4th International Conference

Digital Culture & AudioVisual Challenges

Interdisciplinary Creativity in Arts and Technology

Hybrid - Corfu/Online, May 13-14, 2022

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“Another Day, Another…”: Designing Game Mechanics to Communicate Major Depressive Disorder
Date and Time: 14/05/2022 (17:00-18:45)
Location: Ionian Academy
Konstantina Gavriilidou, Polyxeni Kaimara, Andreas Karampas, Vasileios Komianos

Summary
The paper explores the capacity of game mechanics to facilitate the understanding of people suffering from major depressive disorder and to create an environment for cognitive, emotional and compassionate empathy [1]. To this end, four mini-games showcasing everyday struggles in the life of a patient were designed and developed [3]. In contrast to the stereotypically negative portrayal of mental illness in video games [4,5], this work approaches the topic based on principles set by empathy games [2] and aims to offer insight into the challenges patients are confronted with to non-familiar audiences. Each mini-game addresses another feature of the selected disorders, namely: (i) symptom of clinophilia, (ii) symptom of fatigue, (iii) social interaction distress and (iv) stress-induced thinking process.

Objectives
The presented work aims to explore the degree to which symptoms of major depressive disorder can be translated into game mechanics. The work is based on relevant literature and examines the hypothesis that games can be used for communicating symptoms of such disorders by designing a video game and putting it to the assessment of patients who have experienced such disorders. The main objective is served by a complimentary goal, which is the development of a prototype video game that is used to present the symptoms of the mental disorder, as well as exam its effectiveness and subsequently the proposed hypothesis. To this end, an interdisciplinary team was initially created to set the criteria to be met by the game “Another Day, Another…”. The criteria, which focus on the symptoms of depressive disorder, are based theoretically and empirically on psychiatry and computer science that specializes in the process of game development. The ultimate goal of the game is to be implemented as an educational resource for psychoeducation and to be used in different contexts so that end users can understand and empathize with the person experiencing depression.

Method
The method employed for the completion of the work’s objectives consists of: (i) the research for major depressive disorder and the stigmatized, negative portrayal of mental illness in video games as a whole, (ii) an overview of pre-existing video games that touch upon the selected mental disorder, with special attention on the category of empathy games, (iii) the design and development of four mini-games, each addressing a different facet of the selected mental disorder, implemented in the narrative frame of a patient’s diary and finally (iv) play-testing and user-based evaluation by patients and potential players, to establish the game’s efficacy and to what degree it has been achieved.

Conclusion
This work takes on the hypothesis that games can be utilized for communicating the symptoms of major depressive disorder and presents a case of translating such an experience into game mechanics. For the fulfillment of the objectives, a set of four mini-games are designed and developed into a prototype video game, based on the symptoms of major depressive disorder, in the narrative frame of a patient’s diary. This approach aims to deliver a psychoeducational intervention in the aforementioned mental disorder in an empathetic light to non-familiar audiences. Future work includes the advancement of the narrative frame, the employment of participatory design through interviewing patients and the enhancement of the player experience through expressive game graphics.

References
[1] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) - Fifth Edition, American Psychiatric Association, Arlington, VA, 2013. doi:10.1176/appi.books.9780890425596.
[2] J. Belman, and M. Flanagan, Designing Games To Foster Empathy, Cogn. Technol. 14 (2010) 5–15.
[3] K. Dunlap, Representation of Mental Illness in Video Games, in: Proc. 2018 Connect. Learn. Summit, Massachusetts Inst. Technol. August 1-3, 2018, Carnegie Mellon University: ETC Press, Pittsburgh, PA, 2018: pp. 77–86.
[4] M. Ferrari, S. V. McIlwaine, G. Jordan, J.L. Shah, S. Lal, and S.N. Iyer, Gaming With Stigma: Analysis of Messages About Mental Illnesses in Video Games, JMIR Ment. Heal. 6 (2019) e12418. doi:10.2196/12418.
[5] S. Shapiro, and M. Rotter, Graphic Depictions: Portrayals of Mental Illness in Video Games, J. Forensic Sci. 61 (2016) 1592–1595. doi:10.1111/1556-4029.13214.

Konstantina Gavriilidou
Konstantina Gavriilidou is an undergraduate student at the Department of Audio & Visual Arts of Ionian University, Greece. The focus of her studies has been on visual storytelling, with emphasis on 2D animation and illustration. In addition, she has participated as an animator in projects such as “Project-Mapping: Sound and Light 1821-2021”, produced by Ionian University’s InArts, and an animation piece for the Exhibition "ENGRAVING - From Prehistory to Today's Greece" for the Chamber of Fine Arts for Greece.
Polyxeni Kaimara
Polyxeni Kaimara, PhD in Educational Psychology & Educational Technoloy, MSc Developmental and School Psychology, MSc Public Health and BSc in Counseling and Guidance is Certified Trainer and Assessor of the Greek National Organization for the Certification of Qualifications & Vocational Guidance and Trainer of the National Centre for Public Administration and Local Government. She has teaching experience at the University of Western Macedonia and the Ionian University. She is currently working at the Psychiatric Clinic of the General Hospital of Corfu. She is a co-author of many papers and chapters and has presented research works at international conferences. Her research interests focus on the design and evaluation systems and games for special education and training and inclusive education.
Andreas Karampas
Andreas Karampas is a consultant psychiatrist at the General Hospital of Corfu, Greece. His research interests are mostly focused on Early Intervention in Psychosis and Mood Disorders. He has been a Phd candidate since 2017 at the Department of Psychiatry, University of Ioannina School of Medicine. He held an honorary position in the Division of Psychiatry at University College London (UCL) in 2018 (February-May). He has attended a number of international and greek psychiatric conferences.
Vasileios Komianos

Vasileios Komianos is a faculty member at Dept. of Audio and Visual Arts, Ionian University, Greece, teaching courses related to Virtual/Augmented/Mixed Reality, video games and interactive multimedia. His research interests are mostly focused on Mixed Reality (MR) systems, on user interaction and user interfaces in MR systems and applications as well as on approaches for artistic expression and cultural communication. He has work experience on designing audiovisual content and installations in the cultural heritage sector, and his works are hosted or have been hosted in permanent and temporary exhibitions as well as in art festivals.


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