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Emotional Health Designing Games for Emotional Health

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Key Summary Points There is a growing understanding of key skills that can help individuals better manage emotions to improve well-being, such as emotional understanding, executive functioning, and emotion regulation skills. In promoting emotional health, games can operate at the low-order brain training level (e.g., drill-and-skill), as well as the higher order meaning-making level. Emotional health is broad, and efficacious approaches to skills development in emotional health are highly contextual, taking into account expected outcomes, environmental context, and individual psychometric conditions.

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... However, some elements can be activated within an instructional context that may enhance the learning process [42]. Some authors [62] provide several reasons why games are essential tools in teaching and learning. They consider that games (i) attract participation by students; (ii) can assist students in setting goals, ensuring goal rehearsal, and providing feedback, as well as reinforce learning and maintain records of behavioural change; (iii) can be used as research and/or measurement tools; (iv) allow the researcher to measure performance on a wide variety of tasks that can be easily changed, standardised and understood; (v) are fun and stimulating; (vi) allow students to experience novelty, curiosity and challenge, stimulating learning; (vii) help in the development of competencies; (viii) allow the examination of individual characteristics such as self-esteem, self-concept, goal setting, and individual differences; and (ix) can act as simulations. ...
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Studies highlight researchers’ concerns about how science should be taught today. It is recognised that teachers have difficulty involving and motivating students to learn about different complex topics, such as geology. Schools must promote skills development to develop citizens who can be active and informed in society. One way of undertaking this is to use active methodologies such as educational games, in which students play an essential role in developing activities. Games encourage changes in conceptions regarding the relevance of this scientific topic that is often undervalued by students. Games have gained space in recent years in several disciplines, and it is essential that this tool is thought out and planned within a consistent pedagogical proposal. This educational resource is used to increase motivation for learning, as well as enhance and strengthen the effects of learning. An intervention plan can be framed within game-based teaching. Teachers have been underrepresented in the game-based learning literature, with more emphasis on games’ effects. However, the pedagogical issue of games has been particularly relevant in recent decades. The current investigation used a survey given to geology teachers (n = 112) from public and private middle and secondary schools in Portugal. Its purpose was to assess teachers’ perceptions regarding game-based teaching and its potential to promote active learning. Our sample ages ranged from 24 to 64 years (average of 48.9 years old); 81.3% were women and 18.8% were men. The analysis of the results seems to confirm that although they do not always use games to promote learning in geology, most teachers still recognise their potential to motivate, enhance, and reinforce the learning of geological content, with digital games being the preferred option. They emphasise the importance of teacher training in this area and the inclusion of game applications in school textbooks to approach different geology-related themes. Our results seem to indicate some lack of consistency in teachers’ opinions on the impact of games on student learning.
... Other authors suggest that games can support the development of social and emotional skills in addition to more disciplinary skills. Skills related to compassion and empathy such as perspective-taking, cultural awareness, and reflection (Belman & Flanagan, 2010;Darvasi, 2016;Schrier & Farber, 2018); ethics and ethical thinking, such as argumentation, deliberation, and consideration of others viewpoints (Ryan, Staines, & Formosa, 2016;Schrier, 2015Schrier, , 2017; other skills such as communication, social awareness, personal expression, and collaboration (Foster & Shah, 2016a;Foster & Shah, 2016b;Shah & Foster, 2018;Steinkeuhler, 2007;Steinkuehler & Oh, 2012;) and emotion expression and emotional and mental health (Dunlap, 2018;Isbister, 2016;Vacca, Bromley, Leyrer, Sprung, & Homer, 2014;). However, more work is needed to understand how to better design games that both support these types of social and emotional skills, while also supporting and encouraging STEM knowledge acquisition and understanding. ...
