Abstract
Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138) was conducted to test the effectiveness of a biofeedback video game (Dojo) for adolescents with elevated levels of anxiety. Adolescents (11–15 years old) were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape). Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the “at-risk” cut-off on the Spence Children Anxiety Survey were eligible. Adolescents’ anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents’ anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms) in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants’ expectations, and take critical design issues into consideration, such as individual- versus group-based intervention and contamination issues.
Highlights
Anxiety disorders are one of the most common adolescent psychiatric disorders, affecting up to 17% of adolescents in Western countries [1,2]
No differences were observed between the two conditions at baseline for sex, age, ethnicity, education, game expectations, game experience, total anxiety symptoms, and personalized anxiety symptoms (Table 1)
We found no significant interactions for sex or age in the relation between condition and either total anxiety symptoms or personalized anxiety symptoms anxiety (Table 6)
Summary
Anxiety disorders are one of the most common adolescent psychiatric disorders, affecting up to 17% of adolescents in Western countries [1,2]. Adolescent anxiety is associated with school dropout, lower school grades, suicidality, early substance use, teen pregnancies, and behavioral problems, such as attention deficit hyperactivity disorder and conduct disorder [3,4,5,6,7]. Adolescent anxiety tends to persist into adulthood and is related to other health problems, such as substance misuse and depression [7,8]. Despite the number of individuals suffering from anxiety and the accompanying personal, economic, and social costs, the focus in mental health has been primarily on treatment rather than prevention [9]. Identifying effective prevention strategies for adolescent anxiety is crucial
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