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Cited by 328Educational Games and GamificationDigital Mental Health InterventionsAutism Spectrum Disorder Research

Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis

Open access
Lau, Ho Ming, Smit, Johannes H., Fleming, Theresa M., Riper, Heleen·2017·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2016.00209PMC PMC5241302
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Abstract

The development and use of serious games for mental health disorders are on the rise. Yet, little is known about the impact of these games on clinical mental health symptoms. We conducted a systematic review and meta-analysis of randomized controlled trials that evaluated the effectiveness of serious games on symptoms of mental disorder. Method: We conducted a systematic search in the Pubmed, PsycINFO and Embase databases, using mental health and serious games related keywords. Ten studies met the inclusion criteria and were included in the review, nine were included in the meta-analysis. Results: All of the serious games were provided via personal computer, mostly on CD-ROM without the need for an internet connection. The studies targeted age groups ranging from 7 to 80 years old. The serious games focussed on symptoms of depression (n = 2), post-traumatic stress disorder (n = 2), autism spectrum disorder (n = 2), attention deficit hyperactivity disorder (n = 1), cognitive functioning (n = 2) and alcohol use disorder (n = 1). The studies used goal-oriented (n = 4) and cognitive training games (n = 6). A total of 674 participants were included in the meta-analysis (380 in experimental and 294 in control groups). A meta-analysis of nine studies comprising ten comparisons, using a random effects model, showed a moderate effect on improvement of symptoms (g = 0.55 [95% CI 0.28 to 0.83]; P < 0.001), favoring serious games over no intervention controls. Discussion/Conclusion: Though the number of studies in the meta-analysis was small, these findings suggest that serious gaming interventions may be effective for reducing disorder related symptoms. More studies are needed in order to attain deeper knowledge of the efficacy for specific mental disorders and the longer term effects of this new type of treatment for mental disorders.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis of RCTs found that serious games for mental health were mostly PC-based and showed a moderate pooled effect on symptom improvement (g = 0.55, 95% CI 0.28–0.83) across 9 studies and 10 comparisons. The authors conclude serious gaming is feasible and potentially effective, but the evidence base is limited by few small trials and methodological concerns.

Key findings

  • Across 9 studies (10 comparisons; 674 participants: 380 experimental, 294 control), serious games improved mental disorder-related symptoms versus controls: Hedges’ g = 0.55 (95% CI 0.28–0.83, P < 0.001), NNT = 3.31; heterogeneity was substantial (I² = 58.53).
  • Disorder-specific pooled effects were: depression g = 1.36 (95% CI 0.58–2.13), cognitive functioning g = 0.79 (95% CI 0.36–1.21), PTSD g = 0.59 (95% CI 0.20–0.99), ASD g = 0.46 (95% CI 0.10–0.81, non-significant), and ADHD g = 0.22 (95% CI −0.40–0.83).
  • Subgroup analyses showed youth ≤18 years g = 0.70 (95% CI 0.32–1.07) versus adults >18 years g = 0.53 (95% CI 0.07–0.99), and clinical participants g = 0.59 (95% CI 0.18–0.99) versus non-clinical participants g = 0.68 (95% CI 0.26–1.09); subgroup differences were non-significant.
  • All serious games were PC applications requiring no internet connection; 8 were designed as serious games and 2 were purpose-shifted (Tetris). No modified games, exergames, or anxiety-targeted serious games were identified.

Methods

  • Systematic search of PubMed, PsycINFO, and Embase using PRISMA; inclusion required a digital game delivered on any technical platform, targeting mental disorders, and evaluated in an RCT. Simulations, VR interventions, and interactive programs without game elements were excluded. The search returned 4,130 items; 10 studies were included in the review and 9 in the meta-analysis.
  • Data were extracted by two independent reviewers; study validity was assessed with the Cochrane Risk of Bias tool. Meta-analysis used a random-effects model with Hedges’ g in Comprehensive Meta-Analysis, plus subgroup analyses by age and clinical/non-clinical status, and publication-bias checks including funnel plot, Duval and Tweedie trim-and-fill, and Egger’s test.
  • The meta-analysis included 674 participants; studies targeted depression (n = 2), PTSD (n = 2), ASD (n = 2), ADHD (n = 1), cognitive functioning (n = 2), and alcohol use disorder (n = 1). The AUD study was excluded from the meta-analysis because it did not provide amenable data.

