Casual video game play as an augmentation intervention for anxiety: a controlled study

Abstract

Anxiety is an innate reaction to stress, but when excessive it can develop into a clinical disorder. Traditional anxiety treatments such as pharmaceuticals in combination with psychotherapy have established efficacy in relieving anxiety symptoms but are often costly and stigmatizing. This study tested the efficacy of prescribed casual video games (CVG) play in reducing symptoms of anxiety when compared to a traditional second medication treatment group. CVGs are fun, easy to play, spontaneous, and extremely popular. Data for this study were acquired from a larger study on the effectiveness of prescribed CVG play in a population with major depression and comorbid anxiety. Participants were screened for depression using a score of 5 or greater (mild depression) on the Quick Inventory of Depressive Symptomatology. Participants chose to participate in the traditional (n = 24) or alternative (n = 30) treatment group. All participants were actively taking a selective serotonin reuptake inhibitor (SSRI) medication and were in need of a second augmentative medication to further alleviate symptoms when starting the study. The traditional treatment group was prescribed a second medication to alleviate symptoms. The alternative treatment group was prescribed CVG play four times per week, for 30-45 minutes, over a one-month period to decrease anxiety symptoms. The State Trait Anxiety Inventory and heart rate variability (HRV) measures were used to test hypotheses. Repeated measures analysis of variance was utilized for hypothesis testing and Cohen's Delta for effect size changes comparing baseline and one-month prescription scores. The results of this study demonstrated a significant decrease in state anxiety scores after the one-month prescription and a medium to large effect. Although trait anxiety scores and HRV measures did not demonstrate significance, trait anxiety had a medium effect size and HRV measures demonstrated small and small to medium effect sizes. In conclusion, prescribed CVG play added to participants' medication performed significantly better than medication for state anxiety while trait anxiety and HRV measures had meaningful effect sizes. Clinicians should consider these non-stigmatizing and low cost CVGs as a viable alternative intervention for individuals who are in need of a second medication to address symptoms associated with anxiety.