Background Difficulties in emotion regulation are common in adolescence and are associated with poor social and mental health outcomes. However, psychological therapies that promote adaptive emotion regulation may be inaccessible and unattractive to youth. Digital interventions may help address this need. Objective The aim of this systematic review and meta-analysis was to synthesize evidence on the efficacy, feasibility, and acceptability of emotion regulation digital interventions in children and early adolescents aged 8 to 14 years. Methods Systematic searches of Web of Science, MEDLINE, PsycINFO, EMBASE, Education Resources Information Centre, ACM Digital Library, and IEEE Xplore up to July 2020 identified 39 studies, of which 11 (28%) were included in the meta-analyses (n=2476 participants). A bespoke tool was used to assess risk of bias. Results The studies evaluated digital games (27/39, 69%), biofeedback (4/39, 10%), virtual or augmented reality (4/39, 10%), and program or multimedia (4/39, 10%) digital interventions in samples classified as diagnosed, at risk, healthy, and universal. The most consistent evidence came from digital games, which reduced negative emotional experience with a small significant effect, largely in youth at risk of anxiety (Hedges g=–0.19, 95% CI –0.34 to –0.04). In general, digital interventions tended to improve emotion regulation, but this effect was not significant (Hedges g=0.19, 95% CI –0.16 to 0.54). Conclusions Most feasibility issues were identified in diagnosed youth, and acceptability was generally high across intervention types and samples. Although there is cause to be optimistic about digital interventions supporting the difficulties that youth experience in emotion regulation, the predominance of early-stage development studies highlights the need for more work in this area.
BACKGROUND Difficulties in emotion regulation are common in adolescence and associated with poor social and mental health outcomes. However, psychological therapies that promote adaptive emotion regulation may be inaccessible and unattractive to youth. Digital interventions may help address this need. OBJECTIVE In this systematic review and meta-analysis, evidence on the efficacy, feasibility and acceptability of emotion regulation digital interventions in children and early adolescents aged 8-14 years was synthesised. METHODS Systematic searches of Web of Science, Medline, PsychINFO, EMBASE, Education Resources Information Centre, ACM Digital Library and IEEE Xplore up to July 2020 identified 39 studies, 11 of which were included in the meta-analyses. A bespoke tool was used to assess risk of bias across the diverse methodologies in the included studies. RESULTS Studies evaluated digital games (n = 27), biofeedback (n = 4), virtual/augmented reality (n = 4) and programme/multimedia (n = 4) digital interventions in diagnosed, at-risk, healthy and universal samples. The most consistent evidence came from digital games, which reduced negative emotional experience with a small significant effect, largely in youth at-risk of anxiety (g = -0.19, [-0.34, -0.04]). In general, digital interventions tended to improve emotion regulation, but this effect was not significant (g = 0.19, [-0.16, 0.54]). Most feasibility issues were identified in diagnosed youth and acceptability was generally high across intervention types/samples. CONCLUSIONS Although there is cause to be optimistic about digital interventions supporting the difficulties youth experience in emotion regulation, the predominance of early stage development studies highlights the need for more work in this area.
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