Limitations

  • The paper states that the number of eligible studies and participants was small; risk of bias was unclear in many cases due to incomplete reporting, possibly indicating selection, performance, and detection bias and overestimated effect sizes.
  • The paper states that several mental health disorders and clinical outcomes were collated as psychiatric-related disorders rather than analyzed separately, so findings can only indicate improvement rather than clear symptom reduction; subgroup analyses of distinct mental disorders were not conducted because the number of studies and power were too low.
  • Evident from the text: all included games were PC-based and required no internet connection, limiting generalizability to smartphone/tablet platforms; no anxiety-targeted serious games were found; overall heterogeneity was substantial (I² = 58.53); and funnel plot/trim-and-fill indicated possible publication bias, with the adjusted effect size changing from g = 0.63 to 0.48, although Egger’s test did not indicate asymmetry (P > 0.10).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2016.00209

Cites

81 of 81 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 140 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    A meta-analysis of 9 studies comprising 10 comparisons, using a random effects model, showed a moderate effect on improvement of symptoms [g = 0.55 (95% confidence interval 0.28-0.83); P < 0.001], favoring serious games over no intervention controls.

    “A meta-analysis of 9 studies comprising 10 comparisons, using a random effects model, showed a moderate effect on improvement of symptoms [g = 0.55 (95% confidence interval 0.28–0.83); P < 0.001], favoring serious games over no intervention controls.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: The random effects model assumes that the calculated effect sizes differ because of true variation in effect size from one study to the next and not only because of random error within studies.
  • Findingown data

    No modified games were found in the study.

    “However, we found no modified games in our study.”
    Quote in the paperNot a substantial claim
  • Findingown data

    A total of 674 participants were included in the meta-analysis (380 in experimental and 294 in control groups).

    “A total of 674 participants were included in the meta-analysis (380 in experimental and 294 in control groups).”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Post-traumatic stress disorder was the focus in two serious game studies.

    “Post-traumatic stress disorder was the focus in two serious game studies (48, 64).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Holmes, 2010, Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial tetris versus verbal pub quiz, PLoS One source

      Not checked in the free run.

    • cites [64] Holmes, 2009, Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science, PLoS One source

      Not checked in the free run.

  • Findingnone given

    All the studies used serious games for training purposes.

    “All the studies used serious games for training purposes.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 58

  • May combine two claims.

    Findingown data

    Eight studies used serious games that were designed as such, and two studies used an existing entertainment game for a serious purpose (purpose-shifted).

    “Eight studies used serious games that were designed as such (34, 35, 58–63). Two studies used an existing entertainment game for a serious purpose (purpose-shifted) (48, 64).”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [34] Fleming, 2012, A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education, Behav Cogn Psychother source

      Not checked in the free run.

    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [58] Ballesteros, 2014, Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial, Front Aging Neurosci source

      Not checked in the free run.

    • cites [59] Dovis, 2015, Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. A randomized double-blind placebo controlled trial, PLoS One source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

    • cites [61] Rezaiyan, 2007, Effect of computer game intervention on the attention capacity of mentally retarded children, Int J Nurs Pract source

      Not checked in the free run.

    • cites [62] Verduin, 2013, Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder, J Subst Abuse Treat source

      Not checked in the free run.

    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [48] Holmes, 2010, Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial tetris versus verbal pub quiz, PLoS One source

      Not checked in the free run.

    • cites [64] Holmes, 2009, Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science, PLoS One source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The serious games focused on symptoms of depression (n = 2), post-traumatic stress disorder (n = 2), autism spectrum disorder (n = 2), attention deficit hyperactivity disorder (n = 1), cognitive functioning (n = 2), and alcohol use disorder (n = 1).

    “The serious games focused on symptoms of depression (n = 2), post-traumatic stress disorder (n = 2), autism spectrum disorder (n = 2), attention deficit hyperactivity disorder (n = 1), cognitive functioning (n = 2), and alcohol use disorder (n = 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The studies used goal-oriented (n = 4) and cognitive training games (n = 6).

    “The studies used goal-oriented (n = 4) and cognitive training games (n = 6).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Ten studies met the inclusion criteria and were included in the review, and nine studies were included in the meta-analysis.

    “Ten studies met the inclusion criteria and were included in the review, and nine studies were included in the meta-analysis.”
    • Also stated in: § Study Selection · plain
      “After applying the exclusion criteria, 10 studies were included in the review and 9 in the meta-analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The studies targeted age groups ranging from 7 to 80 years old.

