Original Article

Molecular Psychiatry advance online publication 28 March 2017; doi: 10.1038/mp.2017.23

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

L Iyadurai1, S E Blackwell2,3, R Meiser-Stedman4, P C Watson2, M B Bonsall5, J R Geddes1,6, A C Nobre1 and E A Holmes7

  1. 1Department of Psychiatry, University of Oxford, Oxford, UK
  2. 2Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
  3. 3Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
  4. 4Department of Clinical Psychology, University of East Anglia, Norwich, UK
  5. 5Department of Zoology, University of Oxford, Oxford, UK
  6. 6Oxford Health NHS Foundation Trust, Oxford, UK
  7. 7Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Correspondence: Professor EA Holmes, Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm SE-171 77, Sweden. E-mail: emily.holmes@ki.se

Received 28 June 2016; Revised 22 December 2016; Accepted 17 January 2017
Advance online publication 28 March 2017



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. 20min game play) vs attention-placebo control (written activity log for same duration) were both delivered in an emergency department within 6h 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.