Casual Video Games Demonstrate Ability to Relieve Stress, Improve Mood: Potential Clinical Significance Highlighted

East Carolina University's Department of Recreation and Leisure Studies revealed the results of a six-month long, randomized, controlled study that measured the stress-relieving and other mood-lifting effects of so-called "casual" video games. The three puzzle and word games used in the study, Bejeweled® 2, Peggle™ and Bookworm™ Adventures, are all made by PopCap Games, a leading publisher of casual video games. (PopCap underwrote the study and provided copies of the games for research purposes.) The hypotheses were tested using state-of-the-art technologies and methodologies to measure heart-rate variability (HRV), electroencephalography (EEG) and subjects' mood states pre- and post-activity (POMS). The study yielded significant findings in several areas while identifying potential therapeutic applications of casual games as a means of addressing serious mental and physical disorders. Due to the significance of the findings and their implications in health promotion, disease prevention and treatment, East Carolina University's Psychophysiology Lab and is planning to start clinical trials in the fall to determine the efficacy of these games and their prescriptive parameters.

In all cases, the changes in stress levels and mood were measured in comparison to a control group that experienced a Web-based activity similar in physical and mental nature to the game-playing groups. Full results of the study will be presented at the Games for Health Conference in Baltimore, Maryland by the director of the study, Dr. Carmen Russoniello, associate professor of recreational therapy and director of the Psychophysiology Lab and Biofeedback Clinic at ECU's College of Health and Human Performance. The study results will also be published in a peer-reviewed journal later this year. High-level findings of the study are provided below.

"I've conducted many clinical studies in the area of recreational therapy in the past, but this was the first one seeking to determine the potential therapeutic value of video games," stated Dr. Russoniello. "The results of this study are impressive and intriguing, given the extent of the effects of the games on subjects' stress levels and overall mood. When coupled with the very high degree of confidence we have in those results based on the methodology and technologies used, I believe there is a wide range of therapeutic applications of casual games in mood-related disorders such as depression and in stress-related disorders including diabetes and cardiovascular disease. Granted, this study was a first step and much more needs to be done before video games can be prescribed to treat medical conditions. However, these exciting results confirm anecdotal evidence that people are playing casual video games to improve their mood and decrease their stress, and herald casual games' potential in health promotion, disease prevention, and treatment of stress- and mood-related disorders."

Stress Relief

With respect to stress relief, measured primarily through HRV which captures sympathetic (fight or flight) and para-sympathetic (relaxation) nervous system activity by assessing the variability in the heart's "beat-to-beat" interval, Bejeweled was found to reduce physical stress activity by 54% compared to the control group. There was no statistical difference between male and female subjects. Peggle and Bookworm Adventures did not reduce subjects' physical stress levels significantly but did affect psychological tension, depression and other aspects of mood, in some cases dramatically (see below).

Changes in Aspects of Mood
Mood was measured in six different categories: Psychological Tension, Anger, Depression, Vigor, Fatigue and Confusion. Cumulatively, these six aspects of mood are called "total mood disturbance," with a decrease in total mood disturbance being a positive change in mood. In terms of total mood disturbance, Peggle had the greatest effect, improving mood by 573% across all study subjects compared to the control group (which saw a modest improvement in mood). Bejeweled 2 (435%) and Bookworm Adventures (303%) also had significant positive effects on subjects' overall mood. Interestingly, among those subjects who played Bejeweled 2, male subjects showed a 10% greater increase in total mood than female subjects, while females who played Peggle experienced a 40% greater improvement in mood than males who played that game. "It's not surprising that Peggle had the greatest effect on overall mood, given the game's over-the-top celebration of players' success each time they complete a level," noted Dr. Russoniello. "The other games also provide positive feedback to players, but not to the same extent or in the same ‘exhilarating' fashion."

