Testing The Effectiveness Of A Gamified Emotional Cognitive Bias Modification Task As An Intervention For Low Mood: Randomised Controlled Trial (Preprint)

Abstract

Emotion recognition bias in depression is well documented and is proposed to play a causal role in depression. A Cognitive Bias Modification (CBM) intervention targeting the bias in emotional expression perception was developed, but despite robust training effects on emotion perception, the effect on mood was unreliable and weak. We propose a new gamified version of CBM (GCBM) to address potential limitations that may attenuate therapeutic effects.

This study aims to test the effectiveness of GCBM in altering the perception of emotional facial expressions and improving the immediate mood of healthy participants. Study 1 aimed to investigate the effectiveness of a single session of GCBM on emotion perception and to assess whether the gamified version of the task would produce the same robust training effects on the interpretation of emotional expressions as the original CBM. Study 2 aimed to compare the effectiveness of a single session of CBM training, CBM (no training) control, and GCBM training on immediate mood.

We reported two between-subjects online experimental studies that recruited participants from the general population. Study 1 (N = 58) tested the effectiveness of GCBM in changing participants' responses to ambiguous facial expressions. The primary outcome was emotion recognition bias, measured by increased identification of happy faces. Study 2 (N = 916) compared the effects of a single session of GCBM training, CBM training and CBM control conditions on immediate mood. The primary outcome was immediate mood after the training, measured by the Immediate Mood Scaler (IMS).

Study 1 showed that participants in the intervention condition classified more ambiguous faces as 'happy' after the training compared to controls, indicating an increased perception of happiness in ambiguous faces. (B = 1.73, P < .001). Study 2 provided evidence that GCBM training produced more positive changes in immediate mood compared to the CBM control condition (B = -3.64, P = .003) and compared to the CBM training condition (B = 1.73, P = .044).

These studies showed that GCBM may change participants' emotion recognition bias to ambiguous facial expressions and enhance mood compared to both CBM and control conditions. These results suggest that GCBM might be an effective intervention for addressing mood-related cognitive biases. Further exploration of GCBM's long-term effects on mood and its clinical application is needed.