Tetris and Word games lead to fewer intrusive memories when applied several days after analogue trauma

Abstract

Background: Intrusive trauma memories are a key symptom of posttraumatic stress disorder (PTSD), so disrupting their recurrence is highly important. Intrusion development was hindered by visuospatial interventions administered up to 24 hours after analogue trauma. It is unknown whether interventions can be applied later, and whether modality or working-memory load are crucial factors. Objectives: This study tested: (1) whether a visuospatial task would lead to fewer intrusions compared to a reactivation-only group when applied after memory reactivation four days after analogue trauma exposure (extended replication), (2) whether both tasks (i.e. one aimed to be visuospatial, one more verbal) would lead to fewer intrusions than the reactivation-only group (intervention effect), and (3) whether supposed task modality (visuospatial or verbal) is a critical component (modality effect). Method: Fifty-four participants were randomly assigned to reactivation+Tetris (visuospatial), reactivation+Word games (verbal), or reactivation-only (no task). They watched an aversive film (day 0) and recorded intrusive memories of the film in diary A. On day 4, memory was reactivated, after which participants played Tetris, Word games, or had no task for 10 minutes. They then kept a second diary (B). Informative hypotheses were evaluated using Bayes factors. Results: Reactivation+Tetris and reactivation+Word games resulted in relatively fewer intrusions from the last day of diary A to the first day of diary B than reactivation-only (objective 1 and 2). Thus, both tasks were effective even when applied days after analogue trauma. Reactivation-only was not effective. Reactivation+Word games appeared to result in fewer intrusions than reactivation+Tetris (objective 3; modality effect), but this evidence was weak. Explorative analyses showed that Word games were more difficult than Tetris. Conclusions: Applying a task four days after the trauma film (during memory reconsolidation) was effective. The modality versus working-memory load issue is inconclusive.

Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application

“…However, it is unclear whether such an app sufficiently taxed working memory. Other tasks that at face value do not appear to be visuospatial have been found to be effective in reducing intrusions too, such as a word game ( Hagenaars, Holmes, Klaassen, & Elzinga, 2017 ) and counting backwards in 3′s ( Krans, Näring, & Becker, 2009 ). Further research is needed to disentangle which elements of a task are crucial to observe cognitive interference.…”

The role of tonic immobility and control in the development of intrusive memories after experimental trauma

“…These expectations were translated into informative hypotheses, i.e., hypotheses that include specific orderings or (in)equalities between the parameters (Klugkist, Laudy, & Hoijtink, 2005), rather than formulating a non-directional "difference" which is done in a frequentist approach. These informative hypotheses were evaluated using Bayes factors in order to test their relative evidence (see also Hagenaars, Holmes, Klaassen, & Elzinga, 2017). Bayes factors allow for quantification of evidence for null hypotheses (e.g., Wagenmakers, Wetzels, Borsboom, & van der Maas, 2011), which is relevant in this study, because some hypotheses of interest are null hypotheses (H2 and H4; see below and Table 1).…”

Digitale Medien in der Psychotherapie – Neue Ansätze und Perspektiven in der Behandlung von Traumafolgestörungen

“…Auf Mechanismen der Rekonsolidierung aufbauend, müssten sich Interventionen prinzipiell auch mit (langem) zeitlichem Abstand zum traumatischen Ereignis einsetzen lassen, wenn zuvor eine Reaktivierung der Erinnerung stattgefunden hatte [31]. Das Spielen von Tetris nach aktiver Wiedererinnerung von Filminhalten auch 24h [32] oder gar 72h [33,34] nach dem Traumafilm führte zu einer Reduktion der Intrusionen in den Folgetagen. Eine erste Studie konnte bereits bei Patienten mit komplexer PTBS zeigen, dass deren Intrusionen an Jahre zurückliegende traumatische Ereignisse durch eine einfache Intervention reduziert werden konnten: Das Aufschreiben der traumatischen Erinnerung (Wiedererinnern) und anschließende Spielen von Tetris (Interferenz zur Erzeugung eines Rekonsolidierungs-Updates) [20].…”