Video Games for Well-Being: A Systematic Review on the Application of Computer Games for Cognitive and Emotional Training in the Adult Population

Effect of virtual reality-based biofeedback for depressive and anxiety symptoms: Randomized controlled study

BACKGROUND

The use of virtual reality (VR)-based biofeedback (BF), a relatively new intervention, is a non-pharmacological treatment of depressive and anxiety symptoms. However, studies on VR-based BF are lacking and inconclusive.

METHODS

A total of 131 adults were recruited from the community. Participants who scored ≥10 on the Patient Health Questionnaire-9 (PHQ-9) or ≥9 on the Panic Disorder Severity Scale (PDSS) were included in the group with depressive or anxiety symptoms (DAS group), and others as the healthy control group (HC group). Participants from the DAS group were randomly assigned to VR-based or conventional BF intervention. All individuals visited at three times (weeks 0, 2, and 4), and completed the Montgomery-Asberg Depression Rating Scale (MADRS), the State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS) before and after the intervention, and PHQ-9 at the beginning and final visit.

RESULTS

The analysis included a total of 118 participants (DAS/VR: 40, DAS/BF: 38, HC/VR: 40). There was no significant difference in demographic variables among the three groups. After the intervention, the DAS/VR group exhibited significant decreases in MADRS (70.0 %), PHQ-9 (64.1 %), STAI (29.5 %), and VAS (61.7 %) scores compared to the baseline (p <0.001). There were no significant differences between the effects of VR-based BF and conventional BF with a therapist. The HC group also showed significant decreases in the measures of depression and anxiety after receiving VR-based BF.

CONCLUSION

VR-based BF was effective in reducing depressive and anxiety symptoms, even for subthreshold depression and anxiety symptoms in the HC group.

Investigating the impact of gaming and spatial cognition on laparoscopic surgical skills

BACKGROUND

The purpose of this study was to examine the association between video gaming experience, spatial cognition, and laparoscopic surgical skills in a cohort of 50 medical students.

METHOD

Participants were assessed for video gaming experience, spatial cognition, and laparoscopic skills. The number of hours played per week was also recorded. Structural equation modeling was used to determine the relationship between these variables.

RESULTS

Our findings revealed that video gaming experience and spatial cognition exerted a positive influence on laparoscopic skills. Interestingly, students who excessively indulged in video games without concomitant improvements in spatial cognition experienced a negative impact on their laparoscopic skills.

CONCLUSIONS

These findings underscore the potential of video gaming as a tool for improving surgical skills, but also highlight the potential downsides of excessive gaming. The positive correlation between gaming and surgical skills suggests that video games could be integrated into surgical education. Future research should focus on identifying specific video games that effectively promote visuospatial skills as well as determining the optimal balance between gaming and traditional surgical training.

Exploring the relationship between digital gaming, language attitudes, and academic success in EFL university students

The potential of digital games in education has been widely discussed, yet there is a significant gap in the literature regarding their influence on foreign language learning, particularly in Central Europe, and using mixed-method research designs. This study aims to fill this gap by providing empirical data from a new cultural context. Using a mixed-method research design, it investigates the impact of gaming on language learning outcomes of English as a Foreign Language (EFL) university students. A total of 99 Slovak university students of English as a foreign language were selected by convenience sampling, of which 10 were chosen for qualitative interviews to triangulate the data. The results reveal a significant improvement in vocabulary knowledge and a reported increase in positive language attitudes among gamers compared to non-gamers, with no significant difference in grade point averages between the two groups. These findings highlight the potential of digital gaming to enhance vocabulary learning and foster positive attitudes towards language learning among EFL students. Recommendations for future research are provided.

Music as an Evolved Tool for Socio-Affective Fiction

The question of why music evolved has been contemplated and debated for centuries across multiple disciplines. While many theories have been posited, they still do not fully answer the question of why humans began making music. Adding to the effort to solve this mystery, we propose the socio-affective fiction (SAF) hypothesis. Humans have a unique biological need for emotion regulation strengthening. Simulated emotional situations, like dreams, can help address that need. Immersion is key for such simulations to successfully exercise people's emotions. Therefore, we propose that music evolved as a signal for SAF to increase the immersive potential of storytelling and thereby better exercise people's emotions. In this review, we outline the SAF hypothesis and present cross-disciplinary evidence.

Digital interventions to support morality: A scoping review

BACKGROUND

Morality and moral reasoning develop over the course of life, but such development may encounter obstacles. Psycho-educational interventions could be designed to improve moral reasoning and attitude towards prosociality. In the last decades, many interventions employed digital technologies ranging from multicomponent online platforms to serious games and virtual reality, making use of interactivity and immersive properties that could make moral stimuli more engaging.

AIMS

This study aimed at reviewing the literature on digital interventions to support morality and moral reasoning, carried out with subjects of all age groups.

METHODS AND RESULTS

Two electronic databases were searched with a systematic approach, and retrieved publications were scanned by authors against inclusion criteria. Twenty-three articles were reviewed. In general, the literature describes encouraging results of digital interventions to support morality. Moreover, a huge variety of morality conceptualizations emerged across various contexts (e.g., professional, school and sports) as well as various outcome measurements (e.g., change in attitudes and change in behaviour).

CONCLUSIONS

Effectiveness of digital interventions may relate to immersive and interactive simulations in particular, in that they allow participants not only to learn about moral rules and principles but also to actively exercise their own morality to make decisions. Future research may build on the present scoping review to analyse specific types of interventions' effectiveness with a meta-analytical approach.

