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Psychosocial and Mental Health Characteristics of RePresent Game Users

Jack Tsai, Minda Huang, Billy Huang, Kathleen Daniels, Casper Harteveld and Dan Jackson
Journal of the American Academy of Psychiatry and the Law Online September 2020, 48 (3) 335-344; DOI: https://doi.org/10.29158/JAAPL.003922-19
Jack Tsai
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Minda Huang
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Billy Huang
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Kathleen Daniels
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Casper Harteveld
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Dan Jackson
Dr. Tsai is Research Director of the U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Fl and Campus Dean and Professor of Public Health at University of Texas Health Science Center. Mr. M. Huang is a doctoral student at the University of Hartford, The Graduate Institute of Professional Psychology, West Hartford, CT. Mr. B. Huang is a business student at Yale School of Management. Ms. Daniels is a Retired Information Technology Administrator from Statewide Legal Services of Connecticut, New Haven, CT. Dr. Harteveld is Associate Professor of Game Design at Northeastern University, Boston, MA. Mr. Jackson is Director of NuLawLab at Northeastern University School of Law, Boston, MA.
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Article Figures & Data

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    Table 1

    State-specific Game Versions

    Game VersionWebsite
    Connecticut RePresenthttps://ctlawhelp.org/en/represent
    Connecticut RePresent Renterhttps://ctlawhelp.org/en/represent-renter
    Maine RePresenthttps://ptla.org/represent-game
    Maine RePresent Renterhttps://ptla.org/represent-renter-game
    Massachusetts RePresenthttps://www.masslegalhelp.org/court/represent
    New Hampshire RePresenthttps://www.nhlegalaid.org/represent
    • View popup
    Table 2

    Background Characteristics and Legal Problems of RePresent Game Users and Nonusers

    Game Users (n = 136)Nonusers (n = 141)Test of Difference
    Age, yearsχ2 = 2.86
        18–246 (4.4)9 (6.4)
        25–3446 (33.8)51 (36.2)
        35–4452 (38.2)54 (38.3)
        45–5425 (18.4)17 (12.1)
        ≥ 557 (5.1)10 (7.1)
    Gender: male56 (41.2)65 (46.1)χ2 = 4.58
    Ethnicity: white62 (45.6)95 (67.4)χ2 = 13.38c
    Educationχ2 = 28.61c
        High school or below53 (39.0)23 (16.3)
        Some college36 (26.5)26 (18.4)
        Associates/bachelors44 (32.4)82 (58.2)
        Advanced degree3 (2.2)10 (7.1)
    Marital status: married56 (41.2)60 (42.6)χ2 = 0.05
    Annual personal incomeχ2 = 10.01
        < $15,00024 (17.6)21 (14.9)
        $15,000–$30,00027 (19.9)17 (12.1)
        $31,000–$50,00031 (22.8)41 (28.4)
        $51,000–$70,00020 (14.7)26 (18.4)
        $71,000–$90,00025 (18.4)17 (12.1)
        $91,000–$110,0005 (3.7)11 (7.8)
        > $110,0004 (2.9)9 (6.4)
    Full/part-time employment113 (87.6)109 (79.0)χ2 = 3.54
    Ever been to jail33 (24.3)18 (12.8)χ2 = 6.09a
    Ever been homeless24 (17.6)37 (26.2)χ2 = 2.98
    Current legal problem(s)
        Money or debt44 (32.4)52 (36.9)χ2 = 0.63
        Family42 (30.9)59 (41.8)χ2 = 3.59
        Apartment housing50 (36.8)32 (22.7)χ2 = 6.58a
        Home foreclosure16 (11.8)10 (7.1)χ2 = 1.78
        Immigration12 (8.8)3 (2.1)χ2 = 6.06a
        Criminal record history17 (12.5)15 (10.6)χ2 = 0.24
        Estate/probate19 (14.0)6 (4.3)χ2 = 7.96b
        Tax24 (17.6)19 (13.5)χ2 = 0.92
        Unemployment or WC23 (16.9)15 (10.6)χ2 = 2.30
        Criminal problem11 (8.1)15 (10.6)χ2 = 0.53
        Other5 (3.7)8 (5.7)χ2 = 0.62
    Number of current legal problems6.29 ± 4.874.63 ± 3.07t = 3.40b
    Past legal problem(s)
        Money or debt69 (50.7)56 (39.7)χ2 = 3.394
        Family28 (20.6)49 (34.8)χ2 = 6.919b
        Apartment housing40 (29.4)28 (19.9)χ2 = 3.411
        Home foreclosure16 (11.8)9 (6.4)χ2 = 2.442
        Immigration18 (13.2)5 (3.5)χ2 = 8.536b
        Criminal record history12 (8.8)13 (9.2)χ2 = 0.013
        Estate/probate15 (11.0)7 (5.0)χ2 = 3.483
        Tax32 (23.5)17 (12.1)χ2 = 6.258a
        Unemployment or WC21 (15.4)15 (10.6)χ2 = 1.412
        Criminal problem19 (14.0)18 (12.8)χ2 = 0.087
        Other5 (3.7)9 (6.4)χ2 = 1.057
    Number of past legal problems3.67 ± 1.764.41 ± 2.72t = −.98
    Self-rating of legal knowledge3.24 ± 0.992.84 ± 0.80t = 3.73
    Procedural Justice Scale3.85 ± 0.983.57 ± 1.08t = 2.26a
    • Data are presented as n (%) or mean ± SD.

