JMIR Serious Games最新文献

{"title":"Feasibility, Usability, and Effects of Leisure-Based Cognitive Training Using a Fully Immersive Virtual Reality System in Older Adults: Single-Arm Pretest-Posttest Pilot Study.","authors":"I-Ching Chuang, Xiao-Ting Huang, I-Chen Chen, Yih-Ru Wu, Ching-Yi Wu","doi":"10.2196/66673","DOIUrl":"10.2196/66673","url":null,"abstract":"<p><strong>Background: </strong>Cognitive training is an effective approach to support cognitive function in older adults. Incorporating meaningful leisure activities, such as gardening, may enhance both engagement and training outcomes. While fully immersive virtual reality (VR) offers ecologically valid and engaging environments that can further boost motivation, limited research has explored the combination of VR-based cognitive training and leisure activities for older adults.</p><p><strong>Objective: </strong>This study aims to assess the feasibility, usability, and preliminary effectiveness of leisure-based VR cognitive training for community-dwelling older adults.</p><p><strong>Methods: </strong>A fully immersive VR cognitive training system, controlled via a head-mounted display, was developed, incorporating gardening-themed activities such as planting, fertilizing, watering, and harvesting. These tasks were designed to engage multiple cognitive domains, including memory, attention, executive function, processing speed, and visuospatial abilities. The program consisted of 16 sessions delivered over 8 weeks (twice weekly, 1 hour per session). Cognitive outcomes were assessed before and after training using the Montreal Cognitive Assessment, the digit symbol substitution test, word list immediate and delayed recall, spatial span, and the Stroop Color and Word Test. Feasibility, acceptance, and usability were evaluated using the System Usability Scale and a posttraining questionnaire. Licensed occupational therapists from both community and institutional settings assessed the training system's usability.</p><p><strong>Results: </strong>All 41 participants (mean age 69.79, SD 5.05 y) completed the training with 100% adherence and no serious adverse events. Feasibility ratings-particularly for perceived usefulness, intention to use, and subjective norms-reflected strong acceptance. Usability ratings from older adults indicated high ease of use, enjoyment, and positive experience, while professionals rated the system as moderately usable (mean System Usability Scale score 68.01, SD 8.38). Statistically significant improvements were observed in general cognition (P=.004), processing speed (P=.049), immediate and delayed memory (P<.001), and executive function (P=.002). No significant changes were found in visuospatial memory (P=.29).</p><p><strong>Conclusions: </strong>This study provides preliminary evidence supporting the feasibility and usability of a gardening-based VR cognitive training program for older adults. Feasibility was demonstrated through full adherence, absence of major adverse events, and high participant acceptance. Usability feedback was favorable from both older adults and professionals across community and long term care settings. Additionally, improvements in multiple cognitive domains, including general cognition, processing speed, memory, and executive function, suggest potential cognitive benefits. Future randomized cont","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e66673"},"PeriodicalIF":4.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability Evaluation of a Virtual Reality Multisensory Sham-Feeding Device for Patients Undergoing Fasting Periods for Colorectal Cancer Surgery: Mixed Methods Study.","authors":"Xingzhu Yuan, Peiling Ye, Xinyue Liu, Yuehan Hu, Qin Xu, Wenyi Zhao, Ka Li","doi":"10.2196/75641","DOIUrl":"https://doi.org/10.2196/75641","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer surgery requires perioperative fasting to ensure safety, but this can cause physiological and psychological discomfort, such as impaired intestinal motility, bloating, immune suppression, anxiety, and appetite loss. To address this challenge, we developed the virtual reality (VR) multisensory sham-feeding device (VRMS-SFD), based on Pavlov conditioned reflex mechanism, where vagal stimulation triggered by seeing, smelling, or thinking about food activates cephalic-phase responses, promoting digestive secretion and intestinal motility. The device integrates multisensory stimulation-visual (food presentation), auditory (eating sounds and relaxing music), and olfactory (food-specific scents)-to create a VR dining experience. It features three VR scenes (Chinese restaurant, fruit shop, and dessert shop) with 23 food options, offering immersive interaction through a head-mounted display and synchronized scent release.</p><p><strong>Objective: </strong>This study aimed to evaluate the usability, acceptability, and safety of the VRMS-SFD in patients with colorectal cancer during postoperative fasting, assessing its potential to alleviate discomfort, stimulate appetite, and enhance emotional well-being.