6 271 EXPLICIT MESSAGING PROMOTES GAME SELECTION the other half (n = 63) saw the abstract trailer as the mental health trailer and the detailed trailer as the entertainment trailer. Both messages consisted of five short phrases. For both messages the first sentence introduced the game as appealing, as one would expect from a promotional trailer. The next four phrases focused on the mental health or the entertainment message (Table 1). Table 1 Messages included in the mental health and entertainment trailers Mental Health Entertainment Perfect for a single marathon playthrough A game you must play Learn to manage stress more efficiently Think outside the box to solve intricate puzzles Therapeutic insights for emotional mastery 9/10 Polygon 5/5 Touch Arcade Both challenging and relaxing Almost impossibly gorgeous Recommended by games for mental health iPad game of the year Instruments Mental Health Symptoms The DASS-21 (Lovibond & Lovibond, 1995) was used both in the original English version as well as in the Dutch translation by De Beurs (2010). All 21-items were scored on a 4-point scale (Did not apply to me at all = 0, Applied to me to some degree, or some of the time = 1, Applied to me to a considerable degree, or a good part of the time = 2, Applied to me very much, or most of the time = 3) with seven items for each of the subscales: depressive symptoms (e.g., ‘I felt that I had nothing to look forward to.’; α = 0.83), anxiety symptoms (e.g., ‘I felt scared without any good reason.’; α = 0.70) and stress symptoms (e.g., ‘I found it difficult to relax.’; α = 0.79). Participants rated to what degree each statement applied to them over the past week. The summed score for each subscale indicated mild symptoms at or above a score of 5 for depression, 4 for anxiety, and 8 for stress. Thus, when we refer to elevated symptoms, we are referring to symptoms at or above the mild cut-off. Additionally, in the analyses all participants who scored at or above the severe cutoff (11 for depression, 8 for anxiety, and 13 for stress) for one or more of the subscales were compared to participants who had no symptoms within the severe or extremely severe range. As symptoms of the different subscales have different cutoffs (e.g., a score of 8 can indicate mild stress or severe anxiety) a continuous sum score cannot be used to indicate overall mental health. Thus, when referring to severe symptoms, we are referring to a score at or above the severe cut-off on one or more DASS-21 subscales.
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