Luby
- Washington University Department of Psychiatry, St. Louis, MO, USA
| | - Daniel S Pine
- National Institute of Mental Health, Emotion and Development Branch, St. Louis, MO, USA
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12
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Schachar RJ. Fifty years of executive control research in attention-deficit/hyperactivity disorder:What we have learned and still need to know. Neurosci Biobehav Rev 2023; 155:105461. [PMID: 37949153 DOI: 10.1016/j.neubiorev.2023.105461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
For 50 years, attention-deficit/hyperactivity disorder (ADHD) has been considered a disorder of executive control (EC), the higher-order, cognitive skills that support self-regulation, goal attainment and what we generally call "attention." This review surveys our current understanding of the nature of EC as it pertains to ADHD and considers the evidence in support of eight hypotheses that can be derived from the EC theory of ADHD. This paper provides a resource for practitioners to aid in clinical decision-making. To support theory building, I draw a parallel between the EC theory of ADHD and the common gene-common variant model of complex traits such as ADHD. The conclusion offers strategies for advancing collaborative research.
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Affiliation(s)
- Russell J Schachar
- Department of Psychiatry, The Hospital for Sick Children and University of Toronto, Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
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13
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Mendez-Encinas D, Sujar A, Bayona S, Delgado-Gomez D. Attention and impulsivity assessment using virtual reality games. Sci Rep 2023; 13:13689. [PMID: 37608015 PMCID: PMC10444747 DOI: 10.1038/s41598-023-40455-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023] Open
Abstract
The assessment of cognitive functions is mainly based on standardized neuropsychological tests, widely used in various fields such as personnel recruitment, education, or health. This paper presents a virtual reality game that allows collecting continuous measurements of both the performance and behaviour of the subject in an immersive, controllable, and naturalistic experience. The application registers variables related to the user's eye movements through the use of virtual reality goggles, as well as variables of the game performance. We study how virtual reality can provide data to help predict scores on the Attention Control Scale Test and the Barratt Impulsiveness Scale. We design the application and test it with a pilot group. We build a random forest regressor model to predict the attention and impulsivity scales' total score. When evaluating the performance of the model, we obtain a positive correlation with attention (0.434) and with impulsivity (0.382). In addition, our model identified that the most significant variables are the time spent looking at the target or at distractors, the eye movements variability, the number of blinks and the pupil dilation in both attention and impulsivity. Our results are consistent with previous results in the literature showing that it is possible to use data collected in virtual reality to predict the degree of attention and impulsivity.
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Affiliation(s)
| | - Aaron Sujar
- Departamento de Ciencias de la Computación, Universidad Rey Juan Carlos, Móstoles, Spain.
| | - Sofia Bayona
- Departamento de Ciencias de la Computación, Universidad Rey Juan Carlos, Móstoles, Spain
| | - David Delgado-Gomez
- Departamento de Estádistica, Universidad Carlos III de Madrid, Leganes, Spain
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14
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Vacca RA, Augello A, Gallo L, Caggianese G, Malizia V, La Grutta S, Murero M, Valenti D, Tullo A, Balech B, Marzano F, Ghezzo A, Tancredi G, Turchetta A, Riccio MP, Bravaccio C, Scala I. Serious Games in the new era of digital-health interventions: A narrative review of their therapeutic applications to manage neurobehavior in neurodevelopmental disorders. Neurosci Biobehav Rev 2023; 149:105156. [PMID: 37019246 DOI: 10.1016/j.neubiorev.2023.105156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/10/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
Children and adolescents with neurodevelopmental disorders generally show adaptive, cognitive and motor skills impairments associated with behavioral problems, i.e., alterations in attention, anxiety and stress regulation, emotional and social relationships, which strongly limit their quality of life. This narrative review aims at providing a critical overview of the current knowledge in the field of serious games (SGs), known as digital instructional interactive videogames, applied to neurodevelopmental disorders. Indeed, a growing number of studies is drawing attention to SGs as innovative and promising interventions in managing neurobehavioral and cognitive disturbs in children with neurodevelopmental disorders. Accordingly, we provide a literature overview of the current evidence regarding the actions and the effects of SGs. In addition, we describe neurobehavioral alterations occurring in some specific neurodevelopmental disorders for which a possible therapeutic use of SGs has been suggested. Finally, we discuss findings obtained in clinical trials using SGs as digital therapeutics in neurodevelopment disorders and suggest new directions and hypotheses for future studies to bridge the gaps between clinical research and clinical practice.
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15
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Aneni K, Gomati de la Vega I, Jiao MG, Funaro MC, Fiellin LE. Evaluating the validity of game-based assessments measuring cognitive function among children and adolescents: A systematic review and meta-analysis. PROGRESS IN BRAIN RESEARCH 2023; 279:1-36. [PMID: 37661161 DOI: 10.1016/bs.pbr.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Games offer advantages over traditional methods of assessing cognitive function among children and adolescents. However, the validity of game-based assessments has not been systematically evaluated. We conducted a systematic review and meta-analysis to assess the validity of game-based assessments measuring cognitive function among children and adolescents. We systematically searched several databases using pre-defined inclusion criteria. For papers that met the criteria, we extracted and analyzed the cognitive functions measured by each study, the correlation coefficients between game-based and traditional assessments, and factors that could influence the validity of game-based assessments. Our review identified 19 articles featuring 20 studies, 18 games, and 378 unique correlations between game-based and traditional assessments of cognitive function. Game-based assessments yielded significant correlations (n=282, 75%) with traditional assessments, over half of which were in the low to medium range in strength (r=0.3-0.69, n=227, 80%). Factors related to the child, such as age, gender, and prior gaming experience, may influence the validity of game-based assessments by modifying performance on game-based assessments. In addition, we found that game-based assessments that measured cognitive functions across more than one neurocognitive domain and used a prediction model for scoring were more likely to yield significant correlations. In contrast, including a narrative storyline in a game-based assessment was less likely to yield significant correlations. Most studies were of good quality, although the lack of sample size justification was a limiting factor. Further research is needed to elucidate the influence of identified factors on the validity of game-based assessment to justify the wide adoption of game-based assessments of cognitive function among children and adolescents.
