2 169 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH Figure A.16 Forest plot of standardised effect sizes of studies examining general psychological difficulties David et al. 2019b Mannweiler et al., 2023 Valenzuela et al. 2022 Axford et al. 2020 David et al. 2019b David & Fodor, 2023 Valenzuela et al. 2022 Hammond et al. 2014 Applied game vs Active condition Applied game vs Passive condition Active condition vs Casual game Cohen's d [95% CI] 0.33 [-0.08, 0.73] -0.05 [-0.55, 0.46] -0.10 [-0.17, -0.02] 0.08 [0.01, 0.15] 0.36 [-0.04, 0.77] 0.35 [0.10, 0.61] -0.06 [-0.13, 0.02] 0.13 [-1.31, 1.56] -1.50 -1.25 -1.00 -0.75 -0.50 -0.25 0.00 0.25 0.50 0.75 1.00 1.25 1.50 1.75 Favours comparison group Favours applied game / active condition General psychological difficulties Notes. David & Fodor (2023) report a Cohen’s d of 0.35. The studies of Axford et al. (2020) and Valenzuela et al. (2022) used cluster randomisation. For Axford et al. (2020), the adjusted effect size was calculated based on an average cluster size of 153.05 and an ICC of 0.097 (i.e., design effect = 15.75), which gave a Cohen’s d of 0.08, with 95% CI [-0.20, 0.35]. In contrast to the unadjusted effect size, the adjusted effect size was nonsignificant. For Valenzuela et al. (2022), the adjusted effect size was calculated based on an average cluster size of 166.33 and an ICC of 0.02 (i.e., design effect = 4.31), which gave for the applied game vs. active condition comparison a Cohen’s d of -0.10, with 95% CI [-0.26, 0.07], and for the applied game vs. passive condition comparison a Cohen’s d of -0.06, with 95% CI [-0.21, 0.10]. In contrast to the unadjusted effect size for the applied game vs. active condition comparison, the adjusted effect size for this comparison was nonsignificant. Valenzuela et al. (2022) report a Cohen’s d of 0.13 with 95% CI [0.01, 0.25] for the applied game vs. active condition comparison, and a Cohen’s d of 0.11 with 95% CI [-0.01, 0.23] for the applied game vs. passive condition comparison. CI = confidence interval, ICC = intracluster/intraclass correlation coefficient.
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