2 53 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH and anxiety after the procedure. In this case, distress during the procedure was taken as outcome variable. Eight studies included two intervention arms comparing the effect of game distraction to standard care (Burns-Nader et al., 2017; Chan et al., 2019, study 1 and 2; Dwairej et al., 2020; Jung et al., 2021; Osmanlliu et al., 2021) or medication (Marechal et al., 2017; Stewart et al., 2019). Five studies included three intervention arms, additionally adding a condition in which participants watched a video of their choice (Ko et al., 2016), were given lollipops (Nilsson et al., 2013), had their parents present (Patel et al., 2006), were not given any anxiolytic (Sahin & Karkiner, 2022), or watched an informative cartoon about anaesthesia (Sakızcı Uyar et al., 2021). Two studies included four intervention arms, with Inan and Inal (2019) comparing (1) game distraction to (2) watching a cartoon, (3) verbal distraction by parents, and (4) regular procedure without distraction. In Pande et al. (2020), the effect of (1) game distraction was compared to (2) audio distraction, (3) audiovisual distraction in virtual reality (watching a cartoon), and (4) the Tell-Show-Do techniques. For the purpose of this review, medication use (Marechal et al., 2017; Patel et al., 2006; Sahin & Karkiner, 2022; Sakızcı Uyar et al., 2021; Stewart et al., 2019) and the Tell-Show-Do technique (Pande et al., 2020) were coded as standard care as well. As shown in Figure A.11 (Appendix), effect sizes for the 15 studies ranged from –1.48 to 0.59, with seven studies showing a significant effect size in favour of game distraction (Burns-Nader et al., 2017; Chan et al., 2019, study 2; Dwairej et al., 2020; Inan & Inal, 2019; Jung et al., 2021; Patel et al., 2006; Stewart et al., 2019) and Sahin and Karkiner (2022) showing a significant effect size in favour of standard care. Positive and Negative Affect Thirteen studies (described in 14 papers) examined momentary effects of games in a (mentally) healthy sample. All studies included conditions in which participants played a game for one session, with the exception of the study of Andrade and colleagues (reported in Andrade et al., 2019; and Andrade et al., 2020) in which three gameplay sessions within one week took place. After gameplay, state positive or negative affect, or current emotions were measured. Seven studies measured both positive and negative affect/ emotions. Participants’ mean age ranged from 9 to 23 years, with the majority of studies focusing on adolescents and university students. The proportion of male participants varied from 22.0 to 100%. The studies of Alloway and Carpenter (2021), Branton et al. (2014), Gheller et al. (2019) and Douris et al. (2012) used a crossover design, the study of Andrade and colleagues (2019;
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