Becoming Superheroes: Developing Research Methodology and Evaluating the Feasibility of a Multiplayer Role-Playing Game as a Behavioral Health Intervention in Adolescent Patients with Chronic Physical or Mental Conditions (Preprint)

Abstract

Numerous studies have revealed that adolescents with chronic physical or mental conditions (CPMC) are at an increased risk for depression and anxiety, with serious direct and indirect negative effects on treatment adherence, family functioning, and health-related quality of life. As game-based approaches have shown to be effective interventions in treating anxiety and depression, we propose to explore the use of a multiplayer role-playing game (RPG) as a potential intervention for social isolation, anxiety, and depression.

(1) Determine the feasibility of using Masks, a multiplayer RPG, as an intervention for social isolation, anxiety, and depression in adolescents with chronic physical or mental health conditions, (2) evaluate the viability of the research process; and (3) gauge participation in and engagement with RPG-based interventions.

This study is a remote synchronous game-based intervention for adolescents aged 14-19 with CPMC. Eligible participants complete a web-based baseline survey to assess anxiety, depression, and social isolation, as well as to identify their gaming habits. After completing the baseline survey, they participate in a moderated multiplayer game called Masks. After each game sessions, participants complete surveys to assess changes in anxiety, depression, and social isolation, as well as their attitude towards the game and the user experience.

Six subjects were recruited for the pilot study to participate in moderated online game sessions of Masks; three completed all game sessions and all required assessments. While the number of subjects was too low to draw generalizable conclusions, self-reported clinical outcomes did seem to indicate positive change in depression, anxiety, and social isolation symptoms. Furthermore, the participants provided feedback about improved mood and engagement related to weekly participation in Masks.

We established a workflow for game play and evaluated a research protocol for evaluating the impact of RPG participation on isolation, anxiety, and depression symptoms in adolescents with CPMC. Preliminary data collected from the pilot study supports the validity of the research protocol and the use of RPG-based interventions in larger clinical studies.