A Simple Cognitive Task to Reduce the Build-Up of Flashbacks After a Road Traffic Accident

Study Overview
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Brief Summary
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This research study is designed to investigate the effects of a simple cognitive task (a memory reactivation cue following by playing the computer game Tetris) on flashbacks and other post-traumatic stress symptoms after a road traffic accident. Patients presenting to a hospital emergency department soon after a road traffic accident will be randomly allocated to either the simple cognitive task intervention or usual care. Participants will be followed up at one week and one month. It is predicted that participants given the simple cognitive task intervention will develop fewer flashbacks and less severe clinical symptoms than those who are not. This will inform the potential future development of a simple technique to prevent distressing psychological symptoms after a traumatic event.

Official Title
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A Simple Cognitive Task to Reduce the Build-Up of Flashbacks After a Road Traffic Accident: A Randomised Controlled Study in an Emergency Department

Conditions
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Post-traumatic Stress Disorders

Intervention / Treatment
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* Behavioral: Simple cognitive task


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 or over Experienced or witnessed a road traffic accident (as a driver, passenger, motorcyclist, cyclist or pedestrian) Met the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criterion A1 for Post-Traumatic Stress Disorder (PTSD) (experienced, witnessed, or confronted with actual or threatened death or serious injury) Can be seen in the emergency department within 6 hours of leaving the scene of the accident Report memory of the accident Fluent in written and spoken English Alert and orientated, Glasgow Coma Scale score (GCS) = 15 Have sufficient physical mobility to play a computer game on the intervention platform (a Nintendo DS) at the point of taking informed consent Willing and able to provide informed consent and complete study procedures Willing and able to be contacted following discharge to complete follow-up assessments Exclusion Criteria: Loss of consciousness of > 5 minutes Current intoxication Report a history of severe mental illness Current substance abuse or neurological condition Currently suicidal

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Simple cognitive task<br>A memory reactivation cue followed by playing the computer game Tetris | Behavioral: Simple cognitive task<br> <br> |
| No Intervention: Usual care<br>Usual care in the emergency department | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of flashbacks recorded by participants in a Flashback Record in the week after the accident |  | Within one week after the accident (Flashback Record will be returned to a researcher at one week follow-up) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-traumatic Stress Diagnostic Scale (PDS) |  | One week and one month follow-up | 
| Impact of Event Scale - Revised (IES-R) |  | One week and one month follow-up | 
| Hospital Anxiety and Depression Scale (HADS) |  | One week and one month follow-up |