The Effects of Open-World and Fun, Accessible Games on Perceived Loneliness and Stoicism in Adults: Cross-Sectional Survey Study.

Background: Loneliness has been linked to reduced mental and physical health. The "loneliness epidemic" is recognized as a public health crisis. However, questions remain about the potential of video games, which people play by themselves, to help reduce perceived loneliness. Objective: This study explored the extent to which open-world games (eg, The Legend of Zelda: Breath of the Wild) and fun, accessible games (eg, Yoshi's Crafted World) can help reduce loneliness in adults. We examined how such gameplay can foster a stoic approach to life and how stoicism mediates the reduction of perceived loneliness. Methods: A cross-sectional survey was conducted using convenience sampling near a video game store. The sample comprised 2252 adults aged 21 years and older (women: n=966, 42.90%; men: n=1281, 56.90%; prefer not to disclose: n=5, 0.20%). Participants completed a questionnaire to measure perceived loneliness and stoicism, as well as their gameplay habits. Data were analyzed using ANOVA and moderated mediation with the PROCESS macro (bootstrapped samples=5000; 95% CI) to examine the effects of video gameplay on stoicism and loneliness, with the α level set at .05. Results: Zelda players indicated higher stoicism (mean 4.87, SD 0.11; 95% CI 4.66-5.08) than nonplayers (mean 3.23, SD 0.07; 95% CI 3.09-3.37; F1,2252=164.95; P<.001). Yoshi players also noted significantly higher stoicism (mean 4.49, SD 0.12; 95% CI 4.27-4.72) than nonplayers (mean 3.61, SD 0.05; 95% CI 3.50-3.71; F1, 2252=48.33; P<.001), with a significant interaction effect (F1,2252=7.89; P=.005) on stoicism. Furthermore, Zelda players indicated lower loneliness (mean 3.02, SD 0.11; 95% CI 2.81-3.22) than nonplayers (mean 4.28, SD 0.07; 95% CI 4.14-4.42; F1, 2252=98.32; P<.001). Yoshi players also noted significantly lower loneliness (mean 3.09, SD 0.12; 95% CI 2.86-3.32) than nonplayers (mean 4.21, SD 0.05; 95% CI 4.10-4.32; F1, 2252=76.32; P<.001). Moderated mediation analysis demonstrated that Zelda gameplay was positively associated with stoicism (β=1.28, 95% CI 1.07-1.50; P<.001), and stoicism was negatively associated with perceived loneliness (β=-0.49, 95% CI -0.52 to -0.45; P<.001). Conclusions: This study is innovative in identifying stoicism as a potential emotional pathway through which video games may reduce loneliness. Moving beyond views of gaming as passive escapism, our findings suggest that specific gameplay experiences may serve as active spaces for cultivating resilience. We introduce a "digital diet" framework, indicating that balancing open-world challenges (eg, Zelda) with low-stakes restoration (Yoshi) produces synergistic psychological support. Practically, thoughtfully curated gaming experiences may serve as scalable and cost-effective digital adjuncts for public mental health interventions addressing the loneliness epidemic.