Abstract
BackgroundGamification in mental health could increase training adherence, motivation, and transfer effects, but the external validity of gamified tasks is unclear. This study documents that gamified task variants can show preserved associations between markers of behavioral deficits and health-related variables. We draw on the inhibitory control deficit in overweight populations to investigate effects of gamification on performance measures in a web-based experimental task.ObjectiveThis study tested whether associations between inhibitory control and overweight were preserved in a gamified stop-signal task (SST).MethodsTwo versions of an adaptive SST were developed and tested in an online experiment. Participants (n=111) were randomized to 1 of the 2 task variants and completed a series of questionnaires along with either the gamified SST or a conventional SST. To maximize its possible effects on participants’ inhibitory control, the gamified SST included multiple game elements in addition to the task itself and the stimuli. Both variants drew on the identical core mechanics, but the gamified variant included an additional narrative, graphical theme, scoring system with visual and emotional feedback, and the presence of a companion character. In both tasks, food and neutral low-poly stimuli were classified based on their color tone (go trials), but responses were withheld in 25% of the trials (stop trials). Mean go reaction times and stop-signal reaction times (SSRT) were analyzed as measures of performance and inhibitory control.ResultsParticipants in the gamified SST had longer reaction times (803 [SD 179] ms vs 607 [SD 90] ms) and worse inhibitory control (SSRT 383 [SD 109] ms vs 297 [SD 45] ms). The association of BMI with inhibitory control was relatively small (r=.155, 95% CI .013-.290). Overweight participants had longer reaction times (752 [SD 217] ms vs 672 [SD 137] ms) and SSRTs (363 [SD 116] ms vs 326 [SD 77] ms). Gamification did not interact with the effect of overweight on mean performance or inhibitory control. There were no effects of gamification on mood and user experience, despite a negative effect on perceived efficiency.ConclusionsThe detrimental effects of heightened BMI on inhibitory control were preserved in a gamified version of the SST. Overall, the effects of overweight were smaller than in previously published web-based and laboratory studies. Gamification elements can impact behavioral performance, but gamified tasks can still assess inhibitory control deficits. Although our results are promising, according validations may differ for other types of behavior, gamification, and health variables.
Highlights
Overweight and obesity are monumental health problems with dramatic increases in prevalence over the past centuries
Gamification did not interact with the effect of overweight on mean performance or inhibitory control
There were neither significant differences in BMI nor general eating pathology according to the Dutch Eating Behavior Questionnaire (DEBQ)
Summary
Overweight and obesity are monumental health problems with dramatic increases in prevalence over the past centuries. The stop-signal task (SST) is a hallmark adaptive paradigm for assessing inhibitory control that has been used extensively in basic research with healthy, overweight, and patient populations. Inhibitory control deficits in this task have been identified in overweight and obese populations [3,4], overweight children [5], and patients with binge-eating disorder [6]. In the web-based study by Houben et al [4], participants with a BMI of 25 kg/m2 or more had longer stop-signal reaction times (SSRTs) in an SST with food stimuli compared with normal-weight participants, which indicates weaker inhibitory control. Gamification in mental health could increase training adherence, motivation, and transfer effects, but the external validity of gamified tasks is unclear. We draw on the inhibitory control deficit in overweight populations to investigate effects of gamification on performance measures in a web-based experimental task
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