66 Chapter 2 unravel the relative effectiveness of games and to examine how conventional interventions can be optimally enhanced through game add-ons. Nonspecific Factors The current review found that nonspecific factors are not systematically measured and examined in randomised controlled studies on games for mental health. Only a couple of studies controlled for or measured expectations, variables related to hope, and motivation for treatment, of which just two studies explicitly examined the association between nonspecific factors and changes in mental health (Holzer et al., 2014; Wijnhoven et al., 2020). A more substantial number of studies measured variables related to adherence, engagement, time of playing or number of completed sessions, and several more measured variables related to satisfaction, enjoyment, likability or experiences with the game. These concepts can be seen as rather indirect measures of nonspecific factors such as motivation and hope, but more direct and concrete measures are needed. Additionally, due to the large heterogeneity of target groups, outcome measures, and intervention and control conditions employed, a meta-analysis and subsequent moderator analyses on these (indirect) measures could not be performed. Overall, future research may be enriched by examining nonspecific factors, utilising standardised measurements for a more comprehensive understanding. Strengths and Limitations of the Current Review Particular strengths of the current review are the inclusion of a wide range of mental health areas, both applied and casual games in healthy and (sub) clinical populations, and the inclusion of positive mental health outcomes. No particular keywords related to mental health were used and thus a relatively ‘open’ search was performed, leading to results that were not restricted to specific mental health problems or clinical populations. Additionally, because most mental health problems diagnosed in adulthood begin in adolescence and three-quarters of lifetime diagnosable mental health disorders have started by the age of 24 (Kessler et al., 2005; World Health Organization, 2023), it seemed important to us to use an expanded and more inclusive definition of adolescence, including participants up to age of 24 years (Sawyer et al., 2018). These inclusion criteria were unique to our study and yielded important insights about the promise of games in this age group. Several limitations of the current review should also be acknowledged. The first limitation relates to our analytic procedure. By calculating effect sizes based on post-data only, control variables or covariates were not taken
RkJQdWJsaXNoZXIy MTk4NDMw