    “The studies targeted age groups ranging from 7 to 80 years old.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    The search returned 4,130 items; after removal of duplicates, 3,693 records remained; initial screening excluded 3,612 articles, leaving 81 items; after applying exclusion criteria, 10 studies were included in the review and 9 in the meta-analysis.

    “The PubMed, PsycINFO, and Embase search returned 4,130 items. After removal of duplicates, 3,693 records remained. Initial screening of title and abstract excluded a further 3,612 articles, leaving 81 items. After applying the exclusion criteria, 10 studies were included in the review and 9 in the meta-analysis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    All of the serious games were provided via personal computer, mostly on CD-ROM without the need for an internet connection.

    “All of the serious games were provided via personal computer, mostly on CD-ROM without the need for an internet connection.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The cognition training game Let's Face It! was used in order to reduce ASD-related symptoms such as poor facial recognition skills.

    “The cognition training game Let’s Face It! was used in order to reduce ASD-related symptoms such as poor facial recognition skills (63).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    No exergames were identified in the current study.

    “No exergames were identified in the current study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Let's Face It! is available to the public and can be downloaded free of charge from the website of the University of Victoria.

    “Let’s Face It! is available to the public and can be downloaded free of charge from the website of the University of Victoria”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Beaumont and Sofronoff and Tanaka et al. had facial expression as a common primary outcome measure.

    “Beaumont and Sofronoff (35) and Tanaka et al. (63) had facial expression as common primary outcome measure.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The intervention in Tanaka et al. had a duration of 19.1 weeks on average.

    “The intervention had a duration of 19.1 weeks average (63).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One study used a serious game that was goal-oriented only.

    “One study used a serious game that was goal-oriented only (62).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Verduin, 2013, Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder, J Subst Abuse Treat source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Three studies used serious games that can be categorized in two genres, namely, goal-oriented and problem-solving.

    “Three studies used serious games that can be categorized in two genres, namely, goal-oriented and problem-solving (34, 35, 60).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [34] Fleming, 2012, A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education, Behav Cogn Psychother source

      Not checked in the free run.

    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    In both PTSD studies, Tetris was played for 10 min with little instruction needed, after watching a film containing traumatic scenes.

    “Within both studies by Holmes et al. (48, 64), this game was played for 10 min with little instruction needed, after watching a film containing traumatic scenes.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Holmes, 2010, Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial tetris versus verbal pub quiz, PLoS One source

      Not checked in the free run.

    • cites [64] Holmes, 2009, Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    Tetris was used in both PTSD studies in order to reduce PTSD-related symptoms.

    “Tetris was used in both studies in order to reduce PTSD-related symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Two RCTs targeted depression, both with the same serious game SPARX, aimed at adolescents aged from 12 to 19 years.

    “Two RCTs targeted depression, both with the same serious game SPARX (34, 60), aimed at adolescents (aged from 12 to 19 years).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Fleming, 2012, A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education, Behav Cogn Psychother source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    In both depression studies, SPARX was used in order to reduce depression-related symptoms.

    “In both studies, this goal-oriented and problem-solving game was used in order to reduce depression-related symptoms.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Three of the 10 studies also had psychoeducation as a purpose.

    “Three of these 10 studies also had psychoeducation as a purpose (34, 35, 60).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [34] Fleming, 2012, A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education, Behav Cogn Psychother source

      Not checked in the free run.

    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In both PTSD studies, Tetris was played on a PC in the research lab at the university, and no internet connection was needed to play Tetris.

    “In both studies, the game was played on a PC in the research lab at the university. No internet connection was needed to play Tetris.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Let's Face It! used face subtests and object subtests.

    “Let’s Face It! used face subtests (face dimensions, immediate memory for faces, matching identity, masked features, expression, and parts/whole identity) and object subtests (house dimensions and immediate memory for cars) (63).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The version of SPARX used in the studies can be played on a PC without the need for an internet connection.

    “The version of SPARX used in the studies can be played on a PC without the need for an internet connection”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The Children's Depression Rating Scale Revised was used as the primary outcome measure for both depression studies.

    “The Children’s Depression Rating Scale Revised (67) was used as primary outcome measure for both studies.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Poznanski, 1996

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One ASD study used emotion recognition and emotion management as primary outcome measures.

