Abstract
Background: Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits (e.g., behavioral addictions) have been shown to benefit from serious games.Aim: The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients with gambling disorder (GD). Preliminary results from a pilot sample are also reported.Method: A pilot sample of 26 patients undergoing treatment for GD was recruited (ranging from 22 to 74 years, mean = 41.2 and SD = 12.9; 80.8% men). Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate (HR) and heart rate variability (HRV) data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia.Results and Discussion: e-Estesia performed comparatively well for all the explored groups (i.e., sex, age, and online vs. offline gambling: mean usability score = 83.8, SD = 13.1). Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men.
Highlights
Gambling disorder (GD) is persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress (American Psychiatric Association, 2013)
According to the theoretical framework developed by Gratz and Roemer (2004), difficulties in the emotion regulation (ER) can be divided into six dimensions: reactions of non-acceptance of one’s difficulties and the tendency to experience negative secondary emotions in response to the experience of negative emotions; difficulty in adopting goal-oriented behaviors and performing a task in the presence of negative emotions; difficulty in controlling impulses and behaviors in the presence of negative emotions; lack of emotional awareness and willingness to pay attention to your emotions; difficulty in developing effective emotional regulation strategies once emotions have arisen; and lack of qualitative understanding of the emotion experienced
The present study aimed to assess the usability of a new emotion-regulation training app for GD, based on previous studies carried out in eating disorders and GD (FernándezAranda et al, 2012)
Summary
Gambling disorder (GD) is persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress (American Psychiatric Association, 2013). Several factors have been associated with severity in GD: psychiatric comorbidity (Pilver et al, 2013; Parhami et al, 2014), early age of onset (Johansson et al, 2009; JiménezMurcia et al, 2016), criminal behavior (Grant and Potenza, 2007; Folino and Abait, 2009; Granero et al, 2014), lack of emotion regulation (ER; Williams et al, 2012; Elmas et al, 2017; Rogier and Velotti, 2018; Marchica et al, 2020), or specific personality traits such as, high impulsivity (Álvarez-Moya et al, 2007; MacLaren et al, 2011; Black et al, 2014). Patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits (e.g., behavioral addictions) have been shown to benefit from serious games
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