Abstract
Cognitive training has been studied in the context of many psychological disorders, including attention deficit hyperactivity disorder (ADHD), anxiety, depression, and addiction. While several studies have found clinically relevant training effects, both in preclinical (experimental) and in clinical settings, cognitive training is often experienced as rather boring. Therefore, several studies have recently started to integrate serious gaming techniques into cognitive training paradigms to enhance motivation to train, especially among younger subjects. In this chapter, we discuss the relevant theoretical frameworks supporting both the trainings and the gamification techniques, review several attempts that have been made so far, and discuss the progress that has currently been made. The chapter will end with a number of recommendations, based on published evidence, as well as our own experience in this field.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Amir, N., Beard, C., Burns, M., Bomyea, J.: Attention modification program in individuals with generalized anxiety disorder. J. Abnorm. Psychol. 118, 28–33 (2009). doi:10.1037/a0012589
Anguera, J.A., Bernard, J.A., Jaeggi, S.M., Buschkuehl, M., Benson, B.L., Jennett, S., et al.: The effects of working memory resource depletion and training on sensorimotor adaptation. Behav. Brain Res. 228, 107–115 (2012). doi:10.1016/j.bbr.2011.11.040
Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M.J., van IJzendoorn, M.H.: Threat-related attentional bias in anxious and non-anxious individuals: a meta-analytic study. Psychol. Bull. 133, 1–24 (2007)
Baumeister, R.: Meanings of life. Guilford, New York (1990)
Beard, C., Weisberg, R.B., Primack, J.: Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behav. Cogn. Psychother. 40, 618–633 (2012). doi:10.1017/S1352465811000671
Blakemore, S.J., Choudhury, S.: Development of the adolescent brain: implications for executive function and social cognition. J. Child Psychol. Psychiatry. 47, 296–312 (2006)
Boendermaker, W.J., Prins, P.J.M., Wiers, R.W.: Documentation of the CityBuilder game. Theoretical background and parameters. University of Amsterdam, Amsterdam (2013)
Boendermaker, W.J., Boffo, M., Wiers, R.W.: Exploring elements of fun to motivate youth to do cognitive bias modification. Games Health J. 4(6), 434–443 (2015a). doi:10.1089/g4h.2015.0053
Boendermaker, W.J., Prins, P.J.M., Wiers, R.W.: Cognitive bias modification for adolescents with substance use problems – can serious games help? J. Behav. Ther. Exp. Psychiatry. 49, 13–20 (2015b). doi:10.1016/j.jbtep.2015.03.008
Boendermaker, W.J., Sanchez Maceiras, S., Boffo, M., Wiers, R.W.: Attentional bias modification with serious game elements: evaluating the Shots Game. J. Med. Internet. Res.: Serious Games 4(2), e20 (2016). doi:10.2196/games.6464
Boffo, M., Pronk, T., Wiers, R.W., Mannarini, S.: Combining cognitive bias modification training with motivational support in alcohol dependent outpatients: study protocol for a randomised controlled trial. BioMed Cent. Trials. 16, 63 (2015). doi:10.1186/s13063-015-0576-6
Boot, W.R., Kramer, A.F., Simons, D.J., Fabiani, M., Gratton, G.: The effects of video game playing on attention, memory, and executive control. Acta Psychol. 129(3), 387–398 (2008). doi:10.1016/j.actpsy.2008.09.005
