The use of serious games in psychological interventions for anxiety disorders and related psychopathologies: a systematic review

Anxiety and related disorders are among the most common psychological difficulties. The application of serious games in the intervention of anxiety and related disorders is increasing rapidly and shows promising results in terms of game context that provide higher feasibility. Although this increasing interest, the literature shows variant results in the implementation of game elements to the serious games and effectiveness of serious games intervention for anxiety. This shows the requirement to gain better understanding of how anxiety is targeted in games and which game elements are used in these interventions. However, to the authors' knowledge, no review examined serious games by specifically focusing on anxiety disorders and analysed game characteristics based on a game perspective. Therefore, this review aims to provide a comprehensive frame that documents how the serious games intervention for the treatment of anxiety and related disorders were conceptualized and explain these games in scope of a game taxonomy. Web of Science, PubMed, Scopus, and Cochrane databases were searched with relevant keywords in May 2022. As a result of the screening, 14 studies (12 serious games) were found. Serious games mainly targeted state-trait anxiety (n = 5), specific phobia (n = 4), OCD (n = 2), social stress (n = 1), GAD (n = 1), and panic disorder (n = 1). The application area of the serious games was wellbeing, and the activities were mainly mental for all studies. The modalities of the serious games were mainly visual (n = 12) but combined with other measurements. The environment of the games was mainly online (n = 7), and the most used interaction style was touch-screen (n = 7) but the majority of the studies used more than one interaction style. Methodological differences and various game characteristics among the studies prevent the findings from being generalizable. Nevertheless, serious games present promising directions as mental health support for individuals with anxiety and related disorders.