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Computer Game Designed To Treat Depression As Effective As Traditional Treatment
New submitter sirlark writes "'Researchers at the University of Auckland tested an interactive 3D fantasy game called Sparx on a 94 youngsters diagnosed with depression whose average age was 15 and a half. Sparx invites a user to take on a series of seven challenges over four to seven weeks in which an avatar has to learn to deal with anger and hurt feelings and swap negative thoughts for helpful ones. Used for three months, Sparx was at least as effective as face-to-face conventional counselling, according to several depression rating scales. In addition, 44% of the Sparx group who carried out at least four of the seven challenges recovered completely. In the conventional treatment group, only 26% recovered fully.' One has to wonder if it's Sparx specifically — or gaming in general — that provides the most benefit, given that most of the symptoms of depression relate to a feeling of being unable to influence one's environment (powerlessness, helplessness, ennui, etc) and games are specifically designed to make one feel powerful but challenged (if they hit the sweet spot)."
but I was just too depressed to bother.
I, for one, welcome our new robot psychiatrist overlords.
Best anti-depression video game ever.
Anyone? It's coming. Pretty soon our actions in video games will contribute to the profile built on our web habits. Fun fun fun.
For my money, this video game works as well as conventional counseling because conventional counseling doesn't work. People get better, sure, but they get better on their own. Time, improving life circumstances, and new friends are what end depression, not lying on a couch talking about your feelings.
He stared at the two liquids. The one foaming, the other with waves in it like the sea. He tried to guess what kind of death each one held. Probably a fish will come out of the ocean one and eat me. The foamy one will probably asphyxiate me. I hate this game. It isn't fair. It's stupid. It's rotten. And instead of pushing his face into one of the liquids, he kicked one over, then the other, and dodged the Giant's huge hands as the Giant shouted, "Cheater, cheater!" He jumped at the Giant's face, clambered up his lip and nose, and began to dig in the Giant's eye. The stuff came away like cottage cheese, and as the Giant screamed, Ender's figure burrowed into the eye, climbed right in, burrowed in and in. The Giant fell over backward, the view shifted as he fell, and when the Giant came to rest on the ground, there were intricate, lacy trees all around. A bat flew up and landed on the dead Giant's nose. Ender brought his figure up out of the Giant's eye. "How did you get here?" the bat asked. "Nobody ever comes here." Ender could not answer, of course. So he reached down, took a handful of the Giant's eyestuff, and offered it to the bat. The bat took it and flew off, shouting as it went, "Welcome to Fairyland."
Won't work outside the lab. As soon as they release it to market and pump it full of DRM and premium-content-ads, they'll get depressed all over again.
Games DEPRESS you!
This sig is not paradoxical or ironic.
" One has to wonder if it's Sparx specifically — or gaming in general — that provides the most benefit, given that most of the symptoms of depression relate to a feeling of being unable to influence one's environment (powerlessness, helplessness, ennui, etc) and games are specifically designed to make one feel powerful but challenged (if they hit the sweet spot)."
The thing a lot of people especially in the age group tested lack are the emotional tools to deal with normal feelings such as anger and depression. One on one counseling helps the patient build those tools and if the game is designed with that in mind then yes it's Sparx not all games. If it were all video games that made a person feel empowered then I really doubt EMO would have ever been "invented".
"Ubuntu" -- an African word, meaning "Slackware is too hard for me". - stolen from Dan C alt.os.linux.slackware
autism, hemophilia, etc... things like this used to be very rare because people with these genes tended to not pass them down (due to lower survival rate, or in autism's case due to social stigma attached to mating with one).
Left to nature, contra-survival traits like these weed themselves out in any population, not just human. But nowadays they're being kept alive and allowed to breed wantonly, which might be admirable from a moral standpoint... but it's not doing the human gene pool any favors.
tottaly wicked
Depression can't be cured. It can be treated, very effectively, and the outcome will last a long time. But once you've had a depressive episode, you are more likely to have another. The longer and more severe the symptoms, the more likely you are to have a recurrance. Whatever it is that triggers depression can be abated, but it weakens the psychological fabric of the person it afflicts, permanently.
I don't know why this is, or the underlying mechanic. There are many studies out that identify variances in neural activity and neurotransmitter levels that are associated with people having a depressive episode; It has a distinct pathology and has definate biological markers, unlike most personality disorders (as a contrast). But there is scant data on what differences persist in the brain post-recovery... only a marked increase in the odds of relapse.