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Affiliation(s)
- Kammarauche Aneni
- Yale Child Study Center, New Haven, CT, United States; Yale School of Medicine, New Haven, CT, United States
| | | | - Megan G Jiao
- McGovern Medical School, Houston, TX, United States
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, United States
| | - Lynn E Fiellin
- Yale Child Study Center, New Haven, CT, United States; Yale School of Medicine, New Haven, CT, United States; Yale School of Public Health, New Haven, CT, United States.
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16
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Washington P. Digitally Diagnosing Multiple Developmental Delays using Crowdsourcing fused with Machine Learning: A Research Protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.05.23286817. [PMID: 36945467 PMCID: PMC10029023 DOI: 10.1101/2023.03.05.23286817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Background Roughly 17% percent of minors in the United States aged 3 through 17 years have a diagnosis of one or more developmental or psychiatric conditions, with the true prevalence likely being higher due to underdiagnosis in rural areas and for minority populations. Unfortunately, timely diagnostic services are inaccessible to a large portion of the United States and global population due to cost, distance, and clinician availability. Digital phenotyping tools have the potential to shorten the time-to-diagnosis and to bring diagnostic services to more people by enabling accessible evaluations. While automated machine learning (ML) approaches for detection of pediatric psychiatry conditions have garnered increased research attention in recent years, existing approaches use a limited set of social features for the prediction task and focus on a single binary prediction. Objective I propose the development of a gamified web system for data collection followed by a fusion of novel crowdsourcing algorithms with machine learning behavioral feature extraction approaches to simultaneously predict diagnoses of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) in a precise and specific manner. Methods The proposed pipeline will consist of: (1) a gamified web applications to curate videos of social interactions adaptively based on needs of the diagnostic system, (2) behavioral feature extraction techniques consisting of automated ML methods and novel crowdsourcing algorithms, and (3) development of ML models which classify several conditions simultaneously and which adaptively request additional information based on uncertainties about the data. Conclusions The prospective for high reward stems from the possibility of creating the first AI-powered tool which can identify complex social behaviors well enough to distinguish conditions with nuanced differentiators such as ASD and ADHD.
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Corrigan N, Păsărelu CR, Voinescu A. Immersive virtual reality for improving cognitive deficits in children with ADHD: a systematic review and meta-analysis. VIRTUAL REALITY 2023; 27:1-20. [PMID: 36845650 PMCID: PMC9938513 DOI: 10.1007/s10055-023-00768-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 02/05/2023] [Indexed: 06/17/2023]
Abstract
Virtual reality (VR) shows great potential in treating and managing various mental health conditions. This includes using VR for training or rehabilitation purposes. For example, VR is being used to improve cognitive functioning (e.g. attention) among children with attention/deficit-hyperactivity disorder (ADHD). The aim of the current review and meta-analysis is to evaluate the effectiveness of immersive VR-based interventions for improving cognitive deficits in children with ADHD, to investigate potential moderators of the effect size and assess treatment adherence and safety. The meta-analysis included seven randomised controlled trials (RCTs) of children with ADHD comparing immersive VR-based interventions with controls (e.g. waiting list, medication, psychotherapy, cognitive training, neurofeedback and hemoencephalographic biofeedback) on measures of cognition. Results indicated large effect sizes in favour of VR-based interventions on outcomes of global cognitive functioning, attention, and memory. Neither intervention length nor participant age moderated the effect size of global cognitive functioning. Control group type (active vs passive control group), ADHD diagnostic status (formal vs. informal) and novelty of VR technology were not significant moderators of the effect size of global cognitive functioning. Treatment adherence was similar across groups and there were no adverse effects. Results should be cautiously interpreted given the poor quality of included studies and small sample.
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Affiliation(s)
- Niamh Corrigan
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
| | - Costina-Ruxandra Păsărelu
- Department of Clinical Psychology and Psychotherapy, The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babe-Bolyai University, No.37, Republicii Street, 400015 Cluj-Napoca, Romania
| | - Alexandra Voinescu
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
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The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update. Sports (Basel) 2023; 11:sports11020034. [PMID: 36828319 PMCID: PMC9966106 DOI: 10.3390/sports11020034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.
