Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients

Abstract

Cognitive deficits are common in depression and may persist following the resolution of affective symptoms. However, therapeutic strategies that successfully target cognitive impairments are lacking. Recent work has demonstrated that playing action video games leads to improvements in cognition, in particular executive function, in healthy individuals. We therefore set out to test whether playing video games can reduce symptoms associated with depression. We focussed on depressive symptoms and on rumination, since rumination is a good predictor of depression and may contribute to triggering depression. We recruited 68 clinically depressed individuals (mean age: 46 years, 47 females) that were randomized into the training group playing a fast paced action video game for 6 weeks or a waitlist control group. Before and after training participants completed online questionnaires and a neuropsychological test battery. Only participants who actually played the game were included in the analysis. The final sample consisted of n = 21 training group and n = 29 waitlist control group. The training group showed significantly higher subjective cognitive ability, as well as lower self-reported rumination at posttest in contrast to the control group (although these findings do not survive Bonferroni correction). On a subsample with cognitive performance data (n = 19) we detected an improvement in executive function (Trail Making Task A and B) in the training compared with the control group. The results show that the fast paced action video game employed in the present study improved Trail Making performance and may reduce rumination and enhance subjective cognitive ability. Future research may focus on the investigation of the precise cognitive profile of effects.

Commentary: Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients

“…On a cortical level, Benady-Chorney et al ( 2018 ) observed that habitual video game players (who played ≥ 6 h/week for a 6 month period) compared to non-habitual video game players (who played ≤ 6 h/week for a 6 month period) had greater cortical thickness in the dorsal anterior cingulate cortex, which is associated with enhanced learning and attentional control. The lack of a positive result in Kühn et al ( 2018 ) perhaps suggests the gameplay duration (6 weeks vs. 6 months in Benady-Chorney et al, 2018 ) may not have induced sufficient cortical activation for cognitive enhancements and subsequent reduction of rumination (and depressive symptoms).…”

“…Indeed, a meta-analysis by Powers et al ( 2013 ) on the effects of video game play on information processing highlighted how the genre of the video game can influence how effective the video game is at enhancing aspects of cognitive functioning (e.g., auditory and visual processing, executive functions, and spatial imagery). Kühn et al ( 2018 ) used an action video game, a genre that Powers et al ( 2013 ) reported had a moderate effect size (Cohen's d = 0.22–0.62) with respect to cognitive functioning. Research has shown that general cognitive activation and executive functioning are more linked to games that involved learning patterns and logical puzzles, components not found in Boson X, than those that are classified as action video games (Mondéjar et al, 2016 ).…”

“…In recent years, there has been growing interest in the potential of video games to improve health and cognition (Russoniello et al, 2013 ; Allen et al, 2017 ; Bediou et al, 2018 ; Desai et al, 2018 ). In “Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients,” Kühn et al ( 2018 ) investigated the potential effect of an action-based video game, Boxon X, on rumination, depression, and cognition. To do this, Kühn et al ( 2018 ) recruited 68 patients who were clinically diagnosed with depression for their study.…”

“…In “Fighting Depression: Action Video Game Play May Reduce Rumination and Increase Subjective and Objective Cognition in Depressed Patients,” Kühn et al ( 2018 ) investigated the potential effect of an action-based video game, Boxon X, on rumination, depression, and cognition. To do this, Kühn et al ( 2018 ) recruited 68 patients who were clinically diagnosed with depression for their study. The patients were randomized into one of two groups: a training group, who played Boson X, and a waitlist control group.…”

Thalamic morphometric changes induced by first‐person action videogame training

“…Videogames are considered the most popular pastime activity of the last two decades (Granic, Lobel, & Engels, 2014), with an emerging trend to their exploitation for neurorehabilitation purposes, both in cognitive and sensorimotor domains (Horne-Moyer, Moyer, Messer, & Messer, 2014), as well as for neuropsychiatric disorders (Kühn, Berna, Lüdtke, Gallinat, & Moritz, 2018). According to cross-sectional evidence in healthy individuals, videogaming induces several cognitive-behavioral effects, enhancing skills such as selective attention (Green & Bavelier, 2003), short-term memory (Boot, Kramer, Simons, Fabiani, & Gratton, 2008), spatial cognition (Greenfield, 2009), multitasking (Green & Bavelier, 2006a), task-switching (Green & Bavelier, 2012), decision-making (Green, Pouget, & Bavelier, 2010), and cognitive control (Anguera et al, 2013).…”