In that respect, it is much like chicken pox. If you've had it, the virus remains in your body, and for 80% of the population, after the acute infection, there are no further symptoms for the rest of their life. But for some, complications arise in the form of shingles. Depression is like that as well, but without the pathogen -- once you've had it, something is changed in you, forever.
#fuckbeta #iamslashdot #dicemustdie
I always feel better after I've saved the universe, or become Master of Orion, etc.
Ditto on DRM when Ive already paid for a game, but cant play it. Somehow, I just don't feel very empowered by that publisher.
Looks like it to me:
- "In addition, 44% of the Sparx group who carried out at least four of the seven challenges recovered completely."
- "In the conventional treatment group, only 26% recovered fully."
This seems to indicate high effectiveness of the Sparx treatment, yet it actually tells us absolutely nothing. The critically missing data is how many of the Sparx group completed four or more challenges. If it was 1%, them the overall effectiveness of Sparx may be as low as 0.44% and vastly lower than conventional treatment. If it was 100%, then Sparx has a 44% success rate and is vastly better than conventional treatment.
Either someone is intentionally lying here (remember, these people are psychologists and know how to do it) or the reporter is a nil-whit without a clue on how to report statistics.
Most ACs are not even worth the keystrokes to insult them. Be generically insulted by this and ignored otherwise.
The article is quite likely to make peoples' depression worse. It tells about a wonderful new piece of software that helps depression... but doesn't tell where or how to get the software.
A hopeful depressed person sees the /. headline, goes to the article looking for some help, and gets... nothing. How depressing.
"depression" is an umbrella term for a variety of mental health problems with even more diverse causes. Certain forms of depression can certainly be alleviated by giving the patient some task to accomplish. However, the generalization in the header (what is the "traditional treatment" for depression, btw?) makes the probably well-meant research sound like snake oil.
The cited article is not informative. Read the original source at http://www.bmj.com/content/344/bmj.e2598
It answers most of the questions in the comments.
You can view the trailer or learn more about the game as such at http://www.sparx.org.nz/
...but sometimes it's just a response to the state of the world and impotence to change it.
And, just like some people in Soviet Russia would be put in residential care because "surely only a madman wouldn't love our system", similarly we diagnose a gret many people with mental illness because "surely only a madman wouldn't love our system". Then begins the reprogramming to accept and serve a society which we should, for a great many reasons, be hating and wanting to change.
A smart psychologist or psychiatrist knows the difference, of course - but not because they're trained to notice it.
Because Sparx are produced by the Sun!
Hopefully that nerdified this article enough to make up for some of the past ones :)
- vranash
1. Is three months after treatment for the follow-up assessments long enough to determine effectiveness?
I can envision something like the following:
a. The computer program is more effective at providing simple, immediate coping strategies for depression (e.g., repeating positive self-statements, setting medium-term goals and achieving them, etc.) than human intervention.
b. Human intervention is more effective at providing more complex and delayed coping strategies for depression (e.g., developing assertiveness, understanding others' motivations, etc.) than the computer program.
c. Measurements three months post-treatment show that the computer program is more effective. Measurements one year post-treatment show that human intervention is more effective.
This is totally hypothetical, but, I think, plausible.
2. Weakness of the study as noted by the authors: [http://www.bmj.com/content/344/bmj.e2598]
a. "We do not have good data on adherence to treatment as usual. Clinicians often forgot to fill in our forms, and for some the number of sessions planned was unclear. Adherence to SPARX was based on participants’ self report. Ideally, this would have been more robust, but attempts to collect these data on the computers at the different sites foundered as we experienced technical difficulties at some of the sites."
In comparable studies in other fields, time spent on either competing intervention is closely monitored, and, if appropriate, made as equal as possible. This is a major shortcoming.
b. "One of the main weaknesses of our study was the heterogeneity of our treatment as usual group. We considered it unethical to leave young people who had presented for help untreated. We did not have the resources to provide an alternative treatment, such as cognitive behavioural therapy or interpersonal therapy, the "gold standards.""
3. The use of computer programs as treatment is a very interesting trend in psychology and other rehabilitative fields like speech-language pathology. Diagnosis/proper categorization of the patient will become increasingly important.
It has been observed through twenty something years of firsthand experimentation with computer games that they do in fact offer the chance to deal some virtual destruction, which brings with it an immense sense of satisfaction. ...and these assholes needed how much money to come to the same conclusion!?