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Kleeren L, Hallemans A, Hoskens J, Klingels K, Smits-Engelsman B, Verbecque E. A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis. J Atten Disord 2023; 27:354-367. [PMID: 36635879 DOI: 10.1177/10870547221146244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To map the effect of motor-based interventions on motor skills in children with ADHD. METHOD A systematic literature search was performed in Pubmed, Web of Science, and the SCOPUS database (last search: October 30th 2022). Methodological quality was assessed using the PEDro-scale and the quality of evidence was determined with the GRADE-method. Meta-analysis was performed when at least five studies were available. RESULTS Thirteen studies (7 RCTs) satisfied the inclusion criteria, five of which were eligible for meta-analysis. Only one of the included studies reached the low risk of bias threshold. Comparing different motor-based interventions to any non-motor control intervention showed large motor skill improvements (SMD = 1.46; 95% CI = [1.00;1.93]; I² = 47.07%). The most effective type of motor-based intervention and the optimal treatment parameters could not be determined yet. CONCLUSION Motor-based interventions in general seem to improve motor skills in children with ADHD. Additional RCTs are needed to increase current low GRADE confidence.
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20
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Mavragani A, Ranganath V. An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study. JMIR Form Res 2022; 6:e36390. [PMID: 36485019 PMCID: PMC9789490 DOI: 10.2196/36390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 10/23/2022] [Accepted: 11/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the common neurodevelopment disorders. Children with ADHD typically have difficulties with emotional regulation. Previous studies have investigated the assessment for underlying emotional biases using the visual probe task. However, one of the significant limitations of the visual probe task is that it is demanding and repetitive over time. Previous studies have examined the use of gamification methods in addressing the limitations of the emotional bias visual probe task. There has also been increased recognition of the potential of participatory action research methods and how it could help to make the conceptualized interventions more relevant. OBJECTIVE The primary aim of this study was to collate health care professionals' perspectives on the limitations of the existing visual probe task and to determine if gamification elements were viable to be incorporated into an emotional bias modification task. METHODS A co-design workshop was conducted. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore, were invited to participate. Considering the COVID-19 pandemic and the restrictions, a web-based workshop was conducted. There were 3 main phases in the workshops. First, participants were asked to identify limitations and suggest potential methods to overcome some of the identified limitations. Second, participants were shown examples of existing gaming interventions in published literature and commercial stores. They were also asked to comment on the advantages and limitations of these interventions. Finally, participants were asked if gamification techniques would be appropriate. RESULTS Overall, 4 health care professionals consented and participated. Several limitations were identified regarding the conventional emotional bias intervention. These included the nature of the task parameters, included stimulus set, and factors that could have an impact on the accuracy of responding to the task. After examining the existing ADHD games, participants raised concerns about the evidence base of some of the apps. They articulated that any developed ADHD game ought to identify the specific skill set that was targeted clearly. Regarding gamification strategies, participants preferred economic and performance-based gamification approaches. CONCLUSIONS This study has managed to elucidate health care professionals' perspectives toward refining a conventional emotional bias intervention for children with ADHD. In view of the repetitiveness of the conventional task, the suggested gamification techniques might help in influencing task adherence and reduce the attrition rates.
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Affiliation(s)
| | - Vallabhajosyula Ranganath
- Anatomy, Office of Medical Education, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
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21
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Sanuki F, Nakphu N, Tahara A, Iramina K. The comparison of electroencephalography power and event related potential in success and failure during multitask game. Front Neurorobot 2022; 16:1044071. [DOI: 10.3389/fnbot.2022.1044071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
The first game-based treatment for children with attention-deficit hyperactivity disorder (ADHD) was approved by the United States Food and Drug Administration (FDA) in 2020. This game was developed for use at home as part of everyday training and can be used along with one’s usual training plan. In this game, two tasks are performed in parallel: (1) a perceptual discrimination targeting task (response and not response and avoiding responding to sudden pop-up targets) and (2) a sensory-motor navigation task (players continuously adjust their location to interact with or avoid positional targets). However, the brain activity of people playing this game was not examined, and the immersive environment (3D virtual world) was not considered. Therefore, we aimed to develop a system to investigate brain activity using electroencephalography (EEG) during multitask gameplay in virtual reality (VR). In this experiment, we focused on the difference between the success and failure of the Go/No-Go task in a multitask game. We created a color discrimination task and a target tracking task in VR. The content of this game task was designed using previous multitask training. EEG and event data were recorded. Using event data, we can analyze the data in detail. We divided the trial types (Go and No-Go) and results (success and failure). We then compared the success and failure of each task. In the Go trial, the relative theta power in success at Fz was significantly higher than that of failure. However, no difference in power was observed in the No-Go trial. On the other hand, theta power was no different between success and failure in the other task. These results of the Go trial suggest that the participants were attentive to processing both tasks. Thus, it is possible that theta power in the frontal area 1 s before stimulation could predict the success or failure of the Go trial. On the other hand, the results of the No-Go trial may be due to the low number of No-Go failure trials and the fact that stimulus oversight is one of the factors for success.
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22
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A Videogame as a Tool for Clinical Screening of Possible Vulnerability to Impulsivity and Attention Disturbances in Children. CHILDREN 2022; 9:children9111652. [DOI: 10.3390/children9111652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022]
Abstract
An attention disturbance is a problem that affects many school-aged children. The assessment in children is usually report-based, and as a result, controversy surrounds the diagnosis. To solve this issue, the aim of this study was to develop a new tool to detect possible attention-related problems and impulsive behavior in 4- and 5-year-old children. This tool was developed as an Android app and could be used to provide an early indicator of possible future development problems. A sample of 103 children (48 girls and 55 boys) was randomly selected from primary schools and assessed by Pinky-Piggy, a videogame application based on a classical paradigm in experimental psychology. Data from this app were compared with a Child Neuropsychological Maturity Questionnaire. The subjects displayed different patterns of response to play a very simple game called Pinky-Piggy. The application discriminated between high-responders and low responders. The results showed a relationship between these two profiles and the levels of attention and neurodevelopment in each group. The tool could identify different types of profiles and demonstrated its potential to evaluate endophenotypes to predict attentional problems related to impulsive behavior. Additionally, it required less time and fewer tests to identify possible at-risk populations, thus assisting in clinical diagnosis.
