8 329 GENERAL DISCUSSION al., 2017), but also that it may adversely impact effectiveness (Cunningham et al., 2016; Kampman et al., 2008; Lorenzo-Luaces et al., 2020). Taken together, the results of the studies described in Part 2 of this dissertation underscore the potential of theory-based applied games like MindLight as effective interventions. MindLight demonstrates efficacy not only in reducing explicitly targeted anxiety symptoms, but also in improving more general mental health outcomes associated with anxiety. Crucially, the observed improvements in mental health symptoms persisted for up to 6 months post-intervention, even without continued gameplay. Our findings further suggest that nonspecific factors are not that crucial to harness for applied games to be effective, and that both youth with high as well as low expectations, motivation to change and baseline symptoms benefit equally from applied games. INTERVENTION REACH AND UPTAKE: MESSAGING AND (NONSPECIFIC) MOTIVATIONAL FACTORS In Part 3 of this dissertation, we examined the uptake of and engagement with mental health games among individuals exhibiting symptoms of mild to severe internalising issues, encompassing depressive, anxiety and stress symptoms. In our experimental study, participants were presented with two trailers of video games. After viewing these trailers, participants were asked to choose the game they found most appealing and were allowed to play their chosen game as long as they wished. Unbeknownst to the participants, both trailers portrayed the same commercial video game, Monument Valley. To create the impression of two distinct games, we varied the designs of the trailers and incorporated different messages. One trailer presented the game as a mental health game, while the other portrayed it as an entertainment game. Following the viewing of the trailers, we measured participants’ game choices based on the promotional message (i.e., mental health or entertainment). In Chapter 6, we investigated the impact of messaging, symptom type and symptom severity on game choice, perceived attractiveness and fun. In Chapter 7 we further examined how motivation to change and mindsets influence game choice. The results indicated that participants were nearly four times more likely to select a game explicitly marketed as beneficial for mental health, as opposed to when solely promoted for entertainment. Unexpectedly, a significant difference in attractiveness emerged between the two trailer designs, specifically when they contained the mental health message.
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