Operation Guillotine is in effect.
I am unhappy to see such a low-quality reference for this article, when the official press release from the journal is available and the full article itself are available online and
Most of the objections raised in the comments above are answered in the article, which looks to me to be about as high quality as is possible given the differences between the treatments used. Making accusations of "lying" before you have read the full article is unethical.
The main weakness pointed out by the authors was that the compliance with the treatment protocols was reported by the adolescent participants, not by the machines or the professionals providing the treatment. Another was that some 13% of the participants who were supposed to receive treatment as usual were merely put on waiting lists, although that may be treatment as usual in some places; but the real kicker here was that excluding them made the treatment as usual even less effective! There have been plenty of previous studies comparing treatment with non-treatment that find treatment more effective, but testing treatments for depression is very tricky because pretty much anything is beneficial, even telling people they are taking part in an experiment and then doing nothing else, but this article reports “[w]e have carried out two small studies of computerised interventions for depressive symptoms; one showed a significant effect compared with placebo and the other was significantly more effective than a waitlist control.”
I know it is futile to ask people to read an article before they comment on it, and I know it is equally futile to ask people who submit articles such as this to post links to original articles instead of second or third sources, but here goes: If you are submitting an article about an article in a scientific journal, please include a link to the original article in the original journal instead of a newspaper article based on a press release announcing the publication of the article. Thank you. And if you are drinking from the Firehose and come across something like this, at least vote it down, and better yet, submit a better article to replace it.
People should not fear their government. Governments should fear their people.
You mean it fails 60% of the time?
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Can't believe work from my University made it to /. So proud right now!
I've been diagnosed with recurring depression and there is quite a lot of that in my family line (father is currently medicated after years long serious depression, etc.). There have been times I've been depressed and not went for treatment and there have been times I've went to a therapist... and there is a world of difference. Of course, depression affects individuals in different ways so everything I say might not apply to everyone but I'll try to speak on a relatively general level.
First of all... "Time, improving life circumstances, and new friends are what end depression"... Those aren't the kind of things that happen during a depression! When you can't force yourself to get into the job (a job you normally love, really want to keep, etc.) in time (or at all) for months and even if you get in, you can't concentrate enough to do anything complex (e.g., coding) efficiently... When you don't feel any interest to meet friends, girlfriend, etc... there's pretty high chance of getting fired, failing your classes, destroying your relationships, etc. which will make the depression deeper. Time might take care of it but if you allow that situation to go on for months first (untreated, my depression usually lasts about 4-5 months), you've probably nearly ruined your life first (been there, done that).
So, if you're depressed, not getting treatment is usually stupid. There are always medications but studies have shown that if you treat your depression with drugs, you're likely to get depressed again sooner and the next depression is likely to be deeper... until the medicines don't have enough effect anymore.
As for what happens in therapy... I've been to quite a few sessions and I've never had to talk about my childhood and whatnot. There are quite a few schools of therapy but Freudian, Jungian, etc. exist only in movies and as fashionable things to try out for the rich people. The therapist I usually go to helps me do damage control: Helps me take the steps that prevent me from ruining my life (Talk with my boss about my need to work at a reduced capacity for a while instead of me just not showing up for work half the time, etc.) at first and then helps me claw my way out of the pit (prioritize the massive bulk of tasks that seem impossible to handle, get small successes on which to build, etc.), helps me find the things that deepen my depression and find ways to solve them (Your home is filthy? You don't think you're going to lose your job immediately? Well, get a cleaner to visit it once a week until you're up and going again!... type of practical solutions)... Nothing magic but just things that you can't get done without help if you're depressed.
... when you've been turned down by female after female after female?
I mean what's the point of being happy if no female will have you?
Can you pass me that beer?
No, seriously. Reading about something like that is ultra-cool, especially since I now have something to point people towards who are trapped in the "computer games are evil and make you want to go out and shoot people" mindset - but only actually seing the thing with your own eyes is for real.
Assorted stuff I do sometimes: Lemuria.org
I am new here what it's all about?
http://www.jocnou.ro/jocuri-3d/ http://www.jocnou.ro/jocuri-cu-masini/
more time in front of a computer. Brilliant.
After I began playing Second Life, I applied some of the skills I developed to the real world to make and keep friends more easily.
