JMIR Publications

ABSTRACT

Background:

Additional interventions are needed for survivors of psychological trauma. Case studies can help treatment innovation with an intervention designed to disrupt memory reconsolidation, taking a single symptom approach by focusing on intrusive memories of a traumatic event.

Objective:

We aimed to examine a novel brief cognitive intervention to reduce the number of intrusive memories of trauma, in an Icelandic setting and extending previous studies by examining longer-term effects up to 3 months. The intervention comprised a brief memory reminder, then Tetris gameplay with mental rotation, targeting one memory at a time in each session. The intervention was guided by a clinical psychologist and adapted to the Icelandic setting.

Methods:

This was a single case study in Iceland with a woman in her fifties, with 4 different intrusive memories from childhood. The primary outcome was the change in number of intrusive memories from baseline to intervention phase, and to follow-ups. The number of intrusions was monitored in a daily diary for: 4 weeks preintervention; 8 weeks during intervention; 1 week at 1-month and 3-month follow-ups. Intrusions were targeted one-by-one over 6 intervention sessions, creating 4 repetitions of an AB design (i.e., length of baseline ‘A’ and intervention phase ‘B’ varied for each memory). We examined change in both total number of intrusions (summed across all 4 memories) and individually for each memory.

Results:

The number of total intrusions per week was 12.6 at baseline; 6.1 over the intervention phase (a 52% reduction from baseline); 3.0 at the 1-month follow-up (76% reduction); and 1.0 at the 3-month follow-up (92% reduction). Reductions in symptoms of posttraumatic stress and depression were observed post-intervention. Sleep, concentration, stress and functioning improved. The participant considered the gameplay intervention acceptable, and helpful in that she found the memories disappeared while playing.

Conclusions:

This guided brief cognitive intervention reduced the number intrusive memories from over the intervention phase and follow-ups. The brief memory reminder was well-tolerated, removing the need to discuss trauma in detail. Next steps require extension to more cases and exploring remote delivery of the intervention. Clinical Trial: VSNb2017110046/03.01