Aniek Wols

64 Chapter 2 symptoms, respectively. This is especially promising for people with ADHD and depressive symptoms, because the aforementioned findings on applied games for these mental health domains were less positive, and traditional therapy for depression does not show large effect sizes (Weisz et al., 2017; Weisz et al., 2006). The potential of using casual games in clinical practice has been highlighted by previous reviews (e.g., Silva et al., 2021) and our findings provide further support. Healthy Populations Out of the 145 papers in this review, 70 included a healthy sample. Approximately one-third examined anxiety in medical settings, a fifth examined momentary effects on positive and/or negative affect or emotions, and almost half of the papers employed a longitudinal design measuring mental health trait outcomes (mainly internalising symptoms and/or well-being). For the papers focussing on anxiety in medical settings, most of them used (mainly casual) games as distraction tools and compared them to standard care. Our findings showed that games were equally, or more, effective as standard care in reducing anxiety. Although this group of papers included a diverse set of samples (e.g., youth undergoing hydrotherapy, wound dressing or venipuncture, outpatient surgery, general anaesthesia, dental or cast room procedures) and some forms of standard care included distractions while others explicitly did not, the findings are in line with previous promising reviews and meta-analyses noting the potential of games as distractions (e.g., Dwairej et al., 2018; Gates et al., 2020; Suleiman‐Martos et al., 2022). Regarding momentary effects of games on positive and/or negative affect or emotions, the majority of studies examined the effects of (a) casual game(s). These were compared to an active or passive condition, or to (an)other casual game(s). All studies measured negative affect or emotions, and only a subsample of those also measured positive affect or emotions. In line with previous studies (Bowman & Tamborini, 2012; McGonigal, 2011; Osmanovic & Pecchioni, 2016; Ryan et al., 2006), for positive affect and emotions, we found that casual games were as effective, or more, than active conditions. These results, however, should be interpreted cautiously as effect sizes were only calculated on three studies. For negative affect and emotions, our results showed that the applied games examined were as effective as an active condition (Hunter et al., 2019; Matheson et al., 2021), and, in some instances, more effective than an active condition (Matheson et al., 2021), a casual game (Goodie & Larkin, 2001), and a passive condition (Hunter et al., 2019). For the examined casual games, we found them to be as effective as an active condition

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