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Psychological Impact and Influence of Animation on Viewer’s Visual Attention and Cognition: A Systematic Literature Review, Open Challenges, and Future Research Directions. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8802542. [PMID: 36092789 PMCID: PMC9453061 DOI: 10.1155/2022/8802542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
Animation is an excellent method to associate with the audience in a fun and innovative manner. In recent span, animation has been employed in various fields to enhance knowledge, marketing, advertisement, and age groups from infants to adults. The present communication expounds the systematic review on the impact created by animation on the viewer’s visual attention. For this review, a database such as Google Scholar, ScienceDirect, Taylor & Francis, and IEEE Xplore were pursued for publications on the impact of animation on viewer’s visual attention from January 2015 to December 2021. The search results showcased 175 titles with 114 full articles, out of which 35 were related to viewers’ visual attention towards animation. These reviewed studies comprised of physical outcome (
), psychological outcome (
), and cognitive outcome (
) from which the attention-related factors, physical effects, and cognitive effects of animation were assessed. The animation has influenced the viewer’s visual attention through the integration of the different stimuli and the highly organized presentation. Furthermore, the animation has also aided the viewer in attaining greater conceptual understanding, thereby facilitating their cognitive response. As a result, the animation was found to be helpful in enhancing learning skills, food marketing, and teaching strategy. Furthermore, the drawbacks and future recommendations of the studies were elaborated. In addition, challenges and open issues faced during the studies were discussed. Finally, the priority areas in animation identified for promising future directions to visualize large pool data, provide smart communication, and design 3D modeling structures were highlighted.
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Sújar A, Martín-Moratinos M, Rodrigo-Yanguas M, Bella-Fernández M, González-Tardón C, Delgado-Gómez D, Blasco-Fontecilla H. Developing Serious Video Games to Treat Attention Deficit Hyperactivity Disorder: Tutorial Guide. JMIR Serious Games 2022; 10:e33884. [PMID: 35916694 PMCID: PMC9379781 DOI: 10.2196/33884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/12/2022] [Accepted: 06/12/2022] [Indexed: 12/03/2022] Open
Abstract
Video game–based therapeutic interventions have demonstrated some effectiveness in decreasing the symptoms of attention deficit hyperactivity disorder (ADHD). Compared with more traditional strategies within the multimodal treatment of ADHD, video games have certain advantages such as being comfortable, flexible, and cost-efficient. However, establishing the most appropriate type(s) of video games that should be used for this treatment remains a matter of debate, including the commercial existing video games or serious video games that are specifically constructed to target specific disorders. This guide represents a starting point for developing serious video games aimed at treating ADHD. We summarize the key points that need to be addressed to generate an effective and motivating game-based treatment. Following recommendations from the literature to create game-based treatments, we describe the development stages of a serious video game for treating ADHD. Game design should consider the interests of future users; game mechanics should be based on cognitive exercises; and therapeutic mechanisms must include the control of difficulty, engagement, motivation, time constraints, and reinforcement. To elaborate upon this guide, we performed a narrative review focused on the use of video games for the treatment of ADHD, and were inspired by our own experience during the development of the game “The Secret Trail of Moon.”
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Affiliation(s)
- Aarón Sújar
- Department of Psychiatry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Department of Computer Engineering, Universidad Rey Juan Carlos, Madrid, Spain
| | - Marina Martín-Moratinos
- Department of Psychiatry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Rodrigo-Yanguas
- Department of Psychiatry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marcos Bella-Fernández
- Department of Psychiatry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychology, Universidad Pontificia de Comillas, Madrid, Spain
| | | | | | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- ITA Mental Health, Madrid, Spain
- Centro de Investigación Biomédica en Red Salud Mental, Madrid, Spain
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25
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Sujar A, Bayona S, Delgado-Gómez D, Miguélez-Fernández C, Ardoy-Cuadros J, Peñuelas-Calvo I, Baca-García E, Blasco-Fontecilla H. Attention Deficit Hyperactivity Disorder Assessment Based on Patient Behavior Exhibited in a Car Video Game: A Pilot Study. Brain Sci 2022; 12:brainsci12070877. [PMID: 35884684 PMCID: PMC9313446 DOI: 10.3390/brainsci12070877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) include excessive activity, difficulty sustaining attention, and inability to act in a reflective manner. Early diagnosis and treatment of ADHD is key but may be influenced by the observation and communication skills of caregivers, and the experience of the medical professional. Attempts to obtain additional measures to support the medical diagnosis, such as reaction time when performing a task, can be found in the literature. We propose an information recording system that allows to study in detail the behavior shown by children already diagnosed with ADHD during a car driving video game. We continuously record the participants’ activity throughout the task and calculate the error committed. Studying the trajectory graphs, some children showed uniform patterns, others lost attention from one point onwards, and others alternated attention/inattention intervals. Results show a dependence between the age of the children and their performance. Moreover, by analyzing the positions by age over time using clustering, we show that it is possible to classify children according to their performance. Future studies will examine whether this detailed information about each child’s performance pattern can be used to fine-tune treatment.
