scholarly journals Reaching people soon after a traumatic event: an exploratory observational feasibility study of recruitment in the emergency department to deliver a brief behavioral intervention via smartphone to prevent intrusive memories of trauma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Marie Kanstrup ◽  
Ann Rudman ◽  
Katarina Göransson ◽  
Emil Andersson ◽  
Klara Olofsdotter Lauri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Behavioral Intervention ◽  
Study Protocol ◽  
Mental Health Problems ◽  
Road Traffic ◽  
Traumatic Event ◽  
Psychological Trauma ◽  
Clinical Feature ◽  
Intrusive Memories ◽  
Brief Behavioral Intervention

Abstract Background The current study explored how to recruit patients soon after a traumatic event, to deliver a novel intervention in a new emergency department in Sweden. This brief behavioral intervention aims to prevent intrusive memories and is delivered soon after trauma in the emergency department. In the UK, it has shown promising results. Traumatic events resulting in admission to the emergency department (e.g., road traffic accidents) may result in subsequent mental health problems such as post-traumatic stress disorder, where intrusive memories of the trauma constitute a core clinical feature. Early interventions that prevent intrusive memories after psychological trauma are lacking. Specific aims were to explore identification of eligible patients (aim 1), fitting in with emergency department staff routines to deliver the study protocol (aim 2), and using the patients’ own smartphones to deliver intervention/control task (aim 3). Two changes to the previous study were (i) extending the trauma types included (ii) a new control condition, also by smartphone. Methods This is an explorative observational study. Data was both analyzed descriptively and using the Framework method. Results We identified several possible ways to recruit patients, and establish a sense of embeddedness in the Swedish emergency department context and a positive appreciation from staff. The study protocol was tested with 8 participants. Tasks both in the intervention and control condition were readily delivered via patients’ own smartphones. Conclusion Recruitment of patients and smartphone delivery of the intervention indicates initial feasibility. Researcher presence and administration of study procedures was successfully fitted to emergency department routines and well received by staff. Further pilot work is warranted, underscoring the importance of our collaboration between nursing and psychology.

scholarly journals Sleep and intrusive memories immediately after a traumatic event in emergency department patients

SLEEP ◽  
2020 ◽  
Vol 43 (8) ◽  
Author(s):  
Kate Porcheret ◽  
Lalitha Iyadurai ◽  
Michael B Bonsall ◽  
Guy M Goodwin ◽  
Sally A Beer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sleep Duration ◽  
Traumatic Event ◽  
Real Life ◽  
Early Period ◽  
Psychological Trauma ◽  
Clinical Feature ◽  
Depression Symptoms ◽  
Intrusive Memories ◽  
The Impact

Abstract Study objectives Intrusive memories of psychological trauma are a core clinical feature of posttraumatic stress disorder (PTSD), and in the early period post-trauma may be a potential target for early intervention. Disrupted sleep in the weeks post-trauma is associated with later PTSD. The impact of sleep and intrusive memories immediately post-trauma, and their relation to later PTSD, is unknown. This study assessed the relationship between sleep duration on the first night following a real-life traumatic event and intrusive memories in the subsequent week, and how these might relate to PTSD symptoms at 2 months. Methods Patients (n = 87) recruited in the emergency department completed a sleep and intrusive memory diary from the day of their trauma and for the subsequent week, with optional actigraphy. PTSD, anxiety, and depression symptoms were assessed at 1 week and 2 months. Results A U-shaped relationship was observed between sleep duration on the first night and intrusive memories over the subsequent week: sleeping “too little” or “too much” was associated with more intrusive memories. Individuals who met Clinician-Administered PTSD Scale (CAPS) criteria for PTSD at 2 months had three times more intrusive memories in the first week immediately post-trauma than those who did not (M = 28.20 vs 9.96). Post hoc analysis showed that the absence of intrusive memories in the first week post-trauma was only observed in those who did not meet CAPS criteria for PTSD at 2 months. Conclusions Monitoring intrusive memories and sleep in the first week post-trauma, using a simple diary, may help identify individuals more vulnerable to later psychopathology.

