01/01/2021 - 08/01/2021
Eidolon
Eating disorders, often closely linked to sociocultural factors, are a prevalent mental health concern. Although China's sociocultural environment presents a heightened risk for eating disorders, limited research has been conducted in this area. As a result, this study delves into the sociocultural factors that contribute to eating disorders in China. By investigating risk factors and recovery processes, the project culminates in a gamified therapeutic experience that portrays the journey of healing to foster empathy and awareness for those affected by eating disorders.
My Role: Researcher & Designer & Developer
Process:
-
Discover
-
Define
-
Design
-
Deliver
Deliverables:
-
Game demo
-
Academic paper
Discover & Research
I began my research with extensive secondary research. After reading of the psychological and psychiatric literature, I found that risk factors for eating disorders could be divided into 3 groups: cultural background, family environment, and self-concept. These risk factors influence an individual's eating disorder from the outside to the inside. Some factors are what individuals want to pursue, such as the socio-cultural ideal of a slender body type, and others are what individuals want to avoid, such as excessive parental control over children or the reproductive function of female gender roles.
By generalizing and conceptualizing these findings, I thought that there are two dimensions of risk factors that influence eating disorders: internal-external and approach-avoidance. On top of these two dimensions, they can be further divided into three tiers from external to internal: social expectation, family environment, and self-concept. Thus, I designed a questionnaire to test the above hypotheses using four psychological scales.
I obtained a total of 890 data, of which 472 were valid samples. After standardizing the data, I believed that the experiment validated my hypothesis and can be further tested in clinical samples subsequently.
In my research on the recovery process, through focus groups, I have found that individuals may need to go through a specific process to reach full acceptance of an eating disorder. Therefore, I combined the Kübler-Ross model (As known as the five stages of grief) with Shame Resilience Theory (SRT). In theory, people need different types of help at different stages to move forward.
The model was also validated by two Expert Interviews. The validation found that the theoretical model mostly matched reality, with only a slight blurring of the boundaries between the different stages.
Define
Recovery from eating disorders is a highly sensitive, yet highly personal subject. Therefore, at the beginning of the research, I did not decide on a final product or type of output; I did not want to have a solution and then look for a problem to match it. After brainstorming, I decided that the appropriate interaction needed for eating disorder recovery would be one that was safe, took time, had an exchange of information, and involved multiple parties in a personal conversation.
Two elements that I believed were critical to recovery from some first-hand research and direct interaction with patients were a sense of accomplishment and authentic connection with other people. Combining this with the recovery pathway model derived above, I find that this is very similar to the elements of a game: goals, rules, challenges, and interactions.
Therefore, I think the game or gamification should be the most appropriate solution for now.
Design & Ideate
In the early stages of design, I was inspired by That Game Company's award-winning game Journey, believing that the ideal game experience should be a journey with other people (real players instead of Non-player characters), and made the first version of the concept design demo based on that assumption.
In subsequent focus groups, however, most participants felt that the choice was more important to them than the journey itself.
For the second edition, I, therefore, chose a visual novel format that focuses more on narrative and choice. The overall storyline of the novel is derived from the eating disorder recovery model above, which visualizes the five stages of recovery into five chapters of the novel. The characters are based on risk factors for eating disorders, for example, the role of the patient's mother represents the influence of the family environment.
All backgrounds in the game demo are from manipulation of photos under the CC0 license, and all characters are hand-drawn by me.
The Protagonist
&
Her Instructor
Develop & Deliver
While developing the first version of the game demo, I taught myself the Unreal Engine because I thought its approach to event programming was intuitive. However, when developing the second version of the visual novel, I decided that the Unreal Engine did not meet my needs and could prolong the development. So I switched to Unity and use a visual novel-specific plugin to complete the development more efficiently.
After completing the development, I validated the new version of the demo. The validation was divided into two parts, one of which was a focus group conversation for people with clinical eating disorders. After demonstrating the game demo, I asked the participants what they thought and felt about it. The second part was a questionnaire. I exported the WebGL version of the demo and uploaded it to Github, and included a link to the questionnaire at the end of the demo.
Both studies yielded very good results. The majority of people with eating disorders felt that they could empathize with the characters in the game and that the game could help them recover. The majority of non-eating disorder patients felt that the game helped them to understand the group better and have more empathy for them.
Next Steps
I know it might be a bit late to talk about next steps 3 years later after I graduated. But I still remember when I did the final demo test, a lot of eating disorders patients asked me when they could have the full version. It's almost painful for me to tell them I am not able to develop this game all by myself.
At that time, I never imagined AI will evolve so fast. Actually, many contents on my portfolio were developed my Midjourney and GPT4.
I recently took another look at this project, thinking what i can do with it, with the new tools in my hand. I started some ideation of the protagonist, what she might look like beyond my drawing skills.
It's almost childish to start a project like this while I have a full time job, but I also don't want this to be all buried in my mind.
