Can Playing the Computer Game “Tetris” Reduce the Build-Up of Flashbacks for Trauma? A Proposal from Cognitive Science

Abstract

BackgroundFlashbacks are the hallmark symptom of Posttraumatic Stress Disorder (PTSD). Although we have successful treatments for full-blown PTSD, early interventions are lacking. We propose the utility of developing a ‘cognitive vaccine’ to prevent PTSD flashback development following exposure to trauma. Our theory is based on two key findings: 1) Cognitive science suggests that the brain has selective resources with limited capacity; 2) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation. The rationale for a ‘cognitive vaccine’ approach is as follows: Trauma flashbacks are sensory-perceptual, visuospatial mental images. Visuospatial cognitive tasks selectively compete for resources required to generate mental images. Thus, a visuospatial computer game (e.g. “Tetris”) will interfere with flashbacks. Visuospatial tasks post-trauma, performed within the time window for memory consolidation, will reduce subsequent flashbacks. We predicted that playing “Tetris” half an hour after viewing trauma would reduce flashback frequency over 1-week.Methodology/Principal FindingsThe Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress. All participants viewed a traumatic film consisting of scenes of real injury and death followed by a 30-min structured break. Participants were then randomly allocated to either a no-task or visuospatial (“Tetris”) condition which they undertook for 10-min. Flashbacks were monitored for 1-week. Results indicated that compared to the no-task condition, the “Tetris” condition produced a significant reduction in flashback frequency over 1-week. Convergent results were found on a clinical measure of PTSD symptomatology at 1-week. Recognition memory between groups did not differ significantly.Conclusions/SignificancePlaying “Tetris” after viewing traumatic material reduces unwanted, involuntary memory flashbacks to that traumatic film, leaving deliberate memory recall of the event intact. Pathological aspects of human memory in the aftermath of trauma may be malleable using non-invasive, cognitive interventions. This has implications for a novel avenue of preventative treatment development, much-needed as a crisis intervention for the aftermath of traumatic events.

Development and testing of TraumaGameplay: an iterative experimental approach using the trauma film paradigm

“…Similar studies have also shown that visuospatial tasks performed soon after film viewing, hence when the memory is not yet consolidated, reduced subsequent intrusions by retroactively interfering with memory consolidation (Deeprose, Zhang, DeJong, Dalgleish, & Holmes, 2012; Holmes, James, Coode-Bate, & Deeprose, 2009; Holmes, James, Kilford, & Deeprose, 2010). The effects of verbal tasks, however, are less robust, with some studies finding an increase in reported intrusions (Bourne et al, 2010; [exp.…”

“…These images were taken from a moment just prior to the worst part of the scene (e.g. Holmes et al, 2009; James et al, 2015). The participants then selected the image representing the participant’s most aversive film memory.…”

“…This film has been used in previous studies as an analogue to real trauma (e.g. Holmes et al, 2009; James et al, 2015). The film was projected on a 180 cm × 240 cm screen using a projector.…”

“…After the film, participants rated 14 excerpts of classical music on pleasantness (10 min), then answered non-PTSD related open-ended questions using a personality psychology handbook during the remaining 20 min (based on Holmes et al, 2009, 2010). …”

“…Images were displayed automatically with a 2000 ms interval (Holmes et al, 2009; James et al, 2015). …”