Effect of the serious game 'You & I' on the mentalizing abilities of adults with mild to borderline intellectual disabilities

This randomized controlled trial aims to study the effect of the serious game 'You & I' on the mentalizing abilities and stress regulations in adults with mild to borderline intellectual disabilities. Participants will be assessed at baseline, posttest (four weeks after baseline) and follow-up (six to eight weeks after baseline) using several questionnaires.

The primary hypothesis is that playing the serious game 'You & I' will be associated with an improvement of the mentalizing abilities in adults with mild to borderline intellectual disabilities.



The secondary hypothesis is that playing the serious game 'You & I' will be associated with an improvement of stress regulation in adults with mild to borderline intellectual disabilities.

T0: baseline

T1: posttest (4 weeks after baseline)

T2: follow-up (6-8 weeks after T1)

The intervention is a serious game called ‘You & I’ that focuses on the improvement of mentalizing abilities, including the regulation of stress. The game was developed by researchers of the Vrije Universiteit Amsterdam in collaboration with healthcare professionals and adults with MBID. The serious game is based on the attachment theory (Bowlby, 1982), the practice-oriented book ‘Mentalization can be learned’ (in Dutch: ‘Mentaliseren kan je leren’) by Dekker & Sterkenburg (2015) and the practice-oriented book ‘Mentalization in clinical practice’ (in Dutch: Mentaliseren in de klinische praktijk) by Allen, Fonagy & Bateman (2008). The game can be played independently by the participant on a tablet or computer.

The serious game revolves around a main character called Mo, who the player follows throughout the game by watching videos. In the first level, the player finds out that Mo is sad because he misses his friend Emily, who moved to the United States. He decides to visit her and travel to the United States. The player will follow Mo on his adventure, while he leaves his house, takes the bus, the airplane and finds his way through a foreign country to finally be able to visit Emily. By watching videos, playing games and answering questions, the player will improve its mentalizing abilities and learn how to cope with stress better.

The game consists of eight gaming levels, which will take about 30 to 45 minutes to complete. The participant is asked to play the game twice a week, completing one level every time. Each level has the same structure consisting of eight different elements. That is, videos following Mo’s journey, multiple choice questions, an emotion picture game, a stress measurer and a game about stress. The gaming levels cover different domains of mentalization, as described by Choi-Kan & Gunderson (2008).