Changes in concentration performance and alternating attention after short-term virtual reality training in E-athletes: a pilot study

In the dynamic landscape of e-sports, where intense competitive gaming demands high cognitive abilities, concentration performance and alternating attention play a pivotal role. E-sports encompass diverse genres, each requiring specific cognitive functions. Maintaining unwavering focus is crucial, as split-second decisions can determine victory. The study explores the potential of Virtual Reality (VR) training to enhance concentration performance and alternating attention, shedding light on the importance and possibilities of optimizing cognitive abilities for e-athletes. VR training emerges as a promising intervention, offering immersive environments for cognitive exercises. The study investigates the impact of VR training on concentration performance and alternating attention in amateur e-athletes, utilizing standardized tests. A randomized controlled trial with 66 participants reveals significant improvements in the VR training group, highlighting the adaptability and plasticity of cognitive processes. The findings suggest that VR training can enhance concentration abilities, providing valuable insights for e-sports and potentially extending to other fields requiring sustained attention and rapid task-switching. The study underscores the convergence of cognitive psychology, neuroscience, and VR technology, paving the way for innovative training methodologies and advancements in e-sports performance.

Video games and disability-a risk and benefit analysis

Purpose

Over the past decades, video games have become a substantial part of the entertainment industry. While ubiquitous, video game participation remains low among people with disabilities amid potential negative effects. This article analyzes the risks and benefits that video games may present to individuals with disabilities.

Methodology

In this conceptual article, we explored the literature pertaining to video games and disability. To better understand the impact of video games on individuals with disabilities, we focused on the unique features of video games through the lens of the Self-Determination Theory.

Findings

Our findings show that individuals with disabilities are most at risk from excessive video game use, leading to increased aggression, sedentary behavior, and negative impact on academic performance. Identified benefits include promoting physical rehabilitation and psychological well-being, improving cognitive abilities and emotional regulation, and utility in promoting exercises, and managing chronic pain.

Originality

This article presents a number of strategies and resources to help guide individuals with disabilities, educators, practitioners, and researchers in maximizing the benefits of video games while controlling the risks.

Exploring the Impact of Gaming Habits on Sleep Patterns Among Young Adults in Saudi Arabia: A Cross-Sectional Study

Background Video gaming is increasingly popular among young adults, potentially affecting health and daily routines, especially sleep patterns. In Al-Ahsa, Saudi Arabia, the impact of video gaming on sleep and health among young adults is not well understood. This study aims to explore this relationship, focusing on how video gaming habits influence sleep patterns and associated health outcomes. Methods This cross-sectional survey utilized an adapted online questionnaire to gather data on demographics, video gaming habits, sleep patterns, and body mass index from young adults in Al-Ahsa. Statistical analysis, including descriptive statistics, chi-square tests, and multivariable logistic regression, was applied to examine the associations between video gaming habits and sleep sufficiency. Results The study included 302 participants, including 165 (54.6%) females. A majority reported playing video games for less than one hour daily (36.1%), with 82.5% preferring online gaming. Notably, 54.3% of participants slept more than six hours nightly, yet challenges with sleep initiation were evident, as 48.0% went to bed past midnight. Multivariable logistic regression highlighted significant factors affecting sleep sufficiency: participants who played games after completing tasks had 80% lower odds of sleep insufficiency compared to those who played before tasks. Overweight participants were found to be 7.7 times more likely to experience sleep insufficiency compared to their underweight peers. Conclusion The study underscores a complex relationship between video gaming habits and sleep patterns among young adults in Al-Ahsa, with significant health implications. It suggests the necessity for interventions promoting balanced gaming habits and improved sleep hygiene to mitigate adverse health outcomes.

Tablet-Based Puzzle Game Intervention for Cognitive Function and Well-Being in Healthy Adults: Pilot Feasibility Randomized Controlled Trial

Background

Promoting cognitive health is key to maintaining cognitive and everyday functions and preventing the risk of cognitive impairment or dementia. Existing scientific evidence shows the benefits of various training modalities on cognition. One way to promote cognitive health is through engagement in cognitive activities (eg, board and video games).

Objective

This study aims to investigate the benefits of dynamic adaptive casual puzzle games on cognitive function and well-being in healthy adults and older people.

Methods

A total of 12 adults and older people (female participants: n=6; mean age 58.92, SD 10.28 years; range 46-75 years) were included in this pilot randomized controlled trial. This study used a crossover design with two phases (8 weeks each) and three measurement waves (pretest, midtest, and posttest). The participants were randomly allocated either to the control or experimental group. In the control group, participants read newspapers between the pre- and midtest, then switched to cognitive training with puzzle games. In the experimental group, the interventions were reversed. Baseline measurements (pretest) were collected before the intervention. The interventions were delivered on tablet computers and took place unsupervised at participants' homes.

Results

The outcome measures included global cognitive function, higher cognitive function, and emotional well-being at 3 time points (pretest, midtest, and posttest) using standardized neuropsychological tests. The participants showed improvements in their visual attention and visuospatial measures after the puzzle game intervention.

Conclusions

The study showed that digital games are a feasible way to train cognition in healthy adults and older people. The algorithm-based dynamic adaption allows accommodations for persons with different cognitive levels of skill. The results of the study will guide future prevention efforts and trials in high-risk populations.

