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Title: Gamified cognitive bias modification interventions for psychiatric disorders : review
Authors: Zhang, Melvyn
Ying, Jiangbo
Song, Guo
Smith, Helen
Fung, Daniel S. S.
Keywords: Science::Medicine
Attention Bias
Cognitive Bias
Issue Date: 2018
Source: Zhang, M., Ying, J., Song, G., Fung, D. S. S., & Smith, H. (2018). Gamified cognitive bias modification interventions for psychiatric disorders : review. JMIR Mental Health, 5(4), e11640-. doi:10.2196/11640
Series/Report no.: JMIR Mental Health
Abstract: Background: Automatic biases, such as attentional biases and avoidance and interpretative biases, have been purported to be responsible for several psychiatric disorders. Gamification has been considered for cognitive bias modification, mainly to address the core issues of diminishing motivation to train over time, as bias modification intervention tasks tend to be highly repetitive. While a prior review has suggested how gamification strategies could be applied to such tasks, there remains a lack of systematic evaluation of gamified cognitive bias modification interventions in the literature. Objective: The objective of this review is to understand the overall effectiveness of a gamified approach for cognitive bias modification and inform future research that seeks to integrate gamification technologies into existing conventional bias modification interventions. Methods: To identify the relevant articles for our review, the following search terminologies were used: (“cognitive bias” OR “attention bias” OR “interpret* bias” OR “approach bias” OR “avoidance bias”) AND (“training” OR “modification” OR “practice” OR “therapy”) AND (“gamification” OR “game elements” OR “game” OR “gaming” OR “game mechanics”). PubMed, MEDLINE, PsycINFO, and Scopus databases were searched systematically for articles published after 2000. Articles were included if they described a gamified cognitive bias modification task and included participants with underlying psychopathological symptoms. Data were systematically extracted from the identified articles, and a qualitative synthesis was performed. Results: Four studies evaluated gamified cognitive bias modification interventions. Two studies included participants with anxiety symptoms, one with affective symptoms, and one with alcohol problems. The conventional visual probe task paradigm was used in 3 studies, and the attentional visual search task paradigm was used in the last study. We found gaming elements incorporated to include that of animations, sounds, feedback, and a point-scoring system for response time and difficulty. Of the 4 identified studies, only 2 reported their gamified interventions to be effective. Conclusions: Our review is the first to systematically synthesize the evidence for gamified cognitive bias modification interventions. The results arising from our review should be considered in the future design and conceptualization of gamified cognitive bias modification interventions.
DOI: 10.2196/11640
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Family Medicine and Primary Care
Rights: © 2018 Melvyn Zhang, Jiangbo Ying, Guo Song, Daniel SS Fung, Helen Smith. Originally published in JMIR Mental Health (, 25.10.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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