Original Paper
Psychopathology 1992;25:117-119
Sergio Samoilovich Carlos Riccitelli Adriana Schiel Agustín Siedi
Attitude of Schizophrenics to Computer Videogames
Fundación de Investigaciones Psiquiátricas, Pueyrredón 2478 40 ‘C \ Buenos Aires, Argentina
Abstract
Introduction
With the increasing use of personal com puters, the psychology of computing repre sents a broad, new field of research. Psychiat ric patients can have interaction with the ma chine through data collection [1], testing [2] and even psychotherapy [3], Computer-as sisted interviewing can be accepted by pa tients and their relatives, in spite of initial resistance [ 1]. In patients with attention diffi culties, computer videogames improved scan ning and tracking abilities [4], Computer vid eogames were informally used in a psychiatric service to facilitate communication with nursing personnel [5], Videogames can trigger
epileptic seizures [6] and cause overt patho logic addiction [7], but these adverse effects are relatively rare. Psychologic factors that define acceptance or rejection of computers are little known, in spite of the wide computerizing trend in mod ern society. Chronic schizophrenics have low volition, low communication and sponta neous activity levels. If they were attracted to videogames as most normal individuals arc, they could be given diagnostic and thera peutic roles: evaluation of attitudes and re sponses, psychologic testing, motivation and reward. It is not known whether schizophren ics have a particular attitude to computer games, or if addiction and adverse effects can
Sergio Samoilovich, PhD 3896 Biscayne Boulevard Apt. 1246 Miami, FL 33137-9012 (USA)
© 1992 S. Karger AG. Basel 0254-4962/92/ 0253-0117S2.75/0
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
We investigated the initial attitude of 10 chronic, defected schizophrenic patients to a computer videogame session. Six of them enjoyed the experience and wanted to repeat it. Coop eration and performance were compared by means of videogames and a standard psychometric test (WAIS). Videogame performance correlated with the execution test IQ more than with the verbal test IQ. Computer games could be useful in these patients for evaluation of attitudes and responses, psy chologic testing, motivation and reward.
6
5+ O
Fig. 1. Collaboration with computer videogames (o), or with a psychometric test (•; WAIS) and videogame performance (A) in chronic schizophrenic inpa tients aged 3 2-71 years.
Fig. 2. Performance in videogames and WAIS [8] IQ in the 5 subjects that completed the test, o = Verbal IQ: • = execution IQ.
occur. Here we report the initial attitude of a group of chronic schizophrenic inpatients to computer videogames.
Have you ever seen anything like this? Can you describe the games? Would you like to play some other time? Collaboration and Performance. We rated collabo ration with WAIS test and with the videogames session between 0 (no cooperation) and 5 (active participa tion). Performance in the WAIS test is expressed as an IQ. Videogame performance was rated from 0 (no cooperation) to 5 (average score in the game).
Patients. Patients were selected in a male chronic case unit of the José T. Borda Neuropsychiatrie Hospi tal at Buenos Aires. They all had chronic schizophrenia with defect. They were compensated with standard maintenance medication of neuroleptics and anxiolyt ics. This unit is open but the patients have little chance for contact with the outside world. None of them had ever used videogames before. Three subjects were used as controls for the videogames sessions: a doctor, a nurse and a psychologist. Interview. Wc evaluated the clinical condition, fo cusing on activity, volition and initiative levels. A standard psychometric test (WAIS. [8]) was used for testing verbal and execution IQ. Computer Videogame Session. Individual play ses sions took place. An IBM compatible monochrome computer was loaded with Pacman, Breakout and Tetris, three popular games chosen for being simple and visually attractive. One researcher explained and demonstrated each game and invited the subject to play while another took notes. At the end of the ses sion, every patient was asked: Did you like the games?
i is
Results
The results of the WAIS test are shown in figures l and 2. Only 5 out of 10 patients cooperated until completion of the test. Re sults were consistent with chronic schizophre nia with different degrees of defect. Patients cooperated better with videogames than with the psychometric test or with the daily activi ties in their unit. The attitude of the patients towards the videogames was positive, some times with spontaneous comments and ques tions reflecting surprise or enthusiasm. We did not observe adverse reactions as a result of the game session. Performance in video-
Samoilovich/Riccitclli/Schiel/Siedi
Schizophrenics and Videogames
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
Materials and Methods
games was poor: either the patients did not understand the purpose of the game, did not relate the keyboard input with the monitor output, or forgot the functions of the keys. They also had trouble describing the games after playing them. Videogame performance showed good correlation with the execution part of the WAIS test, and poor correlation with the verbal part of the test, or with age. The three control subjects actively collabo rated in the game session. Contrary to the schizophrenic patients they looked anxious and pressured to win when confronted with the machine.
