EP21.27: Reducing intrusive memories after early pregnancy loss using a brief cognitive task involving Tetris computer gameplay: a randomised controlled trial

Early pregnancy loss (EPL) can be psychologically traumatic leading to distressing intrusive memories of the trauma. This study assesses the efficacy of a brief cognitive intervention (memory reminder and Tetris computer gameplay using mental rotation) in reducing intrusive memories of trauma 1 week following EPL compared to an active control group. Women were recruited from the early pregnancy unit in a West London hospital following a diagnosis of EPL (miscarriage or ectopic pregnancy). Participants were randomised to the intervention (brief memory reminder procedure, Tetris gameplay and mental rotation) or control task (listening to a podcast) in a 1 to 1 ratio. Participants completed the task during a follow up video call within 72 hours of discharge from EPL treatment/follow up. The frequency of intrusive memories was recorded daily for 1 week after task completion in an electronic ‘flashback’ diary. Between-group differences were tested using a two-tailed t-test (α=0.05) and cohen's d effect sizes were calculated. Secondary outcomes (frequency of intrusive memories, PTSD, anxiety, depression and functional impairment) were measured using validated tools at 1 and 3 months but are not reported in this abstract. 146 of 168 recruited women were randomised with 69 and 72 completing the intervention and control tasks respectively. 135 participants returned the week 1 ‘flashback’ diary. Significantly fewer intrusive memories (38% p = 0.03) were reported by the intervention group (mean 9.87, SD 11.36) than control group (mean 16.12, SD 21.27), with a treatment effect size of d=-0.36 (95% CI-0.7 to -0.02). We have shown that a brief cognitive intervention involving Tetris computer gameplay resulted in fewer intrusive memories at 1 week post-completion of EPL follow up/treatment. Further analysis is required to assess the long-term impact of the intervention on intrusive memories and mental health problems associated with EPL such as post-traumatic stress disorder.