Buday, R., Baranowski, T., Thompson, D.: Fun and games and boredom. Games Health J. 1(4), 257–261 (2012). doi:10.1089/g4h.2012.0026
Cousijn, J., Goudriaan, A.E., Wiers, R.W.: Reaching out towards cannabis: approach-bias in heavy cannabis users predicts changes in cannabis use. Addiction. 106, 1667–1674 (2011). doi:10.1111/j.1360-0443.2011.03475.x
Cristea, I.A., Mogoașe, C., David, D., Cuijpers, P.: Practitioner review: cognitive bias modification for mental health problems in children and adolescents: a meta-analysis. J. Child Psychol. Psychiatry. 56(7), 723–734 (2015). doi:10.1111/jcpp.12383
Crone, E.A., Dahl, R.E.: Understanding adolescence as a period of social-affective engagement and goal flexibility. Nat. Rev. Neurosci. 13(9), 636–650 (2012). doi:10.1038/nrn3313
de Boer, A., Peeters, M., Koning, H.M.: An experimental study of risk taking behavior among adolescents: a closer look at peer and sex influences. J Early Adolesc, in press (2016)
Deci, E.L., Koestner, R., Ryan, R.M.: A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychol. Bull. 125(6), 627–668 (1999)
Dennis, T.A., O'Toole, L.J.: Mental health on the go: effects of a gamified attention-bias modification mobile application in trait-anxious adults. Clin. Psychol. Sci. 2(5), 576–590 (2014). doi:10.1177/2167702614522228
Diamond, A.: Executive functions. Annu. Rev. Psychol. 64, 135–168 (2013). doi:10.1146/annurev-psych-113011-143750
Dörrenbächer, S., Müller, P.M., Tröger, J., Kray, J.: Dissociable effects of game elements on motivation and cognition in a task-switching training in middle childhood. Front. Psychol. 5, 1275 (2014). doi:10.3389/fpsyg.2014.01275
Dovis, S., van der Oord, S., Wiers, R.W., Prins, P.J.: What part of working memory is not working in ADHD? Short-term memory, the central executive and effects of reinforcement. J. Abnorm. Child Psychol. 41(6), 901–917 (2013). doi:10.1007/s10802-013-9729-9
Eberl, C., Wiers, R.W., Pawelczack, S., Rinck, M., Becker, E.S., Lindenmeyer, J.: Approach bias modification in alcohol dependence: do clinical effects replicate and for whom does it work best? Dev. Cogn. Neurosci. 4, 38–51 (2013). doi:10.1016/j.dcn.2012.11.002
Emmelkamp, P.M.G.: Attention bias modification: the emperor's new suit? BioMed Cent. Med. 10, 63 (2012). doi:10.1186/1741-7015-10-63
Entertainment Software Association.: Essential facts about the computer and video game industry. www.theesa.com/wp-content/uploads/2014/10/ESA_EF_2014.pdf (2014). Accessed 2 Apr 2016
Fadardi, J.S., Cox, W.M.: Reversing the sequence: reducing alcohol consumption by overcoming alcohol attentional bias. Drug Alcohol Depend. 101, 137–145 (2009). doi:10.1016/j.drugalcdep.2008.11.015
Field, M., Cox, W.M.: Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend. 97, 1–20 (2008)
Field, M., Eastwood, B., Bradley, B.P., Mogg, K.: Selective processing of cannabis cues in regular cannabis users. Drug Alcohol Depend. 85, 75–82 (2006). doi:10.1016/j.drugalcdep.2008.03.030
Field, M., Kiernan, A., Eastwood, B., Child, R.: Rapid approach responses to alcohol cues in heavy drinkers. J. Behav. Ther. Exp. Psychiatry. 39, 209–218 (2008)
Field, M., Mogg, K., Mann, B., Bennett, G.A., Bradley, B.P.: Attentional biases in abstinent alcoholics and their association with craving. Psychol. Addict. Behav. 27(1), 71–80 (2013). doi:10.1037/a0029626