Discussion
These results show that chronic schizo phrenic patients can become interested in videogames more than in other games or ac tivities. Compared to a standard psychomet ric test, videogames allowed a shorter and eas ier evaluation of psychomotor activity. Re peated evaluation by videogames or video game-like tests will probably be welcome by the subjects, thus allowing the measure of learning curves and the effect of therapy. The videogames used here required visual and motion coordination, speed, attention, con
centration, anticipation and planning. All these abilities were diminished in our sub jects. It is possible to choose videogames re quiring different abilities, or to design them specifically for testing purposes. As testing methods, videogames are unique: they all have a built-in scoring method, are self-administered, and have automatic change of dif ficulty level. Four subjects showed no interest in repeat ing the game session, but did not cooperate with the psychometric test either. None of the patients looked anxious or frightened by the computer. Color and sound could further in crease the attraction of videogames for abulic patients. Considered as labor or game therapy, the games are attractive, safe and easy to monitor, even in defected patients. The value of contin ued use of videogames in individual or group sessions merits to be investigated.
Acknowledgements We thank for the help of Dr. Ricardo Picasso of the José T. Borda Neuropsychiatrie Hospital, Buenos Aires. S.S. is a Research Fellow of the National Scientific and Technological Research Council of Argentina (CONICET).
References
2
3
Sawyer M: The attitude of parents to the use of computer-assisted inter viewing in a child psychiatry ser vice. BrJ Psychiatry 1990; 157:675. Groth-Marnat G, Schumaker J: Computer-based psychological test ing: Issues and guidelines. Am J Or thopsychiatry 1989;59:257-263. Selmi PM. Klein MH. Greist JH. Sorrell SP, Erdman HP: Computeradministered cognitive-behavioral therapy for depression. Am J Psy chiatry 1990:147:1.
4
5 6
Larose S. Gagnon S. Ferland C, Pe pin M: Psychology of computers 14: Cognitive rehabilitation through computer games. Percept Mot Skills 1989,69:851. Confue P: Computer-assisted thera py. Nurs Times 1990:86:65. Macda Y. Kurokawa T. Sakamoto K. Kitamoto 1. Ueda K. Tashima S: Electroclinical study of video-game epilepsy. Dev Med Child Neurol 1990:32:493.
7
8
Keepers GA: pation with Acad Child 1990:29:49. Wechsler D: para adultos Paidos, 1984.
Pathological preoccu video-games. J Am Adolesc Psychiatry Test de inteligencia (WAIS). Barcelona,
119
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
1
Psychopathology 1992;25:117-119
Sergio Samoilovich Carlos Riccitelli Adriana Schiel Agustín Siedi
Attitude of Schizophrenics to Computer Videogames
Fundación de Investigaciones Psiquiátricas, Pueyrredón 2478 40 ‘C \ Buenos Aires, Argentina
Abstract
Introduction
With the increasing use of personal com puters, the psychology of computing repre sents a broad, new field of research. Psychiat ric patients can have interaction with the ma chine through data collection [1], testing [2] and even psychotherapy [3], Computer-as sisted interviewing can be accepted by pa tients and their relatives, in spite of initial resistance [ 1]. In patients with attention diffi culties, computer videogames improved scan ning and tracking abilities [4], Computer vid eogames were informally used in a psychiatric service to facilitate communication with nursing personnel [5], Videogames can trigger
epileptic seizures [6] and cause overt patho logic addiction [7], but these adverse effects are relatively rare. Psychologic factors that define acceptance or rejection of computers are little known, in spite of the wide computerizing trend in mod ern society. Chronic schizophrenics have low volition, low communication and sponta neous activity levels. If they were attracted to videogames as most normal individuals arc, they could be given diagnostic and thera peutic roles: evaluation of attitudes and re sponses, psychologic testing, motivation and reward. It is not known whether schizophren ics have a particular attitude to computer games, or if addiction and adverse effects can
Sergio Samoilovich, PhD 3896 Biscayne Boulevard Apt. 1246 Miami, FL 33137-9012 (USA)
© 1992 S. Karger AG. Basel 0254-4962/92/ 0253-0117S2.75/0
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
We investigated the initial attitude of 10 chronic, defected schizophrenic patients to a computer videogame session. Six of them enjoyed the experience and wanted to repeat it. Coop eration and performance were compared by means of videogames and a standard psychometric test (WAIS). Videogame performance correlated with the execution test IQ more than with the verbal test IQ. Computer games could be useful in these patients for evaluation of attitudes and responses, psy chologic testing, motivation and reward.
6
5+ O
Fig. 1. Collaboration with computer videogames (o), or with a psychometric test (•; WAIS) and videogame performance (A) in chronic schizophrenic inpa tients aged 3 2-71 years.
Fig. 2. Performance in videogames and WAIS [8] IQ in the 5 subjects that completed the test, o = Verbal IQ: • = execution IQ.
occur. Here we report the initial attitude of a group of chronic schizophrenic inpatients to computer videogames.
