In everyday decision-making, individuals make trade-offs between short-term and long-term benefits or costs. Depending on many factors, individuals may choose to wait for larger delayed reward, yet ...in other situations they may prefer the smaller, immediate reward. In addition to within-subject variation in the short-term versus long-term reward trade-off, there are also interindividual differences in delay discounting (DD), which have been shown to be quite stable. The extent to which individuals discount the value of delayed rewards turns out to be associated with important health and disorder-related outcomes: the more discounting, the more unhealthy or problematic choices. This has led to the hypothesis that DD can be conceptualized as trans-disease process. The current systematic review presents an overview of behavioral trainings and manipulations that have been developed to reduce DD in human participants aged 12 years or older. Manipulation studies mostly contain one session and measure DD directly after the manipulation. Training studies add a multiple session training component that is not per se related to DD, in between two DD task measurements. Ninety-eight studies (151 experiments) were identified that tested behavioral trainings and manipulations to decrease DD. Overall, results indicated that DD can be decreased, showing that DD is profoundly context dependent and changeable. Most promising avenues to pursue in future research seem to be acceptance-based/mindfulness-based trainings, and even more so manipulations involving a future orientation. Limitations and recommendations are discussed to identify the mechanistic processes that allow for changes in discount rate and behavior accordingly.
Successful emotion regulation (ER) is a central aspect of psychosocial functioning and mental health and is thought to improve and be refined in adolescence. Past research on ER has mainly focused on ...one-time measurements of habitual ER. Linking regulatory strategies to emotions in daily lives is key to understanding adolescents’ emotional lives. Using an Experience Sampling Method with 78 adolescents (Mage = 13.91, SDage = .95, 66% girls), we investigated the use, selection, and success in down-regulating negative emotions of eight ER strategies across 44 assessments. Acceptance was the strategy employed most often followed by problem-solving, rumination, distraction, avoidance, reappraisal, social support, and suppression. Interestingly, negativity of the event influenced the use of ER strategies: With low intensity negative emotions, acceptance was more likely to be used, and with high intensity negative emotions, suppression, problem-solving, distraction, avoidance, social support, and rumination were more likely to be used. With regard to success, multilevel models revealed that problem-solving, reappraisal, and acceptance were more successful in down-regulating negative emotions than rumination. Further, among girls, no relations between the momentary use of ER strategies and depressive symptoms was found. Among boys, a negative relation between acceptance and depressive symptoms emerged. Results from this study suggest that there is a reciprocal relationship between the intensity of negative emotions and ER strategies and that gender differences may exist. Taken together, this study showed which ER strategies are used by a healthy adolescent sample, and these results are discussed with regard to their theoretical and practical importance.
Smoking is a major cause of worldwide morbidity and mortality. Almost no evidence-based intervention programs are available to help youth quit smoking. We argue that ineffective targeting of peer ...influence and engagement difficulties are significant barriers to successful youth smoking cessation. To address these barriers, we developed the mobile game intervention HitnRun. A two-armed randomized controlled trial (RCT; n = 144) was conducted and young smokers (Mage = 19.39; SDage = 2.52) were randomly assigned to either play HitnRun or read a psychoeducational brochure. Prior to, directly following the intervention period, and after three-month follow-up, weekly smoking behavior, abstinence rates, intervention dose, and peer- and engagement-related factors were assessed. Results indicated similar reductions in weekly smoking levels and similar abstinence rates for both groups. Yet, we found a dose effect with HitnRun only: The longer participants played HitnRun, the lower their weekly smoking levels were. In the brochure group, a higher dose was related to higher weekly smoking levels at all measurement moments. Exploratory analyses showed the most powerful effects of HitnRun for participants who connected with and were engaged by the intervention. Future work should build on the promising potential of HitnRun by increasing personalization efforts and strengthening peer influence components.
Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138) was conducted ...to test the effectiveness of a biofeedback video game (Dojo) for adolescents with elevated levels of anxiety. Adolescents (11-15 years old) were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape). Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the "at-risk" cut-off on the Spence Children Anxiety Survey were eligible. Adolescents' anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents' anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms) in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants' expectations, and take critical design issues into consideration, such as individual- versus group-based intervention and contamination issues.
Literature concerning the relationship between social media use and wellbeing is inconsistent in its findings, and most research has focused on time spent on social media rather than on what emerging ...adults do there, with whom and why. Here, we investigated whether momentary social stress affects emerging adults' social media use, and whether this social media use relates to subsequent changes in wellbeing. We implemented a multi-method paradigm utilising objective and self-report data to investigate how social stress relates to how (much) and why emerging adults use social media. We report on findings based on 114 17-25-year-old emerging adults recruited on university campus. Our findings suggest that social stress does not affect adolescents' subsequent social media use and that there is no relationship between social media use after stress and changes in momentary wellbeing. Our work illustrates the need for detailed approaches in social media and psychological wellbeing research.
Depressive symptoms and disorders are major public health concerns, affecting many adolescents and young adults. Despite extensive research, depression prevention programs for youth show limited ...effectiveness. Moreover, the maximal potential of youth psychotherapy - on which depression prevention programs are based - may have been reached. Commercial video games may offer an engaging alternative vehicle for youth to practice emotional and social skills vital to mental health. The current study investigated the potential for the commercial video game Journey to prevent the exacerbation of depressive symptoms. A pre-registered randomized controlled trial tested the effectiveness of Journey as an indicated depression prevention approach compared to a control game condition and a passive control condition (Dutch Trial Register: NL4873, https://www.trialregister.nl/trial/4873). Additionally, potential action mechanisms for depression prevention using video games were examined. Participants aged 15 to 20 years old with elevated depressive symptoms (
= 244,
= 17.11,
= 1.76, 66.4% female) were given 4 weeks to play Journey (
= 3 h 20 min) or the control game, Flower (
= 2 h 36 min). Results showed no beneficial effects of playing the commercial video game, Journey, on youth's change in depressive symptoms above and beyond the active and passive control conditions up to 12-months after the intervention. Additionally, no action mechanisms were found specifically for Journey. Nevertheless, over the whole study, participants decreased in depressive symptoms, became less sensitive to rejection, and experienced more hope and optimism. Moreover, participants who during the study decreased in rejection sensitivity or rumination or who increased in hope and optimism or in distraction and problem solving showed the strongest decrease in depressive symptoms. Although results do not support the use of the studied commercial game as an effective indicated depression prevention strategy, our results do suggest that rejection sensitivity, hope, optimism, rumination, distraction, and problem solving are promising targets for future depression prevention efforts. We conclude with important lessons for future research on games to promote mental health. Particularly, encouraging careful consideration of research designs to explore for whom and how potential action mechanisms and associated game mechanics may be effective.
Numerous reviews and meta-analyses have indicated the enormous potential of technology to improve the appeal, effectiveness, cost, and reach of mental health interventions. However, the promise of ...digital mental health interventions for youth has not yet been realized. Significant challenges have been repeatedly identified, including engagement, fidelity, and the lack of personalization. We introduce the main tenets of design thinking and explain how they can specifically address these challenges, with an entirely new toolbox of mindsets and practices. In addition, we provide examples of a new wave of digital interventions to demonstrate the applicability of design thinking to a wide range of intervention goals. In the future, it will be critical for scientists and clinicians to implement their scientific standards, methods, and review outlets to evaluate the contribution of design thinking to the next iteration of digital mental health interventions for youth.