    “As primary outcome measures, one study used emotion recognition (facial expression and body posture) and emotion management (Dylan is being teased, a coping with bullying test and James and the Maths Test, a coping with anxiety test) (35).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    JDTP can be played on a PC without the need for an internet connection.

    “JDTP can be played on a PC without the need for an internet connection.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Tetris was purpose-shifted, since it was originally developed for entertainment.

    “Tetris (68) was purpose-shifted, since it was originally developed for entertainment.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Tetris

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingnone given

    The common ground between the included studies is the evaluation through RCTs of possible improvement to mental health symptoms using serious games.

    “The common ground between the included studies is, however, the evaluation through RTCs of possible improvement to mental health symptoms using serious games.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A cognition training computer games program that focused on path-finding was used in order to reduce cognitive decline symptoms.

    “A cognition training computer games program that focused on path-finding (proceeding from easy to hard) was used in order to reduce cognitive decline symptoms (61).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Rezaiyan, 2007, Effect of computer game intervention on the attention capacity of mentally retarded children, Int J Nurs Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two studies targeted depression.

    “Two studies targeted depression (34, 60).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Fleming, 2012, A pragmatic randomized controlled trial of computerized CBT (SPARX) for symptoms of depression among adolescents excluded from mainstream education, Behav Cogn Psychother source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Three studies reported that research assistants were blinded for the outcome assessment.

    “Three studies reported that research assistants were blinded for the outcome assessment (35, 59, 60).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [59] Dovis, 2015, Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. A randomized double-blind placebo controlled trial, PLoS One source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    PTSD was the subject of two studies.

    “PTSD was the subject of two studies (48, 64).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Holmes, 2010, Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial tetris versus verbal pub quiz, PLoS One source

      Not checked in the free run.

    • cites [64] Holmes, 2009, Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science, PLoS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One study focused on ADHD.

    “One study focused on ADHD (59).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Dovis, 2015, Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. A randomized double-blind placebo controlled trial, PLoS One source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The study of Verduin et al. on AUD did not provide amenable data for inclusion in the meta-analysis and is therefore excluded.

    “The study of Verduin et al. (62) on AUD did not provide amenable data for inclusion in the meta-analysis and is therefore excluded (Table 3).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Verduin, 2013, Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder, J Subst Abuse Treat source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The cognition training PC game Braingame Brian was used in order to reduce ADHD-related symptoms.

    “The cognition training PC game Braingame Brian (78) was used in order to reduce ADHD-related symptoms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78] Prins, 2013, “Braingame Brian”: toward an executive function training program with game elements for children with ADHD and cognitive control problems, Games Health J source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Two studies targeted cognitive functioning symptoms, meaning limited attention capacity due to impairment and age-related decline in cognitive performances including working memory, speed of processing, and cognitive control.

    “Two studies targeted cognitive functioning symptoms (58, 61), meaning limited attention capacity due to impairment (61) and age-related decline in cognitive performances including working memory, speed of processing, and cognitive control (58).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [58] Ballesteros, 2014, Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial, Front Aging Neurosci source

      Not checked in the free run.

    • cites [61] Rezaiyan, 2007, Effect of computer game intervention on the attention capacity of mentally retarded children, Int J Nurs Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Several domains were rated unclear due to incomplete reporting.

    “Several domains were rated unclear—the reason for this was incomplete reporting.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Two studies reported allocation to be concealed.

    “Two studies reported allocation to be concealed (59, 60).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [59] Dovis, 2015, Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. A randomized double-blind placebo controlled trial, PLoS One source

      Not checked in the free run.

    • cites [60] Merry, 2012, The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    ASD was the focus of two studies.

    “ASD was the focus of two studies (35, 63).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [35] Beaumont, 2008, A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program, J Child Psychol Psychiatry source

      Not checked in the free run.

    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    AUD was targeted in one study.

    “AUD was targeted in one study (62).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Verduin, 2013, Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder, J Subst Abuse Treat source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Cognitive functioning was targeted in two studies.

    “Cognitive functioning was targeted in two studies (58, 61).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [58] Ballesteros, 2014, Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial, Front Aging Neurosci source

      Not checked in the free run.

    • cites [61] Rezaiyan, 2007, Effect of computer game intervention on the attention capacity of mentally retarded children, Int J Nurs Pract source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    There were eight different games in the study.