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Affiliation(s)
- Aaron Sujar
- Department of Computer Engineering, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.S.); (S.B.)
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain;
| | - Sofia Bayona
- Department of Computer Engineering, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.S.); (S.B.)
- Center for Computational Simulation, Universidad Politécnica de Madrid, 28040 Boadilla del Monte, Spain
| | - David Delgado-Gómez
- Department of Statistics, Universidad Carlos III, 28903 Getafe, Spain
- Correspondence:
| | | | - Juan Ardoy-Cuadros
- Department of Psychology, Faculty of Health Sciences, University Rey Juan Carlos, Avda. Atenas s/n, 28922 Alcorcón, Spain;
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, University Hospital 12 de Octubre, 28041 Madrid, Spain;
| | - Enrique Baca-García
- Department of Psychiatry, IIS-Jimenez Diaz Foundation, 28040 Madrid, Spain;
- CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain;
- CIBERSAM (Centro de Investigación en Salud Mental), Carlos III Institute of Health, 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- ITA Mental Health, 28043 Madrid, Spain
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Chen IC, Chen CL, Chang CH, Fan ZC, Chang Y, Lin CH, Ko LW. Task-Rate-Related Neural Dynamics Using Wireless EEG to Assist Diagnosis and Intervention Planning for Preschoolers with ADHD Exhibiting Heterogeneous Cognitive Proficiency. J Pers Med 2022; 12:jpm12050731. [PMID: 35629153 PMCID: PMC9143733 DOI: 10.3390/jpm12050731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
This study used a wireless EEG system to investigate neural dynamics in preschoolers with ADHD who exhibited varying cognitive proficiency pertaining to working memory and processing speed abilities. Preschoolers with ADHD exhibiting high cognitive proficiency (ADHD-H, n = 24), those with ADHD exhibiting low cognitive proficiency (ADHD-L, n = 18), and preschoolers with typical development (TD, n = 31) underwent the Conners’ Kiddie Continuous Performance Test and wireless EEG recording under different conditions (rest, slow-rate, and fast-rate task). In the slow-rate task condition, compared with the TD group, the ADHD-H group manifested higher delta and lower beta power in the central region, while the ADHD-L group manifested higher parietal delta power. In the fast-rate task condition, in the parietal region, ADHD-L manifested higher delta power than those in the other two groups (ADHD-H and TD); additionally, ADHD-L manifested higher theta as well as lower alpha and beta power than those with ADHD-H. Unlike those in the TD group, the delta power of both ADHD groups was enhanced in shifting from rest to task conditions. These findings suggest that task-rate-related neural dynamics contain specific neural biomarkers to assist clinical planning for ADHD in preschoolers with heterogeneous cognitive proficiency. The novel wireless EEG system used was convenient and highly suitable for clinical application.
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Affiliation(s)
- I-Chun Chen
- International Ph.D. Program in Interdisciplinary Neuroscience, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Department of Physical Medicine and Rehabilitation, Ton-Yen General Hospital, Hsinchu 30268, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-L.C.); (L.-W.K.)
| | - Chih-Hao Chang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Zuo-Cian Fan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Yang Chang
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | | | - Li-Wei Ko
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan; (C.-H.C.); (Z.-C.F.)
- Brain Research Center and the Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Department of Electronics and Electrical Engineering, Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Drug Development and Value Creation Research Center, Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-L.C.); (L.-W.K.)
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27
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Martin-Moratinos M, Bella-Fernandez M, Blasco-Fontecilla H. Effects of music on ADHD symptomatology and potential application of music in video games: A systematic review (Preprint). J Med Internet Res 2022; 25:e37742. [PMID: 37171837 DOI: 10.2196/37742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/30/2022] [Accepted: 03/08/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) has a considerable impact on an individual's daily life. Some difficulties with timing deficits may be associated with deficiencies in attention, reading, language skills, or executive function. Music therapy, either active (playing an instrument) or passive (listening to music) has demonstrated its efficacy in reducing symptomatology in many disorders. Video games may prove to be a useful assessment and treatment tool in compensating for the difficulties with multimodal treatment in ADHD. OBJECTIVE The aim of the study is to (1) analyze the evidence that music is beneficial in reducing the symptomatology of ADHD using systematic review and (2) propose the application of music in video games following music therapy strategies. METHODS Searches were conducted in PubMed, Embase, PsycINFO, Cochrane, and gray literature (Google Scholar and WorldCat). We used the following search syntax: ((music[Title/Abstract]) or (music therapy[Title/Abstract])) and (attention deficit disorder[MeSH or thesaurus term]). RESULTS Of the 70 records identified, 17 provided findings that music can be beneficial in various domains of ADHD. Active music therapy improves hemispheric synchrony, social skills, aggressivity, and impulsivity. Passive music therapy improves academic skills like arithmetic, drawing, and reading comprehension, as well as attention and disruptive behaviors. The effects depend on the music genre, tempo, or task difficulty. Music in video games was generally found to be beneficial for people with ADHD. Music improves immersion and flow while playing video games. Using rhythm may also improve timing skills and immersion in patients with ADHD. Regarding the proposed application of aspects of music to therapeutic video games for ADHD, some paradigms in timing and music therapy were considered in the proposed design of video games. CONCLUSIONS Improving ADHD treatment through the application of music in video games is proposed. TRIAL REGISTRATION PROSPERO CRD42021288226; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=288226.