Forbes, E.E., Dahl, R.E.: Pubertal development and behavior: hormonal activation of social and motivational tendencies. Brain Cogn. 72(1), 66–72 (2010). doi:10.1016/j.bandc.2009.10.007
Gamito, P., Oliveira, J., Lopes, P., Brito, R., Morais, D., Silva, D., Silva, A., Rebelo, S., Bastos, M., Deus, A.: Executive functioning in alcoholics following an mHealth cognitive stimulation program: randomized controlled trial. J. Med. Internet Res. 16(4), 102 (2014). doi:10.2196/jmir.2923
Geurts, H.M., Verte, S., Oosterlaan, J., Roeyers, H., Sergeant, J.A.: How specific are executive functioning deficits in ADHD and autism? J. Child Psychol. Psychiatry. 45(4), 836–854 (2004)
Gladwin, T.E., Figner, B., Crone, E.A., Wiers, R.W.: Addiction, adolescence, and the integration of control and motivation. Dev. Cogn. Neurosci. 1(4), 364–376 (2011). doi:10.1016/j.dcn.2011.06.008
Granic, I., Lobel, A., Engels, R.C.: The benefits of playing video games. Am. Psychol. 69(1), 66–78 (2014). doi:10.1037/a0034857
Grenard, J.L., Ames, S.L., Wiers, R.W., Thush, C., Sussman, S., Stacy, A.W.: Working memory moderates the predictive effects of drug-related associations on substance use. Psychol. Addict. Behav. 22, 426–432 (2008). doi:10.1037/0893-164X.22.3.426
Hadwin, J.A., Richards, H.J.: Working memory training and CBT reduces anxiety symptoms and attentional biases to threat: a preliminary study. Front. Psychol. 7, 47 (2016). doi:10.3389/fpsyg.2016.00047
Hawkins, G.E., Rae, B., Nesbitt, K.V., Brown, S.D.: Gamelike features might not improve data. Behav. Res. Methods. 45(2), 301–318 (2013). doi:10.3758/s13428-012-0264-3
Hibell, B., Guttormsson, U., Ahlström, S., et al.: The 2011 ESPAD re-port: substance use among students in 36 European countries. The Swedish Council for Information on Alcohol and Other Drugs, Stockholm (2012)
Holmes, J., Gathercole, S.E., Dunning, D.L.: Adaptive training leads to sustained enhancement of poor working memory in children. Dev. Sci. 12, F9–F15 (2009). doi:10.1111/j.1467-7687.2009.00848.x
Hosenbocus, S., Chahal, R.: A review of executive function deficits and pharmacological management in children and adolescents. J Can. Acad. Child Adolesc. Psychiatry. 21(3), 223–229 (2012)
Houben, K., Wiers, R.W.: Response inhibition moderates the relationship between implicit associations and drinking behavior. Alcohol. Clin. Exp. Res. 33, 626–633 (2009). doi:10.1111/j.1530-0277.2008.00877.x
Houben, K., Schoenmakers, T.M., Wiers, R.W.: I didn’t feel like drinking but I don’t know why: the effects of evaluative conditioning on alcohol-related attitudes, craving and behavior. Addict. Behav. 35, 1161–1163 (2010). doi:10.1016/j.addbeh.2010.08.012
Houben, K., Nederkoorn, C., Wiers, R.W., Jansen, A.: Resisting temptation: decreasing alcohol-related affect and drinking behavior by training response inhibition. Drug Alcohol Depend. 116, 132–136 (2011a). doi:10.1016/j.drugalcdep.2010.12.011
Houben, K., Wiers, R.W., Jansen, A.: Getting a grip on drinking behavior: training working memory to reduce alcohol abuse. Psychol. Sci. 22, 968–975 (2011b). doi:10.1177/0956797611412392
Houben, K., Havermans, R.C., Nederkoorn, C., Jansen, A.: Beer a no-go: learning to stop responding to alcohol cues reduces alcohol intake via reduced affective associations rather than increased response inhibition. Addiction. 107, 1280–1287 (2012). doi:10.1111/j.1360-0443.2012.03827.x