    “There were eight different games in our study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    The number of studies that were eligible for inclusion in this review was small and the number of participants included in those studies likewise.

    “First, the number of studies that were eligible for inclusion in this review was small and the number of participants included in those studies likewise.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    All of the serious games were PC applications that required no internet connection to play.

    “All of the serious games were PC applications that required no internet connection to play.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Three types of serious games in terms of design processes can be identified: designed, purpose-shifted, and modified games.

    “Three types of serious games in terms of design processes can be identified, namely, designed, purpose-shifted, and modified games (4).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Djaouti, 2011, Origins of serious games source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The remaining items were screened on the basis of title, abstract, and keywords by two independent raters.

    “The remaining items were screened on basis of title, abstract, and keywords by two independent raters (Ho Ming Lau and Ka Wai Ma).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The PRISMA statement was used as a guideline to conduct the study.

    ““The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” statement (44) was used as guideline to conduct this study.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Moher, 2014, Preferred reporting items for systematic reviews and meta-analyses, Ann Intern Med

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A data extraction sheet was developed and pretested on two studies.

    “A data extraction sheet was developed and pretested on two studies.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The validity of the included studies was assessed using the Risk of Bias Assessment tool of the Cochrane Collaboration.

    “The validity of the included studies was assessed using the Risk of Bias Assessment tool of the Cochrane Collaboration (45).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [45] Higgins, 2011

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    While a few reviews have been conducted on the potential impact of serious games for common mental disorders, none of these are robust.

    “Thus while a few reviews (36, 37) have been conducted on the potential impact of serious games for common mental disorders, none of these are robust.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [36] Li, 2014, Game-based digital interventions for depression therapy: a systematic review and meta-analysis, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

    • cites [37] Van der Krieke, 2012

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    VRET, simulations, and interactive computerized interventions do not necessarily contain elements that make a game a game and thus should not be categorized as serious games.

    “VRET, simulations, and interactive computerized interventions do not necessarily contain elements that make a game a game and thus should not be categorized as serious games (43).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [43] Sauvé, 2007, Distinguishing between games and simulations: a systematic review, Educ Techno Soc

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    To date, few serious games have been tested and reported in the scientific literature.

    “To date, few serious games have been tested and reported in the scientific literature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Support for the effectiveness of game-based interventions for depression was found.

    “Support for the effectiveness of game-based interventions for depression was found.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Li, 2014, Game-based digital interventions for depression therapy: a systematic review and meta-analysis, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Games and simulations are different conceptual entities.

    “Games and simulations are, however, different conceptual entities (43).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [43] Sauvé, 2007, Distinguishing between games and simulations: a systematic review, Educ Techno Soc

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Data were extracted by two independent reviewers.

    “Data were extracted by two independent reviewers (Ho Ming Lau and Jan Smit Jr.).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The remaining records were assessed for eligibility by two independent raters.

    “The remaining records were assessed for eligibility by two independent raters (Ho Ming Lau and Jan Smit Jr.).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisereasoning

    When visuospatial tasks are performed after a traumatic event and within the time window of memory consolidation, competition for the same resources occurs, causing interference with and reduction of flashbacks.

    “When visuospatial tasks are performed after a traumatic event and also within the time window of memory consolidation, competition for the same resources will occur, causing interference with and reduction of flashbacks.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Flashbacks of traumatic events consist of sensory-perceptual and visuospatial mental images.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The games of Tanaka et al. are based on the theory of enhancement of recognition skills.

    “The games of Tanaka et al. (63) are based on the theory of enhancement of recognition skills (63).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [63] Tanaka, 2010, Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisenone given

    The theory of using Tetris is based on findings in cognitive science and neurobiology of memory.

    “The theory of using Tetris is based on findings in cognitive science and neurobiology of memory.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The serious game is based on ADHD theories which argue that deficits in executive functioning are related to impulsivity, hyperactivity, and attention.

    “The serious game is based on ADHD theories which argue that deficits in executive functioning are related to impulsivity, hyperactivity, and attention (69–77).”
    Quote in the paperNot a substantial claim0 of 9 sources checked
    • cites [69] Barkley, 2006

      Not checked in the free run.

    • cites [70] Nigg, 2006

      Not checked in the free run.

    • cites [71] Rapport, 2009, Hyperactivity in boys with attention-deficit/hyperactivity disorder (ADHD): a ubiquitous core symptom or manifestation of working memory deficits?, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [72] Burgess, 2010, Attentional control activation relates to working memory in attention-deficit/hyperactivity disorder, Biol Psychiatry source

      Not checked in the free run.