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Tang X, Mo L, Liu Q, Liu Y, Yu L, Liu Y, Gao C. Adverse experiences of social adaptation in children with leukaemia: a qualitative study from China. BMJ Open 2022; 12:e051953. [PMID: 35232780 PMCID: PMC8889316 DOI: 10.1136/bmjopen-2021-051953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM AND OBJECTIVE This study aimed to build an indepth and comprehensive understanding of the social maladaptation experience of Chinese children with leukaemia of different ages. METHODS The purposive sampling method was adopted to conduct semistructured interviews with 20 Chinese children with leukaemia or their main caregivers and Colaizzi's method for qualitative research was used to organise and analyse the data. The study followed the guiding principles of the Standards for Reporting Qualitative Research. RESULTS The existing social adaptation problems of children with leukaemia of different ages were assessed. In terms of psychological maladjustment, children with leukaemia aged 2-7 years showed fear and excessive attachment, while children aged 8-18 years were characterised by impatience, irritability and anxiety. In terms of behavioural maladjustment, children aged 2-7 years presented less independent behaviour and dependence on electronics, while children aged 8-18 years showed learning obstruction and indulgence in mobile games. CONCLUSIONS Targeted intervention strategies should be developed based on the physical and mental characteristics of children with leukaemia of different ages to improve existing social adaptation problems. RELEVANCE TO CLINICAL PRACTICE Early intervention for social adaptation of children with leukaemia should be considered. Children's social adaptation should be improved to prevent more adaptation problems so that they can return to their families and to the society without difficulty and improve their quality of life in the long term.
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Affiliation(s)
- Xinyue Tang
- School of Pediatrics, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Lin Mo
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
- Nursing Department, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
| | - Qian Liu
- School of Pediatrics, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Yixuan Liu
- School of Pediatrics, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
| | - Lu Yu
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
- Department of VIP Outpatient, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
| | - Yang Liu
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Paediatrics, Chongqing, China
- Department of Haematology Oncology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China
| | - Chunhai Gao
- Research Centre of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
- Key Laboratory of Brain and Cognitive Neuroscience, Dalian, Liaoning, China
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29
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Jiang H, Natarajan R, Shuy YK, Rong L, Zhang MW, Vallabhajosyula R. The Use of Mobile Games in the Management of Patients With Attention Deficit Hyperactive Disorder: A Scoping Review. Front Psychiatry 2022; 13:792402. [PMID: 35308884 PMCID: PMC8931195 DOI: 10.3389/fpsyt.2022.792402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/17/2022] [Indexed: 12/03/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with significant morbidity. Current treatment approaches consist of a mixture of pharmacological and psychological approaches. The emergence of digital technology, and mobile gaming applications, represents a promising novel method in potentially augmenting existing interventions for ADHD. In this review, we will map out the use of mobile gaming applications in the management of ADHD and evaluate the effectiveness of these technologies and any areas for future research. Four electronic databases were searched for relevant articles. All articles were screened for abstract and full text by two independent reviewers, and data extracted onto a common data extraction sheet. The data was narratively synthesized and reported in line with the PRISMA-ScR guidelines. A total of 19 studies were included. Studies mostly evaluated the effectiveness of games on male children with ADHD. Most games were focused on the treatment of ADHD, while a minority were focused on the diagnosis and monitoring of ADHD. Some of the common gaming mechanisms employed in games included having participants responding to cures, remembering details, and making associations between different entities. The studies generally showed an improvement in performance of children as they played the games, but evidence for the effectiveness of these modalities remains scarce and mixed. While it is exciting that there is such a wide variety of games available currently in the diagnosis, treatment, and monitoring of ADHD, many of the games lack clinical evidence to prove their effectiveness. Furthermore, most studies contain several limitations including small sample size, limited ages of participants, lack of control group, and lack of comprehensive outcomes. To promote the application of these games to clinical practice, robust clinical trials, collaboration between stakeholders and using a comprehensive set of outcome measurements is essential.
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Affiliation(s)
- Haowen Jiang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rohit Natarajan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Lim Rong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Melvyn Weibin Zhang
- Family Medicine and Primary Care, Lee Kong Chain School of Medicine, Nanyang Technological University, Singapore, Singapore
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30
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Rodrigo-Yanguas M, González-Tardón C, Bella-Fernández M, Blasco-Fontecilla H. Serious Video Games: Angels or Demons in Patients With Attention-Deficit Hyperactivity Disorder? A Quasi-Systematic Review. Front Psychiatry 2022; 13:798480. [PMID: 35573357 PMCID: PMC9091561 DOI: 10.3389/fpsyt.2022.798480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/11/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To carry out a quasi-systematic review of the use of serious video games for health as a cognitive rehabilitative tool in patients diagnosed with attention-deficit hyperactivity disorder. METHOD A quasi-systematic review of serious video games used as an evaluative and rehabilitative tool in patients with ADHD was conducted. It included behavioral patterns in the use of video games and addiction problems in this population. For its elaboration the PRISMA GUIDES were followed. The search was carried out in three PubMed databases, MEDLINE, and PsycInfo using the keywords: [game OR serious game OR computer game) AND (psychotherapy OR rehabilitation OR intervention OR mental disorders) AND (adhd)], [(adhd) AND (Video game addiction)]. All articles written in English, Spanish, or Portuguese from January 1970 to June 2021 were included: those in which reference was made to the use of video games and/or new technologies as a therapeutic and evaluative tool in children and adults diagnosed with ADHD, as well as those that referred to behavioral and clinical patterns in the use of video games. RESULTS We found 605 articles of which 128 were reviewed (44 observational studies, 26 quasi-experimental studies, 26 experimental studies, 8 systematic reviews, 9 narrative texts, 6 case reports, 7 pilot studies, 8 systematic reviews, and 2 meta-analyses). Serious video games can be used to ameliorate ADHD symptoms while improving adherence to treatment. Some serious video games show high accuracy properties assessing ADHD features. CONCLUSION Serious video games for health are increasingly being used as a cognitive rehabilitation tool in patients with attention-deficit hyperactivity disorder (ADHD). SYSTEMATIC REVIEW REGISTRATION [www.crd.york.ac.uk/prospero], identifier [CRD42021247784].
