Effectiveness of tetris as an early intervention for preventing intrusive memories and post-traumatic stress disorder related symptoms after a real-world trauma: a systematic review and narrative synthesis

Introduction Post-traumatic stress disorder (PTSD) is a worldwide, life-changing condition associated with intrusions/flashbacks, avoidance and changes in mood, cognition and arousal after experiencing a trauma. It is costly financially as well as socially and personally, and a call for an early intervention to prevent PTSD from developing is clear. Cognitive neuroscience has been drawn upon to develop the hypothesis that utilisation of a visuospatial intervention (tetris) during the early hours following a trauma, can reduce the development of intrusive memories and other PTSD-related symptoms. This has been explored in laboratory-based trials, with the field starting to expand into ‘real-world trauma’. This review systematically identified, reviewed and critically appraised literature investigating the effectiveness of tetris as an early intervention for preventing/reducing intrusive memories and other PTSD symptoms after a real-world trauma. Method PsycINFO, Medline, Scopus, CINAHL, Web of Science and ProQuest were systematically searched (final search in July 2024). Studies were subjected to a critical quality appraisal using risk of bias tools (combination/adaptation of The Critical Appraisal Skills Programme Randomised-Controlled Trial Standard Checklist and the Risk of Bias-2) and narrative synthesis. Reports were required to: use adults, use tetris as an early intervention (<72 h after trauma), use quantitative methods for measuring intrusive memories and PTSD symptoms and be real-world trauma. Findings Four studies were included (314 participants). A fifth study is reported but not included in synthesis due to being terminated. Studies had limitations such as: small sample size, differing statistical models and differing control conditions with no justifications. Overall, all studies demonstrate tetris is effective at reducing intrusive memories after one week, but there were mixed and inconclusive results for other PTSD symptoms at follow-ups ranging from one to six months. Conclusions The findings show promise at the effectiveness of tetris for reducing the initial development of intrusive memories, in line with laboratory trials. Research with larger sample sizes, more robust statistical approaches, better utilisation of control groups and a more in-depth look at any trauma-specific effect are needed before this low-cost, ‘therapist-free’ intervention could be implemented. Other This review was registered on Prospero (CRD42024555956).