Aniek Wols

4 201 MENTAL HEALTH OUTCOMES OF APPLIED GAME MINDLIGHT anxiety prevention programs are able to improve other internalising problems as well. Whether anxiety prevention programs also have beneficial effects on externalising problems is unclear, but there are reasons to believe this may be so. Research on the comorbidity between anxiety and aggression could be informative. Two recent reviews about the often-found comorbidity between anxiety and aggression focus on attention control (Fraire & Ollendick 2013; Granic, 2014). Anxious children pay more attention to potential threats in their environment (i.e., attentional bias; Bar-Haim et al., 2011) and have less processing capacity left to focus and sustain attention on other stimuli (i.e., attentional control; Fraire & Ollendick 2013; Reinholdt-Dunne et al., 2013; Eysenck et al., 2007). This vigilant focus on the potential negative aspect of the environment might consume most of the available resources. As a result, anxious children may have difficulties inhibiting their impulses and act out and behave aggressively (Granic, 2014). Thus, when anxiety symptoms are decreasing as a result of the prevention program this might free up cognitive resources to better regulate impulses (Hadwin & Richards 2016) and consequently externalising problems might decrease. Last, previous research has not focused on changes in self-efficacy following anxiety prevention programs, but it seems important to consider as well (Muris 2001; Muris et al., 2009). Self-efficacy has been theorized to play a key role in the aetiology and maintenance of anxiety and refers to the belief in one’s ability to produce a desired behaviour (Bandura, 1997; Maric et al., 2011). More specifically, self-efficacy in the social domain (i.e., perceived capability to deal with social situations), academic domain (i.e., perceived capability to master academic affairs), and emotional domain (i.e., perceived capability to cope with negative emotions) seem relevant for the study of anxiety in youth (Muris, 2001). In the literature focusing on intervention and treatment, one study assessed self-efficacy in a CBT-program for school-refusing children and found improvements in children’s self-efficacy for school situations (i.e., perceived ability to cope with anxiety-provoking situations at school; King et al., 1998). Another study found improvements in self-efficacy for anxiety management in youth with anxiety disorders following CBT (Suveg et al., 2009). These findings suggest that it may be important to examine changes in selfefficacy following anxiety prevention programs. Next to investigating whether MindLight has beneficial effects on other outcomes associated with anxiety symptoms, another important question pertains to the idea that individuals respond differently to prevention programs. There may be important predictors of efficacy to consider. Past

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