Have you ever seen anything like this? Can you describe the games? Would you like to play some other time? Collaboration and Performance. We rated collabo ration with WAIS test and with the videogames session between 0 (no cooperation) and 5 (active participa tion). Performance in the WAIS test is expressed as an IQ. Videogame performance was rated from 0 (no cooperation) to 5 (average score in the game).
Patients. Patients were selected in a male chronic case unit of the José T. Borda Neuropsychiatrie Hospi tal at Buenos Aires. They all had chronic schizophrenia with defect. They were compensated with standard maintenance medication of neuroleptics and anxiolyt ics. This unit is open but the patients have little chance for contact with the outside world. None of them had ever used videogames before. Three subjects were used as controls for the videogames sessions: a doctor, a nurse and a psychologist. Interview. Wc evaluated the clinical condition, fo cusing on activity, volition and initiative levels. A standard psychometric test (WAIS. [8]) was used for testing verbal and execution IQ. Computer Videogame Session. Individual play ses sions took place. An IBM compatible monochrome computer was loaded with Pacman, Breakout and Tetris, three popular games chosen for being simple and visually attractive. One researcher explained and demonstrated each game and invited the subject to play while another took notes. At the end of the ses sion, every patient was asked: Did you like the games?
i is
Results
The results of the WAIS test are shown in figures l and 2. Only 5 out of 10 patients cooperated until completion of the test. Re sults were consistent with chronic schizophre nia with different degrees of defect. Patients cooperated better with videogames than with the psychometric test or with the daily activi ties in their unit. The attitude of the patients towards the videogames was positive, some times with spontaneous comments and ques tions reflecting surprise or enthusiasm. We did not observe adverse reactions as a result of the game session. Performance in video-
Samoilovich/Riccitclli/Schiel/Siedi
Schizophrenics and Videogames
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
Materials and Methods
games was poor: either the patients did not understand the purpose of the game, did not relate the keyboard input with the monitor output, or forgot the functions of the keys. They also had trouble describing the games after playing them. Videogame performance showed good correlation with the execution part of the WAIS test, and poor correlation with the verbal part of the test, or with age. The three control subjects actively collabo rated in the game session. Contrary to the schizophrenic patients they looked anxious and pressured to win when confronted with the machine.
Discussion
These results show that chronic schizo phrenic patients can become interested in videogames more than in other games or ac tivities. Compared to a standard psychomet ric test, videogames allowed a shorter and eas ier evaluation of psychomotor activity. Re peated evaluation by videogames or video game-like tests will probably be welcome by the subjects, thus allowing the measure of learning curves and the effect of therapy. The videogames used here required visual and motion coordination, speed, attention, con
centration, anticipation and planning. All these abilities were diminished in our sub jects. It is possible to choose videogames re quiring different abilities, or to design them specifically for testing purposes. As testing methods, videogames are unique: they all have a built-in scoring method, are self-administered, and have automatic change of dif ficulty level. Four subjects showed no interest in repeat ing the game session, but did not cooperate with the psychometric test either. None of the patients looked anxious or frightened by the computer. Color and sound could further in crease the attraction of videogames for abulic patients. Considered as labor or game therapy, the games are attractive, safe and easy to monitor, even in defected patients. The value of contin ued use of videogames in individual or group sessions merits to be investigated.
Acknowledgements We thank for the help of Dr. Ricardo Picasso of the José T. Borda Neuropsychiatrie Hospital, Buenos Aires. S.S. is a Research Fellow of the National Scientific and Technological Research Council of Argentina (CONICET).
References
2
3
Sawyer M: The attitude of parents to the use of computer-assisted inter viewing in a child psychiatry ser vice. BrJ Psychiatry 1990; 157:675. Groth-Marnat G, Schumaker J: Computer-based psychological test ing: Issues and guidelines. Am J Or thopsychiatry 1989;59:257-263. Selmi PM. Klein MH. Greist JH. Sorrell SP, Erdman HP: Computeradministered cognitive-behavioral therapy for depression. Am J Psy chiatry 1990:147:1.
4
5 6
Larose S. Gagnon S. Ferland C, Pe pin M: Psychology of computers 14: Cognitive rehabilitation through computer games. Percept Mot Skills 1989,69:851. Confue P: Computer-assisted thera py. Nurs Times 1990:86:65. Macda Y. Kurokawa T. Sakamoto K. Kitamoto 1. Ueda K. Tashima S: Electroclinical study of video-game epilepsy. Dev Med Child Neurol 1990:32:493.
7
8
Keepers GA: pation with Acad Child 1990:29:49. Wechsler D: para adultos Paidos, 1984.
Pathological preoccu video-games. J Am Adolesc Psychiatry Test de inteligencia (WAIS). Barcelona,
119
Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 3/4/2018 10:03:47 AM
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