scholarly journals A simple cognitive task intervention to prevent intrusive memories after trauma in patients in the Emergency Department: A randomized controlled trial terminated due to COVID-19

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Marie Kanstrup ◽  
Laura Singh ◽  
Katarina E. Göransson ◽  
Beau Gamble ◽  
Rod S. Taylor ◽  
...  
Keyword(s):  
Emergency Department ◽  
Traumatic Event ◽  
Cognitive Task ◽  
Controlled Trial ◽  
Virus Transmission ◽  
Computer Game ◽  
Similar Time ◽  
Intrusive Memories ◽  
Randomised Controlled ◽  
Simple Cognitive Task

Abstract Objective This randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Anticipated enrolment was N = 148. Results The RCT was terminated prematurely after recruiting N = 16 participants. The COVID-19 pandemic prevented recruitment/testing in the ED because: (i) the study required face-to-face contact between participants, psychology researchers, ED staff, and patients, incurring risk of virus transmission; (ii) the host ED site received COVID-19 patients; and (iii) reduced flow of patients otherwise presenting to the ED in non-pandemic conditions (e.g. after trauma). We report on delivery of study procedures, recruitment, treatment adherence, outcome completion (primary outcome: number of intrusive memories during week 5), attrition, and limitations. The information presented and limitations may enable our group and others to learn from this terminated study. Trial registration ClinicalTrials.gov: NCT04185155 (04-12-2019)

Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: A Case Study in Iceland (Preprint)

2021 ◽  
Author(s):  
Kristjana Thorarinsdottir ◽  
Emily Holmes ◽  
Johann Palmar Hardarson ◽  
Unnur Hedinsdottir ◽  
Marie Kanstrup ◽  
...  
Keyword(s):  
Traumatic Event ◽  
Single Case ◽  
Psychological Trauma ◽  
Cognitive Intervention ◽  
Clinical Psychologist ◽  
Post Intervention ◽  
Intrusive Memories ◽  
Intervention Phase

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. CLINICALTRIAL VSNb2017110046/03.01

scholarly journals Collision Every Night: Treating Nightmares with Trauma-focused Methods: Case Report

2021 ◽  
Author(s):  
József Szabó ◽  
Szilvia Tóth
Keyword(s):  
Stress Disorder ◽  
Acute Stress ◽  
Road Traffic ◽  
Psychological Trauma ◽  
Acute Stress Disorder ◽  
Symptomatic Improvement ◽  
Post Traumatic Stress ◽  
Comprehensive Therapy ◽  
Medicinal Treatment ◽  
Trauma Processing

Abstract Introduction We would like to present the case of a young patient with acute stress disorder and recurrent nightmares following the psychological trauma caused by a severe road traffic accident. The comprehensive therapy carried out at the Department of Traumatology included medication, trauma processing and a psychological method whose aim is to cease the development of nightmares. Case Presentation Psychiatric assessment and treatment was asked for a polytraumatised female patient at the Intensive Care Unit after she had undergone a neurosurgical intervention. Her medicinal treatment was continued at the Department of Traumatology. Besides the antidepressant venlafaxine she was treated in accordance with the EMDR protocol for acute stress disorder, and we also applied imagery rescripting to prevent her from having recurrent (daily) nightmares. As a result of the therapy, her symptoms were fast relieved, the nightmares stopped almost instantly, her mood improved, rumination and anxiety decreased significantly. Conclusions In view of the fast and significant symptomatic improvement, we can expect that the EMDR therapy and its protocol for acute stress disorder have successfully reactivated information processing, and besides the subjective relief we have managed to prevent a mental crisis that could lead to a suicide risk as well as the development of post-traumatic stress disorder. We also hope that the improvement will be long-lasting.

scholarly journals Provider attitudes towards a brief behavioral intervention for sexual health in Moldova

