Ana Maria Abreu

Combat sports involve physical confrontation between two athletes, including a range of striking and grappling techniques (Barley & Harms, 2021; Barley et al., 2019). In sports with head impact (st...

This umbrella review explores the effects of Extended Reality (XR) and Game-Based Interventions (GBI) on anxiety, depression, and stress, covering augmented (AR), virtual (VR), and mixed reality (MR), along with serious games, gamification, game-based learning and training, exergames, and commercial video games. Following PRISMA and AMSTAR 2 guidelines, 201 articles were screened, with 16 reports selected (nine meta-analyses, six systematic reviews, and one scoping review). Findings highlight XR-GBI’s potential as a promising, flexible, and replicable intervention, demonstrating significant preliminary mental health improvement across children, adolescents, adults, and older people. Regarding anxiety, VR aids preoperative and procedural anxiety, promotes distraction and relaxation, and supports VR exposure therapy (VRET), matching Cognitive Behavioral Therapy (CBT) effectiveness with higher engagement. For depression, VRET reduces symptoms, while VR exergames combining physical activity and engagement show strong antidepressant effects. Stress management remains less explored, though AR video games enhance cognitive and social well-being, and VRET alleviates stress symptoms. Despite the XR-GBI promise, research is still emerging, with publications only beginning to expand recently, few randomized controlled trials, and methodological limitations. From our findings, we highlight practical and theoretical implications by showing how XR-GBI rely on core technical features and proposing a five-pathway theoretical model (cognitive, emotional, bodily, social, and motivational) that systematizes their potential for mental health, guiding future design, evaluation, and research. Further research should also expand on AR, MR, gamification, game-based learning and training, biofeedback, neurophysiological assessment, and social dynamics, while integrating artificial intelligence, digital mental health literacy, and psychoeducation to enhance XR-GBI’s impact.

The aim of this study was to investigate whether participation in rugby or padel is associated with differences in cognitive functioning, specifically in processing speed, attention, and executive functions. Sixty-four participants were divided into rugby athletes, padel athletes, and non-athletes. Cognitive performance was assessed using the Digit Symbol-Coding and Symbol Search subtests of the WAIS-III (Processing Speed Index) and the Trail Making Test (Parts A and B). Significant group differences emerged in processing speed and executive functions, while no significant differences were found in attention. Rugby athletes showed significantly lower performance in these domains than padel athletes, performing similarly to non-athletes. In contrast, padel athletes significantly outperformed non-athletes in processing speed, suggesting an association between padel practice and enhanced cognitive performance. These findings are consistent with a possible association between participation in padel and higher cognitive performance, particularly processing speed, although causal inferences cannot be drawn from this small cross-sectional study. Further research is needed to clarify the cognitive correlates of padel as the sport gains popularity.

This research explores the neurosociological dimensions of video games, focusing on their evolution, social impact, and neurological effects. Using a narrative review, we first examine their progression from playful activities to digital and connected experiences. We assess potential risks such as youth vulnerability, excessive screen time, lack of physical presence, gaming disorder, and aggressiveness. Conversely, we highlight positive aspects, including self-expansion, social play, flow states, excitement and relaxation, neurophysiological and psychological effects, and mental health applications. We further analyze gaming’s role in socialization, high-stimulation environments, disembodied interactions, and as a source of fun in modern society. Finally, we synthesize these themes through three key perspectives: the allure of screen flow among youth; the balance between digital and physical play for healthy development; and the importance of understanding both the risks and benefits of video games. This study frames video games as a cultural and cognitive technological force shaping human development.

Background/Objectives: Autism is characterized by atypical sensory processing, which affects spatial and temporal perception. Here, we explore sensory processing in children with autism, focusing on visuospatial and temporal tasks across visual and auditory modalities. Methods: Ninety-two children aged 4 to 6 participated, divided into three groups: autism (n = 32), neurotypical chronological age-matched controls (n = 28), and neurotypical developmental age-matched controls (n = 32). The autism group consisted of high-functioning children (26 boys). The participants completed computer-based tasks requiring spatial and temporal processing. Response accuracy and reaction times were recorded. Results: The autism group demonstrated higher accuracy in temporal tasks (visual and auditory modalities) and comparable accuracy in visuospatial modality, but slower response times in all tasks compared to both neurotypical controls. These results suggest a strategy that prioritizes accuracy over speed, while preserving spatial and temporal processing in autism. Conclusions: These findings suggest that temporal processing, rather than the sensory modality, drives decision-making strategies in children with autism. Our findings highlight the need for interventions aligned with autistic children’s slower but accurate processing style to support social interaction and reduce stress. In a fast-paced digitalized world, autistic children might benefit from slower, balanced, and inclusive, evidence-based approaches that align with their cognitive rhythm and reduce overstimulation. By incorporating these unique strategies, targeted programs can enhance the quality of life and adaptive skills of children with autism, thereby fostering better integration into social and sensory-rich environments.