... Other authors suggest that games can support the development of social and emotional skills in addition to more disciplinary skills. Skills related to compassion and empathy such as perspective-taking, cultural awareness, and reflection (Belman & Flanagan, 2010;Darvasi, 2016;Schrier & Farber, 2018); ethics and ethical thinking, such as argumentation, deliberation, and consideration of others viewpoints (Ryan, Staines, & Formosa, 2016;Schrier, 2015Schrier, , 2017; other skills such as communication, social awareness, personal expression, and collaboration (Foster & Shah, 2016a;Foster & Shah, 2016b;Shah & Foster, 2018;Steinkeuhler, 2007;Steinkuehler & Oh, 2012;) and emotion expression and emotional and mental health (Dunlap, 2018;Isbister, 2016;Vacca, Bromley, Leyrer, Sprung, & Homer, 2014;). However, more work is needed to understand how to better design games that both support these types of social and emotional skills, while also supporting and encouraging STEM knowledge acquisition and understanding. ...
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In this study, we examine how we might design and use games to support Science, Technology, Engineering, and Mathematics (STEM) learning as well as relevant social and emotional learning skills such as self-efficacy, curiosity, and STEM identity. We investigate a deck-building card game, Assassins of the Sea (Killer Snails, 2017), which teaches about marine biology, ecology, and environmental science. 178 middle school participants played the game and took an assessment before and after the game. Our results suggest that players’ STEM knowledge increased significantly. We also share social and emotional learning results, identify gaps, and make initial recommendations for creating and using games for STEM learning.
... The specific type or genre of a game used is less important than the notion that games can be used for educational purposes. For example, games have been suggested as effective in literature and literacy acquisition (e.g., Ferdig & Pytask, 2014), learning research methods and statistics (Boyle, et al., 2014), STEM education (Bertozzi, 2014;Werner, et al., 2014), music education (Hein, 2014), and emotional health education (Vacca et al., 2014). How a game is designed, its goals, the context where it is used, a teacher's guidance and use of the game, and the audience and community playing the DESIGNING ROLE-PLAYING VIDEO GAMES FOR ETHICAL THINKING game, among many other factors, contribute to the effectiveness of a game for educational purposes (Schrier, 2014d). ...
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How can we better design games, such as role-playing video games (RPGs), to support the practice of ethical thinking? Ethical thinking is a critical component of twenty-first century citizenship and we need to design ways to creatively support its practice. This study investigates how male participants, ages 18–34, make ethical decisions in three in-game scenarios in Fable III, an RPG, and one additional scenario. The decision-making processes of thirty participants were analyzed; twenty were randomly assigned to play Fable III and ten were assigned to a control condition of written ethical scenarios. Results suggested that participants practiced a variety of ethical thinking skills and thought processes in both conditions, including reasoning-, empathy-, reflection-, and information gathering-related skills and thought processes. Three hypotheses were investigated and detailed, and any significant differences or similarities that emerged between conditions and across game scenarios were explored. Based on this analysis, four preliminary design principles were described.
... For over twenty years researchers have been using games in education, providing the following reasons as to why games are useful tools in teaching and learning concept. For instance [11]- [16]: ...
... For over twenty years researchers have been using games in education, providing the following reasons as to why games are useful tools in teaching and learning concept. For instance [11]- [16]: ...
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Abstract— Computer games have grown in many directions. Many studies and systems deals with different elements such as ”Fun” and ”pleasure” in the game structure to improve a learners motivation in the field of educational learning. In this paper, we will explain different theoretical support for the benefit of using game in education and learning. We will also demonstrate the difference among those methods such as , Game Base Learning(GBL), educational game and Gamification in education. A clear description among these new terms with explanation of the possible impact on teaching and learning will be presented. Games can make learning concept more enjoyable for students and provide a platform for their creative thought. Games will of- ten act as learning triggers inducing lively discussion on learning concepts amongst students following game play. A couple of new ways of teaching like Game Based Learning and Gamification can be applied to enhance the learning procedure of students in various age levels.
