338 Chapter 8 (Bakkes et al., 2012; Bakkes et al., 2014), thereby enhancing motivation and creating optimal learning environments. Drawing from our research described in Chapter 3, the game could, for example, offer more hiding spaces at the beginning of the game for more anxious children (Milosevic & Radomsky, 2008; Rachman et al., 2008) or provide additional exposures to fear events when children demonstrate calmness in the face of less challenging fear events. Research by, for instance, Alsem et al. (2023) has also shown that virtual reality scenarios in which therapists could dynamically adjust the game to children’s needs (by manipulating the virtual situation itself or the actions of the virtual characters), were found to be more effective in reducing aggressive behaviour than care-as-usual and CBT with roleplay practices. Secondly, game designers should consider the specific characteristics of their target group. Our results in Part 3 revealed that youth with varying types and severity of mental health problems may react differently to (promotional messages for applied) games. In Chapter 6, we observed that youth with severe internalising symptoms reported higher levels of autonomy, competence, and affect. Therefore, it is crucial to focus on fostering autonomy and competence, particularly for youth with mild to moderate symptoms, either through game design or promotional messaging, as these factors correlate with a more positive gaming experience (Ryan et al., 2006). Moreover, it may be advantageous to design games in ways that improve mood of youth without severe depressive symptoms, especially if the game’s effectiveness relies partly on short-term mood enhancements (Olson, 2010; R. Pine, Fleming, et al., 2020; Russoniello et al., 2009). Lastly, for those developing applied games to reduce anxiety, explicitly promoting the game as enjoyable may be beneficial. Although our research highlighted that youth with elevated anxiety symptoms were as likely to select the mental health game as youth with other internalising symptoms (Chapter 6) and that they showed similar engagement patterns than youth with other or milder symptoms (Chapters 3, 5 and 7), we did find that youth with elevated levels of anxiety symptoms anticipated less enjoyment from video games. Considering this aspect can ensure that youth with elevated anxiety symptoms are more inclined to take the initiative to play applied games. Finally, in Chapter 7, our research revealed a noteworthy change in participants’ stress mindset, specifically after selecting and playing the game when it was promoted as a mental health game, as opposed to an entertainment game. We posited that expectations set through pre-game trailers, guiding youth to interpret stress as manageable, drove these effects. This interpretation, coupled with the unique gameplay experiences and design inherent to Monument Valley (i.e., balancing difficulty and enjoyment through
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