Nomophobia, or the fear of not being able to use a smartphone and/or the services, has gained increasing attention due to its growing prevalence. This study aimed to examine the prevalence of nomophobia and of potential variables associated with the phenomenon. Additionally, it sought to determine if the average of total nomophobia and the four second-order factors differed across gender. Finally, it analyzed the associations between nomophobia (overall and second-order factors) and psychological variables (self-esteem, loneliness, life satisfaction, and phubbing behavior), internet use, and sociodemographic characteristics. A cross-sectional survey was conducted with 306 participants (68.6% women), aged between 18 and 79 years (M = 38.0, SD = 16.3), using an online questionnaire. Descriptive statistics, independent samples t-tests comparing groups by gender, and bivariate correlations were computed. After, multiple linear regression analyses were performed to obtain parsimonious models with the most relevant variables (psychological variables, internet use, and sociodemographic characteristics) associated with overall nomophobia and its four dimensions. The results were generally consistent with the previous literature. Notably, gender and phubbing behavior were significantly associated with nomophobia. These findings contribute to a better understanding of the nomophobia phenomenon and may inform future interventions aimed at mitigating its potential impact on well-being.

This study builds on a previous umbrella review that highlighted the effectiveness of combining Extended Reality (XR) and Game-Based Interventions (GBI) in mental health treatment, showing positive results in reducing anxiety, depression, and stress. XR included augmented, virtual, and mixed reality, while GBI encompassed serious games, gamification, game-based learning and training, exergames, and commercial video games. The review analyzed 201 studies and selected 16 (nine meta-analyses, six systematic reviews, and one scoping review). Given the role of design in digital mental health solutions, here, we conducted a reverse engineering analysis to understand how these interventions worked by reviewing descriptions and visual representations from each study, breaking down XR-GBI into core game elements. This allowed us to identify design features and motivational purposes linked to their effectiveness, as well as underused elements to inform future research and innovation. Frequently used game elements included “Emotions”, “Single-player”, “Consequence”, “Simulation”, “Customization”, “Meaning”, “Level”, “Exploration”, “Narrative”, and “Feedback”. The knowledge of frequent and underused game elements offers insights to advance XR-GBI design knowledge and support their use in digital mental health to boost intrinsic motivation, supporting cognitive and behavioral change. However, the absence of multiplayer features reveals a research gap, suggesting XR-GBI could be improved by adding cooperative, competitive, or collaborative elements. Future research and interventions should build on the game elements identified here to enhance mental health outcomes while exploring new elements, particularly social dynamics, to strengthen engagement and therapeutic impact.

This study examines the impact of gamification on education using a novel gamified digital learning platform and a randomized controlled trial (RCT) protocol. Following established research guidelines (CONSORT, Cochrane Collaboration, EVAT©), we assessed the individual and combined effects of points, badges, and challenges against a control group without gamification. The RCT evaluated participant characteristics (sociodemographics, game habits, player traits) and outcomes in cognition (learning, engagement, webcam-based eye-tracking for visual attention, cognitive load), emotions (affective states, webcam-based facial emotion recognition), and motivation (intrinsic motivation). Results showed significantly higher learning for participants using all game elements versus the control group, while badges alone increased cognitive load compared to the other gamification groups. These findings suggest that gamification is more effective when thoughtfully integrating game elements rather than applying elements in isolation, aligning goal-setting with feedback, and combining intrinsic and extrinsic motivational cues. The absence of significant results in other variables may reflect the novelty effect, emphasizing the importance of aligning gamification with pedagogical goals, considering individual and contextual factors, and designing systems that address usability and long-term impact. Educational implications and design recommendations are provided.

Gamification has emerged as a powerful strategy in digital education, enhancing engagement, motivation, and learning outcomes. However, most research lacks theoretical grounding and often applies multiple and uncontextualized game elements, limiting its impact and replicability. To address these gaps, this study introduces a Systemic Gamification Theory (SGT)—a comprehensive, human-centered model for designing and evaluating inclusive and effective gamified educational environments. Sustained in Education, Human–Computer Interaction, and Psychology, SGT is structured around four core principles, emphasizing the importance of integrating game elements (1—Integration) into cohesive systems that generate emergent outcomes (2—Emergence) aligned synergistically (3—Synergy) with contextual needs (4—Context). The theory supports inclusivity by accounting for individual traits, situational dynamics, spatial settings, and cultural diversity. To operationalize SGT, we developed two tools: i. a set of 10 Heuristics to guide and analyze effective and inclusive gamification; and ii. a Framework for designing and evaluating gamified systems, as well as comparing research methods and outcomes across different contexts. These tools demonstrated how SGT enables robust, adaptive, and equitable gamified learning experiences. By advancing theoretical and practical development, SGT fosters a transformative approach to gamification, enriching multimedia learning through thoughtful system design and reflective evaluation practices.