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The Unified Protocol (UP) is a transdiagnostic, emotion-focused cognitive-behavioral treatment developed to be applicable across the emotional disorders. The UP consists of 4 core modules: increasing emotional awareness, facilitating flexibility in appraisals, identifying and preventing behavioral and emotional avoidance, and situational and interoceptive exposure to emotion cues. Here we present data from 2 open clinical trials. In the first trial, an initial version of the UP was administered to a heterogeneous clinical sample, yielding significant pre- to posttreatment effects across disorders on a variety of measures. Analyses of clinical significance demonstrated modest results, with 56% of participants achieving responder status and 33% achieving high end-state functioning. Further manual development ensued, resulting in specific modifications and enhancements to core treatment components, and a second trial presents data from an additional pilot study of this revised version of the UP. Results from this trial demonstrated more robust treatment effects, with 73% achieving responder status and 60% achieving high end-state functioning. Results improved further at 6-month follow-up, with 85% classified as treatment responders and 69% achieving high end-state functioning. Implications for the treatment of emotional disorders as well as dimensional conceptualizations of psychopathology are discussed.
Article
Although player enjoyment is central to computer games, there is currently no accepted model of player enjoyment in games. There are many heuristics in the literature, based on elements such as the game interface, mechanics, gameplay, and narrative. However, there is a need to integrate these heuristics into a validated model that can be used to design, evaluate, and understand enjoyment in games. We have drawn together the various heuristics into a concise model of enjoyment in games that is structured by flow. Flow, a widely accepted model of enjoyment, includes eight elements that, we found, encompass the various heuristics from the literature. Our new model, GameFlow, consists of eight elements -- concentration, challenge, skills, control, clear goals, feedback, immersion, and social interaction. Each element includes a set of criteria for achieving enjoyment in games. An initial investigation and validation of the GameFlow model was carried out by conducting expert reviews of two real-time strategy games, one high-rating and one low-rating, using the GameFlow criteria. The result was a deeper understanding of enjoyment in real-time strategy games and the identification of the strengths and weaknesses of the GameFlow model as an evaluation tool. The GameFlow criteria were able to successfully distinguish between the high-rated and low-rated games and identify why one succeeded and the other failed. We concluded that the GameFlow model can be used in its current form to review games; further work will provide tools for designing and evaluating enjoyment in games.
Article
Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case-control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustained attention abilities. Additionally, MMPs could enhance working memory capacity and some executive functions. However, many of the included studies show methodological limitations and negative results have been reported as well, plausibly reflecting differences in study design, study duration and patients' populations. Accordingly, even though findings here reviewed provided preliminary evidence suggesting that MMPs could enhance cognitive functions, available evidence should be considered with caution and further high quality studies investigating more standardized mindfulness meditation programs are needed.
Article
We examined the relationships between six emotion-regulation strategies (acceptance, avoidance, problem solving, reappraisal, rumination, and suppression) and symptoms of four psychopathologies (anxiety, depression, eating, and substance-related disorders). We combined 241 effect sizes from 114 studies that examined the relationships between dispositional emotion regulation and psychopathology. We focused on dispositional emotion regulation in order to assess patterns of responding to emotion over time. First, we examined the relationship between each regulatory strategy and psychopathology across the four disorders. We found a large effect size for rumination, medium to large for avoidance, problem solving, and suppression, and small to medium for reappraisal and acceptance. These results are surprising, given the prominence of reappraisal and acceptance in treatment models, such as cognitive-behavioral therapy and acceptance-based treatments, respectively. Second, we examined the relationship between each regulatory strategy and each of the four psychopathology groups. We found that internalizing disorders were more consistently associated with regulatory strategies than externalizing disorders. Lastly, many of our analyses showed that whether the sample came from a clinical or normative population significantly moderated the relationships. This finding underscores the importance of adopting a multi-sample approach to the study of psychopathology.