Jaeggi, S.M., Buschkuehl, M., Jonides, J., Shah, P.: Short- and long term benefits of cognitive training. Proc. Natl. Acad. Sci. 108, 10081–10086 (2011). doi:10.1073/pnas.1103228108
Jaeggi, S.M., Buschkuehl, M., Shah, P., Jonides, J.: The role of individual differences in cognitive training and transfer. Mem. Cogn. 42, 464–480 (2014). doi:10.3758/s13421-013-0364-z
Johnston, L.D., O'malley, P.M., Bachman, J.G., Schulenberg, J.E.: Monitoring the Future: National Survey Results on Drug Use, 1975–2012. Volume I: Secondary School Students. NIH Publication No. 10–7584. National Institute on Drug Abuse (NIDA) (2012)
Karbach, J., Kray, J.: How useful is executive control training? Age differences in near and far transfer of task-switching training. Dev. Sci. 12, 978–990 (2009). doi:10.1111/j.1467-7687.2009.00846.x
Kato, P.M.: Video games in health care: closing the gap. Rev. Gen. Psychol. 14(2), 113–121 (2010). doi:10.1037/a0019441
Katz, B., Jaeggi, S., Buschkuehl, M., Stegman, A., Shah, P.: Differential effect of motivational features on training improvements in school-based cognitive training. Front. Hum. Neurosci. 8, 242 (2014). doi:10.3389/fnhum.2014.00242
Kerst, W.F., Waters, A.J.: Attentional retraining administered in the field reduces smokers’ attentional bias and craving. Health Psychol. 33(10), 1232–1240 (2014). doi:10.1037/a0035708
Klingberg, T.: Training and plasticity of working memory. Trends Cogn. Sci. 14, 317–324 (2010). doi:10.1016/j.tics.2010.05.002
Krueger, R.F., Caspi, A., Moffitt, T.E., White, J., Stouthamer-Loeber, M.: Delay of gratification, psychopathology, and personality: is low self-control specific to externalizing problems? J. Pers. 64(1), 107–129 (1996). doi:10.1111/j.1467-6494.1996.tb00816.x
Kuckertz, J.M., Amir, N.: Attention bias modification for anxiety and phobias: current status and future directions. Curr. Psychiatry Rep. 17, 9 (2015). doi:10.1007/s11920-014-0545-x
Lumsden, J., Edwards, E.A., Lawrence, N., Coyle, D., Munafò, M.R.: Gamification of cognitive assessment and cognitive training: a systematic review of applications and efficacy. JMIR Serious Games. 4, e11 (2016)
Luna, B., Garver, K.E., Urban, T.A., Lazar, N.A., Sweeney, J.A.: Maturation of cognitive processes from late childhood to adulthood. Child Dev. 75(5), 1357–1372 (2004)
MacLeod, C., Mathews, A., Tata, P.: Attentional bias in emotional disorders. J. Abnorm. Psychol. 95, 15–20 (1986)
Martinussen, R., Hayden, J., Hogg-Johnson, S., Tannock, R.: A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry. 44(4), 377–384 (2005)
Miller, W.R., Rollnick, S.: Motivational interviewing: preparing people to change addictive behaviors, 2nd edn. Guilford, New York (2002)
Moran, T.P.: Anxiety and working memory capacity: a meta-analysis and narrative review. Psychol Bull. 142, 831–864 (2016)
Paus, T., Keshavan, M., Giedd, J.N.: Why do many psychiatric disorders emerge during adolescence? Nat. Rev. Neurosci. 9(12), 947–957 (2008). doi:10.1038/nrn2513
Peckham, A.D., McHugh, R.K., Otto, M.W.: A meta-analysis of the magnitude of biased attention in depression. Depress. Anxiety. 27, 1135–1142 (2010). doi:10.1002/da.20755
Peeters, M., Wiers, R.W., Monshouwer, K., Schoot, R., Janssen, T., Vollebergh, W.A.: Automatic processes in at-risk adolescents: the role of alcohol-approach tendencies and response inhibition in drinking behavior. Addiction. 107, 1939–1946 (2012). doi:10.1111/j.1360-0443.2012.03948.x