    • cites [73] Crosbie, 2013, Response inhibition and ADHD traits: correlates and heritability in a community sample, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [74] Kofler, 2010, ADHD and working memory: the impact of central executive deficits and exceeding storage/rehearsal capacity on observed inattentive behavior, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [75] Raiker, 2012, Objectively-measured impulsivity and attention-deficit/hyperactivity disorder (ADHD): testing competing predictions from the working memory and behavioral inhibition models of ADHD, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [76] Rapport, 2001, A conceptual model of child psychopathology: implications for understanding attention deficit hyperactivity disorder and treatment efficacy, J Clin Child Psychol source

      Not checked in the free run.

    • cites [77] Tillman, 2011, The relation between working memory components and ADHD symptoms from a developmental perspective, Dev Neuropsychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    SPARX is based on CBT.

    “This game is based on CBT (66).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [66] Burns, 1999

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The serious games studied by Rezaiyan et al. are based on the finding that playing video games based on internal motivation can be a source of increasing attention power.

    “The serious games studied by Rezaiyan et al. (61) are based on the finding that playing video games based on internal motivation can be a source of increasing attention power (61).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Rezaiyan, 2007, Effect of computer game intervention on the attention capacity of mentally retarded children, Int J Nurs Pract source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    The strength of this study is that it is the first to provide insight into the potential effectiveness of serious games on psychiatric disorder-related symptoms based on RCTs only and on a strict definition of what is regarded to be a "serious game."

    “The strength of this study is that it is the first to provide insight into the potential effectiveness of serious games on psychiatric disorder-related symptoms based on RCTs only and on a strict definition of what is regarded to be a “serious game.””
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The development and/or validation of serious games for mental health on the PC platform is lagging behind.

    “It seems that the development and/or validation of serious games for mental health on this technical platform is lagging behind.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Trends show that PC sales are declining, tablet sales are increasing, more time is spent on the smartphone and that most time spent on the smartphone is in playing games (in the US).

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A very generic comparison, with similar results could be made with the meta-analysis of Ebert et al. on youth (2015) who likewise found evidence for the moderate efficacy of internet and computer-based CBT in the treatment of depression and anxiety (g = 0.76).

    “A very generic comparison, with similar results could be made with the meta-analysis of Ebert et al. (27) on youth (2015) who likewise found evidence for the moderate efficacy of internet and computer-based CBT in the treatment of depression and anxiety (g = 0.76).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Ebert, 2015, Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials, PLoS One source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We decided not to conduct subgroup analyses of distinct mental disorders as the number of studies and power for doing so was too low.

    “As a consequence, we decided not to conduct subgroup analyses of distinct mental disorders as the number of studies and power for doing so was too low.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The review by Fleming et al. was not confined to RCTs.

    “This review was not confined to RCTs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Fleming, 2014, Serious games for the treatment or prevention of depression: a systematic review, Revista de Psicopatología y Psicología Clínica source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Given the small number of studies, several mental health disorders and clinical outcomes were collated as psychiatric-related disorders instead of focusing on single ones. This means the findings can only indicate improvement instead of clear symptom reduction.

    “Furthermore, given the small number of studies, several mental health disorders and clinical outcomes were collated as psychiatric-related disorders instead of focusing on single ones. This means the findings can only indicate improvement instead of clear symptom reduction (89).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [89] Wantland, 2004, The effectiveness of web-based vs. non-web-based interventions: a meta-analysis of behavioral change outcomes, J Med Internet Res source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    This study also showed that reminders and guidance are important moderators for treatment outcome.

    “This study also showed that reminders and guidance are important moderators for treatment outcome.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84] Cowpertwait, 2013, Effectiveness of web-based psychological interventions for depression: a meta-analysis, Int J Ment Health Addict source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    This finding is similar to that of a recently conducted meta-analysis of game-based interventions by Li et al. for depression only.

    “This finding is similar to that of a recently conducted meta-analysis of game-based interventions by Li et al. (36) for depression only.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Li, 2014, Game-based digital interventions for depression therapy: a systematic review and meta-analysis, Cyberpsychol Behav Soc Netw source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The risk of bias in these studies was unclear in many cases due to incomplete reporting and may have been a problem (selection, performance, and detection bias) indicating that the methodological quality of studies could be improved and effect sizes could be overestimated.