    • ↵a P < .05

    • ↵b P < .01

    • ↵c P < .001

    • WC, Worker's Compensation.

    • View popup
    Table 3

    Clinical and Psychosocial Characteristics of RePresent Game Users and Nonusers

    Game Users (n = 136)Game Nonusers (n = 141)Test of Difference
    General Self-Efficacy Scale29.11 ± 4.628.81 ± 5.50t = .49
    Empowerment Scale2.93 ± 0.502.97 ± 0.50t = .79
    BASIS-242.18 ± 0.702.45 ± 0.70t = −.88
    PHQ-23.97 ± 1.564.40 ± 1.74t = −2.12a
    GAD-24.00 ± 1.694.37 ± 1.77t = −1.74
    Q-LES-Q-SF0.61 ± 0.170.53 ± 0.15t = 4.05b
    Positive screen for alcohol use problems41 (30.1)4 (2.8)χ2 = 37.95b
    Positive screen for drug use problems53 (39.0)71 (50.4)χ2 = 3.63
    Any mental health service use in past year43 (23.1)52 (39.1)χ2 = 1.43
    Any substance abuse treatment in past year26 (19.4)21 (15.8)χ2 = 0.60
    • Data are presented as mean ± SD or n (%).

    • ↵a P < .05.

    • ↵b P < .001.

    • BASIS-24, Behavior and Symptom Identification Scale; PHQ-2, Patient Health Questionnaire-2; GAD-2, Generalized Anxiety Disorder scale; Q-LES-Q-SF, Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form.

    • View popup
    Table 4

    Comparison of Groups with Different Clusters of Legal Problems

    Many Civil and Criminal Problems (n = 100)Mostly Debt/Tax Problems (n = 73)Mostly Family Problems (n = 48)Combination of Housing/Family/Debt Problems (n = 56)Group Comparisonsa
    Debt28 (28.0)55 (75.3)0 (0.0)13 (23.2)2>1,4>3
    Family24 (24.0)12 (16.4)48 (100.0)17 (30.4)3>1,2,4
    Apartment housing24 (24.0)2 (2.7)0 (0.0)56 (100.0)4>1>2,3
    Foreclosure26 (26.0)0 (0.0)0 (0.0)0 (0.0)1>2,3,4
    Immigration13 (13.0)0 (0.0)1 (2.1)1 (1.8)1>2,3,4
    Criminal record expungement29 (29.0)3 (4.1)0 (0.0)0 (0.0)1>2,3,4
    Estate/probate24 (24.0)0 (0.0)1 (2.1)0 (0.0)1>2,3,4
    Tax problem16 (16.0)26 (35.6)0 (0.0)1 (1.8)2>1>3,4
    Unemployment37 (37.0)0 (0.0)0 (0.0)1 (1.8)1>2,3,4
    Criminal charge22 (22.0)0 (0.0)3 (6.3)1 (1.8)1>3>2; 1>4
    Other8 (8.0)0 (0.0)2 (4.2)3 (5.4)NS
    Total7.8 ± 5.44.2 ± 2.03.5 ± 1.64.6 ± 3.11>2,3,4
    • Data are presented as n (%) or mean ± SD.

