Mobilum—a new mobile app to engage visuospatial processing for the reduction of intrusive visual memories

Abstract

Intrusive memories are a key symptom of posttraumatic stress disorder (PTSD), a prevalent condition causing considerable personal suffering, and entailing large direct and indirect societal costs.While effective treatment options for PTSD exist, on a global scale they are not readily available to many patients in need. In the last years, several studies have shown that the computer game Tetris can reduce the frequency of intrusive memories in healthy subjects (after a trauma analogue), in populations at high risk of developing PTSD, as well as in patients already suffering from PTSD. The presumed mechanism behind this effect is that both Tetris and intrusions require-and therefore compete for-limited visuospatial working memory resources. In search for a new alternative tool that can engage visuospatial processing as effectively as Tetris, we developed a game named Mobilum. This is an app for Android devices, in which users have to rotate in an imaginative way around a translucent virtual cube in order to decide from which perspective a complex three-dimensional figure inside the cube is seen. Mobilum was developed to investigate whether the intrusion-reducing effect is exclusively inherent to Tetris, or if it can be achieved with another task engaging users in visuospatial processing. Also, unlike available versions of Tetris, Mobilum offers full control over key game parameters (e.g., difficulty, game duration), and is free of copyright and commercial issues. In this method paper, we describe the new Mobilum app, its theoretical background and development. Additionally, the first data on usability and feasibility are reported, as rated by N=16 inpatients. Finally, we will provide an outlook on the next steps necessary to investigate Mobilum's potential as a therapeutic tool.

Mobile applications for individuals affected by a traumatic event: A systematic review of qualitative findings

“…Mindset, an app for the selfassessment and self-management of stress, offers emotion assessment, emotion re-orientating based on CBT, a breath-timing exercise, pre-recorded therapies, and a forum on which users can post positive content publicly or privately (Latour et al, 2020). One study used Mobilum, a game-based app that involves mental rotation as a visual-spatial task aimed at reducing intrusive thoughts (Kessler et al, 2019). Four studies reported on mobile apps that mainly allow individuals exposed to a traumatic event to self-assess their symptoms.…”

“…Most of these concerned "bugs" and challenges with wireless Internet and Bluetooth connections (e.g., Betthauser et al, 2020;Latour et al, 2020). Design issues were reported in five studies where participants thought that certain design choices made the app more challenging to use, such as the localization of certain app components (Riisager et al, 2021), the insufficient color contrast (Kessler et al, 2019), or a font size that was too small (Shakespeare-Finch et al, 2020).…”

“…"In line with this, a lighter background and brighter colours were suggested as well as better visibility of the menu function (letter size, colour and font)." (Kessler et al, 2019) To add intervention components (1)…”

“…Of the 12 subthemes, "Preferred features" was the most frequent. The features, functions, or design aspects that were appreciated included the feedback that was provided after an exercise was completed in Mobilum (Kessler et al, 2019) and the "calming and engaging" design of the app evaluated by (Price et al, 2016). In another study conducted with veterans, some participants mentioned that they liked the veterans-centric nature of PTSD Coach (Blonigen et al, 2022).…”

“…The most frequent was "Improved well-being and symptoms", which was present in eight studies. It was mentioned that using the apps helped manage PTSS, sleep problems, and stress (Kuhn et al, 2014;Miner et al, 2016;Reyes, 2022;Reyes, Serafica, et al, 2020;Shakespeare-Finch et al, 2020), reach a state of relaxation, calm, or concentration (Cernvall et al, 2018;Reyes, 2022;Reyes, Serafica, et al, 2020;Riisager et al, 2021), and distract from intrusive or negative thoughts (Kanstrup et al, 2021;Kessler et al, 2019). Apps were perceived as beneficial for individuals who are in treatment in four studies (Bush et al, 2014;Cernvall et al, 2018;Price et al, 2016;Shakespeare-Finch et al, 2020).…”