A bibliometric analysis and literature review on emotional skills

The content, management, and implementation of social skills have been developed since the end of the 20th century as a model of capabilities. Thus, as human beings develop and train their basic cognitive and perceptual-motor functions, they increase their ability to solve and cope with difficulties. This article aims to present a bibliometric and systematic review of social skills, using query sources in databases such as Web of Science (WoS) and Scopus between the years 2000 and 2022, with platforms such as Bibliometrix and Gephi. This search yielded a total of 233 records in WoS and 250 records in Scopus that were merged and, after eliminating 143 duplicate data, were consolidated into 340 records that enclose the academic production of 20 years. Through scientific mapping, the main authors, journals, and countries in this field were determined; similarly, the most relevant studies were classified into three categories, namely, classic, structural, and perspectives, which were represented by means of the metaphor of the tree of science. In addition, a program for further studies was planned, such as in-depth qualitative research measuring observationally and directly taking into account emotional expressiveness, emotional understanding, emotion regulation, and behavior, and the impact of social skills training on social problem-solving. Finally, another important aspect to mention is that this research work is useful for the scientific academic community in many areas of knowledge such as psychology, education, and managers of educational institutions.

Digital game-based interventions for cognitive training in healthy adults and adults with cognitive impairment: protocol for a two-part systematic review and meta-analysis

INTRODUCTION

Digital game-based training interventions are scalable solutions that may improve cognitive function for many populations. This protocol for a two-part review aims to synthesise the effectiveness and key features of digital game-based interventions for cognitive training in healthy adults across the life span and adults with cognitive impairment, to update current knowledge and impact the development of future interventions for different adult subpopulations.

METHODS AND ANALYSIS

This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. A systematic search was performed in PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PsycINFO and IEEE Explore on 31 July 2022 for relevant literature published in English from the previous 5 years. Experimental, observational, exploratory, correlational, qualitative and mixed methods studies will be eligible if they report at least one cognitive function outcome and include a digital game-based intervention intended to improve cognitive function. Reviews will be excluded but retained to search their reference lists for other relevant studies. All screening will be done by at least two independent reviewers. The appropriate Joanna Briggs Institute Critical Appraisal Tool, according to the study design, will be applied to perform the risk of bias assessment. Outcomes related to cognitive function and digital game-based intervention features will be extracted. Results will be categorised by adult life span stages in the healthy adult population for part 1 and by neurological disorder in part 2. Extracted data will be analysed quantitatively and qualitatively, according to study type. If a group of sufficiently comparable studies is identified, we will perform a meta-analysis applying the random effects model with consideration of the I² statistic.

ETHICS AND DISSEMINATION

Ethics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42022351265.

Time to Think "Meta": A Critical Viewpoint on the Risks and Benefits of Virtual Worlds for Mental Health

The metaverse is gaining traction in the general population and has become a priority of the technological industry. Defined as persistent virtual worlds that exist in virtual or augmented reality, the metaverse proposes to afford a range of activities of daily life, from socializing and relaxing to gaming, shopping, and working. Because of its scope, its projected popularity, and its immersivity, the metaverse may pose unique opportunities and risks for mental health. In this viewpoint article, we integrate existing evidence on the mental health impacts of video games, social media, and virtual reality to anticipate how the metaverse could influence mental health. We outline 2 categories of mechanisms related to mental health: experiences or behaviors afforded by the metaverse and experiences or behaviors displaced by it. The metaverse may benefit mental health by affording control (over an avatar and its virtual environment), cognitive activation, physical activity, social connections, and a sense of autonomy and competence. However, repetitive rewarding experiences may lead to addiction-like behaviors, and high engagement in virtual worlds may facilitate and perpetuate the avoidance of challenges in the offline environment. Further, time spent in virtual worlds may displace (reduce) other determinants of mental health, such as sleep rhythms and offline social capital. Importantly, individuals will differ in their uses of and psychological responses to the metaverse, resulting in heterogeneous impacts on their mental health. Their technological motivations, developmental stage, sociodemographic context, and prior mental health problems are some of the factors that may modify and frame the positive and negative effects of the metaverse on their mental health. In conclusion, as the metaverse is being scaffolded by the industry and by its users, there is a window of opportunity for researchers, clinicians, and people with lived experience to coproduce knowledge on its possible impacts on mental health and illness, with the hope of influencing policy-making, technological development, and counseling of patients.

Effects of Low-Immersive vs. High-Immersive Exercise Environment on Postural Stability and Reaction and Motor Time of Healthy Young Adults

(1) Background: Many young adults spend their time playing games and watching television. This type of spending time should be used effectively, so it's worth adding exercise and immersion to them. Bearing in mind that the video games and physical exercise also improve postural stability, motor time (MT) and reaction time (RT), it is worth reaching for new technologies with immersion that are widely available and can be used, for example, as a remote intervention. This study aimed to compare the effects of a low vs. high-immersive exercise environment on postural stability, RT and MT in young adults. (2) Methods: Ninety-three participants were randomly divided into a control group (CG; n = 48) and experimental group (EG; n = 45). The CG exercised according to the Tabata self-made video display on a television set, and the EG exercised according to the Audio Trip exergame. In addition to the postural stability, RT and MT, we monitored the heart rate, breath rate and energy expenditure for safety reasons and to note any differences. (3) Results: Significant differences were observed for both groups in RT (F(2.182) = 3.14, p = 0.046, η² = 0.03) and MT (F(2.182) = 3.07, p = 0.049, η² = 0.03) and in postural stability in eyes closed (EC): F(2.182) = 3.66, p = 0.028, η² = 0.04 and eyes open in one leg (EO-OL): F(2.182) = 5.814, p = 0.04, η² = 0.07. (4) Conclusions: The inclusion of a higher immersion produces greater improvements in RT, MT. Additionally, after a low-immersive exercise environment, participants have higher center of pressure (COP) path length values with EC and EO-OL tests, which testifies to less postural stability. Regarding COP trajectory, a smaller area surface means better performance for high-immersive participants after 30 min of exercise.