Data from electroencephalography (EEG) supports the study's hypotheses and confirms the participant's psychological assessment (POMS). All three PopCap® games increased mood but in different ways. Peggle significantly increased positive approach/engage brain activity, especially in females — who accounted for 97% of the positive change. Bejeweled 2 significantly decreased brain activity associated with avoid/withdrawal activity. Males had a significant (191%) decrease when compared to females and significantly differed from the control group. Bookworm Adventures had the greatest impact on left brain - right brain synchrony (421% increase). Males had a 214% greater increase in mood after playing Bejeweled and a 78% increase in mood after playing Bookworm Adventures, compared to females. Age was an important factor as well. Those subjects under the age of 25 had a 156% increase in left brain alpha, indicating a substantial decrease in avoid/withdrawal brain activity when compared to those subjects age 25 and older. In addition subjects under 25 had a significant increase in right brain activity (318%) indicating that they also had an increase in approach/engage brain activity. On the other hand, those subjects age 25 and older experienced an 891% increase in right/left brain synchrony indicating a greater mental relaxation state. (Additional break-outs of the study data by gender and age are available online.)

Psychological Tension
Peggle had the greatest effect on psychological tension, with study subjects who played that game averaging a 66% reduction compared to 36% reduction among those who played Bejeweled 2 and 24% reduction among players of Bookworm Adventures. Specifically with respect to Peggle, female subjects accounted for two thirds of the overall reduction in tension after playing that game.

Anger
Bejeweled 2 and Peggle had similarly positive effects on subjects' anger levels, reducing anger by 65% and 63%, respectively. Bookworm Adventures had a more modest effect, reducing anger by 33%. Among female subjects, Peggle produced the greatest anger reduction, 86%. Men experienced the greatest reduction of anger while playing Bejeweled 2 (63%). "Peggle may have reduced anger more effectively in women due to its light-hearted characters and somewhat cartoony presentation featuring unicorns and rainbows," Dr. Russoniello conjectured. "For men, it's likely the nature of this game — Bejeweled 2 encourages focus, introspection and calmness — which facilitated a release of anger-oriented feelings like certain other therapeutic activities such as art."

Depression
All three games had similar effects on depression, reducing subjects' depressions levels by 45% (Peggle), 43% (Bookworm Adventures) and 37% (Bejeweled 2). Among men, however, Bookworm Adventures had the greatest depression-reducing effect, with male subjects accounting for 98% of depression reduction, on average, when playing that game. "All three games, but particularly Peggle, should be used in more focused trials with a group of clinically depressed subjects, to gauge the effects," suggested Dr. Russoniello. "If these games can reduce depression this significantly among a population of people who are not diagnosed with depression, the potential for positively affecting the mental state of someone who is in fact depressed is very significant."

Vigor
Vigor is the only positive variable reflected in the POMS and represents a state of increased mental energy. Bejeweled 2 increased vigor by an average of 210% among subjects who played that game. Bookworm (10%) and Peggle (24%) had modest affects on subjects' vigor levels. Among players of Bejeweled 2, females accounted for 59% of the overall increase in vigor.

Fatigue
Peggle had the most significant impact on fatigue, reducing it by an average of 61% among subjects who played that game. Bejeweled 2 (49%) and Bookworm Adventures (33%) also reduced fatigue. Peggle was nearly equally effective at reducing fatigue among male (52%) and female (48%) subjects.

Confusion
Compared to the control group surfing the Web for articles (which collectively experienced a modest decrease in confusion), all three games reduced confusion dramatically, suggesting that the rules, objectives and input controls for the game were very clearly understood by the subjects. Subjects playing Peggle saw confusion drop by an average of 486%, while those playing Bookworm Adventures (462%) and Bejeweled 2 (426%) also experienced sizable reductions in confusion. "These findings are especially intriguing as they present the possibility that casual games may be useful in ameliorating conditions such as attention deficit disorder, memory loss and general confusion attributed to dementia and Alzheimer's disease," said Dr. Russoniello.

Study Methodology
The study was conducted between October 2007 and April 2008 and included a total of 134 subjects. Thirty-one subjects served as members of the control group, tasked with surfing the Internet looking for journal articles. The experimental groups consisted of 31 subjects who played Bejeweled 2, 29 subjects who played Bookworm Adventures, and 36 subjects who played Peggle. The study included the collection of physical data (based on Heart Rate Variability (HRV) measurements) and psychological data (based on POMS (a profile of mood states pre- and post- activity) and electroencephalography (EEG) measurements) during a 5-minute baseline period and 15 minutes of game playing or (in the case of the control group) Internet surfing.