Article
A specific psychotherapeutic strategy for increasing psychological well-being and resilience, well-being therapy, has been developed and validated in a number of randomized controlled trials. The findings indicate that flourishing and resilience can be promoted by specific interventions leading to a positive evaluation of one's self, a sense of continued growth and development, the belief that life is purposeful and meaningful, the possession of quality relations with others, the capacity to manage effectively one's life, and a sense of self-determination. A decreased vulnerability to depression and anxiety has been demonstrated after well-being therapy in high-risk populations. There are important implications for the state/trait dichotomy in psychological well-being and for the concept of recovery in mood and anxiety disorders.
Article
This paper considers Fonagy et al's concept of mentalization and contrasts aspects of this with aspects of Bion's model of the mind. The author argues that although mentalization adds to our understanding of mind it has limitations; that it may tend to over-emphasize certain types of external interaction between infant and carer and under-emphasize internal psychobiological processes. What is at issue here is the way in which an infant's carers facilitate the development of meaning out of experience. Bion's concept supposes a relatively 'interior' model in which, in important ways, the carer enables the infant to derive the meaning of his or her experience, whilst on the other hand Fonagy et al tend to talk more in terms of the ways in which the carer endows the infant's experience with meaning. Reference is made to Fordham's concept of states of 'Identity'. Fordham has pointed out that Freud's model is one in which mind is conceived of as evolving out of an infant's complex identifications with his or her carer(s); Jung's model envisages developmentally early states of identity as the means by which inherent capacities are realized.
Article
Recently, there has been a convergence in lesion and neuroimaging data in the identification of circuits underlying positive and negative emotion in the human brain. Emphasis is placed on the prefrontal cortex (PFC) and the amygdala as two key components of this circuitry. Emotion guides action and organizes behavior towards salient goals. To accomplish this, it is essential that the organism have a means of representing affect in the absence of immediate elicitors. It is proposed that the PFC plays a crucial role in affective working memory. The ventromedial sector of the PFC is most directly involved in the representation of elementary positive and negative emotional states while the dorsolateral PFC may be involved in the representation of the goal states towards which these elementary positive and negative states are directed. The amygdala has been consistently identified as playing a crucial role in both the perception of emotional cues and the production of emotional responses, with some evidence suggesting that it is particularly involved with fear-related negative affect. Individual differences in amygdala activation are implicated in dispositional affective styles and increased reactivity to negative incentives. The ventral striatum, anterior cingulate and insular cortex also provide unique contributions to emotional processing.
Article
Following leads from differential emotions theory and empirical research, we evaluated an index of emotion knowledge as a long-term predictor of positive and negative social behavior and academic competence in a sample of children from economically disadvantaged families (N = 72). The index of emotion knowledge represents the child's ability to recognize and label emotion expressions. We administered control and predictor measures when the children were 5 years old and obtained criterion data at age 9. After controlling for verbal ability and temperament, our index of emotion knowledge predicted aggregate indices of positive and negative social behavior and academic competence. Path analysis showed that emotion knowledge mediated the effect of verbal ability on academic competence. We argue that the ability to detect and label emotion cues facilitates positive social interactions and that a deficit in this ability contributes to behavioral and learning problems. Our findings have implications for primary prevention.
Article
This research examined the relation between individual differences in inhibitory control (IC; a central component of executive functioning) and theory-of-mind (ToM) performance in preschool-age children. Across two sessions, 3- and 4-year-old children (N = 107) were given multitask batteries measuring IC and ToM. Inhibitory control was strongly related to ToM, r = .66, p < .001. This relation remained significant controlling for age, gender, verbal ability, motor sequencing, family size, and performance on pretend-action and mental state control tasks. Inhibitory tasks requiring a novel response in the face of a conflicting prepotent response (Conflict scale) and those requiring the delay of a prepotent response (Delay scale) were significantly related to ToM. The Conflict scale, however, significantly predicted ToM performance over and above the Delay scale and control measures, whereas the Delay scale was not significant in a corresponding analysis. These findings suggest that IC may be a crucial enabling factor for ToM development, possibly affecting both the emergence and expression of mental state knowledge. The implications of the findings for a variety of executive accounts of ToM are discussed.
