282 Chapter 6 severe symptoms [F(1, 122) = 10.30, p < .01, η2 p = .08], but affect did not change for participants without severe symptoms [F(1, 122) = 1.29, p = .26, η2 p = .01]. In sum, participants with more severe symptoms experienced less positive affect prior to gameplay, but showed an increase in positive affect, resulting in equal positive affect for participants with more and less severe symptoms after gameplay. Symptom severity had no further effects on the dependent variables. Depressive Symptoms Elevated depressive symptoms did not influence game choice either directly [X2 (1, n = 129) = 2.69, p = .10] or in interaction with trailer design [X2 (1, n = 129) = 1.22, p = .27], which indicates that there was no difference in the odds for participants with and without elevated depressive symptoms to select the mental health game (62.7% and 54.3%, respectively). Also, depressive symptoms did not predict dependent variables except for affect. Elevated depressive symptoms were related to less positive affect both before and after gameplay. Further analyses showed that there was an interaction for time × elevated depressive symptoms on affect [F(1, 122) = 4.40, p < .05, η2 p = .04], indicating that affect became more positive for participants with elevated depressive symptoms [F(1, 122) = 12.45, p < .001, η2 p = .09], while affect did not change for participants without elevated depressive symptoms [F(1, 122) = .01, p = 0.94, η2 p < .01]. There was no three-way interaction: time × game choice × elevated depressive symptoms [F(1, 122) = 3.68, p = .06, η2 p = .03]. This effect replicates what we previously saw for severe symptoms. Anxiety Symptoms We found no direct effect of anxiety symptoms [X2 (1, n = 129) = 0.46, p = .50], nor an interaction effect of anxiety symptoms × trailer design on game choice [X2 (1, n = 129) = 0.34, p = .56]. Thus, anxiety symptoms did not predict how often the mental health trailer was selected (non-elevated symptoms: 59.5%; elevated symptoms: 59.8%). Moreover, no main or interaction effects of anxiety symptoms with game choice were found on gameplay duration, intrinsic motivation, autonomy, competence, attractiveness, or affect before and after gameplay. However, there was a significant effect of anxiety symptoms on perceived fun of the trailers, showing that participants with elevated anxiety symptoms rated the games as less fun than participants without these symptoms based on the trailers. Further analyses did not show an interaction of time × anxiety symptoms [F(1, 122) = 1.29, p = .26, η2 p = .01] or a three-way interaction of time
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