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Affiliation(s)
- María Rodrigo-Yanguas
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Marcos Bella-Fernández
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychology, Universidad Pontificia de Comillas, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Consulting Asistencial Sociosanitario SL, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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31
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Winning The Game Against Depression: A Systematic Review of Video Games for the Treatment of Depressive Disorders. Curr Psychiatry Rep 2022; 24:23-35. [PMID: 35113313 PMCID: PMC8811339 DOI: 10.1007/s11920-022-01314-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW To review the evidence about video game-based therapeutic intervention for people diagnosed with depressive disorders. RECENT FINDINGS Psychotherapy has been proved to reduce depressive symptoms and is a key element in the treatment of depressive disorders. However, geographical, economical and stigmatized concerns are barriers to access to psychotherapy. New technologies and videos games can overcome some of these barriers by providing teleconferencing evidence-based therapy as time as they may offer an interactive entertainment. Overall, video game-based interventions were useful and effective in reducing symptoms of depressive disorders. Seven of the studies were published in the last 5 years, which reflects the increased research interest in video game-based interventions for depression. Overall, when adherence was reported, rates of acceptability and feasibility were high.
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Sampedro Baena L, la Fuente GACD, Martos-Cabrera MB, Gómez-Urquiza JL, Albendín-García L, Romero-Bejar JL, Suleiman-Martos N. Effects of Neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review. J Clin Med 2021; 10:jcm10173797. [PMID: 34501246 PMCID: PMC8432262 DOI: 10.3390/jcm10173797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders in childhood and adolescence. Choosing the right treatment is critical to controlling and improving symptoms. An innovative ADHD treatment is neurofeedback (NF) that trains participants to self-regulate brain activity. The aim of the study was to analyze the effects of NF interventions in children with ADHD. A systematic review was carried out in the CINAHL, Medline (PubMed), Proquest, and Scopus databases, following the PRISMA recommendations. Nine articles were found. The NF improved behavior, allowed greater control of impulsivity, and increased sustained attention. In addition, it improved motor control, bimanual coordination and was associated with a reduction in theta waves. NF combined with other interventions such as medication, physical activity, behavioral therapy training, or attention training with brain-computer interaction, reduced primary ADHD symptoms. Furthermore, more randomized controlled trials would be necessary to determine the significant effects.
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Affiliation(s)
- Lucía Sampedro Baena
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida del Conocimiento, s/n, 18016 Granada, Spain; (L.S.B.); (M.B.M.-C.)
| | | | - María Begoña Martos-Cabrera
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida del Conocimiento, s/n, 18016 Granada, Spain; (L.S.B.); (M.B.M.-C.)
| | - José L. Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Calle Cortadura del Valle S.N., 51001 Ceuta, Spain; (J.L.G.-U.); (N.S.-M.)
| | - Luis Albendín-García
- Casería de Montijo Health Center, Granada Metropolitan District, Andalusian Health Service, Calle Virgen de la Consolación, 12, 18015 Granada, Spain;
| | - José Luis Romero-Bejar
- Department of Statistics and Operational Research, University of Granada. Av. Fuentenueva, 18071 Granada, Spain
- Correspondence:
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Calle Cortadura del Valle S.N., 51001 Ceuta, Spain; (J.L.G.-U.); (N.S.-M.)
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Weissenberger S, Schonova K, Büttiker P, Fazio R, Vnukova M, Stefano GB, Ptacek R. Time Perception is a Focal Symptom of Attention-Deficit/Hyperactivity Disorder in Adults. Med Sci Monit 2021; 27:e933766. [PMID: 34272353 PMCID: PMC8293837 DOI: 10.12659/msm.933766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is classically associated with symptoms that include inattentiveness, hyperactivity, and impulsivity together with a variety of other observable externalized symptoms. ADHD has also been associated with specific internalized cognitive symptoms, including restlessness and emotional impulsivity. This disorder has been recognized as a lifelong condition and can be recognized by a variety of unique cognitive phenomena. In addition to the frequently ignored affective symptoms exhibited by individuals diagnosed with ADHD, problems with time perception have been noted, although these are considered to be secondary issues. Temporal shifts in cognitive processing, however, may be at the very root of ADHD-related symptoms, given the importance of coordinated signal translation in the construction of behavior. In this review, we consider the evidence that suggests that differences in time perception are a central symptom in adults with ADHD. Some of these differences include the feeling of time moving faster, which causes difficulties in prospective time tasks and inaccuracies in time estimation tasks. We analyze the literature from both neurological and psychological perspectives and include an assessment of tools that can be administered via computer to measure time perception. We also suggest several computer-based methods that might be used to address problems with time perception in both children and adults. We strongly recommend the inclusion of ADHD symptoms associated with time perception in the next revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association.
