2 65 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH (Andrade et al., 2019; Poppelaars, Lichtwarck-Aschoff, et al., 2018; Russell & Newton, 2008) or passive condition (Ferguson & Rueda, 2010), with also no differences between violent and nonviolent casual games (Ferguson & Rueda, 2010; Ferguson et al., 2016; Russell & Newton, 2008; Valadez & Ferguson, 2012). Only in the study of Russell and Newton (2008), an interactive videogame bicycle exercise was more effective than a video game-only condition in reducing negative affect. In studies employing a longitudinal design measuring mental health traits, almost two-thirds focused on applied games, while more than a third focused on casual games. The majority of these studies compared the applied or casual game to a passive condition. With regard to mental health domains, well-being and internalising symptoms were most often researched. For well-being, mixed evidence was found with no clear pattern. For internalising symptoms, no clear patterns were found for the effects of both applied and casual games. Six other studies employing a longitudinal design measured general psychological difficulties, but here as well mixed evidence was found (Axford et al., 2020; David et al., 2019b; David & Fodor, 2023; Hammond et al., 2014; Mannweiler et al., 2023; Valenzuela et al., 2022). Overall, these mixed findings resonate with conventional prevention research, showing smaller effect sizes for universal prevention (i.e., in a healthy population) compared to selective and indicated prevention (i.e., in a clinical population; Horowitz & Garber, 2006; Stockings et al., 2016). Future research on digital games in healthy populations may want to focus more on positive outcomes, thereby fostering resilience and well-being rather than preventing negative outcomes (Adachi & Willoughby, 2013; C. Jones et al., 2014; Kelly, 2020). Multi-modal Interventions For the purpose of the current review, the specific intervention arms were coded as applied game, casual game, active condition, or passive condition. We noticed, however, several studies that examined the effect of multi-modal interventions in which a digital game and other therapy components were offered simultaneously. Interestingly, most multi-modal interventions were used within (sub)clinical populations. Using games as an adjunct to therapy is common practice in clinical settings (Horne-Moyer et al., 2014). The downside of researching experimental conditions that include a multi-modal intervention and the way in which they were coded in the current review is that it is not possible to single out the (additional) effect of the game (or the standard intervention components for that matter). Additional work is needed to
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