Guided feedback in an online text-based game impacts activity choices

Abstract

Background. Many behavioral interventions to improve mood are focused on activity planning and identifying valued actions. Research investigating psychotherapy can be intensive and incorporate many aspects of treatment. This study aimed to explore whether psychoeducation or a text game with positive feedback could change behavior within the game or change symptoms one week later. Methods. Online participants (n=350) were randomly assigned to one of six conditions (5-min behavioral video, brief behavioral game, brief neutral game, video + behavioral game, video + neutral game, control). After completing the intervention, participants provided demographics and reported on symptoms of depression and anxiety. Most participants (n=311) reported symptoms again after one week. We tested whether the intervention changed how participants participated in the game and whether condition changed symptoms over time. Results. No group had improvements in symptoms compared to control. Certain game behaviors—e.g., transitions between technology and consumption compared to transitions between technology and activities—were associated with greater baseline symptoms of anxiety, and certain conditions chose differently in the game. Limitations. Online interventions may be impacted by participant disinterest, and participants were primarily college students. Feedback in the active game condition may have been ignored. Conclusions. Positive reinforcement during games is a technique of interest in guiding behavior change. Participants’ gameplay was associated with changes in anxiety symptoms.

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