Children with serious anger problems can be helped by a video game that helps them learn how to regulate their emotions, according to a new study.
Noticing that children with anger control problems are often uninterested in psychotherapy, but eager to play video games, Jason Kahn, Ph.D., and Joseph Gonzalez-Heydrich, M.D., at Boston Children’s Hospital developed “RAGE Control,” a video game with a biofeedback component that helps children practice emotional control skills. The game involves shooting at enemy spaceships while avoiding shooting at friendly ones. As children play, a monitor on one finger tracks their heart rate and displays it on the computer screen. When the heart rate goes above a certain level, players lose their ability to shoot at the enemy spaceships.
To improve their game, they must learn to keep calm, the researchers explain. “The connections between the brain’s executive control centers and emotional centers are weak in people with severe anger problems,” said Gonzalez-Heydrich, chief of Psychopharmacology at Boston Children’s and senior investigator on the study. “However, to succeed at RAGE Control, players have to learn to use these centers at the same time to score points.”
The study, led by first author Peter Ducharme, M.S.W., a clinical social worker at Boston Children’s, compared two groups of 9- to 17-year-old children admitted to the hospital’s Psychiatry Inpatient Service who had high levels of anger. To qualify for the study, the children had to have a normal IQ and not need a medication change during the five-day study period.
One group, with 19 children, received standard treatments for anger, including cognitive-behavioral therapy, presentation of relaxation techniques and social skills training for five consecutive business days. The second group, with 18 children, got these same treatments, but spent the last 15 minutes of their psychotherapy session playing RAGE Control. After five sessions, the gamers were significantly better at keeping their heart rate down, the researchers report. They also showed clinically significant decreases in anger scores on the State Trait Anger Expression Inventory-Child and Adolescent (STAXI-CA). Specific decreases were seen in the intensity of anger at a particular time, the frequency of angry feelings over time, and the expression of anger towards others or objects. The gamers also had a decrease in suppressed, internalized anger, according to the researchers.
In contrast, the standard-treatment group showed no significant change from baseline on any of the above measures. The gamers gave their therapy experience high marks for helpfulness (5 to 6 on a scale of 7), according to the researchers. “Kids reported feeling better control of their emotions when encountering day-to-day frustrations on the unit,” said Ducharme. “While this was a pilot study, and we weren’t able to follow the kids after they were discharged, we think the game will help them control their emotions in other environments.”
The scientists are now conducting a randomized, controlled clinical trial of RAGE Control in the outpatient clinic at Boston Children’s that adds a cooperative component. The children team up with a parent for 10 game sessions at the clinic; if either the parent’s or the child’s heart rate goes up, neither of them can shoot, forcing them to help calm each other. The research team plans another clinical trial to test whether letting children take RAGE Control home, to play with parents and siblings, will increase its effect. The study was published in the journal Adolescent Psychiatry.