Biofeedback video game helps kids control anger

Researchers at Boston Children's Hospital had the bright idea that, since kids with anger-control problems tend to resist psychotherapy but enjoy video games, the researchers should develop a game that sneakily helps kids practice emotion-control skills -- and in the process perhaps reduces the need for medication.

The game, called RAGE Control (short for Regulate and Gain Emotional Control), employs a finger heart rate monitor; users with elevated heart rates actually lose the ability to shoot enemy spaceships. Researchers say the idea is to teach kids to better control their emotional responses -- and specifically to reduce outbursts of anger or frustration -- by reaching certain targets.

"The connections between the brain's executive control centers and emotional centers are weak in people with severe anger problems," Joseph Gonzalez-Heydrich, chief of psychopharmacology at Boston Children's Hospital and senior investigator on the study, said in a news release. "To succeed at RAGE Control, players have to learn to use these centers at the same time to score points."

The researchers report on their pilot study in the current issue of the journal Adolescent Psychiatry. They compared two groups of 9- to 17-year-old children admitted to the hospital's psychiatric unit with high levels of anger. Participants had to have normal IQ levels and be able to participate in the five-day study without requiring medication.

The control group received the current standard treatment for anger, including cognitive behavioral therapy. The second group had the same treatment but spent the final 15 minutes of therapy playing RAGE Control.

After five sessions, the kids who'd played the game were better at keeping their heart rate down, and showed lower anger scores related to the intensity of anger at a particular time, the frequency of anger over time, and expressions of anger directed at other people or objects. The control group, however, exhibited no significant changes from baseline on any of these measures.

What's more, the kids who played the game gave it good marks for helpfulness (5 to 6 on a scale of 7).

This pilot study is small (19 control kids, 18 who played the game) and didn't follow up with the kids after the five sessions, so these findings are preliminary at best. The researchers are now conducting a randomized, controlled clinical trial of the game that adds cooperation as one aspect of success; kids team up with parents for 10 game sessions, and if anyone's heart rate goes up, neither can shoot, encouraging the pairs to calm each other.

The researchers also plan to test whether RAGE Control in a home setting with parents and siblings will increase its effect, and are developing toys for kids too young to play the (somewhat ironically) violent game -- for example, a game that encourages children to help one another stack blocks, only this time elevated heart rate makes the table wobbly.