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rob Stephenson ◽  
Galina Lesco ◽  
Viorel Babii ◽  
Andrei Luchian ◽  
Nataliia Bakunina ◽  
...  
Keyword(s):  
Sexual Health ◽  
Behavioral Intervention ◽  
Brief Intervention ◽  
Behavioral Interventions ◽  
Brief Interventions ◽  
Health Centers ◽  
Capital City ◽  
Vulnerable Groups ◽  
Provider Attitudes ◽  
Brief Behavioral Intervention

Abstract Background Brief behavioral interventions are seen as an efficient way to improve knowledge, change behavior, and reduce provider stigma regarding sexual health. When grounded in evidence-based behavioral change techniques and delivered using Brief Sexuality-related Communication (BSC) tools, brief behavioral interventions can address client-driven sexual health goals in a single session with their provider. Evidence for the efficacy of brief interventions for creating gains in sexual health comes largely from resource rich settings, and there is a lack of knowledge of how brief interventions can be implemented in the more resource constrained environments of low- and middle-income countries. As a first step in developing a brief intervention to address sexual health issues in Moldova, this paper reports on qualitative data collected from Moldovan providers to understand their attitudes, willingness and perceived barriers to the brief intervention and its implementation. Methods Thirty-nine in-depth interviews (IDI) were conducted between February and March 2020, with health providers recruited from three primary health care institutions, two Youth Friendly Health Centers and counselors from three NGOs who work with key populations in Moldova, including health centers selected from two cites - the capital city, Chisinau and from the Comrat Region. The IDI addressed four domains of provider attitudes: 1) attitudes towards the intervention; 2) willingness and motivation to implement the intervention; 3) logistics of providing the intervention and 4) ability to implement the intervention. A coding analysis approach was applied to all interview transcripts. Results Providers largely reported being willing to be trained in and implement the brief intervention. Willingness to implement the intervention stemmed from two perceptions: that it would improve the ability of providers to talk with their clients about sex, and that vulnerable groups would benefit from these conversations. However, while there were generally positive attitudes towards the intervention, providers consistently reported structural barriers to their perceived ability to implement the intervention. Conclusions While providers reported high levels of initial acceptance of a brief behavioral intervention, care is needed to ensure that brief interventions, and the training of providers on brief interventions, incorporate cultural attitudes and norms around sex, particularly in highly patriarchal settings, and provide opportunities for providers to practice the intervention in ways that address their assumptions and implicit biases.

scholarly journals Selectively Interfering With Intrusive but Not Voluntary Memories of a Trauma Film: Accounting for the Role of Associative Memory

2021 ◽  
pp. 216770262199831
Author(s):  
Alex Lau-Zhu ◽  
Richard N. Henson ◽  
Emily A. Holmes
Keyword(s):  
Emotional Disorders ◽  
Traumatic Event ◽  
Emotional Memory ◽  
Control Procedure ◽  
Witness Testimony ◽  
Intrusive Memories ◽  
Therapeutic Benefits ◽  
Selective Interference ◽  
Intrusive Memory

Intrusive memories of a traumatic event can be reduced by a subsequent interference procedure, seemingly sparing voluntary memory for that event. This selective-interference effect has potential therapeutic benefits (e.g., for emotional disorders) and legal importance (e.g., for witness testimony). However, the measurements of intrusive memory and voluntary memory typically differ in the role of associations between a cue and the emotional memory “hotspots.” To test this, we asked participants to watch a traumatic film followed by either an interference procedure (reminder plus Tetris) or control procedure (reminder only). Measurement of intrusions (using a laboratory task) and voluntary memory (recognition for film stills) were crossed with the presence or absence of associative cues. The reminder-plus-Tetris group exhibited fewer intrusions despite comparable recognition memory, replicating the results of prior studies. Note that this selective interference did not appear to depend on associative cues. This involuntary versus voluntary memory dissociation for emotional material further supports separate-trace memory theories and has applied advantages.

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