2 57 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH Internalising Symptoms Nineteen studies (described in 25 papers) measured internalising symptoms. Participants’ mean age ranged from 8 to 23 years, and the proportion of male participants varied from 0% to 100%. Ten studies used a regular RCT design (Cioffi & Lubetzky, 2023; David et al., 2019a, 2019b; David & Fodor, 2022, 2023; David & Magurean, 2022; David, Magurean, et al., 2022; David et al., 2021; David, Stroian, et al., 2022; Egan et al., 2021; Kato et al., 2008; Mannweiler et al., 2023; Schakel et al., 2020; Walsh et al., 2019; Wu et al., 2022; Yu et al., 2023), five studies used cluster randomisation (Axford et al., 2020; Kuosmanen et al., 2017; Perry et al., 2017; Shum et al., 2019; Tuijnman et al., 2022), one study employed a crossover design (Abbott et al., 2014), and one study combined cluster randomisation with a crossover design (Mack et al., 2020). Yunus et al. (2020) and Maden et al. (2022) used a regular RCT design but the intervention group underwent the exergame activity in (random) pairs. See Table A.12 (Appendix) for the characteristics and findings of these studies. Effect sizes were calculated on data from 15 papers. Outcome measures used were caregiver-reported internalising symptoms (Mannweiler et al., 2023), self-reported depressive mood (disorder) or symptoms (David et al., 2019b; Egan et al., 2021; Kuosmanen et al., 2017; Perry et al., 2017; Wu et al., 2022; Yunus et al., 2020), emotional symptoms (Axford et al., 2020 (teacher-reported); David & Fodor, 2023), anxiety (Cioffi & Lubetzky, 2023; Maden et al., 2022; Shum et al., 2019), mental health (Yu et al., 2023), perceived stress (Kato et al., 2008), and negative affect1 (Schakel et al., 2020). Data from nine papers were not included in the plot, because the paper used the same data as an already included paper (David et al., 2019a; David & Fodor, 2022), focused on effects of one intervention arm (David & Magurean, 2022; David, Magurean, et al., 2022) or the outcome measure did not match with the outcome measure used by the majority of papers (Abbott et al., 2014; David et al., 2021; David, Stroian, et al., 2022; Mack et al., 2020). In the study of Tuijnman et al. (2022), the outcome measure was comparable to the papers included in the plot, but the aim of the intervention was not to reduce depressive symptoms and depressive symptoms were only measured to examine adverse effects. Therefore, data from this paper was not included in the forest plot. Regarding the papers included in the plot, three studies compared the applied game to an active condition (Egan et al., 2021; Mannweiler et al., 2023; Perry et al., 2017), one to a casual game (Kato et al., 2008) and five studies compared an applied game 1 Similar to the studies examining momentary effects, Schakel et al. (2020) measured negative affect. The study was categorised under internalising symptoms, however, because it employed a longitudinal design.
RkJQdWJsaXNoZXIy MTk4NDMw