Video games and depression

There’s a lot of talk these days about the harm or benefit of playing video games, a lot of time ignoring the issue of what kind of video games we’re talking about.

Merry et al. (2012) designed a game for helping adolescents with depression. The game is called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) and is based on the cognitive behavioral therapy (CBT) principles.

CBT has been proven to be more efficacious that other forms of therapy, like psychoanalysis, psychodynamic, transpersonal and so on in treating (or at least alleviating) a variety of mental disorders, from depression to anxiety, form substance abuse to eating disorders. Its aim is to identify maladaptive thoughts (the ‘cognitive’ bit) and behaviors (the ‘behavior’ bit), change those thoughts and behaviors in order to feel better. It is more active and more focused than other therapies, in the sense that during the course of a CBT session, the patient and therapist discuss one problem and tackle it.

SPARX is a simple interactive fantasy game with 7 levels (Cave, Ice, Volcano, Mountain, Swamp, Bridgeland, Canyon) and the purpose is to fight the GNATs (Gloomy Negative Automatic Thoughts) by mastering several techniques, like breathing and progressive relaxation and acquiring skills, like scheduling and problem solving. You can customize your avatar and you get a guide throughout the game that also assess your progress and gives you real-life quests, a. k. a. therapeutic homework. If the player does not show the expected improvements after each level, s/he is directed to seek help from a real-life therapist. Luckily, the researchers also employed the help of true game designers, so the game looks at least half-decent and engaging, not a lame-worst-graphic-ever-bleah sort of thing I was kind of expecting.

To see if their game helps with depression, Merry et al. (2012) enrolled in an intervention program 187 adolescents (aged between 12-19 years) that sought help for depression; half of the subjects played the game for about 4 – 7 weeks, and the other half did traditional CBT with a qualified therapist for the same amount of time.  The patients have been assessed for depression at regular intervals before, during and after the therapy, up to 3 months post therapy. The conclusion?

SPARX “was at least as good as treatment as usual in primary healthcare sites in New Zealand” (p. 8)

Not bad for an RPG! The remission rates were higher for the SPARX group that in treatment as usual group. Also, the majority of participants liked the game and would recommend it. Additionally, SPARX was more effective than CBT for people who were less depressed than the ones who scored higher on the depression scales.

And now, coming back to my intro point, the fact that this game seems to be beneficial does not mean all of them are. There are studies that show that some games have deleterious effects on the developing brain. In the same vein, the fact that some shoddy company sells games that are supposed to boost your brain function (I always wandered which function…) that doesn’t mean they are actually good for you. Without the research to back up the claims, anybody can say anything and it becomes a “Buyer Beware!” game. They may call it cognitive enhancement, memory boosters or some other brainy catch phrase, but without the research to back up the claims, it’s nothing but placebo in the best case scenario. So it gives me hope – and great pleasure – that some real psychologists at a real university are developing a video game and then do the necessary research to validate it as a helping tool before marketing it.

Oh, an afterthought: this paper is 4 years old so I wondered what happened in the meantime, is it on the market or what? On the research databases I couldn’t find much, except that it was tested this year on Dutch population with pretty much similar results. But Wikipedia tells us that is was released in 2013 and is free online for New Zealanders! The game’s website says it may become available to other countries as well.

Reference: Merry SN, Stasiak K, Shepherd M, Frampton C, Fleming T, & Lucassen MF. (18 Apr 2012). The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial. The British Medical Journal, 344:e2598. doi: 10.1136/bmj.e2598. PMID: 22517917, PMCID: PMC3330131. ARTICLE | FREE FULLTEXT PDF  | Wikipedia page | Watch the authors talk about the game

By Neuronicus, 15 October 2016