Neuroanatomical predictors of complex skill acquisition during video game training

It is known that the outcomes of complex video game (VG) skill acquisition are correlated with individual differences in demographic and behavioral variables, such as age, intelligence and visual attention. However, empirical studies of the relationship between neuroanatomical features and success in VG training have been few and far between. The present review summarizes existing literature on gray matter (GM) and white matter correlates of complex VG skill acquisition as well as explores its relationship with neuroplasticity. In particular, since age can be an important factor in the acquisition of new cognitive skills, we present studies that compare different age groups (young and old adults). Our review reveals that GM in subcortical brain areas predicts complex VG learning outcomes in young subjects, whereas in older subjects the same is true of cortical frontal areas. This may be linked to age-related compensatory mechanisms in the frontal areas, as proposed by The Scaffolding Theory of Aging and Cognition. In the case of plasticity, there is no such relationship – in the group of younger and older adults there are changes after training in both cortical and subcortical areas. We also summarize best practices in research on predictors of VG training performance and outline promising areas of research in the study of complex video game skill acquisition.

Virtual/Augmented Reality for Rehabilitation Applications Using Electromyography as Control/Biofeedback: Systematic Literature Review

Virtual reality (VR) and augmented reality (AR) are engaging interfaces that can be of benefit for rehabilitation therapy. However, they are still not widely used, and the use of surface electromyography (sEMG) signals is not established for them. Our goal is to explore whether there is a standardized protocol towards therapeutic applications since there are not many methodological reviews that focus on sEMG control/feedback. A systematic literature review using the PRISMA (preferred reporting items for systematic reviews and meta-analyses) methodology is conducted. A Boolean search in databases was performed applying inclusion/exclusion criteria; articles older than 5 years and repeated were excluded. A total of 393 articles were selected for screening, of which 66.15% were excluded, 131 records were eligible, 69.46% use neither VR/AR interfaces nor sEMG control; 40 articles remained. Categories are, application: neurological motor rehabilitation (70%), prosthesis training (30%); processing algorithm: artificial intelligence (40%), direct control (20%); hardware: Myo Armband (22.5%), Delsys (10%), proprietary (17.5%); VR/AR interface: training scene model (25%), videogame (47.5%), first-person (20%). Finally, applications are focused on motor neurorehabilitation after stroke/amputation; however, there is no consensus regarding signal processing or classification criteria. Future work should deal with proposing guidelines to standardize these technologies for their adoption in clinical practice.

Electronic Sports Sustainable Development of Probing into Digital Games, Teenage Domestication, and Mutual Construction

The purposes is to investigate how digital games affect teenagers’ physical and mental sustainable development and analyze the interactions and communications between teenagers and digital games using the domestication theory. (1) Background. A healthy mutual-domestication relationship is needed between teenagers and digital games. Digital games are expected to play a positive and decisive role, while parents and teachers should master the correct game literacy. (2) Methods. This study described the mutual domestication between them using interviews and questionnaires. (3) Results. Results demonstrate that digital games entering teenagers’ lives are domesticated and marked with unique attributes caused by teenagers’ different habits, during which parents and teachers are critical. In turn, digital games tame teenagers lifestyles and habits, becoming a popular social media among them. Spending excessive time and energy, teenagers will be addicted to digital games. (4) Conclusions. It can provide a reference for investigating the connection between teenagers and digital games.

Families Playing Animal Crossing Together: Coping With Video Games During the COVID-19 Pandemic

The COVID-19 pandemic was stressful for everyone, particularly for families who had to supervise and support children, facilitate remote schooling, and manage work and home life. We consider how families coped with pandemic-related stress using the video game Animal Crossing: New Horizons. Combining a family coping framework with theorizing about media as a coping tool, this interview study of 27 families (33 parents and 37 children) found that parents and children individual coped with pandemic-related stress with media. Parents engaged in protective buffering of their children with media, taking on individual responsibility to cope with a collective problem. Families engaged in communal coping, whereby media helped the family cope with a collective problem, taking on shared ownership and responsibility. We provide evidence for video games as coping tools, but with the novel consideration of family coping with media.

Analysis of the coexistence of gaming and viewing activities in Twitch users and their relationship with pathological gaming: a multilayer perceptron approach

The enormous expansion of the video game sector, driven by the emergence of live video game streaming platforms and the professionalisation of this hobby through e-sports, has spurred interest in research on the relationships with potential adverse effects derived from cumulative use. This study explores the co-occurrence of the consumption and viewing of video games, based on an analysis of the motivations for using these services, the perceived positive uses, and the gamer profile. To that end, a multilayer perceptron artificial neural network is developed and tested on a sample of 970 video game users. The results show that the variables with a significant influence on pathological gaming are the motivation of a sense of belonging to the different platforms, as well as the positive uses relating to making friends and the possibility of making this hobby a profession. Furthermore, the individual effects of each of the variables have been estimated. The results indicate that the social component linked to the positive perception of making new friends and the self-perceived level as a gamer have been identified as possible predictors, when it comes to a clinical assessment of the adverse effects. Conversely, the variables age and following specific streamers are found to play a role in reducing potential negative effects.