    “The risk of bias in these studies was unclear in many cases due to incomplete reporting and may have been a problem (selection, performance, and detection bias) indicating that the methodological quality of studies could be improved and effect sizes could be overestimated.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The effect sizes found in this study correspond to NNTs of approximately 3, indicating that three patients have to be treated in order to have one who would benefit, slightly lower than Li and colleagues.

    “The effect sizes found in this study correspond to NNTs of approximately 3, indicating that three patients have to be treated in order to have one who would benefit, slightly lower than Li and colleagues.”
    Quote in the paperNot a substantial claim
71 of 71

  • The authors state this as an assumption.

    The random effects model assumes that the calculated effect sizes differ because of true variation in effect size from one study to the next and not only because of random error within studies.

    “It assumes that the calculated effect sizes differ because of true variation in effect size from one study to the next and not only of the random error within studies.”

  • The authors state this as an assumption.

    Flashbacks of traumatic events consist of sensory-perceptual and visuospatial mental images.

    “Flashbacks of traumatic events are assumed to consist of sensory-perceptual and visuospatial mental images.”

  • The paper relies on this without support.

    RCTs are the gold standard of research to measure effectiveness of interventions and to make clear what a serious game is or is not.

    “This is important as RCTs are considered the gold standard of research to measure effectiveness of interventions and to make clear what a serious game is or is not.”

  • The paper relies on this without support.

    Trends show that PC sales are declining, tablet sales are increasing, more time is spent on the smartphone and that most time spent on the smartphone is in playing games (in the US).

    “However, trends show that PC sales are declining, tablet sales are increasing, more time is spent on the smartphone and that most time spent on the smartphone is in playing games (in the US).”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Mental health apps provide a potential way to reduce symptoms and increase adherence by dispensing psychoeducation and therapeutic skills through an accessible electronic format.

    “Mental health apps provide a potential way to reduce symptoms and increase adherence by dispensing psychoeducation and other therapeutic skills through an electronic, easily accessible format [26-34].”

    From Examining the effectiveness of gamification in mental health apps for depression: Systematic review and meta-analysis (2021) · cites this paper as [33]

    The Results describe serious games that provide psychoeducation and skills training, and the Introduction discusses their potential to reduce mental-health complaints. The Discussion says smartphone distribution could improve accessibility. But the reviewed interventions were PC games, not mental-health apps, and the paper does not establish that they increase treatment adherence. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Serious games demonstrate increased efficacy and effectiveness across a spectrum of conditions.

    “Serious games demonstrate increased efficacy and effectiveness across a spectrum of conditions (Lau et al., 2017; McCallum, 2012)”

    From Therapeutic games to reduce anxiety and depression in young people: A systematic review and exploratory meta‐analysis of their use and effectiveness. (2024) · cites this paper as Lau et al., 2017

    The Results (Results of the Meta-analysis; page unavailable) report a moderate overall improvement with serious games versus no intervention across studies of several mental-health conditions. The claim omits that mental-health scope and implies demonstrated effectiveness across conditions individually; the Discussion (Strengths and Limitations; page unavailable) cautions that the small evidence base supports an indication of improvement, not clear symptom reduction for each disorder. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Evidence on the effectiveness of serious games for improving mental health and wellbeing is still limited.

    “Although the evidence on the effectiveness of serious games (“computerized interventions which utilize gaming for serious purposes” [Fleming et al., 2014, p. 1]) for improving mental health and wellbeing is still limited (Lau et al., 2017, Johnson et al., 2016)”

    From A pilot evaluation of the SPARX-R gaming intervention for preventing depression and improving wellbeing among adolescents in alternative education (2017) · cites this paper as Lau et al., 2017

  • Video games are an effective tool to reduce anxious and depressive symptomatology in patients and are useful to reduce misconceptions and stigmatization about severe mental illnesses such as schizophrenia or bipolar disorder.

    “Among this type of interventions, the use of video games has been highlighted as an effective tool to reduce anxious and depressive symptomatology in patients, and has been useful to reduce misconceptions and stigmatization about severe mental illnesses, such as schizophrenia or bipolar disorder [12,13].”

    From Innovative Technology–Based Interventions to Reduce Stigma Toward People With Mental Illness: Systematic Review and Meta-analysis (2022) · cites this paper as [12]

  • Much less work has been done with serious games for mental health as compared to other conditions, but several game-based interventions have been developed.

