Tetris as a "cognitive vaccine" against traumatic flashbacks?

Everyone is familiar with Tetris. This simple, but addictive game has been studied quite a few times by researchers (see older post). A group from the University of Oxford investigated whether Tetris could be used as a “cognitive vaccine” against flashback development after trauma exposure. Flashbacks are one of the most persistent symptoms of Post Traumatic Stress Disorder (PTSD).

In a previous study the same group had shown that playing Tetris after viewing traumatic material reduced flashbacks compared to no-task on healthy volunteers.

In their new study they investigated whether other games could have this effect via distraction/enjoyment by conducting two experiments. More specifically, Holmes and colleagues compared the effectiveness of Tetris with Pub Quiz, a general knowledge, verbal computer game. In both experiments, the participants viewed film footage that contained scenes of death and injury. Then a group played Tetris, another Pub Quiz and a third one (control condition) was not give any task. In the first experiment the participants played Tetris or Pub Quiz 30 minutes after being exposed to the traumatic film. In the second there was a gap of 4 hours between the time the videos were presented and the time the tasks were performed.

In both experiments playing Tetris led to a significant reduction in flashbacks compared to no-task control. Pub Quiz in first experiment had the opposite effect and led to an increase of traumatic flashbacks. No such effect was observed when the task was performed 4 hours post-film.

According to the authors this is the first study to provide evidence:

that different computer games have differential effects on the development of flashbacks post-trauma… This was the case despite the games being rated as equally as enjoyable and as of similar difficulty.

The different effects of these games suggest that further research is needed before using computer games as psychological interventions in healthcare, as not all computer games are beneficial – some may even be harmful.

Holmes and colleagues explain this differential pattern of findings via their model of trauma memory formation from cognitive science. According to this theory:

1) Human memory differentiates visual and verbal components
2) Pathological trauma flashbacks consist of sensory, visual images
3) Cognitive science shows that visuospatial cognitive tasks compete for resources with visual images
4) The biology of memory consolidation suggests a 6 hour time frame post-trauma within which memories are malleable
5) Thus, visuospatial cognitive tasks given within 6 hours post-trauma will interfere with visual flashback memory consolidation, and reduce later flashbacks, as demonstrated in our previous study
6) In contrast, verbal tasks post-trauma will not reduce flashbacks as verbal tasks compete with verbal, conceptual processing of the event but not the visual images that make up flashbacks
7) Further, verbal tasks post-trauma will compete with the type of verbal-conceptual processing necessary to make sense of what has happened and from clinical models may serve to increase (rather then reduce) later trauma flashbacks

These findings are quite promising and could lead to a possible development of a computerized “cognitive vaccine” against the development of flashbacks for trauma in the future.

Holmes, E., James, E., Kilford, E., & Deeprose, C. (2010). Key Steps in Developing a Cognitive Vaccine against Traumatic Flashbacks: Visuospatial Tetris versus Verbal Pub Quiz PLoS ONE, 5 (11) DOI: 10.1371/journal.pone.0013706

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