Sleep in Habitual Adult Video Gamers: A Systematic Review

Video gaming is a popular, globally recognized phenomenon, played recreationally or competitively as esports. Gaming is a typically sedentary nighttime activity; therefore, the potential to impact sleep and health is high. Furthermore, there are limited studies on adult gamers, who represent the majority demographic in esports. This review examines evidence describing sleep in habitual adult gamers to understand the associated risk for cardiometabolic disease or the benefits to gaming performance. Three electronic databases (PubMed, Scopus, ISI Web of Science) were searched for peer-reviewed articles published between January 2000 - April 2020. Twelve studies reporting on sleep in habitual adult gamers were included. A narrative synthesis was employed to report results, owing to high levels of heterogeneity across the included studies. Gamers with higher gaming addiction scores were more likely to have shorter, poorer quality sleep and greater daytime sleepiness and insomnia scores than gamers with lower gaming addiction scores and non-gamers. In addition, high-volume gamers were more likely to have worsened sleep quantity and quality, with delayed sleep timing and increased prevalence of insomnia. Despite limitations in the design of the included studies, excessive gaming is broadly associated with worsened sleep parameters. Noteworthy is the lack of studies investigating cardiometabolic health in gamers. Future work should explore the relative contribution and associated risk that various games, genres, and timing of gaming activities have on sleep, physical and mental health, particularly in vulnerable gaming cohorts engaged with contemporary forms of gaming and esports.

Subtyping treatment-seeking gaming disorder patients

BACKGROUND AND AIMS

Gaming Disorder (GD) is characterized by a pattern of persistent and uncontrolled gaming behavior that causes a marked impairment in important areas of functioning. The evolution of the worldwide incidence of this disorder warrants further studies focused on examining the existence of different subtypes within clinical samples, in order to tailor treatment. This study explored the existence of different profiles of patients seeking treatment for GD through a data-driven approach.

METHODS

The sample included n = 107 patients receiving treatment for GD (92% men and 8% women) ranging between 14 and 60 years old (mean age = 24.1, SD = 10). A two-step clustering analysis approach explored the existence of different underlying GD profiles based on a broad set of indicators, including sociodemographic features, clinical course of the condition (e.g., onset or evolution), psychopathological symptoms, and personality traits.

RESULTS

Two GD profiles emerged. The first cluster grouped together patients who presented with a lower psychological impact (n = 72, 66.1%), whereas the second cluster comprised patients with a higher psychological impact (n = 35, 32.7%). Cluster comparisons revealed that those patients presenting the higher impact were older, with a later onset of pathological gaming patterns, and more pronounced psychopathological symptoms and dysfunctional personality profiles.

CONCLUSIONS

GD severity is influenced by specific demographic, clinical, and psychopathological factors. The identification of two separate profiles provides empirical evidence that contributes to the conceptualization of this disorder, as well as to the development of reliable and valid screening tools and effective intervention plans focused on the precise characteristics of the treatment-seeking patients.

The effectiveness of serious games in improving memory among the elderly with cognitive impairment: A systematic review and meta-analysis (Preprint)

Background

Objective

Methods

Results

Conclusions

Interventions with Serious Games and Entertainment Games in Autism Spectrum Disorder: A Systematic Review

The use of serious games and entertainment games was compared as adjuvant tools for intervention in Autism Spectrum Disorder (ASD). A comprehensive search was performed in the MEDLINE, PsycINFO, Scopus, and Web of Science databases. From 295 studies, 53 studies were selected and included in this review. Overall, studies showed improvement after intervention, regardless of the type of video games, mostly for social skills and behavior. However, these changes should be regarded with caution, as they are limited to the tests applied. Furthermore, neither the entertainment nor the serious approach had a therapeutic impact on emotional resilience, representing the current gap in the field. Thus, even considering the limitations, our study is important because it shows that both categories have strengths.

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review

BACKGROUND

Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games.

OBJECTIVE

The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play).

METHODS

A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")].

RESULTS

A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety.

CONCLUSIONS

Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety.

TRIAL REGISTRATION

International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.

The role of individual differences in attentional blink phenomenon and real-time-strategy game proficiency

The impact of action videogame playing on cognitive functioning is the subject of debate among scientists, with many studies showing superior performance of players relative to non-players on a number of cognitive tasks. Moreover, the exact role of individual differences in the observed effects is still largely unknown. In our Event-Related Potential (ERP) study we investigated whether training in a Real Time Strategy (RTS) video game StarCraft II can influence the ability to deploy visual attention measured by the Attentional Blink (AB) task. We also asked whether individual differences in a psychophysiological response in the AB task predict the effectiveness of the video game training. Forty-three participants (non-players) were recruited to the experiment. Participants were randomly assigned to either experimental (Variable environment) or active control (Fixed environment) group, which differed in the type of training received. Training consisted of 30 h of playing the StarCraft II game. Participants took part in two EEG sessions (pre- and post-training) during which they performed the AB task. Our results indicate that both groups improved their performance in the AB task in the post-training session. What is more, in the experimental group the strength of the amplitude of the P300 ERP component (which is related to a conscious visual perception) in the pre training session appeared to be predictive of the level of achievement in the game. In the case of the active control group in-game behaviour appeared to be predictive of a training-related improvement in the AB task. Our results suggest that differences in the neurophysiological response might be treated as a marker of future success in video game acquisition, especially in a more demanding game environment.