Peeters, M., Janssen, T., Monshouwer, K., Boendermaker, W., Pronk, T., Wiers, R.W., Vollebergh, W.: Weaknesses in executive functioning predict the initiating of adolescents’ alcohol use. Dev. Cogn. Neurosci. 16, 139–146 (2015). doi:10.1016/j.dcn.2015.04.003
Prins, P.J.M., ten Brink, E., Dovis, S., Ponsioen, A., Geurts, H.M., de Vries, M., et al.: “Braingame Brian”: toward an executive function training program with game elements for children with ADHD and cognitive control problems. Games Health J. 2(1), 44–49 (2013). doi:10.1089/g4h.2013.0004
Robinson, S., Goddard, L., Dritschel, B., Wisley, M., Howlin, P.: Executive functions in children with autism spectrum disorders. Brain Cogn. 71(3), 362–368 (2009). doi:10.1016/j.bandc.2009.06.007
Schmidt, N.B., Richey, J.A., Buckner, J.D., Timpano, K.R.: Attention training for generalized social anxiety disorder. J. Abnorm. Psychol. 118, 5–14 (2009). doi:10.1037/a0013643
Schoemaker, K., Mulder, H., Dekovic, M., Matthys, W.: Executive functions in preschool children with externalizing behavior problems: a meta-analysis. J. Abnorm. Child Psychol. 41, 457–471 (2013). doi:10.1007/s10802-012-9684-x
Schoenmakers, T., Wiers, R.W., Jones, B.T., Bruce, G., Jansen, A.T.M.: Attentional re-training decreases attentional bias in heavy drinkers without generalization. Addiction. 102, 399–405 (2007)
Schoenmakers, T., de Bruin, M., Lux, I.F., Goertz, A.G., van Kerkhof, D.H., Wiers, R.W.: Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients. Drug Alcohol Depend. 109, 30–36 (2010). doi:10.1016/j.drugalcdep.2009.11.022
Shipstead, Z., Redick, T.S., Engle, R.W.: Is working memory training effective? Psychol. Bull. 138, 628–654 (2012). doi:10.1037/a0027473
Singleton, R.A.: Collegiate alcohol consumption and academic performance. J. Stud. Alcohol Drugs. 68(4), 548–555 (2007)
Somerville, L.H.: The teenage brain: Sensitivity to social evaluation. Curr. Dir. Psychol. Sci. 22(2), 129–135 (2013). doi:10.1177/0963721413476512
Steinberg, L.: Risk taking in adolescence. New perspectives from brain and behavioral science. Curr. Dir. Psychol. Sci. 16(2), 55–59 (2007). doi:10.1111/j.1467-8721.2007.00475.x
Thush, C., Wiers, R.W., Ames, S.L., Grenard, J.L., Sussman, S., Stacy, A.W.: Interactions between implicit cognition and working memory in the prediction of alcohol use in at-risk adolescents. Drug Alcohol Depend. 94, 116–124 (2008). doi:10.1016/j.drugalcdep.2007.10.019
van der Oord, S., Ponsioen, A.J.G.B., Geurts, H.M., Ten Brink, E.L., Prins, P.J.M.: A pilot study of the efficacy of a computerized executive functioning remediation training with game elements for children with ADHD in an outpatient setting: outcome on parent and teacher-rated executive functioning and ADHD behavior. J. Atten. Disord. 18(8), 699–712 (2012). doi:10.1177/1087054712453167
van Deursen, D.S., Salemink, E., Smit, F., Kramer, J., Wiers, R.W.: Web-based cognitive bias modification for problem drinkers: protocol of a randomized controlled trial with a 2x2x2 factorial design. BioMed Cen. Public Health. 13, 674 (2013). doi:10.1186/1471-2458-13-674
Verbeken, S., Braet, C., Goossens, L., van der Oord, S.: Executive function training with game elements for obese children: a novel treatment to enhance self-regulatory abilities for weight-control. Behav. Res. Ther. 51(6), 290–299 (2013). doi:10.1016/j.brat.2013.02.006