Article
A neglected question regarding cognitive control is how control processes might detect situations calling for their involvement. The authors propose here that the demand for control may be evaluated in part by monitoring for conflicts in information processing. This hypothesis is supported by data concerning the anterior cingulate cortex, a brain area involved in cognitive control, which also appears to respond to the occurrence of conflict. The present article reports two computational modeling studies, serving to articulate the conflict monitoring hypothesis and examine its implications. The first study tests the sufficiency of the hypothesis to account for brain activation data, applying a measure of conflict to existing models of tasks shown to engage the anterior cingulate. The second study implements a feedback loop connecting conflict monitoring to cognitive control, using this to simulate a number of important behavioral phenomena.
Article
This paper considers the role of emotion regulation (i.e., extrinsic and intrinsic monitoring and adjusting of emotion) and emotion understanding (i.e., comprehension of the signs of, causes of, and ways to regulate emotion) in childhood adjustment. Developmental and clinical research focused on emotion regulation and emotion understanding are reviewed with an emphasis on studies including psychopathological samples. The implications of emotion research for the study of child psychopathology and child therapy are examined.
Article
This study examined physiological and neurocognitive correlates of teacherreported adaptive behavior in preschool among children in Head Start. Child physiology was assessed by cardiac vagal tone and was measured during a baseline period and during the administration of a mildly effortful cognitive task. Neurocognitive function was measured using two tasks of executive function, which require children to inhibit a prepotent response, while remembering and executing the rule for correct responding. Parents reported on aspects of child negative emotionality associated with fear and anger. Information on child receptive language ability was also collected. Although correlates of teacher-reported social competence and on-task behavior were expected to be similar, some evidence for differentiation was obtained. Results indicated that higher resting vagal tone, vagal increase during the administration of the cognitive task, and higher levels of fearful emotionality were related to higher ratings of social competence, after adjusting for levels of on-task behavior. In contrast, lower resting vagal tone, vagal suppression in response to the cognitive task, and higher levels of executive function were associated with higher teacher ratings of on-task behavior, adjusted for social competence. Implications are considered of findings for developmental relations between social and academic competence and adaptation to preschool among children in Head Start.
Article
Abstract Concurrent and 2-year longitudinal relations were investigated between two indicators of children's ( n =60; mean age = years 11 months) executive function, inhibitory control and sequencing ability, and behavior problem symptomatology. Dependent measures were parent and teacher reported internalizing and externalizing behavior. Hierarchical multiple regression analyses demonstrated few significant concurrent associations between either inhibitory control or sequencing ability, and behavior problem symptoms. In contrast, baseline inhibitory control predicted decreased teacher reported externalizing, and parent reported externalizing and internalizing behavior problems over a 2-year period. Baseline sequencing ability also predicted decreased teacher reported externalizing and parent reported internalizing behavior over this same time period. Results suggest that some aspects of executive function in early elementary grade-school children may be more strongly associated with change in behavior over time than concurrent behavior. Implications of these findings for the prevention of behavior problems are discussed.
Article
Emotion regulation has emerged as a popular topic, but there is doubt about its viability as a scientific construct. This article identifies conceptual and methodological challenges in this area of study and describes exemplar studies that provide a substantive basis for inferring emotion regulation. On the basis of those studies, 4 methods are described that provide compelling evidence for emotion regulation: independent measurement of activated emotion and purported regulatory processes; analysis of temporal relations; measurement across contrasting conditions; and multiple, convergent measures. By offering this perspective, this article aims to engage thoughtful debate and critical analysis, with the goal of increasing methodological rigor and advancing an understanding of emotion regulation as a scientific construct.
