title: Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: a proof-of-concept randomized controlled trial.
abstract: After psychological trauma, recurrent intrusive visual memories may be distressing and disruptive. Preventive interventions post trauma are lacking. Here we test a behavioural intervention after real-life trauma derived from cognitive neuroscience. We hypothesized that intrusive memories would be significantly reduced in number by an intervention involving a computer game with high visuospatial demands (Tetris), via disrupting consolidation of sensory elements of trauma memory. The Tetris-based intervention (trauma memory reminder cue plus c. 20 min game play) vs attention-placebo control (written activity log for same duration) were both delivered in an emergency department within 6 h of a motor vehicle accident. The randomized controlled trial compared the impact on the number of intrusive trauma memories in the subsequent week (primary outcome). Results vindicated the efficacy of the Tetris-based intervention compared with the control condition: there were fewer intrusive memories overall, and time-series analyses showed that intrusion incidence declined more quickly. There were convergent findings on a measure of clinical post-trauma intrusion symptoms at 1 week, but not on other symptom clusters or at 1 month. Results of this proof-of-concept study suggest that a larger trial, powered to detect differences at 1 month, is warranted. Participants found the intervention easy, helpful and minimally distressing. By translating emerging neuroscientific insights and experimental research into the real world, we offer a promising new low-intensity psychiatric intervention that could prevent debilitating intrusive memories following trauma.
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: L
authors.initials: L
authors.lastname: Iyadurai
authors.affiliation: Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.|Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: S E
authors.initials: SE
authors.lastname: Blackwell
authors.affiliation: Department of Clinical Psychology, University of East Anglia, Norwich, UK.
authors.forename: R
authors.initials: R
authors.lastname: Meiser-Stedman
authors.affiliation: Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: P C
authors.initials: PC
authors.lastname: Watson
authors.affiliation: Department of Zoology, University of Oxford, Oxford, UK.
authors.forename: M B
authors.initials: MB
authors.lastname: Bonsall
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.|Oxford Health NHS Foundation Trust, Oxford, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Geddes
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Nobre
authors.affiliation: Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: E A
authors.initials: EA
authors.lastname: Holmes
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D003071:Cognition / Q000502:physiology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D000075082:Proof of Concept Study; D000067073:Psychological Trauma / Q000517:prevention & control* / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control / Q000523:psychology; D013577:Syndrome; D018910:Video Games / Q000523:psychology; D014947:Wounds and Injuries / Q000523:psychology*