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Completed

NCT Number: NCT06025838

Positive Feedback vs. No-Feedback Games for Behavioral Change

We aim to investigate here whether we can develop a reinforcement learning game which provides game-based feedback to encourage positive actions (behaviors) both inside and outside of the game. Does providing positive reward when participants make decisions which are associated with value-based actions (like those in BA) result in different game decisions? We propose that it will increase positive actions in the game. And, secondly, how does it affect short-term behavior (in one week)? We propose that it will increase pro-health activities and may reduce depressive symptoms.

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Key information

Conditions

Major Depressive Disorder Consciousness Disorders Depressive Disorder Depressive Disorder, Major Low Mood Mental Disorders Mood Disorders Nervous System Diseases Neurobehavioral Manifestations Neurocognitive Disorders Neurologic Manifestations Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–34 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Online research conducted through Bard College

Annandale-on-Hudson, New York, 12504, United States

About this study

We know that behavior influences mood -- our best interventions to improve mood rely upon the relationship between these. Treatments like this are thought to work in part by helping individuals to increase value-derived behaviors; participants are given guidance which results in an increase of positive behaviors and a decrease of coping behaviors that don't help -- that is, their health-seeking behavior is reinforced while behaviors that diminish health are reduced. In past work, we showed that a text-based game could be used to explore what sort of decisions people would make in certain environments. That game showed associations between in-game behaviors and real-life depressive symptoms and actions. Such work focuses on low-level symptoms of depression -- increasingly common, especially after the onset of the covid-19 pandemic. We aim to investigate here whether we can develop a reinforcement learning game which provides game-based feedback to encourage positive actions (behaviors) both inside and outside of the game.

Thus, the experiment described below and proposed in this application would test the role of positive rewards (positive-feedback) in a dichotomous-choice game, compared to neutral (no-feedback).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18-34 years old
  • Fluent in English
  • Based in the United States

Exclusion criteria

  • None

Treatment and study plan

Positive feedback

Behavioral

The positive feedback game uses techniques relating to established therapies like Behavioral Activation and Acceptance and Commitment Therapy's valued living to encourage positive action in game and outside of the game.

Primary outcomes

  1. Depressive symptoms (Patient Health Questionnaire-8 item)

    Time frame: baseline (T0) - before intervention

    8 items rated in a self-report questionnaire. Scores range from 0 to 24 with higher scores indicating more depression symptoms.

  2. Depressive symptoms (Patient Health Questionnaire-8 item)

    Time frame: one week following intervention (T1)

    8 items rated in a self-report questionnaire. Scores range from 0 to 24 with higher scores indicating more depression symptoms.

  3. Day Reconstruction Method (DRM)

    Time frame: baseline (T0) - before intervention

    The DRM measures how people spend their time and asks them how they felt while doing the activities they report. Ratings on a Likert scale indicate valence (how pleasant/unpleasant the activities were) and range from 0 (not at all) to 6 (very much), with higher pleasantness being better (and lower unpleasantness being better).

  4. Day Reconstruction Method (DRM)

    Time frame: one week following intervention (T1)

    The DRM measures how people spend their time and asks them how they felt while doing the activities they report. Ratings on a Likert scale indicate valence (how pleasant/unpleasant the activities were) and range from 0 (not at all) to 6 (very much), with higher pleasantness being better (and lower unpleasantness being better).

  5. Behavior in study-specific game

    Time frame: baseline (T0)

    For both conditions, behavior and choices made during the game will be used as data for analyses. Game choices allow participants to decide what next activities they will "do" in the game. Analyses incorporate decision probabilities (which of 2 choices are selected) and compare them between conditions. The game is completed at baseline following assessment.

  6. Motivation to change

    Time frame: baseline (T0) - after intervention

    A 7-point item, "It is important to me to do more positive activities in my life". Scores range from 0 [not at all] to 6 [very much]. Higher scores indicate more motivation to change.

Secondary outcomes

  1. Mood and Anxiety Symptoms Questionnaire (MASQ)

    Time frame: baseline (T0) - before intervention

    The MASQ measures mood and anxiety symptoms on three subscales: Anhedonic Depression, Anxious Arousal, and General Distress. Scores on each subscale range from 10 (low symptoms) to 50 (high symptoms). Higher scores indicate more depression, anxiety, and distress.

  2. Mood Ratings

    Time frame: baseline (T0) - before intervention

    Mood will be rated on positive and negative scales: "On the whole, how sad were you today?" (Rated from 0 [not at all] to 6 [extremely]); "On the whole, how happy were you today?" (Rated from 0 [not at all] to 6 [extremely]). Higher scores indicate more sadness or happiness.

  3. Mood Ratings

    Time frame: one week following intervention (T1)

    Mood will be rated on positive and negative scales: "On the whole, how sad were you today?" (Rated from 0 [not at all] to 6 [extremely]); "On the whole, how happy were you today?" (Rated from 0 [not at all] to 6 [extremely]). Higher scores indicate more sadness or happiness.

Sponsors and collaborators

Lead sponsor

Bard College

Other

Registry information

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Sep 6, 2023
Registry last updated
Aug 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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