Biofeedback-based Digital Games and Well-being in Childhood: A Systematic Review

Biofeedback-based digital games offer an engaging solution to the burgeoning youth mental health crisis. This review identified and evaluated empirical evidence of biofeedback-based digital games in the treatment of youth mental health challenges and the promotion of youth well-being. A systematic search of four electronic databases (CINAHL, PsycInfo, PubMed Central, and Web of Science) was conducted from the publication's year of inception. We identified 604 unique studies, 16 of which were included in the review based on eligibility criteria. The results of 7 studies were deemed generalizable due to their design. Participants in these 7 studies played Dojo, emWave, Mightier, RAGE-Control, or Wild Divine, all of which utilized a form of cardiac biofeedback. These games proved effective in reducing internalizing symptoms, externalizing behaviors, and general psychopathology, especially within clinical populations. In addition, there is promising evidence of their ability to promote emotion regulation skills as a universal intervention. Future directions include further evaluation of biofeedback-based digital games in school-based settings, as an interim treatment for waitlisted families in outpatient settings, as an add-on to existing evidence-based treatments, and of the cost-benefits to promote insurance coverage of biofeedback-based digital interventions.