The thing about many problems of the mind is that there are many different reasons a person could have them, and thus different treatments can work on different people. For a number of issues you find that drugs, therapy, etc all have some success, and there is a fair bit of non-overlap (as in one failed, but another succeeded with the same person).
So I could well see a game based therapy working for some people, but not for others.
Yes, I RTFA.
Now, I played a fair amount of computer games in my life, and as far as I could tell, they all worked along those lines. They gave you a challenge, they gave you an obstacle to overcome, they gave you anger and hurt emotions to deal with (if for no other reason than you dying at the same boss for the n-th time) and a reward when you overcame it, rewarding you for the "helpful thought" that you bit the bullet and pushed through.
What exactly makes this game special and different?
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
This has 'Feed The Trolls' written all over it. Depression is not a problem you 'figure' your way out of. It would be like telling someone with no legs the best way to lose wait is by walking and running. And then you tell them they are stupid for not figuring that out. If you think depression is a logic problem then I'm telling you you haven't been depressed. I used to think PSD in Vietnam vets was bullshit. Then I got shocked by a defibrillator while concious. Guess what kids. I believe in PSD now. Cuase I had it for almost a year. It was that painful. So, in the end. An order of humility at a new level. There are lots more people who need it, too.
It is NOT gaming in general. Gaming as a hobby, especially with a focus on challenge, encourages isolation, which is the kiss of death for mental health. The fact that a person is more powerful in games than the world isn't helpful either. At best it causes one to look behind the curtain too much; more commonly it simply generates a psychological dependence on escapism.
:p
I'm using a bunch of "psychobabble" here, but I should be clear: my years of experience are not in practice and study of the field. This happened to me, and I've known several others who got it worse. To be even clearer, I'm not saying that games are bad for you. In my best health, I enjoy them much more, in fact. Having a life in balance allows me to take on games that require more effort and which are deeper as works of art. But they are not good medicine unless they're made that way.
A further insight as a sort of... tenured mental patient: if the game teaches people to "replace thoughts," it's teaching Cognitive Behavioral Therapy. While that method has seen some success, it's mainly because most cases of depression frankly deal with first world problems that people need to bootstrap themselves out of. People with physiologically-rooted cases, those who have experienced severe trauma, and those who see the man behind the curtain will see better long-term gains from a newer approach: Acceptance and Committment Therapy. Luckily, there's already a game for that! A significant portion of ACT is the practice of mindfulness and meditation. Bejeweled 3's meditation mode is surprisingly effective for a silly gimmick.
There have been multiple studies about how excessive gaming can lead to depression, and even a behavioral addiction. While I'm sure that taking this position is going to be massively unpopular among the /. crowd, I've experienced both the depressive and addictive aspect of video games, myself. Of course, I still love gaming, but I've found that if I don't exert some control over how much I play, my depression gets worse, and yes, I do get addicted (complete with a sort of emotional "withdrawal" when I stop playing).
Here's a reference, though better ones are surely out there:
http://www.videogamingaddiction.com.au/how-to-avoid-video-game-addiction-depression/
That being said, it may well be the nature of the games I play: mostly ultra-violent FPS games, and a few RPGs (Skyrim, etc.). While it's surely also unpopular to remind people about the article on /. a while back about such games "turning-off" certain parts of the brain (especially the area that more-or-less monitors whether our actions are considered "acceptable;" I don't remember the name for it), I'll point the phenomenon out, anyway. Notably, other parts of the brain are stimulated in much the opposite way (motor cortex, etc.), and can find benefit therein. (Link contains a good info-graphic.)
http://ansonalex.com/infographics/effect-video-games-brain/
Don't take this as me saying "video games are evil," because I don't believe that. Still, misuse can be a problem and can actually cause episodes of depression, as I've experienced, myself.
These researchers have probably hit on something important, and it would seem that the nature of the game plays a major role in how it affects a person. Congrats to them for being sensible about studying these things (rather than basing their findings on ideology). I should probably point out that this article deals only with comparison to traditional "talk therapy"--which not everyone finds helpful (and whose efficacy is extremely dependent on who's doing it)--and that this probably isn't dealing with severe, chemical depression, so much as socially-induced depression (which is certainly just as valid; it's simply different). Still, that the program was this helpful is quite remarkable.
"44% of the Sparx group who carried out at least four of the seven challenges recovered completely."
Or was it rather "Most of those with a recoverably light case of depression were able to carry out at least four of the seven challenges."?