Exploring EEG Characteristics to Identify Emotional Reactions under Videogame Scenarios

In this article we present the study of electroencephalography (EEG) traits for emotion recognition process using a videogame as a stimuli tool, and considering two different kind of information related to emotions: arousal–valence self-assesses answers from participants, and game events that represented positive and negative emotional experiences under the videogame context. We performed a statistical analysis using Spearman’s correlation between the EEG traits and the emotional information. We found that EEG traits had strong correlation with arousal and valence scores; also, common EEG traits with strong correlations, belonged to the theta band of the central channels. Then, we implemented a regression algorithm with feature selection to predict arousal and valence scores using EEG traits. We achieved better result for arousal regression, than for valence regression. EEG traits selected for arousal and valence regression belonged to time domain (standard deviation, complexity, mobility, kurtosis, skewness), and frequency domain (power spectral density—PDS, and differential entropy—DE from theta, alpha, beta, gamma, and all EEG frequency spectrum). Addressing game events, we found that EEG traits related with the theta, alpha and beta band had strong correlations. In addition, distinctive event-related potentials where identified in the presence of both types of game events. Finally, we implemented a classification algorithm to discriminate between positive and negative events using EEG traits to identify emotional information. We obtained good classification performance using only two traits related with frequency domain on the theta band and on the full EEG spectrum.

Video Games for the Treatment of Autism Spectrum Disorder: A Systematic Review

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.

Can Worried Parents Predict Effects of Video Games on Their Children? A Case-Control Study of Cognitive Abilities, Addiction Indicators and Wellbeing

Many parents worry over their children’s gaming habits, but to what extent do such worries match any detrimental effects of excessive gaming? We attempted to answer this question by comparing children of highly concerned parents with other adolescents of the same age. A cohort of parents who identified as highly concerned over their children’s video game habits were recruited for a public study in collaboration with a national television network. Using an online experimental platform in conjunction with surveys of parents’ beliefs and attitudes, we compared their children to age-matched peers in an exploratory case-control study. The scores of children with highly concerned parents on tests of cognitive control (cued task-switching and Iowa Gambling Task) and psychological wellbeing (WHO-5) were statistically similar to controls, suggesting no selective cognitive or psychological detriments from gaming or otherwise in the cases with concerned parents. The case group, however, did spend more time gaming, and scored higher than controls on problem gaming indicators (Gaming Addiction Scale), which also correlated negatively with wellbeing. Within the case group, wellbeing effects seemed mainly to consist in issues of relaxation and sleep, and related to gaming addiction indicators of playing to forget real-world problems, and the feeling of neglecting non-gaming activities. Where most results of research staged for TV never get published, making it difficult to interpret both methods and results, this paper describes findings and participant recruitment in detail. The relationship between parental concern and children’s gaming is discussed, as is the merits and challenges of research conducted with media, such as TV programs and their recruited on-screen participants.

How does a (Smart) Age-Friendly Ecosystem Look in a Post-Pandemic Society?

COVID-19 has impacted not only the health of citizens, but also the various factors that make up our society, living environments, and ecosystems. This pandemic has shown that future living will need to be agile and flexible to adapt to the various changes in needs of societal populations. Digital technology has played an integral role during COVID-19, assisting various sectors of the community, and demonstrating that smart cities can provide opportunities to respond to many future societal challenges. In the decades ahead, the rise in aging populations will be one of these challenges, and one in which the needs and requirements between demographic cohorts will vary greatly. Although we need to create future smart age-friendly ecosystems to meet these needs, technology still does not feature in the WHO eight domains of an age-friendly city. This paper extends upon Marston and van Hoof's 'Smart Age-friendly Ecosystem' (SAfE) framework, and explores how digital technology, design hacking, and research approaches can be used to understand a smart age-friendly ecosystem in a post-pandemic society. By exploring a series of case studies and using real-life scenarios from the standpoint of COVID-19, we propose the 'Concept of Age-friendly Smart Ecologies (CASE)' framework. We provide an insight into a myriad of contemporary multi-disciplinary research, which are capable to initiate discussions and bring various actors together with a positive impact on future planning and development of age-friendly ecosystems. The strengths and limitations of this framework are outlined, with advantages evident in the opportunity for towns, regions/counties, provinces, and states to take an agile approach and work together in adopting and implement improvements for the greater benefits of residents and citizens.

Does mathematics training lead to better logical thinking and reasoning? A cross-sectional assessment from students to professors

Mathematics is often promoted as endowing those who study it with transferable skills such as an ability to think logically and critically or to have improved investigative skills, resourcefulness and creativity in problem solving. However, there is scant evidence to back up such claims. This project tested participants with increasing levels of mathematics training on 11 well-studied rational and logical reasoning tasks aggregated from various psychological studies. These tasks, that included the Cognitive Reflection Test and the Wason Selection Task, are of particular interest as they have typically and reliably eluded participants in all studies, and results have been uncorrelated with general intelligence, education levels and other demographic information. The results in this study revealed that in general the greater the mathematics training of the participant, the more tasks were completed correctly, and that performance on some tasks was also associated with performance on others not traditionally associated. A ceiling effect also emerged. The work is deconstructed from the viewpoint of adding to the platform from which to approach the greater, and more scientifically elusive, question: are any skills associated with mathematics training innate or do they arise from skills transfer?