TGA Interview with NYCGameIndustry.com

Below is a recent Q&A with NYCGameIndustry.com

"Spotlight On" is a recurring feature on nycgameindustry.com that allows us an opportunity to get to know the passionate students, talented developers and professional companies which make up the New York video game industry even better. This month we sat down with The Game Agency, a marketing firm uniquely devoted to meeting the video game, interactive entertainment, and social media needs of clients.

NYCGI: What is The Game Agency and what is its focus?

TGA: The Game Agency is an awarding winning marketing firm that specializes in video games, interactive entertainment, and social media. Our employees have worked in every facet of the interactive software industry and we pride ourselves on delivering this medium to our clients. We leverage a deep network of developers, publishers, distributors and retailers to find new markets to create, market, and distribute content. Bringing content to life is fun and maximizing the reach and impact of that content is our sweet spot!

NYCGI: You recently developed a Facebook game for the Ghostbusters license. Have you seen an upward trend in requests for these social-casual games?

TGA: Social media has changed the way we communicate, both personally and professionally. Without a doubt, marketers are leveraging this medium to position and promote their message, engage dialogue and change behavior. According to a recent Nielsen study, social networks have become more popular than email with more people are now using social networks rather than email to communicate.

NYCGI: What are some ways that people are taking advantage of social networks?

TGA: Many different ways, however social gaming is actually among the most popular activity across the spectrum. On Facebook, the top 10 games have an average of 7 million active monthly users. Among these 10 games, 5 of them focus on building a community and interacting with others and almost every one of our clients wants to be part of this.

NYCGI: How do you make a successful app on an already heavily saturated social platform like Facebook?

TGA: At The Game Agency we have five rules when designing our games/apps for Facebook.

1. Keep Simple

Facebook is simple. The features on Facebook are simple. Our hypothesis is that no application which is more complex than the most complex feature on Facebook will succeed. The simpler you make your app the better it will do.

2. Be Social

Just because you’ve built it doesn’t mean the users will come. Facebook is still first and foremost a social platform. If your application has no social component it will fail to achieve its full potential. Make it a group effort or there will be little reason for people to install it.

3. Get Viral

Write an application which does nothing more than spread itself. If your idea is funny enough, like Vampires or Zombies and Mafia Wars, people will use it.

4. Stay Fun

We ensure that all of our designs incorporate game mechanics. Games are successful for many reasons but understanding the properties and mechanics of popular games and then deploying those properties in our social applications has proven a recipe for true success.

5. Quality Matters

This might be obvious, but quality matters. Apps like Mafia Wars, YoVille, Lil Green Patch and Causes provide a set of high-quality features. They are straight forward and very compelling. In addition, be prepared to deal with your growth. Predict how many users you’ll have in a few days, weeks, months, etc. If it’s more than you anticipated make sure you have the hardware to handle it— users will uninstall apps that are slow or broken, even if it’s not the apps’ fault.

NYCGI: Tell us a bit about the basic idea behind the Ghostbusters Facebook game.

TGA: Atari was looking to promote their Ghostbusters game (now available on PC, X360, PS3, PS2, Wii and DS) in the social media environment. The Game Agency's solution was to create an interactive Ghost Hunt (http://apps.facebook.com/ghostbusters-game/) that challenges players to search for ghosts, share their findings and slime their friends.

Ghosts can be found throughout Facebook profile and product pages, blogs, game sites and corporate websites. This game provides prizes including a custom Ghostbusters designed Dell computer, Intel Core Processors and copies of the Ghostbusters game. In its first month, the game had over 35,000 people sign up and over 1,000,000 slimes.

NYCGI: When a client approaches you with a request for a game, how much do they typically bring to the table and how much is TGA's creative input?

TGA: The Game Agency has 3 divisions: TGA Digital, TGA Events and TGA Public Relations. We have a variety of capabilities that we deploy for clients including game development, marketing, promotions, partnerships, media, licensing and public relations.

Every project is different but often our clients are looking to extend a current campaign via games. We get briefed about their brand, their consumer and the creative components already in the works and we challenge ourselves to deliver a compelling game strategy that will engage a target audience and achieve their overriding goals.
Sometimes we focus on online games, sometime we focus on mobile games, sometimes we focus on live events. We are lucky that our clients trust us to get our hands dirty with them.