</p><p><strong>Methods: </strong>A mixed methods design was used. Participants used VRMS-SFD for 20 minutes during each meal time over 3 postoperative days. Quantitative data included the System Usability Scale (SUS) and demographic or clinical variables. Qualitative data were obtained from 15- to 30-minute semistructured interviews, transcribed verbatim, and thematically analyzed using NVivo (version 15.0; QSR International). When no new themes emerged, the sample size was considered sufficient, and data saturation was achieved. Two researchers independently coded transcripts, with discrepancies resolved by a third reviewer. The study was ethically approved (1087) and clinically registered.</p><p><strong>Results: </strong>A total of 37 patients were included. The mean SUS score was 77.78 (SD 7.90; range 62.5-97.5), indicating high usability. Participants rated ease of use (mean 4.46, SD 0.56), learnability (mean 4.27, SD 0.69), and confidence (mean 4.27, SD 0.61) positively. There was no correlation between SUS score and age (r=0.05). Thematic analysis revealed four themes: (1) immersive and enjoyable experience, with patients describing the device as \"novel\" and \"engaging\"; (2) reduced fasting-related discomfort, including less bloating, improved mood, and reported peristalsis; (3) appetite stimulation, with many noting increased hunger; and (4) improvement suggestions, such as enhancing scent authenticity, simplifying controls, and diversifying music. One participant experienced transient dizziness, resolving within 5 minutes post-device removal, with no other adverse events. Quantitative and qualitative findings converged, confirming robust usability and clinical benefits.</p><p><strong>Conclusions: </s","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e75641"},"PeriodicalIF":4.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Caregiver Perceptions of a Social Robot and Tablet for Serious Game Delivery in Dementia Care: Cross-Sectional Comparison Study.","authors":"Dorothy Bai, Kelvin Tan Cheng Kian, Po-Yin Chen, Yeh-Liang Hsu, Gong-Hong Lin","doi":"10.2196/76209","DOIUrl":"10.2196/76209","url":null,"abstract":"<p><strong>Background: </strong>Social robots integrated with serious games hold promise as innovative nonpharmacological strategies in dementia care. However, limited studies have adopted quantitative, platform-level comparisons from the perspective of formal caregivers, who are key stakeholders in technology implementation in dementia care settings.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility, usability, and overall user experience of a serious game-based interaction model delivered via a screen-equipped social robot, compared to a tablet-based version of the same model, from the perspective of formal dementia caregivers.</p><p><strong>Methods: </strong>A cross-sectional comparative study was conducted with 120 formal dementia caregivers. Each caregiver individually interacted with both a screen-equipped social robot and a touchscreen tablet, delivering identical serious game content incorporating cognitive exercises, music therapy, and reminiscence. The robot featured multimodal interaction capabilities, including voice, gestures, movement, and facial expression display, while the tablet relied on standard touchscreen functions. Caregivers evaluated both platforms using the User Experience Questionnaire (UEQ), System Usability Scale (SUS), and a customized Technology Acceptance Model (TAM). Group comparisons were performed using t tests, with post hoc Benjamini-Hochberg correction applied to control for multiple comparisons.</p><p><strong>Results: </strong>Caregivers generally favored the social robot over the tablet. The robot received higher total UEQ scores (mean 1.29, SD 1.14, vs mean 0.99, SD 1.08; P=.004), particularly in enjoyment (P=.002), friendliness (P=.006), clarity (P=.002), organization (P=.02), interest (P=.01), and innovation (P=.002). In the SUS, caregivers rated the robot higher for quick learning (mean 2.71, SD 0.79 vs mean 2.44, SD 0.81; P=.002), while overall SUS scores were comparable. TAM results indicated higher total scores for the robot (mean 4.03, SD 0.47 vs mean 3.67, SD 0.58; P=.002), with stronger ratings in perceived usefulness (P=.002), ease of use (P=.002), attitudes (P=.002), and behavioral intentions (P=.002). All P values are from 2-tailed t tests and were adjusted using the Benjamini-Hochberg procedure.</p><p><strong>Conclusions: </strong>The social robot used in this study was perceived by formal dementia caregivers as providing a more favorable user experience and eliciting a stronger intention to use compared to a tablet-based platform. These findings support the feasibility of social robots as a platform for delivering technology-supported activities in dementia care and provide a foundation for future research on their implementation and outcomes in dementia care.