It's 70 episodes give it a surprising rewatch value and it's just adorable. I can't think of a better non-chemical antidepresant except perhaps a box of kittens.
But... the future refused to change.
It's surely cheaper
"The study found no significant differences between the therapies; however, the two psychotherapies were slightly less effective than imipramine but more effective than placebo. A meta-analysis of four studies, which included 169 patients with major depression, showed similar results for tricyclic antidepressants and CBT."
Now when they say placebo, they actually mean sugar pill. It's well known now that medication doesn't outperform placebo on most forms of depression so saying CBT is as good as that is a low bar indeed.
Having said that, I'm a psychotherapist and CBT can work well for some kinds of depression. Worth a try.
How exactly do you do placebo counselling?
Anyway what you have and what I have are two very different diseases that happen to share a name, sometimes telling one from the other is difficult so everyone owes it to themselves to explore all the options for treatment. That being said don't call my drugs dangerous and ineffective and I won't call your therapy hippie bullcrap ok?
Actually, I think they're similar diseases that neither of you fully understand (which is fair enough, because nobody really understands them)... I am not a psychologist, but I have been through severe depression with suicidal tendencies. My psych at the time put it best... therapy on its own will work, some of the time. Meds on their own will work, some of the time. For best results, you need to combine them.
What I found from experience was that SSRI's took the edge off my feelings. They didn't make them disappear, but they made them bearable so that I could work on what the real problem was. There was a neurochemical imbalance: my brain was not producing enough seratonin. But blocking the reuptake of that neurotransmitter, which is how most anti-depressants work, didn't do anything to address the issue that was causing my problems in the first place. What it *did* do was make it so that I could see the exit, but I still had to work on getting there. What I found when I reached that goal was that I didn't need the medications any more, and was able to stop taking the SSRI medication. It's now been 5 years since I stopped taking anti-depressants, and 3 years since I stopped seeing a psychologist on a regular basis, and I have not had a single relapse.
Now, I'm not saying that you don't need it. I'm not saying you'll necessarily reach a point where you don't need it... there could be something weird with the way your brain is wired, such that going off the meds is not an option. But I'm also not saying that the person for whom pure therapy works is full of it. Mental health, and how the psyche and physical brain interact, is something we're only just beginning to understand. We've barely scratched the surface, and what we're realizing is that it's easily the most complicated field of medicine that exists. In my case, there was an elephant in the room that I was afraid to address, and it is what was causing my depression. There may be a similar issue going on for the both of you, and I don't think either of you should discount what's working for the other.
... for the chemical imbalance theory that created a $100bn industry.
Anyway, there are plenty of people who understand mental health decently. We're just outnumbered about 10 to 1 by people who don't have a clue.
It might be the most complicated field but the main problem is that it's almost impossible to test... so accurate models are chanced upon more than anything.
Depression is a bitch and if meds was the best help available to you, it's even more impressive to get past it. Respect.
Other health ideas along those lines: http://www.changemakers.com/discussions/discussion-493#comment-38823
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.
This field is so screwed up that we don't even know if the drugs work for anyone. Long term studies are non-existent.
Clearly, the drugs work short-term for some and make others worse. We don't know what the curve looks like.
This guy's blog is excellent:
http://neuroskeptic.blogspot.co.uk/2011/12/do-antidepressants-make-some-people.html
Good luck proving that. Even Big Pharma hasn't managed it so far.
If the statistics that they are stating are true then this game must of been real "fun". They only way we have been able to treat this in the past is by providing happy drugs to depression, as many of us don't have the same chemistry running the body and mind as needed to live in such a society like today.
On the other hand, humans breed like crazy, which causes far more pain, suffering and misery than the egoists that pass serious diseases down to their children. If left unchecked, the human will to reproduce is what may well kill off the human race. Only time will tell what happens. Many industrial nations are already shrinking, so some control mechanism is at work. It may well be that these sicknesses are part of that mechanism.
Actually, the two things that make a huge difference in population growth rates are (1) education levels, and (2) access to birth control.
I imagine the anti-video game conservatives will be depressed over this story. What sort of inspiring game would cheer them up?
If games can influence behaviour for the better, then can they not also for the negative? It is very unfashionable to claim that violent computer games impact behaviour. What i do know is, me and a friend stole a TV, in order to keep playing GTA Liberty City Stories., but, that's anecdotal, of course.