NYCGI: What's the turnaround time on most of these projects?

TGA: There's no firm rule for turnaround. Some games take a few weeks to develop while others take up to a year. It all depends on the platform and the depth of the user experience. The average campaign is 3-6 months.

NYCGI: Do you foresee TGA working with any of the new motion-sensing technologies on display at this year’s E3?

TGA: 3D camera motion sensor games are one of our biggest initiatives right now. The Game Agency is working on one fitness game targeting Microsoft's project Natal’s launch and several games that will be introduced in 2010 with global brand and retail partners. We like to think of these games as the next-next generation in gaming. They all focus on getting consumers active utilizing the human body as a game controller.

The physical activity of running, jumping, crouching, balancing and many more moves allows players to advance through the game. This is cutting edge technology and a real jaw dropper for everyone we've shown it to so far.

NYCGI: What other game technologies are your teams excited about?

TGA: The Game Agency is working with Aspyr Media on a new Nintendo DS game called Treasure World. It's the world’s largest treasure hunt with hundreds of millions of treasure spots around the world. Players use the DS to find Wi-Fi signals and unlock content (characters, clothing, environments, etc.). Our team has established co-promotional programs with restaurant chains, malls, libraries and children's non-profits to engage kids nationwide. We are now focused on the using this game engine for companies trying to reach consumers and employees through custom game development on Nintendo DS and Wi-Fi USBs.

NYCGI: Do you see the industry trending towards casual or core gamers in the next five years?

TGA: The high growth area in gaming is casual. Core games and gamers will always play a huge role in shaping the gaming landscape but technology has thrown open the door for every company to utilize gaming for advertising, social engagement, public relations...even employee training. Whether online, mobile, console, handheld or events we expect more and more content to be introduced for the everyday person (kids, parents and grandparents). The better the hardware gets the lower the barriers are to engage.

NYCGI: Thank you so much for your time and best of luck with all those amazing projects!

Traditional Marketing Budgets Lose to Interactive

According to Forrester Research, 60% of marketers surveyed will increase their interactive marketing budgets by shifting funds from traditional media. Direct mail was cited by 40% of marketers as being one being cut, outranking newspapers (35%), magazines (28%) and television (12%).

Among the interactive channels, the study finds social media and mobile marketing spending expanding between 2009 and 2014, with social media jumping by 34% on a compounded annual basis and mobile marketing increasing by 27%. Social media starts at $716 million in 2009, increasing to $3.11 billion by 2014. Mobile marketing expenditures stand at 319 million this year, and goes to $1.27 billion by 2014.

47% of CMOs whose budgets have been cut are increasing their spending on social media, while another 44% are increasing spending on Web site development. 40% will spend more on online advertising, and nearly that amount will increase financial resources in e-mail, considering these functions critical to their businesses, or needed to maintain competitive advantages.

Online Gaming Continues Strong Growth in U.S.

The number of U.S. citizens visiting online gaming websites rose 22 percent in May 2009 from May 2008 to 87 million, as people search for cheaper entertainment in a tough economy, research firm comScore said Friday.

Online gaming continues to be one of the top gaining categories over the past year growing at ten times the rate of the total U.S. Internet population and reaching nearly one out of every two Internet users.

Yahoo Games led comScore's list of most popular online gaming websites during May 2009, rising 6 percent from May 2008 to 19.4 million. EA Online followed, attracting 18 million users during the month, a 34 percent year-on-year increase. Nickelodeon Casual Games, which didn't exist in May 2008, attracted 14.8 million visitors. WildTangent was up 16 percent year-on-year with 13.8 million users.

comScore said Mochi Media, an online game distrubution company, attracted 17 million unique users, or about 8.7 percent of the total internet audience (193.8 million in total). Games2Win attracted 1.8 million, or 0.9 percent of the total internet population, while Tetris Online attracted 165,000 unique visitors during May, or 0.1 percent of the total internet population.