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e76209"},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality-Based Assessment of Attention-Deficit/Hyperactivity Disorder and Comorbid Symptoms in Children: Framework Development and Standardization Study.","authors":"Harim Jeong, Minjoo Kang, Kennet Sorenson, Jacob Moore, Robert James Blair, Ellen Leibenluft, Jeffrey H Newcorn, Beth Krone, Singi Jeong, Donghee Kim, Soonjo Hwang","doi":"10.2196/69146","DOIUrl":"https://doi.org/10.2196/69146","url":null,"abstract":"<p><strong>Background: </strong>As virtual reality (VR) technology becomes increasingly prevalent, its potential for collecting objective behavioral data in psychiatric settings has been widely recognized. However, the lack of standardized methodologies limits reproducibility and data integration across studies, particularly in assessing attention-deficit/hyperactivity disorder (ADHD) and associated behaviors, such as irritability and aggression.</p><p><strong>Objective: </strong>This study examines the use of VR-based movement data to operationalize core ADHD symptoms (hyperactivity and inattention) and comorbid disruptive behaviors (irritability and aggression), aiming to identify reproducible and clinically actionable metrics and evaluate their explanatory power for each symptom domain to assess the overall use of these variables.</p><p><strong>Methods: </strong>A total of 45 children (mean age 9.06, SD 2.11 years; n=14/45, 31% female) participated in the study and were divided into 2 groups: 28 (62%) diagnosed with ADHD and 17 (38%) controls. Seven VR-derived movement variables were analyzed: average speed, acceleration, total distance, area occupied, distance between the hands and head, frequency of movement, and time spent still. Correlation and stepwise regression analyses identified which variables best predicted ADHD symptoms and comorbid behaviors.</p><p><strong>Results: </strong>Among the 7 VR-derived variables, average speed (mean r=0.460, SD 0.097) and total distance (mean r=0.442, SD 0.116) showed the broadest associations, each correlating with 8 measures. In contrast, frequency of movement was related only to hyperactivity (r=0.416; P=.004), suggesting strong but narrow predictive value. Stepwise regression identified total distance as the sole and strongest predictor of hyperactivity (R²=0.411) and, except for participant-reported irritability, yielded significant models for all other measures (mean R²=0.282, SD 0.064; all P<.05).</p><p><strong>Conclusions: </strong>This study provides empirical evidence on VR-derived movement variables that can inform the development of standardized methodologies for ADHD and comorbid behavior assessment. The identified metrics and their predictive patterns offer a basis for integrating VR-based measures into future research and clinical applications.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69146"},"PeriodicalIF":4.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision AI-Based Gamified Cognitive Prosthesis for Executive Function: Feasibility and Usability Study.","authors":"Co Yih Siow, Yao-Hua Yang, Cheng-Jui Tsai, Wan-Wan Yang, Chaur-Jong Hu, Jia-Ying Sung, Jowy Tani","doi":"10.2196/74157","DOIUrl":"10.2196/74157","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a progressive neurodegenerative condition marked by cognitive decline and loss of functional independence. Among cognitive domains, executive dysfunction is a critical early contributor to reduced self-care capacity and increased caregiver burden. While cognitive assistive technologies have focused primarily on memory, few tools address executive function in real-time, daily tasks. To fill this gap, we developed a novel gamified cognitive prosthesis that integrates artificial intelligence (AI) and computer vision to guide users step-by-step through a simulated egg-cooking task. This system provides real-time audiovisual feedback to support planning, sequencing, and error correction.</p><p><strong>Objective: </strong>This study aimed to evaluate whether the AI-based cognitive prosthesis improves task completion time and executive function performance in individuals with mild dementia.</p><p><strong>Methods: </strong>We conducted a pilot study involving 12 patients with mild dementia and 7 age-matched healthy controls. Participants were asked to complete a 6-step gamified egg boiling task under 2 conditions: with and without guidance. The task was evaluated using a custom \"Daily Task Completion Test\" and a modified executive function performance test (EFPT) adapted to the cooking activity. Demographic and clinical data (age, sex, education, Mini-Mental State Examination, Clinical Dementia Rating, activities of daily living, instrumental activities of daily living, and Dementia Severity Rating Scale) were recorded. The System Usability Scale (SUS) was also collected postintervention.</p><p><strong>Results: </strong>In the mild dementia group, AI assistance significantly reduced median task completion time from 134.75 (IQR 92.50-134.75) to 92.00 (IQR 65.00-92.00; P=.03) seconds, and significantly improved the Executive Function Performance Test (EFPT) scores from 4.25 (IQR 1.75-4.25) to 1.00 (IQR 0.00-1.00; P=.005), reflecting a 31.7% improvement in efficiency and a 76.5% reduction in required assistance. No significant changes were observed in the control group. The mean SUS score was 80.53 (SD 24.97), indicating high usability. The AI system achieved a cumulative recognition precision of 0.93 (SD 0.07) and cumulative recall of 0.94 (SD 0.11).