    “Although much less work has been done with serious games for mental health as compared to other conditions, several game-based interventions have been developed [62-65].”

    From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [64]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The ASD significance claim conflicts with its confidence interval

    Major

    The ASD result is called non-significant at P > 0.05, yet its reported 95% confidence interval, 0.10-0.81, excludes zero.

  • The reported I2 confidence interval excludes its own estimate

    Major

    The overall I2 estimate is 58.53, above the upper bound of its stated 95% confidence interval, 34.15. Several other I2 rows in Table 3 have the same problem.

  • The reported number of meta-analysis comparisons changes

    Minor

    The methods/results text says nine comparisons could be included, whereas the abstract, outcome results, and Table 3 report ten comparisons from nine studies.

  • The stated overall comparator excludes controls used in the analysis

    Minor

    The abstract describes the pooled effect as favoring games over no-intervention controls, but the paper says the included studies also used active controls and treatment as usual.

  • An adolescent study is listed among adult studies

    Minor

    The study-characteristics paragraph classifies Fleming et al. (34) among studies aimed at adults aged 18 or older, but Table 1 describes its participants as adolescents aged 13-16.

  • Ballesteros participants are described as children and elderly

    Minor

    The cognitive-functioning section calls Ballesteros et al.'s participants children, while Table 1 identifies them as healthy elderly people aged 57-80.

  • The Toulouse Pierson Scale is attributed to the wrong study

    Minor

    The text attributes assessment with the Toulouse Pierson Scale to Ballesteros et al., but Table 1 lists it as the primary outcome measure for Rezaiyan et al.; Ballesteros has different listed outcomes.

  • The stated maximum study sample size is below a listed group size

    Minor

    The paper says total study sample sizes reached at most 89, but Table 1 lists 94 participants in the serious-games group alone for Merry et al.

8 of 8

Cites

Flagged first, then by citations

2 of the 83 references couldn’t be matched to a known paper.

Research works printed but not linked: 16

  1. Michael, 2005, Serious Games: Games That Educate, Train, and Inform. Education, 1
  2. Stapleton, 2004, Serious Games: Serious Opportunities. Health Care, 1
  3. Sawyer, 2002, Serious Games: Improving Public Policy through Game Based Learning and Simulation
  4. McGonigal, 2011, Reality is broken, New York, 169, 402
  5. Norman, 2001, Learning from the Success of Computer Games
  6. Stapleton, 2003, Why videogames are cool and school sucks!, Australian Game Developers Conference (AGDC)
  7. Durkin, 1999, Computer Games and Australians Today
  8. Van der Krieke, 2012, Serious Games for People with Mental Health Problems: A Systematic Review
  9. Higgins, 2011, Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [Updated March 2011]
  10. Smith, 2014, Comprehensive Meta-Analysis (Version 2) [Computer software]
  11. Hazmat: Hotzone, Hazmat
  12. Burns, 1999, The Feeling Good Handbook, 1
  13. Poznanski, 1996, Children’s Depression Rating Scale-Revised: Manual
  14. Tetris, The Tetris Company
  15. Lumos Labs, Lumosity
  16. Bowers, 2011, Serious games for therapy: a training perspective, J Cyber Ther Rehabil, 4, 447

Cited by

Sorted by citations

Related

Authors
Lau, H. M., Smit, J. H., Fleming, T. M., & Riper, H.
Affiliations
  • Amsterdam Public Health (NL)
  • University of Auckland (NZ)
Corresponding author
Lau, Ho Ming
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2017-01-18
Volume
7
Pages
209-209
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2016.00209
PMC
PMC5241302
OpenAlex
W2576865508
Semantic Scholar
85314eee1865c5b220d4b89868ccd83f951afc90
Cited by
328
References
83
Citations by year
2026: 17 · 2025: 30 · 2024: 24 · 2023: 44 · 2022: 60 · 2021: 49 · 2020: 38 · 2019: 30 · 2018: 27 · 2017: 8
FWCI
5.41
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • VU Research Portal (submittedVersion, other-oa)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
serious games, mental health, digital interventions, depression, post-traumatic stress disorder, autism spectrum disorder, attention deficit hyperactivity disorder, cognitive training, alcoholism, cognitive function, symptom relief, accessibility, feasibility

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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