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Playing Tetris: prescription for traumatic memories?

January 7, 2009 |  4:20 pm

Tetris Aficionados of the computer-based game Tetris describe the manipulation of its geometric shapes as mind-bending, time-expending and utterly absorbing. But an innoculation against the mental anguish of war memories? Who'd have guessed it?

A study published in the latest issue of the online journal PLoS One found that research subjects who played Tetris in the immediate wake of witnessing a traumatic event were less likely than those who do not play Tetris to experience disturbing, intrusive memories of the horror.

Such distressing flashbacks to horror are a key symptom of post-traumatic stress disorder, a psychiatric diagnosis that as many as 1 in 5 U.S. service personnel returning from Iraq and Afghanistan are receiving. Those PTSD victims are expected to overwhelm the resources of the Veterans Affairs and civilian psychiatric establishment.

As a result, effective treatments for the disorder -- or better yet, preventive measures -- are in high demand. The authors of the study suggest that Tetris play represents a "cognitive vaccine" approach to PTSD. It is one of many efforts to test the effectiveness of blocking the process by which emotionally laden memories are preserved and stored in the brain.

Other such efforts have focused on drugs -- including beta-blockers, which slow the heart rate and in one study, disrupted the formation of painful memories when taken in the immediate aftermath of trauma. The anesthesia drug propofol, sometimes referred to as "milk of amnesia," has been tested as a PTSD-preventive for patients who were anesthetized but were frighteningly conscious during surgery. Some therapists have championed the use of MDMA, the party drug better known as Ecstasy, as a means of relieving PTSD symptoms by facilitating a patient's guided return to a traumatic event.

In the study, conducted at Oxford University's Department of Psychiatry, 40 subjects between age 18 and 47 viewed a 12-minute film that included horrific images of physical injury and death. After a half-hour break during which subjects were kept busy filling out forms, 20 of the subjects were set before a computer screen to play Tetris for 10 minutes. The remaining 20 sat quietly with nothing to do.

Not surprisingly, perhaps, the Tetris players reported fewer flashbacks to the gruesome scenes of injury and death than did the do-nothings in the 10-minute period of play. But in a daily diary all subjects kept for a week after the viewing of the film, Tetris players reported fewer flashbacks to the film's upsetting content than did the group left to entertain themselves in the movie's wake. Tested for PTSD symptoms in the lab a week after watching the film, the Tetris players showed significantly less evidence of trauma than did the control group.

And yet, the Tetris-playing group's memories of the events in the film were perfectly intact, the researchers found. Apparently, they had simply lost their power to horrify.

What saved the Tetris-playing group from post-traumatic stress symptoms was the limited powers of their brains to perform two similar operations at the same time -- to multitask -- the authors wrote. In the hours after witnessing a horrifying scene, a person would normally commit two different versions of the scene to memory -- the sensory-perceptual processing version, which records the upsetting sights, sounds and physical sensation of the event -- and the verbal-conceptual version of the event, in which the brain renders the events witnessed into a more dispassionate narrative.

In the crucial period following the film, the Tetris players were too engaged in the game-playing task -- which taxed their visual and spatial processing skills -- to consolidate the upsetting memory of the film's sights and sounds and their own physiological distress upon watching them, the authors conjectured. These memories "provide ... the foundation for the flashback images" common to PTSD sufferers. Without this stored version of events, the Tetris players had only their more dispassionate narrative memory of the film to draw upon.

As PTSD diagnoses have grown among troops, computer and video games have been explored as a means of desensitizing soldiers to frightening memories. But the Tetris experiment takes the use of video and computer games in a very different direction -- as a means to "jam" the mental process of recording frightening events. The authors say this approach offers "an ethical, safe and economical way" to prevent those subjected to horrors from the further pain of having to relive them.

-- Melissa Healy

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