    • ↵a 1 = Many civil and criminal problems; 2 = Mostly debt/tax problems; 3 = Mostly family problems; 4 = Combination of housing/family/debt problems.

    • NS, not significant.

    • View popup
    Table 5

    Analyses Comparing Groups of Different Clusters of Legal Problemsa

    Many Civil and Criminal Problems (n = 100)Mostly Debt/Tax Problems (n = 73)Mostly Family Problems (n = 48)Combination of Housing/Family/Debt Problems (n = 56)Test of DifferencePairwise Comparisonsb
    Self-rating of legal knowledge3.00 ± .843.32 ± 1.022.92 ± .662.82 ± 1.022.05NS
    Procedural Justice Scale3.58 ± .954.03 ± 1.063.79 ± 1.083.45 ± 1.051.24NS
    General Self-Efficacy Scale27.25 ± 4.9630.86 ± 4.5929.89 ± 5.3228.68 ± 4.664.91c2,3>1
    Empowerment Scale2.77 ± .503.14 ± .483.01 ± .482.96 ± .394.09c2,3>1
    BASIS-242.65 ± 1.021.90 ± .802.45 ± 1.012.44 ± 1.013.68d1>2
    PHQ-24.53 ± 1.713.73 ± 1.434.43 ± 1.623.94 ± 1.742.26NS
    GAD-24.42 ± 1.763.51 ± 1.434.63 ± 1.784.26 ± 1.832.52NS
    Q-LES-Q-SF0.54 ± .160.65 ± .140.56 ± .150.56 ± .203.92c2>1,3,4
    Days of alcohol use, past month2.75 ± 1.372.97 ± 1.352.48 ± 1.552.62 ± 1.63.58NS
    Days of drug use, past month2.58 ± 1.471.92 ± 1.281.96 ± 1.351.62 ± 1.135.80NS
    • Data are presented as mean ± SD.

    • ↵a Multivariate analyses of covariance were adjusted for background differences between groups, including gender, education, marital status, income, and history of incarceration.

    • ↵b 1 = Many civil and criminal problems; 2 = Mostly debt/tax problems; 3 = Mostly family problems; 4 = Combination of housing/family/debt problems.

    • ↵c P < .01.

    • ↵d P < .05.

    • NS, not significant; BASIS-24, Behavior and Symptom Identification Scale; PHQ-2, Patient Health Questionnaire-2; GAD-2, Generalized Anxiety Disorder scale; Q-LES-Q-SF, Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form.

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Journal of the American Academy of Psychiatry and the Law Online: 48 (3)
Journal of the American Academy of Psychiatry and the Law Online
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1 Sep 2020
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Psychosocial and Mental Health Characteristics of RePresent Game Users
Jack Tsai, Minda Huang, Billy Huang, Kathleen Daniels, Casper Harteveld, Dan Jackson
Journal of the American Academy of Psychiatry and the Law Online Sep 2020, 48 (3) 335-344; DOI: 10.29158/JAAPL.003922-19

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Psychosocial and Mental Health Characteristics of RePresent Game Users
Jack Tsai, Minda Huang, Billy Huang, Kathleen Daniels, Casper Harteveld, Dan Jackson
Journal of the American Academy of Psychiatry and the Law Online Sep 2020, 48 (3) 335-344; DOI: 10.29158/JAAPL.003922-19
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