JMIR Publications

ABSTRACT

Background:

We need to develop novel interventions after psychological trauma. In a previous case study we found that the number of intrusive memories of trauma could be reduced with a novel, brief intervention. The intervention includes a brief memory reminder, a visuospatial task and mental rotation, targeting one memory hotspot at a time in separate sessions.

Objective:

The current case series (N=3) extends the first case study to see if a similar pattern of beneficial results is found among other trauma exposed women in Iceland. We explored whether the novel and brief intervention would result in reduced numbers of intrusive memories, and if having fewer intrusive trauma memories would impact posttraumatic stress, depressive and anxiety symptoms and general functioning (secondary outcomes). Acceptability of the intervention was also explored, alongside adaptions in intervention delivery format i.e. remote (online) delivery.

Methods:

Three women completed the study, two with posttraumatic stress disorder (PTSD) and other comorbidities, and one with subthreshold PTSD. The primary outcome was the change in number of intrusive memories from baseline phase to intervention phase and to 1 month follow-up, with also an assessment of intrusion frequency at 3 months Participants monitored the number of intrusive memories in a daily diary during 1 week at baseline, for 6 weeks maximum during the intervention phase, and for 1 week at 1 month follow up. At the 3-month follow-up we used a 1 week diary, but while this time point was specified in our preregistration this choice of measure was not correctly described. The intervention was delivered in person or digitally with guidance from a clinical psychologist. A repeated AB design was used (“A” was a preintervention baseline phase and “B” intervention phase). Intrusions were targeted one-by-one, creating repetitions of an AB design (i.e., length of baseline ‘A’ and intervention phase ‘B’ varied for each memory).

Results:

The total number of intrusive memories reduced from baseline to intervention phase for all three participants. The total number for participant 3 (P3) reduced from 38.75 per week during the baseline phase to 18.0 per week over the intervention phase. It was 13 at the 3-month follow-up week. The total number for P4 reduced from 10.8 per week at baseline to 4.7 per week in the intervention phase. It was zero at 3-month follow-up. The total number for P5 was reduced from 33.7 at baseline to 20.7 per week in the intervention phase. It was 8 at the 3-month follow-up week. All participants reported reductions in post-traumatic stress symptoms post-intervention. Depression and anxiety symptoms showed a reduction for two of three participants post-intervention. Acceptability was favourable.

Conclusions:

We observed good compliance with the intervention and intrusive memory diary for all three cases. The number of intrusive memories reduced for all participants over the intervention phase and 1 month follow-up, with some improvement in other symptoms and functioning. Further research should explore remote delivery of the intervention and whether non-specialists can deliver the intervention effectively. Clinical Trial: The study was preregistered prior to study start on ClinicalTrials.gov (NCT04209283) on 2019-12-24.