The impact of the digital revolution on human brain and behavior: where do we stand?

This overview will outline the current results of neuroscience research on the possible effects of digital media use on the human brain, cognition, and behavior. This is of importance due to the significant amount of time that individuals spend using digital media. Despite several positive aspects of digital media, which include the capability to effortlessly communicate with peers, even over a long distance, and their being used as training tools for students and the elderly, detrimental effects on our brains and minds have also been suggested. Neurological consequences have been observed related to internet/gaming addiction, language development, and processing of emotional signals. However, given that much of the neuroscientific research conducted up to now relies solely on self-reported parameters to assess social media usage, it is argued that neuroscientists need to include datasets with higher precision in terms of what is done on screens, for how long, and at what age.
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When and How Video Games Can Be Good: A Review of the Positive Effects of Video Games on Well-Being

Video games are a source of entertainment for a wide population and have varied effects on well-being. The purpose of this article is to comprehensively examine game-play research to identify the factors that contribute to these disparate well-being outcomes and to highlight the potential positive effects. On the basis of existing literature, we argue that the effects of gaming on well-being are moderated by other variables, such as motivations for gaming and video-game characteristics. Specifically, the inclusion of social activity can benefit prosocial behaviors and affect the relationship between violent video games and aggression that some studies have demonstrated. Moreover, the research on the relationship between violent video games and aggression depends greatly on individual and sociocontextual variables outside of game play. The inclusion of physical activity in games can provide an improvement in physical health with high levels of enjoyment, potentially increasing adherence rates. Overall, following our review, we determined that the effects of gaming on well-being are moderated by and depend on the motivation for gaming, outside variables, the presence of violence, social interaction, and physical activity. Thus, we argue that there is potential for an "optimal gaming profile" that can be used in the future for both academic- and industry-related research.

Virtual Reality Games and the Role of Body Involvement in Enhancing Positive Emotions and Decreasing Anxiety: Within-Subjects Pilot Study

Background

In the last few years, the introduction of immersive technologies, especially virtual reality, into the gaming market has dramatically altered the traditional concept of video games. Given the unique features of virtual reality in terms of interaction and its ability to completely immerse the individual into the game, this technology should increase the propensity for video games to effectively elicit positive emotions and decrease negative emotions and anxiety in the players. However, to date, few studies have investigated the ability of virtual reality games to induce positive emotions, and the possible effect of this new type of video game in diminishing negative emotions and anxiety has not yet been tested. Furthermore, given the critical role of body movement in individuals’ well-being and in emotional responses to video games, it seems critical to investigate how body involvement can be exploited to modulate the psychological benefits of virtual reality games in terms of enhancing players’ positive emotions and decreasing negative emotions and anxiety.

Objective

This within-subjects study aimed to explore the ability of commercial virtual reality games to induce positive emotions and diminish negative emotions and state anxiety of the players, investigating the effects of the level of body involvement requested by the game (ie, high vs low).

Methods

A total of 36 young adults played a low body-involvement (ie, Fruit Ninja VR) and a high body-involvement (ie, Audioshield) video game in virtual reality. The Visual Analogue Scale (VAS) and the State-Trait Anxiety Inventory, Form-Y1 (STAI-Y1) were used to assess positive and negative emotions and state anxiety.

Results

Results of the generalized linear model (GLM) for repeated-measures multivariate analysis of variance (MANOVA) revealed a statistically significant increase in the intensity of happiness (P<.001) and surprise (P=.003) and, in parallel, a significant decrease in fear (P=.01) and sadness (P<.001) reported by the users. Regarding the ability to improve anxiety in the players, the results showed a significant decrease in perceived state anxiety after game play, assessed with both the STAI-Y1 (P=.003) and the VAS-anxiety (P=.002). Finally, the results of the GLM MANOVA showed a greater efficacy of the high body-involvement game (ie, Audioshield) compared to the low body-involvement game (ie, Fruit Ninja VR), both for eliciting positive emotions (happiness, P<.001; and surprise, P=.01) and in reducing negative emotions (fear, P=.05; and sadness, P=.05) and state anxiety, as measured by the STAI-Y1 (P=.05).

Conclusions

The two main principal findings of this study are as follows: (1) virtual reality video games appear to be effective tools to elicit positive emotions and to decrease negative emotions and state anxiety in individuals and (2) the level of body involvement of the virtual video game has an important effect in determining the ability of the game to improve positive emotions and decrease negative emotions and state anxiety of the players.

Effects of computer gaming on cognition, brain structure, and function: a critical reflection on existing literature

Video gaming as a popular form of leisure activity and its effect on cognition, brain function, and structure has come into focus in the field of neuroscience. Visuospatial cognition and attention seem to benefit the most, whereas for executive functions, memory, and general cognition, the results are contradictory. The particular characteristics of video games driving these effects remain poorly understood. We critically discuss major challenges for the existing research, namely, the lack of precise definitions of video gaming, the lack of distinct choice of cognitive ability under study, and the lack of standardized study protocols. Less research exists on neural changes in addition to cognitive changes due to video gaming. Existing studies reveal evidence for the involvement of similar brain regions in functional and structural changes. There seems to be a predominance in the hippocampal, prefrontal, and parietal brain regions; however, studies differ immensely, which makes a meta-analytic interpretation vulnerable. We conclude that theoretical work is urgently needed.


