The MoodWheel app: validation and factor structure of a new tool for the assessment of mood based on the experience sampling method.

BACKGROUND: The MoodWheel app is a newly developed tool that uses experience sampling method (ESM) for assessing negative and positive emotions, based on the circumplex model of emotions and the binary model of distress, and including behavioral and heart rate (HR) measurement via photoplethysmography and the possibility to personalize the application with additional measures. Aims: This study was designed to assess the factorial structure, reliability and validity of the MoodWheel (MW) application for evaluating emotions in children, adolescents. METHODS: A sample of 490 children and adolescents were recruited from the schools. Internal consistency was assessed via Cronbach's alpha test. Concurrent validity was assessed by evaluating the correlations between MW and Profile of Emotional Distress scale (PED) scores, in terms of functional/dysfunctional negative and positive emotions. RESULTS: Results obtained show that MW has good to excellent internal consistency and test-retest reliability, while the convergent validity was also adequate. Moreover, we found support for the organization of the MW based on the binary model of distress, given the predictive value found for the irrational and rational beliefs. CONCLUSIONS: The MW application is a useful and easy to use tool that can be used for the accurate measurement of emotions, which will be complimented in future with additional behavioral parameters to provide a comprehensive and dynamic assessment.

Gamified Assessment of the Emotion Regulation Abilities in Youth: Validation of the REThink Online System.

Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.

The REThink Online Therapeutic Game: A Usability Study.

BACKGROUND: Children and adolescents' help-seeking behaviors are often limited by fear, uncertainty, and stigma, as well as challenges with finding the right intervention, help, and a lack of familiarity with the process. A promising direction for the development of therapeutic interventions targeted at children is embedding them into gamified interventions, known as therapeutic or serious games. The aim of this paper is to describe the protocol of the beta REThink therapeutic game and to evaluate the usability of the game in a sample of children and adolescents. METHODS: The study was delivered in schools, where 137 children and adolescents aged between 9 and 16 years old played the levels of the REThink game, followed by filling in the usability questionnaire. FINDINGS: The results show above average evaluations for all levels of the game, for every dimension evaluated, namely presence/immersion, enjoyment, learning effectiveness, narratives, goal clarity, adequacy of learning material, and motivation. This study contributes to the literature on the usability of cognitive behavioral therapy-based therapeutic games for improvements in the emotion regulation abilities of children and adolescents, which can guide researchers interested in testing the REThink game in different protocols, as well to encourage its use by mental health specialists and parents.

The Efficacy of Guided and Unguided Game-Based Cognitive-Behavioral Therapy in Reducing Distress in College Students.

Objective: College students` mental health is an international prioritized research subject. Dedicated interventions are constantly developed to be more suited, attractive, and effective and to reach as many students as possible. Our study aims to investigate the efficacy of an online game-based cognitive-behavioral therapy transdiagnostic intervention (REThink game) in reducing psychology students' distress. Method: Our sample consisted of 139 students (mean age 26.27; 17 male students and 122 female students) who voluntarily enrolled in our study, and they were randomly assigned to 1 of our 3 groups (REThink game without guidance n = 44; REThink game with guidance n = 46; or care-as-usual control group n = 49). They completed the pretest questionnaires (distress [negative functional and dysfunctional emotions], rational, and irrational cognitions), then they were offered to play the trial version of the REThink game, and after that, two specific levels focused on relaxation with mindfulness abilities, and on cognitive change emotion-regulation abilities. After completing the game, students in the REThink game with guidance received email support aimed to help them implement the skills learned in the game. Results: Results showed medium effect size improvements for the REThink game without guidance group compared to the control group in terms of dysfunctional negative emotions and improvements in irrational cognitions for both experimental groups compared to the control group. Conclusion: So far, the REThink therapeutic game proved to be a promising innovative, efficient, and highly accessible intervention for helping students manage distress. Trial Registration: ClinicalTrials.gov NCT04763954.

Do Improvements in Therapeutic Game-Based Skills Transfer to Real Life Improvements in Children's Emotion-Regulation Abilities and Mental Health? A Pilot Study That Offers Preliminary Validity of the REThink In-game Performance Scoring.

Therapeutic or serious games are considered innovative ways of delivering psychological interventions especially suited for children and adolescents, which can have a positive impact on mental health, while also being fun and easily accessible online. While most serious games for children and adolescents address specific issues, such as anxiety or depression, preventive measures received less attention. REThink is an online therapeutic game designed as a stand-alone prevention tool, aiming to increase resilience in healthy children and adolescents in a Rational Emotive Behavioral Therapy framework (David et al., 2019). The aim of this pilot study was to investigate the validity of in-game performance measurements or scores as indicators of the game effectiveness in building real life emotion-regulation abilities. We analyzed how scores of different game levels (addressing different skills) are associated with improvements in mental health and emotion regulation abilities. Our preliminary results suggest that in-game performance at some levels (scores) consistently reflect improvements in psychological functioning, while in-game performance at other levels are less associated with changes in real life self-reported psychological functioning. These results offer important information about which levels can be used as preliminary indicators of psychological improvements, and which levels need to be revised in terms of task or scoring. Overall, results of our study offer preliminary validation of REThink's game scoring system, while also suggesting the elements to be refined.