Anxiety disorders are the most prevalent mental health problems in childhood. Engaging, adequate, and appropriate prevention programs are needed. Applied games form a potential alternative delivery ...model and recent evidence suggests that they could be effective. The present randomized controlled non-inferiority trial investigated the beneficial effects of the applied game MindLight compared to cognitive behavioral therapy (CBT) on mental health outcomes associated with anxiety symptoms: internalizing problems, externalizing problems, and self-efficacy. In addition, we examined who benefitted most from both programs and analyzed baseline levels of anxiety, maternal mental health problems, and self-efficacy as predictors of changes in anxiety symptoms. After being screened for elevated anxiety, 174 selected children (8–12-year-old) were randomized to play MindLight or to receive a prevention program based on CBT. Study variables were assessed before and after the intervention, and at 3- and 6-months follow-up. Intention-to-treat analyses showed a significant reduction in mother-reported internalizing and externalizing problems and an increase in self-efficacy. Importantly, the magnitude of change did not differ between intervention groups. Non-inferiority analyses showed that MindLight was as effective as CBT in affecting internalizing problems and self-efficacy. However, CBT was more effective in decreasing externalizing symptoms than MindLight. Furthermore, baseline anxiety levels, maternal mental health problems, and self-efficacy did not influence the change of anxiety symptoms over time. Applied games, specifically theory-based games such as MindLight, hold potential as effective interventions for not only targeting anxiety symptoms, but also more general mental health outcomes.
Highlights
Applied games form an alternative delivery model of therapeutic techniques.
The applied game MindLight was as effective as CBT in improving youth mental health.
In both groups, internalizing and externalizing problems and self-efficacy improved.
Differences in baseline mental health were unrelated to intervention outcomes.
Serious games aimed at promoting well-being in youth have promising effects and potential for far-reaching impact. Considering that most mental health disorders remain untreated in youth, therapeutic ...games may be most valuable when they are aimed at untreated youth with internalizing symptoms. However, when targeting youth outside of a clinical setting, the first impression of therapeutic video games may determine whether and how a game is played. Thus, understanding the influence of messaging used in the promotion of therapeutic games on game choice and experience is critical. The current study examined two alternatives in promoting mental health games: one included explicit mental health messaging (e.g., learn to manage stress) and the other was a stealth promotion that did not mention mental health but highlighted the entertainment value. Young adults with mild to severe internalizing mental health symptoms (i.e., depressive, anxiety, and stress symptoms) were shown two distinct trailer designs, with random assignment determining which design held which message. Participants (
= 129,
= 21.33,
= 3.20), unaware that both trailers promoted the same commercial video game, were 3.71 times more likely to choose what they believed was the mental health game. Additionally, an unforeseen difference in the attractiveness of the two trailer designs resulted in participants being 5.65 times more likely to select the mental health game promoted in one trailer design over the other. Messaging did not influence game experience (i.e., gameplay duration, autonomy, competence, intrinsic motivation and affect). Exploratory analyses indicated that game experience, but not game choice, was influenced by symptom severity, symptom type and the interaction between symptom severity and messaging. The present study suggests that explicit mental health messages attract youth with mental health symptoms. Ultimately, youth may be empowered to seek out mental health games if they are promoted properly, allowing for far-reaching positive influences on well-being. Toward this aim, future research is needed on the game selection process, addressing underlying motivations, the balance between explicit health and entertainment messaging, and multiple interacting influences on game selection (e.g., promotion and peers).
Abstract
Concerns regarding smartphones’ and social media’s impact on youth remain high amidst a growing realization that current research is not designed to confirm (or refute) such concerns. This ...study aims to answer fundamental questions regarding youths’ use of smartphones, by implementing a novel user-centric research method. The smartphone use of 114 emerging adults was recorded, followed by in-depth interviews that incorporated the recording and in-app information to help participants recall their behaviours, motivations, and feelings. Results indicate that smartphone use is indeed ubiquitous; 88 out of 114 participants started using their smartphone as soon as they were left alone. However, the findings of this study also demonstrate great diversity in smartphone use, in e.g. social media platforms used and motivations for using different apps. These results illustrate that it no longer seems sensible to refer to “screen time” as if it represents a homogeneous phenomenon across youth. Additionally, preliminary indications have been found of relationships between individual differences in mental health indices and variations in smartphone use. The current study provides new insights into youths’ smartphone use and its relationship with wellbeing.
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