Comparison of Behavioral Changes and Brain Activity between Adolescents with Internet Gaming Disorder and Student Pro-Gamers

While pro-gamers play according to defined living habits and planned schedules, adolescents with internet gaming disorder (IGD) exhibit irregular lifestyles and unregulated impulsive gaming behavior. Fourteen IGD adolescents and 12 pro-gaming students participated in this study. At baseline and after one year, demographic data, the Child Behavior Check List (CBCL), depressed mood, anxiety, and resting-state functional magnetic resonance imaging were assessed. Over the year, IGD adolescents played games as per their usual schedule, while pro-gamer students played according to their school’s team schedule. After one year, the pro-gamers’ scores had decreased in the CBCL-total (total problematic behaviors), CBCL-externalizing (under-controlled behavior, like impulsivity and aggression), and CBCL-internalizing (over-controlled behavior like depression and anxiety) compared to those of the IGD adolescents. Both groups displayed increased brain activity in the parietal lobe (a component of the attention network) over the years. Compared to pro-gamers, IGD adolescents showed higher brain activity within the left orbitofrontal cortex. Brain activity within the orbitofrontal cortex was associated with CBCL-externalizing scores. These results suggest that gaming had increased the attention network’s brain activity, but a well-organized support system could lead to different results, in terms of improved behaviors and suppressing brain activity within the orbitofrontal cortex.

Assessing Cognition Outside of the Clinic: Smartphones and Sensors for Cognitive Assessment Across Diverse Psychiatric Disorders

Traditionally, the assessment of cognition and the administration of cognitive therapies has been performed in the clinic, but with modern technology, this clinic-centric view is changing. This article explores the landscape of digital devices used to measure cognition in settings outside the clinic. These devices range in mobility from user-friendly mobile devices to setting-specific devices able to provide powerful, robust cognitive therapy and living assistance in the comfort of a patient's home. Although these methods remain in early stages of developmental, initial studies suggest they may prove useful in treating patients with serious mental illnesses in a widespread clinical setting.

Can Videogames Be Used to Promote Emotional Intelligence in Teenagers? Results from EmotivaMente, a School Program

Objective: To carry out and investigate the effectiveness of an emotional intelligence (EI) training based on the EI ability model, using videogames as experience-based learning tools to increase EI abilities in adolescents. Materials and Methods: A pre-/post-test/follow-up quasi-experimental design was used with an experimental and a control group (121 adolescents, 15.7% boys, mean age of 14.1 years). The training called "EmotivaMente" consisted of eight sessions lasting 1.5 hours each, conducted with six first-year classes of two Italian senior high schools. Data on emotional competences were collected at baseline, at the end of the training and 3 months later. Data were analyzed by repeated measures analysis of variance. Results: Students who participated in the EI training reported an improvement in the evaluation and expression of emotions in relation to the self (own emotions) compared with the control group, immediately after the training, but this difference did not persist at the follow-up (3 months later). Furthermore, EmotivaMente found an increase in the use of cognitive revaluation as a strategy of emotion regulation in the experimental group over time. Conclusions: EmotivaMente helped adolescents to improve emotional skills. Results confirmed that videogames can be useful to promote EI in adolescents at school, if integrated with a guided and assisted framework. Implication of the findings and recommendations for future research are made.

Newly Developed TV-Based Cognitive Training Games Improve Car Driving Skills, Cognitive Functions, and Mood in Healthy Older Adults: Evidence From a Randomized Controlled Trial

Background: Cognitive training in a laboratory improves car driving skills of older car drivers. However, it remains unclear whether other types of cognitive training at home have beneficial effects on driving skills. Using our developed cognitive training games that can be played on a television with a set-top box in a person's home, we investigated the effects of a 6-week cognitive training program on driving skills, which included on-road evaluation (primary outcome), and cognitive functions and emotional states (secondary outcome) in older people. Methods: In this double-blinded randomized control trial (RCT), 60 older licensed drivers were randomly assigned into one of the two groups: a cognitive training game for car driving (CTCD) group and an active control cognitive training game (ACT) group. Participants in the CTCD group played the CTCD (processing speed, dual attention, and speed prediction) for 20 min in five sessions per week for 6 weeks. Participants in the ACT group played the ACT (selecting the larger number; selecting a number from largest to smallest; play a game of rock, article, scissors) for 20 min in five sessions per week for 6 weeks. We measured driving skills, various cognitive functions, and emotional states before and after the 6-week intervention period. Results: Our main results showed that compared to the ACT group, the CTCD group demonstrated improved driving skills (adjusted p = 0.034). Moreover, the CTCD group demonstrated improved inhibition (stroop, adjusted p = 0.042: reverse Stroop, adjusted p = 0.043) and processing speed performance symbol search (SS), adjusted p = 0.049; digit symbol coding (adjusted p = 0.047), compared to the ACT group. The CTCD group scored higher on vigor-activity mood (adjusted p = 0.041) as measured using the Profile of Mood State. Discussion: This randomized controlled trial provides scientific evidence for the benefits of the 6-week CTCD program on driving skills and cognitive functions, such as processing speed, inhibition, and vigor-activity mood, in healthy older people. Our results suggest that cognitive training is useful to improve the driving skills of older adults. Trial registration: This trial was registered at The University Hospital Medical Information Network Clinical Trials Registry (UMIN 000029769). Registered 31 October 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034010.