</p><p><strong>Conclusions: </strong>This pilot study provides preliminary evidence that an AI-based cognitive prosthesis can enhance executive function and task performance in individuals with mild dementia. The results support the feasibility of using real-time AI guidance in everyday tasks to promote independence. Given its modular design and promising usability profile, this system may serve as the foundation for future digital therapeutics targeting executive dysfunction. Larger, longitudinal studies are warranted to evaluate sustained cognitive and functional benefits.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e74157"},"PeriodicalIF":4.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Active Augmented Reality Games on Physical Activity and Cognition Among Older Adults: Feasibility Study.","authors":"Amy Shirong Lu, Bhagyashree Parkar, Shiveshchandra Gupta, Sierra Hall, Dominika M Pindus, Arthur F Kramer","doi":"10.2196/73221","DOIUrl":"10.2196/73221","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Physical activity (PA) enhances physical health as well as cognitive and brain health, yet motivating older adults to initiate and sustain PA remains challenging, a difficulty exacerbated by the COVID-19 pandemic. Active augmented reality (AAR) games, integrating digital gameplay with real-world physical movement, provide an enjoyable and accessible means for PA promotion among older adults in independent living environments, mitigating barriers such as poor weather and unfavorable neighborhood environments. However, limited research has explored the feasibility and impact of AAR interventions in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This feasibility study examines the acceptability, safety, and preliminary effects of AAR games to enhance PA levels and cognitive functions among older adults, as well as their user experiences. We also examined the practicality of home-based AAR gameplay using minimal equipment and constrained physical space.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixteen independent-living older adults aged 65-85 years (mean 74.6, SD 3.73) participated in a single-session AAR intervention using the Active Arcade game set by playing four 10-minute AAR games. PA levels were assessed using ActiGraph wGT3x-bt accelerometers and Polar H10 heart rate monitors. Cognitive function was evaluated pre- and post-gameplay using NIH Toolbox's visual reasoning test and Flanker inhibitory control and attention tests. Surveys of PA intention and motivation as well as the gaming experience questionnaire, along with semistructured interviews, were conducted afterwards, providing both quantitative and qualitative insights into the feasibility and appeal of AAR gameplay from the target population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All participants completed the study protocol without adverse events, demonstrating high feasibility and acceptability. Participants engaged in moderate-to-vigorous PA during 20%-30% of the gameplay, as measured by accelerometers and heart rate monitors. Of the 16 participants, 7 were taking beta blockers. The mean values of average %HRMax suggest that those not on beta blockers generally met the moderate-intensity threshold, whereas those on beta blockers tended to fall slightly below it. Cognitive assessments revealed significant improvements in visual reasoning postintervention, with the effect sustained after adjustment for age and education (P=.03), suggesting potential cognitive benefits from a single bout of AAR gameplay. Survey responses indicated high levels of PA intention (mean 4.15/5, SD 0.59), motivation (mean 5.67/7, SD 1.24), high positive affect (mean 4.35/5, SD 0.80), and low negative affect (mean 1.30/5, SD 0.46) associated with AAR gameplay. Around 75% of gameplay occurred within a 4×4 ft area (mean 29.77/40 min, SD 2.46), indicating suitability for home environments. Thematically analyzed interview feedback emphasized participants' enjoyment, ease of use, desire for pro","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73221"},"PeriodicalIF":4.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Video Games to Improve Behavioral Intentions and Cognitive Function in Patients With Schizophrenia: Randomized Controlled Trial.","authors":"Huan-Hwa Chen, Ching-Ching Lin, Man-Ling Yu, Hsiu-Lan Wu, Hui-Chu Shen, Hsiu-Fen Hsieh","doi":"10.2196/69116","DOIUrl":"https://doi.org/10.2196/69116","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a severe mental illness that affects the cognitive, social, and daily functions of patients. Physical activity has been found to be important for maintaining these functions in patients with schizophrenia, but many lack the motivation to participate in physical activities.</p><p><strong>Objective: </strong>This study aimed to explore the efficacy of active video games (AVGs) on the behavioral intention and cognitive function of patients with schizophrenia.