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Affiliation(s)
- Simon Weissenberger
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Katerina Schonova
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Pascal Büttiker
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Raffaele Fazio
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Martina Vnukova
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
| | - Radek Ptacek
- Department of Psychiatry, 1st Medical Faculty of Charles University and General Teaching Hospital in Prague, Prague, Czech Republic
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Jiménez-Muñoz L, Peñuelas-Calvo I, Calvo-Rivera P, Díaz-Oliván I, Moreno M, Baca-García E, Porras-Segovia A. Video Games for the Treatment of Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2021; 52:169-188. [PMID: 33651285 DOI: 10.1007/s10803-021-04934-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/28/2022]
Abstract
Video games are a promising area of intervention for children diagnosed with Autism Spectrum Disorders (ASD). However, reviews on this topic are scarce. This review on studies exploring video games for the treatment of ASD followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and its protocol was registered in PROSPERO. PubMed, PsycInfo, Embase, WebOfScience and clinicaltrials.gov databases were searched. Twenty-four articles were included in the review. Video game-based interventions were effective for alleviating ASD symptoms, albeit with small effect sizes. High rates of acceptability and adherence to treatment were obtained. Conclusion: Video games are a promising area for improving the treatment of children with ASD. Exploring commercial video games is one of the lines for future research.
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Affiliation(s)
- Laura Jiménez-Muñoz
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Inmaculada Peñuelas-Calvo
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain. .,Departamento de Psiquiatría Infantojuvenil, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. .,Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain.
| | - Pilar Calvo-Rivera
- Departamento de Psiquiatría Infantojuvenil, Hospital Reina Sofía de Córdoba, Córdoba, Spain
| | - Isaac Díaz-Oliván
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatria, Universidad Autónoma de Madrid, Madrid, Spain.,Departamento de Psiquiatría Infantojuvenil, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Departamento de Psiquiatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario de Valdemoro, Madrid, Spain.,Departamento de Psiquiatría, Hospital Universitario Central de Villalba, Madrid, Spain.,CIBERSAM, Madrid, Spain.,Université de Nîmes, Nîmes, France.,Departamento de Psiquiatría, Universidad Católica del Maule, Talca, Chile
| | - Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain.,Hospital Universitario Rey Juan Carlos, Móstoles, Spain
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35
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Delgado-Gómez D, Sújar A, Ardoy-Cuadros J, Bejarano-Gómez A, Aguado D, Miguelez-Fernandez C, Blasco-Fontecilla H, Peñuelas-Calvo I. Objective Assessment of Attention-Deficit Hyperactivity Disorder (ADHD) Using an Infinite Runner-Based Computer Game: A Pilot Study. Brain Sci 2020; 10:brainsci10100716. [PMID: 33050130 PMCID: PMC7599622 DOI: 10.3390/brainsci10100716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/16/2022] Open
Abstract
In the last few years, several computerized tasks have been developed to increase the objectivity of the diagnosis of attention-deficit hyperactivity disorder (ADHD). This article proposes the "running raccoon" video game to assess the severity of inattention in patients diagnosed with ADHD. Unlike existing tests, the proposed tool is a genuine video game in which the patient must make a raccoon avatar jump to avoid falling into different gaps. The distance to the gap is recorded for each jump. To evaluate the proposed game, an experiment was conducted in which 32 children diagnosed with ADHD participated. For each participant, the median and interquartile range of these distances were calculated, along with the number of omissions. Experimental results showed a significant correlation between the participants' inattention (measured by the Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior rating scale (SWAN) inattention subscale) with each of these three measures. In addition to its accuracy, other benefits are its short duration and the possibility of being run on both standard computers and mobile devices. These characteristics facilitate its acceptance in clinical environments or even its telematic use. The obtained results, together with the characteristics of the video game, make it an excellent tool to support clinicians in the diagnosis of ADHD.
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Affiliation(s)
- David Delgado-Gómez
- Department of Statistics, Universidad Carlos III, Getafe, 28903 Madrid, Spain; (D.D.-G.); (A.B.-G.)
| | - Aaron Sújar
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (A.S.); (H.B.-F.)
| | - Juan Ardoy-Cuadros
- Department of Psychology, Faculty of Health Sciences, University Rey Juan Carlos, Avda. Atenas s/n, 28922 Alcorcón, Madrid, Spain
- Correspondence:
| | - Alejandro Bejarano-Gómez
- Department of Statistics, Universidad Carlos III, Getafe, 28903 Madrid, Spain; (D.D.-G.); (A.B.-G.)
| | - David Aguado
- Department of Social Psychology and Methodology, Autonoma University of Madrid, 28040 Madrid, Spain;
- Instituto Ingeniería del Conocimiento, Autonoma University of Madrid, 28040 Madrid, Spain
| | | | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain; (A.S.); (H.B.-F.)
- CIBERSAM, Autonoma University of Madrid, ITA-Mental Health, 28049 Madrid, Spain;
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
- School of Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, 28223 Madrid, Spain
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