Gamified attentional bias modification in heavy drinking youth

Objective Young adults often experiment with heavy use of alcohol, which poses severe health risks and increases the chance of developing addiction problems. In clinical patients, cognitive re-training of automatic appetitive processes, such as selective attention towards alcohol (known as “Cognitive Bias Modification of Attention”, or CBM-A), has been shown to be a promising add-on to treatment, helping to prevent relapse. To prevent escalation of regular use into problematic use in youth, motivations appear to play a pivotal role. As CBM-A is often viewed as long and boring, we present this training in the form of a serious game, as a novel approach aimed at enhancing motivation to train. Methods: 96 Heavy drinking undergraduate students carried out either a regular CBM-A training, a gamified version (called “Shots”), or a placebo training version over four training sessions. Measures of motivation to change their behavior, motivation to train, attentional bias for alcohol and drinking behavior were included before and after training. Results: Alcohol attentional bias was reduced after training only in the regular training condition. Self-reported drinking behavior went down slightly in all conditions, but motivation to train also decreased in all conditions, suggesting that the motivational features of the Shots game were not enough to fully counteract the tiresome nature of the training. Moreover, some of the motivational aspects decreased slightly more in the Game condition, which may indicate potential detrimental effects of disappointing gamification. Conclusions: We therefore stress that caution is advised when using gamification, as well as underscore the importance of careful scientific evaluation.