Aniek Wols

3 175 IN-GAME PLAY BEHAVIOURS PREDICT IMPROVEMENTS IN ANXIETY MindLight incorporates three evidence-based techniques based on cognitive-behavioural principles: relaxation through neurofeedback training (Price & Budzynski, 2009), exposure training (Feske & Chambless, 1995), and attention bias modification (Bar-Haim, 2010; Bar-Haim et al., 2011). These techniques have been repeatedly shown to address causal processes associated with the development and maintenance of anxiety such as avoidance and negative attention bias (Mathews & MacLeod, 2005; Weersing et al., 2012). In MindLight, the three techniques are translated into specific game mechanics: neurofeedback, approaching fear events, and attention bias modification puzzles (see Table 1), together aiming at teaching children how to cope with anxiety in a playful manner. Below we explain these techniques and game mechanics in more detail. More information can also be found in Appendix A. The first technique incorporated in MindLight is relaxation training through the use of neurofeedback. In conventional neurofeedback training individuals are presented with real-time electroencephalogram (EEG) recordings from their brain and guided through relaxation exercises in order to keep their EEG waves consistent with identified proxies of relaxation (i.e., reduction in relative beta power and increase in relative alpha power; Price & Budzynski, 2009). In MindLight, the player wears an EEG headset with one (dry) sensor touching the forehead and one reference point located in the clip attached to the left earlobe. The headset detects EEG signals and converts them into a continuous data stream representing relaxation (Johnstone et al., 2012). This data stream is fed into the game and controls the amount of light that shines in the game. The brightness of players’ mindlight is proportional to the strength of the real-time relaxation of the player. When the player becomes more relaxed the mindlight becomes brighter, providing more light in the game environment. This way, players get feedback on their level of relaxation. Thus, relaxation is trained through the neurofeedback game mechanic in MindLight (see Table 1). The second technique incorporated in MindLight is exposure training. There are fear events (i.e., fearful obstacles) in the game and by shining one’s mindlight on them they can be chased away or uncovered. Some fear events will then turn into a friendly kitten that follows the player and that reminds the player of past fears conquered. Other fear events turn into a benign object or animal and reward the player with a coin that is needed to unlock puzzles (see below). To play through the game, the fear events need to be approached. However, a player can also escape them (temporally) by hiding inside one of the chests or by turning on a ceiling light (both instances of safety behaviours). Thus, exposure training is done through the fear events in the game (see Table 1).

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