</p><p><strong>Methods: </strong>In this experimental study, 103 participants were recruited from 2 medical centers. All participants were randomly assigned to the experimental or control group, and 82 participants (n=41, 50% in the experimental group and n=41, 50% in the control group) completed all the processes of our protocol. The experimental group was provided with AVGs for 30 minutes twice per week for 6 weeks. The Mini Mental State Examination and a behavioral intention questionnaire were administered before and after playing the AVGs. Data were collected between April 2021 and January 2022. Generalized estimating equations and 2-tailed paired t tests were used for data analysis.</p><p><strong>Results: </strong>The experimental group showed significant improvements in behavioral intention to participate in AVGs compared with the control group at both T1 (β=4.88; P=.009) and T2 (β=4.24; P=.04). In addition, the experimental group experienced significant improvements in orientation (T2: β=0.66; P=.04) and language (T2: β=0.28; P=.03) among cognitive functions compared to the control group. In contrast, there was no significant change in these variables in the control group.</p><p><strong>Conclusions: </strong>Playing AVGs can effectively enhance the behavioral intention of patients with schizophrenia to participate in physical activity and exercise and significantly improve their orientation and language. AVGs are inexpensive and easily operated tools for people with mental or physical disabilities.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05933356; https://clinicaltrials.gov/study/NCT05933356.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e69116"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining Open-World Game and Nostalgic Film Interventions for Broader and More Reliable Therapeutic Impact.","authors":"Chenlei Sun, Ke Meng","doi":"10.2196/82157","DOIUrl":"10.2196/82157","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e82157"},"PeriodicalIF":4.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply: Refining Open-World Game and Nostalgic Film Interventions for Broader and More Reliable Therapeutic Impact.","authors":"Andreas Benedikt Eisingerich, Annisa Arigayota, Barbara Duffek, Congcong Hou","doi":"10.2196/83239","DOIUrl":"10.2196/83239","url":null,"abstract":"","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e83239"},"PeriodicalIF":4.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Game Users' Depressive Symptoms via Behavioral Activation in a Massive Multiplayer Online Game: Randomized Controlled Trial.","authors":"Kenji Yokotani, Masanori Takano, Nobuhito Abe, Takahiro A Kato","doi":"10.2196/73734","DOIUrl":"10.2196/73734","url":null,"abstract":"<p><strong>Background: </strong>Online games developed to improve mental health symptoms are reportedly effective among game users. However, it has not been verified whether massive multiplayer online games (MMOGs) developed for leisure purposes are effective in improving users' mental health symptoms.</p><p><strong>Objective: </strong>Based on 2 theoretical frameworks, this study examined whether MMOGs improve depression and social anxiety. First, behavioral activation theory posits that depressive symptoms improve through the repetition of reward-linked behaviors. Second, inhibitory learning theory suggests that exposure to social stimuli (eg, being the center of attention) previously perceived as threatening reduces fear responses over time.</p><p><strong>Methods: </strong>Participants were Pigg Party users with at least 3 months of previous experience. Overall, 1105 participants were randomly assigned to either the experimental (n=548) or waitlist groups (n=557). Participants in the experimental group were instructed to ring a friend's room bell (an action that clearly draws attention) on weekdays and to customize their avatars on weekends. Those completing ≥60% of the tasks received additional monthly rewards. The waitlist group received no interventions but was given random additional rewards. Both groups completed questionnaires on depression (Quick Inventory of Depressive Symptomatology) and social anxiety (Brief Liebowitz Social Anxiety Scale) at baseline, and again at 1, 2, and 3 months.</p><p><strong>Results: </strong>The experimental group showed a significantly higher frequency of bell ringing compared to that of the waitlist group (standardized mean difference [SMD]=0.13), whereas no significant difference was observed between the groups in avatar customization frequency. As predicted, the experimental group showed a significantly greater reduction in depressive symptoms, with a small effect size observed (SMD=-0.12). However, no significant difference was determined between groups in social anxiety symptoms.</p><p><strong>Conclusions: </strong>This study demonstrated that MMOGs, when combined with administrator-led interventions, can reduce users' depressive symptoms, albeit with a small effect size. Further studies are needed to test the intervention effects on social anxiety symptoms in MMOGs, with improved exposure scenarios.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"13 ","pages":"e73734"},"PeriodicalIF":4.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}