Effective treatment of post-traumatic stress

The new study has been produced by researchers at Uppsala University and the University of Cambridge, together with industry partner P1vital and other partners. The new research findings could help many more people around the world obtain access to effective support for symptoms of post-traumatic stress.

The study follows on from previous research conducted in Sweden involving healthcare staff during the COVID-19 pandemic.

“It’s incredible to see how our research has gone from 20 years in the laboratory to real life, and can help people after trauma. This study is a turning point for establishing a solid, evidence-based treatment,” says Holmes.

Anyone can suffer trauma

According to the World Health Organisation (WHO), seventy per cent of the global population will experience at least one traumatic event during their life. Trauma can affect anyone – even here in Sweden.

A traumatic event could be a car accident, a difficult birth, war, violence or sexual assault. It could also be a difficult experience during the COVID-19 pandemic, for patients or for healthcare staff, for example in connection with intensive care. Intrusive memories are one of the most severe symptoms, but few evidence-based methods have been available that directly target and reduce these symptoms in a simple and scalable way.

Focus on flashbacks

The study focuses on the most common and foremost symptom of PTSD: unpleasant and intrusive memories of a traumatic event in the form of images (commonly known as ‘flashbacks’). During the COVID-19 pandemic, healthcare staff around the world reported alarmingly extensive PTSD symptoms of this kind in connection with caring for critically ill patients, often in life-and-death situations.

An international group of researchers therefore set out to develop and test a short, easily accessible digital treatment that could help staff regain control over these intrusive memories and reduce their general PTSD symptoms.

The treatment, which is called ICTI (see Fact Box), consists of a 35-minute guided digital session in which the individual receives support in briefly calling an intrusive memory to mind and then using a method known as ‘mental rotation’, which is key in Tetris®. When you look at an object from one angle, you can mentally picture what it would look like if it were rotated and observed from a different angle.

Lasting effects for at least six months

The treatment has shown good results. In a study of healthcare staff (99 people), this treatment reduced the number of flashbacks from approximately ten per week to fewer than one, with lasting effects for at least six months.

At the beginning of the study, participants in all groups reported an average of about ten intrusive memories per week. Four weeks after the intervention, the group that had received ICTI showed a striking decrease, down to an average of only 0.5 intrusive memories per week. In contrast, participants in both control groups still experienced around five intrusive memories per week, ten times as many as in the ICTI group.

“This large difference arose after just a single guided digital session and shows that directly targeting the visual aspect of intrusive memories can have a powerful impact on their frequency. At the six-month follow-up, 70 per cent of the participants who had received ICTI reported that they had not experienced any intrusive memories at all,” Holmes says.

Meaningful alleviation of PTSD symptoms

In contrast, participants in both the control groups continued to experience intrusive memories during this period. Moreover, in an assessment using a standard form (PCL-5) that is often employed to assess all PTSD symptoms, the ICTI group had considerably larger improvements compared with both control groups.

Overall, the results show that the treatment not only reduces the number of intrusive flashbacks, it also provides meaningful alleviation of several PTSD symptoms.

“Although this randomised controlled study was tested on nurses and doctors, the treatment is designed to help any member of the population. Our vision is an intervention that can be quickly rolled out in a crisis situation, is safe, evidence-based and able to help everyone affected by trauma,” Holmes concludes.

Annica Hulth