Exploring the use of Tetris as a post-trauma ‘cognitive vaccine’: from memory consolidation to reconsolidation

Re-experiencing trauma in the form of intrusive, image-based memories (here referred to as flashbacks) is a hallmark symptom of Post-Traumatic Stress Disorder (PTSD). There are successful treatments available for full-blown PTSD; however, these can only be administered one month post trauma. There are limited interventions that can be administered to reduce flashbacks in the early aftermath of trauma. The overarching aim of this thesis was to use an experimental psychopathology approach, the trauma film paradigm, to investigate the reduction of flashbacks post-trauma using the cognitive task, Tetris.
Chapter 1 provides a literature review of experimental research that has used the trauma film paradigm. Chapter 2 reviews experimental work on disrupting memory reconsolidation in humans. Chapter 3 details pilot work on the development of an experimental protocol based upon these literature reviews.
Experiment 1 (Chapter 4) investigated disrupting reconsolidation for a 24 hour old analogue trauma (aversive film material) using the cognitive task, Tetris. A procedure designed to disrupt flashback reconsolidation (a memory reactivation task for the film followed by playing the computer game Tetris) was compared with a no-task Control. Compared to Control, those in the Tetris condition reported fewer flashbacks to the film in an intrusion diary across the subsequent week and on convergent measures of flashback frequency. Experiment 2 (Chapter 5) provided a test of replication for findings from Experiment 1, in addition to extending findings by dismantling the procedure’s component parts. Participants who underwent Tetris only (without memory reactivation) or memory reactivation (without Tetris) did not demonstrate a reduction in flashbacks and were comparable to the no-task control condition. Both a memory reactivation task plus Tetris in combination were critical for reducing subsequent flashbacks for a consolidated memory for a trauma film.
Experiment 3 (Chapter 6) tested whether playing Tetris could help disrupt flashback memories for an analogue trauma (film) if administered prior to film viewing, relative to a no-task control condition. Results showed that playing Tetris before a trauma film did not reduce flashbacks, as demonstrated via an intrusion diary and convergent flashback measures.
Chapters 7 reviews email feedback relating to playing Tetris after experiencing real-life adversity from members of the public. Chapter 8 explores a form of treatment for trauma in a NHS, complex patient setting. Chapter 9 discusses the findings from all chapters with reference to their implications and limitations, and new directions for future research. Overall, findings using analogue trauma suggest that memory reactivation followed by playing Tetris may be promising for development as a post-trauma ‘cognitive vaccine’ to disrupt the both the consolidation and potential reconsolidation of flashback memories.

Keywords: emotion
experimental psychopathology
Tetris
cognitive science
posttraumatic stress disorder
PTDS
Advisor: Holmes, E
Gedes, J
Tunbridge, E