Evaluating the Effect of Action-Like Video Game Play and of Casual Video Game Play on Anxiety in Adolescents: Protocol for a Randomized Controlled Trial

Abstract

Abstract Background Adolescence is a critical period for the onset and maintenance of anxiety disorders, which raises the importance of intervening early; one possibility of doing so is via digital interventions. Within that research field, at least two important research paths have been explored in the past years. On the one hand, the anxiolytic effect of casual video games has been tested as such gaming activity may distract away from anxious thoughts through the induction of flow and redirection of attention toward the game and thus away of anxious thoughts. On the other hand, the bidirectional link between weak attentional control and higher anxiety has led to the design of interventions aiming at improving attentional control such as working memory training studies. Taking stock that another genre of gaming, action video games, improves attentional control, game-based interventions that combines cognitive training and action-like game features would seem relevant. Objective This three-arm randomized controlled trial aims to evaluate the feasibility and the efficacy of two video game interventions to document how each may potentially alleviate adolescent anxiety-related symptoms when deployed fully on-line. Methods The study aims to recruit 150 individuals, 12 to 14 years of age, with high levels of anxiety as reported by the parents online form of the Screen for Child Anxiety Related Disorders questionnaire. This trial contrasts a child-friendly, “action-like” video game designed to improve attentional control abilities in a progressive and stepwise manner (Eco-Rescue), a casual puzzle video game selected to act as a positive distraction tool (Bejeweled) and finally a control group with no assigned training intervention to control for possible test-retest effects (No-training). Participants will be assigned randomly to one of the three study arms (i: Eco-Rescue attentional control training, ii: Bejeweled distraction training, iii: No-training). They will be assessed for main (anxiety) and secondary outcomes (attentional control, affective working memory) at three time points, before the training (T1), one week after completing the 6-week training (T2) and four months after completing the training (T3). Discussion The results of this RCT will provide evidence of the feasibility and the efficacy of two online video game interventions at improving mental health and emotional well-being of adolescents with high levels of anxiety. This project will contribute unique knowledge to the field, as there are few studies that have examined the effects of video game play in the context of digital mental health interventions for adolescents. Trial Registration The trial is registered with ClinicalTrials.gov: NCT05923944, June 20, 2023.