Abstract
The mechanisms of change are rarely investigated in the field of gamified interventions for preventing emotional disorders in children and adolescents despite the wide recognition for the advantages they offer as prevention tool. Therefore, the aim of the present study was to investigate the mechanisms of change of a therapeutic game (REThink), specifically mediators and moderators of its efficacy. We conducted a randomized controlled trial, involving 165 children (age range 10–16 years), who were randomly distributed across three groups: the REThink group (N = 54), the Rational Emotive Behavior Education group (N = 55) and the Waitlist condition (N = 56). Results indicated that changes in irrational beliefs were significant mediators for the REThink intervention on depressive mood and overall negative emotions. Age did not moderate the effect of REThink, which indicates that the program was equally effective for children and adolescents.
Trial Registration ClinicalTrials.gov NCT03308981.
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References
Belfer ML (2008) Child and adolescent mental disorders: the magnitude of the problem across the globe. J Child Psychol Psychiatry 49:226–236. https://doi.org/10.1111/j.1469-7610.2007.01855.x
Cullins LM, Mian AI (2015) Global child and adolescent mental health: a culturally informed focus. Child Adolesc Psychiatr Clin N Am 24:823–830. https://doi.org/10.1016/j.chc.2015.06.010
Donovan CL, Spence SH (2000) Prevention of childhood anxiety disorders. Clin Psychol Rev 20:509–531. https://doi.org/10.1016/S0272-7358(99)00040-9
Cuijpers P, van Straten A, Smit F et al (2008) Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions. Am J Psychiatry 165:1272–1280. https://doi.org/10.1176/appi.ajp.2008.07091422
Horowitz JL, Garber J (2006) The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psychol 74:401–415. https://doi.org/10.1037/0022-006X.74.3.401
Anguera JA, Boccanfuso J, Rintoul JL et al (2013) Video game training enhances cognitive control in older adults. Nature 501:97–101
Beale IL, Kato PM, Marin-Bowling VM et al (2007) Improvement in cancer-related knowledge following use of a psychoeducational video game for adolescents and young adults with cancer. J Adolesc Health 41:263–270. https://doi.org/10.1016/j.jadohealth.2007.04.006
Cole SW, Yoo DJ, Knutson B (2012) Interactivity and reward-related neural activation during a serious videogame. PLoS One 7:e33909. https://doi.org/10.1371/journal.pone.0033909
Fagundo AB, Santamaría JJ, Forcano L et al (2013) Video game therapy for emotional regulation and impulsivity control in a series of treated cases with bulimia nervosa. Eur Eat Disord Rev 21:493–499. https://doi.org/10.1002/erv.2259
Fernández-Aranda F, Jiménez-Murcia S, Santamaría JJ et al (2012) Video games as a complementary therapy tool in mental disorders: PlayMancer, a European multicentre study. J Ment Health 21:364–374. https://doi.org/10.3109/09638237.2012.664302
Lenhart A, Kahne J, Middaugh E, et al (2008) Teens, video games, and civics: teens’ gaming experiences are diverse and include significant social interaction and civic engagement. Pew Internet Am Life Proj. https://files.eric.ed.gov/fulltext/ED525058.pdf
Ellis A (1994) Reason and emotion in psychotherapy, Rev edn. Carol Publishing Group, Secaucus
Vernon A (1998) The PASSPORT program: a journey through emotional, social, cognitive, and self-development, grades 9–12. Research Press, Champaign
Merriefield C, Merriefield R (1979) Call me ret-man and have a ball. Institute for Rational Living, New York
David D (2010) Retmagia şi minunatele aventuri ale lui Retman. Poveşti raţionale pentru copii şi adolescenţi [Retmagic and the wonderful adventures of Retman. Stories for children and adolescents]. RTS Cluj, Cluj-Napoca
David OA, Cardos R, Matu S (2018) Is REThink therapeutic game effective in preventing emotional disorders in children and adolescents? Outcomes of a randomized clinical trial. ECAP
Vîslă A, Flückiger C, David D et al (2015) Irrational beliefs and psychological distress: a meta-analysis. Psychother Psychosom 85:8–15. https://doi.org/10.1159/000441231
Trip S, Vernon A, McMahon J (2007) Effectiveness of rational-emotive education: a meta-analytical study. J Cogn Behav Psychother. 7:81–93
Ellis A (1995) Changing rational-emotive therapy (RET) to rational emotive behavior therapy (REBT). J Ration Emotive Cogn Behav Ther 13:85–89
Goodman R, Meltzer H, Bailey V (1998) The strengths and difficulties questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 7:125–130. https://doi.org/10.1007/s007870050057
Ellis LK, Rothbart MK (2001) Revision of the early adolescent temperament questionnaire. In: Poster presented at the 2001 biennial meeting of the society for research in child development, Minneapolis, Minnesota
Bernard ME, Cronan F (1999) The child and adolescent scale of irrationality: validation data and mental health correlates. J Cogn Psychother 13:121–132
Trip S, Popa M (2005) CASI—the child and adolescent scale of irrationality. Analele Univ Din Oradea Fasc Psihol 8:39–51
Hogendoorn SM, Wolters LH, Vervoort L et al (2010) Measuring negative and positive thoughts in children: an adaptation of the Children’s Automatic Thoughts Scale (CATS). Cogn Ther Res 34:467–478. https://doi.org/10.1007/s10608-010-9306-2
Hayes AF (2013) Model templates for PROCESS for SPSS and SAS [White paper]. Retrieved from http://www.afhayes.com
Chu BC, Harrison TL (2007) Disorder-specific effects of CBT for anxious and depressed youth: a meta-analysis of candidate mediators of change. Clin Child Fam Psychol Rev 10:352–372. https://doi.org/10.1007/s10567-007-0028-2
Kendall PC, Treadwell KR (2007) The role of self-statements as a mediator in treatment for youth with anxiety disorders. J Consult Clin Psychol 75:380–389
David D, Szentagotai A (2006) Cognitions in cognitive-behavioral psychotherapies; toward an integrative model. Clin Psychol Rev 26:284–298. https://doi.org/10.1016/j.cpr.2005.09.003
Şoflău R, David DO (2017) A meta-analytical approach of the relationships between the irrationality of beliefs and the functionality of automatic thoughts. Cogn Ther Res 41:178–192. https://doi.org/10.1007/s10608-016-9812-y
Bennett K, Manassis K, Walter SD et al (2013) Cognitive behavioral therapy age effects in child and adolescent anxiety: an individual patient data meta-analysis. Depress Anxiety 30:829–841. https://doi.org/10.1002/da.22099
Acknowledgements
We thank Carmen Pop, Răzvan Predatu, and Mădălina Sucală for their contribution, without which the present study could not have been completed.
Funding
This work was supported by a grant awarded to Oana A. David from the Romanian National Authority for Scientific Research, CNCS—UEFISCDI (Grant number PN-II-PT-PCCA-2013-4-1937).
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David, O.A., Cardoș, R.A.I. & Matu, S. Changes in irrational beliefs are responsible for the efficacy of the REThink therapeutic game in preventing emotional disorders in children and adolescents: mechanisms of change analysis of a randomized clinical trial. Eur Child Adolesc Psychiatry 28, 307–318 (2019). https://doi.org/10.1007/s00787-018-1195-z
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DOI: https://doi.org/10.1007/s00787-018-1195-z