Top Online Gaming Sites May 2009 vs. May 2008 Total U.S. – Home/Work/University Locations Source: comScore Media Metrix
	Total Unique Visitors (000)
	May-2008	May-2009	% Change
Total Internet : Total Audience	190,858	193,825	2
Online Gaming	71,624	87,102	22
Yahoo! Games	18,340	19,391	6
EA Online	13,374	17,988	34
Nickelodeon Casual Games	N/A	14,836	N/A
WildTangent Network	11,896	13,844	16
Disney Games	12,137	11,717	-3
MSN Games	10,017	8,986	-10
AOL Games	8,318	8,711	5
MINICLIP.COM	7,551	8,432	12
Betawave Partners - Partial List	3,894	7,406	90
Spil Games	4,345	7,163	65
GSN Games Network	910	6,034	563
Big Fish Games Sites	4,392	5,592	27
ARMORGAMES.COM	2,684	3,860	44
Y8.COM	1,243	3,537	185
GAMEVANCE.COM	3,982	3,466	-13
RealArcade Sites	6,143	3,427	-44
IWIN.COM	2,112	3,356	59
Midasplayer.com Ltd.	1,601	2,872	79
GAMENINJA.COM	1,172	2,434	108
Stardoll Sites	N/A	2,294	N/A

Games Keep Growing

The following study was released yesterday by Nielsen. As you read below it's worth noting which months consumers play, purchase and subscribe to the most games.

The economic recession could be pushing up gaming hours, and accelerating the used games and video game rent-by-mail businesses, according to a new report from research firm Nielsen. As seen in the chart below from Nielsen's report, average gaming hours per week in 2009 have been ahead of the comparable months in 2008. But hardcore gamers, he said, are not likely driving factors in the rise of hours played. Nielsen recorded that gamers logged nearly 19 hours per week in January 2009, compared to less than 16.5 hours per week in January 2008. In May 2009, the most recent month in Nielsen's report, gamers played just over 16.5 hours per week, compared to under 16 hours per week in May 2008. The full graph explaining this reads as follows:



Also on the rise from last year are used game sales purchases. In May 2009, the ratio of used games purchased by Nielsen survey subjects was 0.36. "Used game purchasing is at all-time highs in 2009, looking back since 2006," Nielsen said.



GameStop is the leading used video game retailer, and in May reported used software sales were up 31.9% for its first fiscal quarter, as consumers have become more value-conscious. Another way that gamers are seeking out more bang for their gaming buck is through rent-by-mail services such as GameFly and Blockbuster's Total Access. The average subscription rate for using such services is trending ahead of prior years so far in 2009.



The rising popularity of used game sales and rentals is at the expense of new game sales, Nielsen suggests. But new game sales are also softer this year because of a lack of huge hits in the first have of 2009. By comparison, 2008 saw massive releases such as Grand Theft Auto IV and Mario Kart Wii. While gamers may be more value-conscious, many of those surveyed also said that the recession will not impact the amount that they spend on games in the year ahead, even though 50 percent said they have been negatively affected by the economy. 35% of gamers claim they are spending more money or plan to spend more on gaming this year than last year and 39% claim they are spending the same amount Nielsen's report said.

THE 2009 E3 SUMMARY

E3 has come and gone and has again graced the gaming world with a glimpse of where the industry is heading. If it wasn’t pronounced clearly enough by the three media briefs, the industry is shifting from pushing high production benchmarks to changing the way in which we interact with games.

As the ones who ultimately started the motion based gaming revolution, it’s only appropriate to start by talking about Nintendo and their Wii Motion Plus add on for the Wii Remote. Previously incapable of tracking subtle movements, the Wii Remote will no longer be bound to broad strokes and simple “waggle” controls due to the precision granted by the Wii Motion Plus, a small attachment that just barely extends the length of the Wii Remote. Through simple demonstrations of how the new technology will work in Wii Sports Resort, it was clear that this was no gimmick, but a way to completely open up a new realm of what is possible on the Wii. The added precision and ability to have one to one motion tracking will vastly improve the current genres of games such as EA is doing with the revamped Tiger Woods PGA Tour 10 and the new Grand Slam Tennis. Imagine having your golf swing accurately tracked to point where your hook is perfectly reflected in game. Or how about a Star Wars lightsaber fighting game that not only tracks your movements perfectly, but has the crackle of clashing beams come out of the Wii Remote speaker for another level of immersion. The possibilities are endless.

