Development of a gamified cognitive training app “Social Brain Train” to enhance adolescent mental health: a participatory design study protocol

Savannah Minihan,Sarah-Jayne Blakemore,Ian M Goodyer,Annabel Songco,Karina Grunewald,Susanne Schweizer,William Raffe,Helen Christensen,Elaine Fox,Jack L Andrews,Aliza Werner-Seidler

doi:10.12688/wellcomeopenres.17441.1

Abstract

Background: Adolescence is a sensitive period for the onset of mental health disorders. Effective, easy-to-disseminate, scalable prevention and early interventions are urgently needed. Affective control has been proposed as a potential target mechanism. Training affective control has been shown to reduce mental health symptoms and improve emotion regulation. However, uptake and adherence to such training by adolescents has been low. Thus, the current study aims to receive end user (i.e., adolescents) feedback on a prototype of a novel app-based gamified affective control training program, the Social Brain Train. Methods: The proposed study aims to recruit participants aged 13-16 years old (N = 20) to provide user feedback on the Social Brain Train app. The first group of participants (n = 5) will complete an online questionnaire assessing demographics, symptoms of depression and anxiety, social rejection sensitivity and attitudes toward the malleability of cognition and mental health. They will complete two tasks assessing cognitive capacity and interpretation bias. Participants will be then be invited to an online group workshop, where they will be introduced to the app. They will train on the app for three days, and following app usage, participants will complete the aforementioned measures again, as well as provide ratings on app content, and complete a semi-structured interview to obtain in-depth user feedback, which will be used to inform modifications to the app. Following these modifications, a second group of participants (n = 15) will follow the same procedure, except they will train on the app for 14 days. Feedback from both groups of participants will be used to inform the final design. Conclusions: By including young people in the design of the Social Brain Train app, the proposed study will help us to develop a novel mental health intervention that young people find engaging, acceptable, and easy-to-use

Highlights

Adolescence is operationally defined here as the period of life between 10 and 24 years (Sawyer et al, 2018). This is a sensitive period for the onset of emotional disorders. 75% of all lifetime cases of mental health disorders emerge before the end of adolescence, with these disorders typically recurring across the lifespan (Kessler et al, 2005)
We have proposed that it is the application of cognitive control in affective contexts, in particular, which is key to the development of effective emotion regulation (Schweizer et al, 2020a)
The association between affective control and mental health was examined in a large-scale meta-analysis, which demonstrated that affective control, affective working memory, distinguished between psychologically healthy individuals and those suffering from a mental health disorder (Schweizer et al, 2019b)

Summary

Introduction

Adolescence is operationally defined here as the period of life between 10 and 24 years (Sawyer et al, 2018). The proposed app aims to improve adolescent emotion regulation and mood, via affective control training and its application during the resolution of ambiguous social interaction scenarios. The affective control training (AffeCT; Schweizer et al, 2019a) has been shown to successfully improve affective control, emotion regulation and mental health in unselected adolescents and young adults (Schweizer et al, 2011; Schweizer et al, 2013), and young people with stress-related and internalising disorders (du Toit et al, 2020; Minihan et al, 2021b; Schweizer et al, 2017). The second component of the app, which requires the positive resolution of ambiguous social interaction scenarios, is based on cognitive interpretation bias modification paradigms (MenneLothmann et al, 2014) To successfully complete this second component (i.e., positively resolve the ambiguous scenarios), individuals will need to apply affective control. User feedback obtained from the current study will be incorporated into the final design of the app to maximise the program’s acceptability, relatability, and user engagement

Methods

Findings

Conclusion