(PS8-57) CLEAR Path: A Game-based Approach to Learning Coping Skills for Co-occurring Depression and Post-traumatic Stress Symptoms

Abstract Text:

Background: Depression is one of the leading causes of disability worldwide, often co-occurring with post-traumatic stress symptoms (PTSS; Bains & Abdijadid, 2023; Stander et al., 2014). Though effective treatment options are being developed to address these concerns concurrently (Gallagher, 2017; Gros, 2019; Varkovitzky et al., 2017), many individuals are unable to pursue these treatments due to logistical or financial barriers. Online interventions that could be available at any time at the convenience of the user could offer much-needed treatment access to individuals in need. However, attrition rates for online mental health programs are notoriously high (Eysenbach, 2005). Gamification via the use of “serious games” could help boost user engagement and adherence to online options.

Methods: CLEAR Path, a serious game intended to teach effective coping strategies to manage co-occurring depression and PTSS through the use of decision-making skills, was developed to understand adherence to and engagement with a serious game and to better understand who engages with serious games (Kingman et al., 2024). The game required participants to lead a character who had experienced a traumatic event through a week of their life, making various decisions in numerous life situations, with a goal of improving the character’s mood and reducing their distress. Decisions and their outcomes introduced coping strategies for mood and distress management. 49 individuals recruited online consented to take part in the study. The study also tested whether introducing delays between character “days” might improve adherence. Thus, of the consented participants, 25 were randomized into a no delay group, 12 were randomized into a short (10-minute) delay group, and 12 were randomized into a long (1-hour) delay group.

Results: Users progressively chose better strategies to improve their character’s mood (p = .003) and recognized that both the character’s mood (p < 0.001) and distress (p < 0.001) improved with their choices over time. However, there was no improvement in self-reported knowledge of effective mood and distress management strategies. Adding time delays to the game improved engagement and program adherence, with short delays improving program adherence (p = .03, OR = 7.00) and engagement, as measured using total time spent in the game (M = 2340.2, SD = 2238.5, when compared to no delay, M = 1396.7, SD = 1235.8), and long delays also improving program adherence (p = .02, OR = 8.75) and engagement, as measured using total time spent in the game (M = 2316.7, SD = 2456.1). Participants’ demographics were explored to understand whether they are related to engagement and adherence, and no significant results were observed, suggesting that CLEAR Path may appeal to a variety of users.

Conclusion: This study highlights the potential of serious games to offer accessible and engaging mental health options for those with co-occurring depression and PTSS. The results further suggest that introducing a sense of scarcity (i.e., delay) may increase engagement and adherence. Gamification approach to psychoeducation and treatment may offer usable and effective resources to individuals with comorbid depression and trauma symptoms.