The one thing getting the most buzz at the moment is Microsoft’s motion tracking camera, the Natal. Like Stephen Spielberg said at the Microsoft conference, “it’s not about reinventing the wheel, it’s about having no wheel at all.” The Natal will be compatible with all Xbox 360 consoles and will track movement and pick up sound from those using it. Judging from the presentation, the technology works and has some true potential for a variety of games. The demonstration of Ricochet, a 3D Breakout-like title that make the user the paddle and tasks them with deflecting a bunch of balls off of their virtual self to break bricks at the end of a corridor. The short demo looks fun and showed that this is truly working in a three dimensional space, not just capturing a 2D representation of yourself like traditional camera peripherals have done in the past. Demos on the show floor including a racing simulator has garnered a lot of positive press and show that the Natal can be applied to current genres and go beyond being a simple gimmick.

Though it’s getting minimal press of the three, Sony’s motion device is blowing many folks away. Maybe it was because the demonstrations were so varied. Maybe it was because my initial perception upon seeing a glowing wand was so low and then immediately picked up when I saw it in action. Whatever it was, it’s Sony’s combination of a remote and its Eye Toy that make it appear to have the most potential of the three. Using what appears to be a glowing ball on the tip of a Wii Remote, the Eye Toy can track the users movements almost flawlessly. At first, the user was standing in a room holding the device, which then transformed into a variety of different things such as a tennis racket, golf club, sword, and (my personal favorite) a plasma whip not far removed from Ratchet and Clank: Up Your Arsenal. The demonstration only became more engaging when possible mechanics were shown for genre titles such as real time strategy, first person shooting, and melee combat. During the shooting demonstration, the person in control said, “this would be impossible without a trigger.” Though clearly a cheep shot at the Natal, it’s better to look at the statement as a way of justifying multiple motion tracking technologies. For a shooting game, I would probably want to use something that has a trigger like Sony’s controller or Nintendo’s Wii Remote, but if I were playing the demoed Ricochet where a controller clearly isn’t required, then the Natal would be the way to go.

This E3 has shown what the future of gaming will hold. Not content with the confines of controllers and buttons, Nintendo, Microsoft, and Sony have officially broken every wall of gameplay restrictions to the point where literally everything is possible.

Size Matters!

Is it unprofessional to write a love letter to a publisher or developer? Whether it is or not, I’m going forth and stating my compassion towards Bethesda and all they’ve done to keep me glued to Fallout 3 for dozens of hours on end without any stopping point in sight. This is something more than just my extreme satisfaction with a particular game (though it’s certainly part of it) it’s a model that developers should aspire to achieve in an effort to satisfy gamers over a longer stretch of time. Sticking strictly to console based games, there are two extremes here. On one hand you have the mentioned Bethesdas and Criterions of the industry that work towards expanding their titles beyond the initial feature set offered on the disk. I should give Criterion a special nod for making its first wave of Burnout Paradise content free, but that’s another topic entirely. On the other end of the spectrum, you get the guys at Grin who recently put out the Terminator Salvation game and Wanted: Weapons of Fate which offer nothing more than a story mode clocking in under five hours of gameplay with little else to offer. I’m not putting down Grin for making bad games, but rather using them as an example to point out the minimum that can be put in a game that sells for $60. Rushing through Fallout 3 will take between fifteen and twenty hours. How’s that for a value? Playing through the game and seeing everything could take up to sixty hours when, again, you’re rushing. Not only that, but once you finish the game, you can download content that seamlessly integrates itself into the game adding new missions, sometimes in new locales, to an already massive world with sure to be unexplored terrain. Criterion is offering another island to their massive world that is Paradise City after already giving away motorcycles, a day/night cycle, new multiplayer modes, and a restart function to races! They gave it away! Capcom should have thought about that before charging $5 for the adversary mode in Resident Evil 5, which was already on the disk to begin with.

Allow me to summarize: I won’t be buying Terminator Salvation because it’s $60 for a five hour game. I will, however, continue to buy additional content for Fallout 3 and Burnout Paradise. Recent drops in game sales prove that gamers are being more selective about their purchases and as a result will be looking towards the future and how a game will continue to stay fresh. It’s why World of Warcraft has stayed so popular and continues to attract new users. It’s why I’m still playing Burnout Paradise over a year after I bought it. Most importantly, it’s why anyone is still playing any given title long after it’s release.

- Jason Polansky