2 61 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH 2022) or motivation for treatment (Holzer et al., 2014; Kirst et al., 2022). Most studies examined whether nonspecific factors were equal between intervention arms, which does not give insight into how nonspecific factors relate to improvements. Only two studies examined the association between nonspecific factors and changes in mental health. Wijnhoven et al. (2020) found that children in the control condition (playing a casual game) showed a greater decrease in anxiety symptoms when they had higher treatment expectancies. Holzer et al. (2014) showed that higher motivation was significantly associated with greater improvements in attention but not with visuospatial abilities and delayed memory in youth with (high risk of) psychosis. DISCUSSION The aim of the current review was to provide an overview of randomised controlled studies that have assessed the effectiveness of applied and casual games for improving mental health in youth. Specifically, we summarized studies in terms of the mental health issues that were targeted, the populations, what types of games were examined, and their effectiveness. We also examined several methodological characteristics. Clinical Populations In total, 145 papers were included in our review of which 75 targeted a (sub) clinical sample. With regard to areas of mental health, most studies focused on ADHD and attentional problems, autism and social skill challenges, and anxiety, followed by depression, psychosis, and externalising problems, respectively. The current findings are in line with previous reviews in terms of the number of studies that examined games in a specific area of mental health (e.g., Cheng et al., 2019; Dewhirst et al., 2022; Ferrari et al., 2022; Shah et al., 2018; Zayeni et al., 2020). The reasons why applied games are more often used as intervention in certain clinical populations compared to others remain unclear. Possible benefits of applied games may be more pronounced in some clinical populations than others. For example, conventional (talk) therapies may be challenging for youth with autism and ADHD because of their cognitive and social impairments (Silver & Oakes, 2001; Weiss et al., 2008). As a result, applied games have been developed as alternative interventions for these populations. Furthermore, the growing reliance on medication in the treatment of ADHD raises concerns, prompting a call for nonmedical alternatives
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