Article
In this longitudinal study, the proportion of time preschoolers directed their attention away from rewarding stimuli during a delay-of-gratification task was positively associated with efficiency (greater speed without reduced accuracy) at responding to targets in a go/no-go task more than 10 years later. The overall findings suggest that preschoolers' ability to effectively direct their attention away from tempting aspects of the rewards in a delay-of-gratification task may be a developmental precursor for the ability to perform inhibitory tasks such as the go/no-go task years later. Because performance on the go/no-go task has previously been characterized as involving activation of fronto-striatal regions, the present findings also suggest that performance in the delay-of-gratification task may serve as an early marker of individual differences in the functional integrity of this circuitry.
Article
Emotion regulation strategies are thought to differ in when and how they influence the emotion-generative process. However, no study to date has directly probed the neural bases of two contrasting (e.g., cognitive versus behavioral) emotion regulation strategies. This study used functional magnetic resonance imaging (fMRI) to examine cognitive reappraisal (a cognitive strategy thought to have its impact early in the emotion-generative process) and expressive suppression (a behavioral strategy thought to have its impact later in the emotion-generative process). Seventeen women viewed 15 sec neutral and negative emotion-eliciting films under four conditions--watch-neutral, watch-negative, reappraise-negative, and suppress-negative--while providing emotion experience ratings and having their facial expressions videotaped. Reappraisal resulted in early (0-4.5 sec) prefrontal cortex (PFC) responses, decreased negative emotion experience, and decreased amygdala and insular responses. Suppression produced late (10.5-15 sec) PFC responses, decreased negative emotion behavior and experience, but increased amygdala and insular responses. These findings demonstrate the differential efficacy of reappraisal and suppression on emotional experience, facial behavior, and neural response and highlight intriguing differences in the temporal dynamics of these two emotion regulation strategies.
Article
Identification of neurobiological factors that confer risk for the development of addiction may substantially advance development of new prevention and treatment strategies to combat substance use disorders. This review focuses on the relationship between impulsivity - a behavior that is common to the clinical picture of both substance use disorders (SUD) and childhood disruptive behavior disorders - and neurobiological risk for SUD. It further examines various behaviors within the over-arching domain of impulsivity, ultimately focusing on the more narrowly defined and measurable construct of inhibitory control, and concluding that underlying deficits in inhibitory control may be central to many of the behaviors associated with high risk for SUD. Targeted cross-sectional study of the neural basis of inhibitory dyscontrol in subjects at high risk for SUD, who have not yet begun to abuse drugs, has the potential to generate important hypotheses regarding the neurobiological underpinnings of SUD risk. Hypotheses developed using this approach can be more definitively evaluated in longitudinal studies with these same populations, extending through the period of maximal risk for SUD in adolescence and early adulthood.
Leela: Taking the mind-body journey
  • R Vacca
Vacca, R. (2013). Leela: Taking the mind-body journey. Proceedings of DiGRA: DeFragging Game Studies, pp. 198-199. Atlanta, Georgia.
Social relationships and health: A flashpoint for health policy Emotional design in multimedia learning
  • D Umberson
  • J E Montez
  • J L Plass
  • E O Hayward
  • B D Homer
Umberson, D., & Montez, J. (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior, 51, 1–16. doi:10.1177/0022146510383501.Social Um, E., Plass, J. L., Hayward, E. O., & Homer, B. D. (2012). Emotional design in multimedia learning. Journal of Educational Psychology, 104(2), 485.
Test of Emotion Comprehension-TEC
  • F Pons
  • P L Harris
Pons, F., & Harris, P. L. (2000). Test of Emotion Comprehension-TEC. Oxford, UK: Oxford University Press.
Center for Investigating Healthy Minds at the Waisman Center
  • Richie Davidson
Richie Davidson, Center for Investigating Healthy Minds at the Waisman Center, University of Wisconsin, Madison (http://www.investigatinghealthyminds.org/)
Deepak Chopra's Leela
  • N-Fusion Interactive
N-Fusion Interactive, C. P. (2011). Deepak Chopra's Leela. Agoura Hills, CA: THQ Inc.