(PS4-35) Playing Tetris Reduces Immediate Intrusions but Not Subsequent Daily Intrusions of a Traumatic Memory: A Multilab Replication Study

Many people experience traumatic events, and up to 19% develop posttraumatic stress disorder (PTSD), characterized by persistent intrusions or flashbacks. Research suggests that playing Tetris after trauma may reduce intrusions by occupying visuospatial working memory, which would otherwise be used for the (re)consolidation of traumatic visual memories (Holmes et al., 2009). Several trauma film paradigm studies have found Tetris effective in reducing intrusions, though results vary due to methodological differences, small samples, and limited independent replications. While real-life studies show mixed findings, Tetris remains a promising tool for PTSD prevention and treatment. To address previous limitations, The Tetris Replication Project Team (consisting of 15 researchers) conducted a large, preregistered, multi-site replication with procedural refinements to test the robustness of the imagery-competing hypothesis.

In Experiment 1, we developed and tested a modern trauma film with higher technical quality, as the original used in early Tetris studies is over 15 years old and may now seem outdated. Participants (N = 141) watched either the original or the new film and recorded their intrusions immediately after viewing, in a diary for a week, and retrospectively at the week's end. Non-inferiority analyses showed comparable intrusion rates, supporting the selection of the new film for Experiment 2.

In Experiment 2, we examined the effects of Tetris versus an active control condition on film-related intrusions. To enhance generalizability, undergraduate students (N = 433) from six sites across four countries (Australia, Germany, United Kingdom, Netherlands) watched the new film before being randomly assigned to either play Tetris or perform a perceptual vigilance task (a low-effort attention task). Intrusions were reported following the same procedure as in Experiment 1. Our results replicated previous findings (Holmes et al., 2009) showing that playing Tetris was associated with fewer immediate intrusions compared to the control task. However, we did not find evidence that Tetris reduced intrusions over the following week.

These mixed results may stem from methodological differences. While such variations between studies are inevitable (Nosek & Errington, 2020), they underscore the need for further research on the reliability and reproducibility of Tetris as an intervention for intrusive memories. Clinically, our findings suggest caution before considering Tetris a fully empirically supported intervention (Halvorsen et al., 2024). Continued exploration is therefore necessary to determine whether and how Tetris can effectively support individuals experiencing intrusive memories.