Werch, C.E., Owen, D.M.: Iatrogenic effects of alcohol and drug prevention programs. J. Stud. Alcohol. 63, 581–590 (2002)
Wiers, R.W., Bartholow, B.D., van den Wildenberg, E., Thush, C., Engels, R.C.M.E., Sher, K.J., et al.: Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model. Pharmacol. Biochem. Behav. 86(2), 263–283 (2007). doi:10.1016/j.pbb.2006.09.021
Wiers, R.W., Rinck, M., Dictus, M., van den Wildenberg, E.: Relatively strong automatic appetitive action-tendencies in male carriers of the OPRM1 G-allele. Genes Brain Behav. 8, 101–106 (2009). doi:10.1111/j.1601-183X.2008.00454.x
Wiers, R.W., Rinck, M., Kordts, R., Houben, K., Strack, F.: Retraining automatic action-tendencies to approach alcohol in hazardous drinkers. Addiction. 105, 279–287 (2010). doi:10.1111/j.1360-0443.2009.02775.x
Wiers, R.W., Eberl, C., Rinck, M., Becker, E., Lindenmeyer, J.: Re-training automatic action tendencies changes alcoholic patients’ approach bias for alcohol and improves treatment outcome. Psychol. Sci. 22, 490–497 (2011). doi:10.1177/0956797611400615
Wiers, R.W., Gladwin, T.E., Hofmann, W., Salemink, E., Ridderinkhof, K.R.: Cognitive bias modification and cognitive control training in addiction and related psychopathology: mechanisms, clinical perspectives, and ways forward. Clin. Psychol. Sci. 1(2), 192–212 (2013). doi:10.1177/2167702612466547
Wiers, R.W., Boelema, S., Nikolaou, K., Gladwin, T.E.: On the development of implicit and control processes in relation to substance use in adolescence. Curr. Addict. Rep. 2(2), 141–155 (2015). doi:10.1007/s40429-015-0053-z
Wilcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., Pennington, B.F.: Validity of the executive function theory of ADHD: a meta-analytic review. Biol. Psychiatry. 57, 1336–1346 (2005)
Acknowledgments
This chapter elaborates on a previously published paper in the 2015 Joint Conference on Serious Games (JCSG) proceedings, as Boendermaker, W. J., Prins, P. J. M., & Wiers, R. W. (2015). Prevention in Addiction: Using Serious Games to (re)train Cognition in Dutch Adolescents. In S. Göbel, M. Ma, J. Baalsrud Hauge, M. F. Oliveira, J. Wiemeyer, & V. Wendel (Eds.), Serious Games: First Joint International Conference, JCSG 2015, Huddersfield, UK, June 3-4, 2015, Proceedings (pp. 173–178). Switzerland: Springer International Publishing. doi: 10.1007/978-3-319-19126-3_15.
This research was supported by the National Initiative Brain & Cognition Grant 433-11-1510 of the Dutch National Science Foundation, awarded to the third and fourth author, as well as a VICI grant (453-08-001), awarded to the fourth author, both from the Dutch National Science Foundation, NWO.
Declaration of Interest
Dr. Prins is a member of the Foundation Gaming & Training, a nonprofit organization that develops and implements online interventions for children and adolescents.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Boendermaker, W.J., Peeters, M., Prins, P.J.M., Wiers, R.W. (2017). Using Serious Games to (Re)Train Cognition in Adolescents. In: Ma, M., Oikonomou, A. (eds) Serious Games and Edutainment Applications . Springer, Cham. https://doi.org/10.1007/978-3-319-51645-5_14
Download citation
DOI: https://doi.org/10.1007/978-3-319-51645-5_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-51643-1
Online ISBN: 978-3-319-51645-5
eBook Packages: Computer ScienceComputer Science (R0)