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Dr. Óscar Soto Angona MD
Email: osoto@vhebron.net
Phone: +34667909711
Dr Thomas Gargot, MD, PhD std
Computer Science
Email: Thomas.gargot@uni-tours.fr
Website and sources:
https://devpost.com/software/proto-trauma-
prevent
Trauma due to the COVID pandemic
seems to be a prevalent event that could
develop to post-traumatic stress disorder if
not properly managed. Some simple
measured begin to have proven efficacy
and could avoid further complications.
We have designed an online multi-centric
study aimed to test an app that would:
1) Screen for post-traumatic stress
symptoms
2) Educate the population on
management and identification of such
symptoms
3) Deliver and test three different
approaches to deal with such
symptoms.
Preventing Post Traumatic Stress Disorder induced by trauma during the COVID pandemic
A simple brief intervention based on cognitive science that could be delivered digitally
Authors: Ó. Soto-Angona*, T. Gargot**
* Department of Psychiatry, Hospital Universitary Vall d’Hebron, Barcelona, Catalonia, Spain
** Child and Adolescent Psychiatry, CHRU Tours, France
Three solutions are considered during the acute phase (golden hours, <24h) after trauma to prevent
transition from PTSS to PTSD, with limited evidence favoring one over another :
(1) Tetris® use (Fig 1) (Iyadurai, 2018 ; Iyadurai, 2019)
(2) Early psychological support (Rose, 2002)
(3) Watchful wait
The use of Tetris® has been assessed in cognitive science: using spatio-visual tasks during an acute phase
prevents memory consolidation of a traumatic event (Kavanagh, 2001).In contrast, verbal tasks, increasing
memorization, should be avoided. Tetris®’ use has been tested in small-sample clinical trials showing
feasibility and efficacy in preventing intrusive memories, yet replications are needed in a larger population
and with a longer follow-up. Furthermore, a survey showed a good acceptability among traumatized subjects.
We are implementing a web-based smartphone application (Fig 2)
that could
(1) Collect data enabling to predict and follow the evolution of PTSS toward PTSD,
(2) Assess the relative efficacy of several methods to prevent the evolution of PTSS right after exposure to
trauma (1-24h).
(3) Educate people about psychological effects that can occur during and after trauma, normalize acute
distress and suggest that they seek professional help if they still experience substantial PTSS one (or more)
month after the traumatic event, which defines PTSD.
Trauma-Prevent could be a useful tool for the
general population in order to manage trauma
due to COVID. It could allow to screen for
subjects requiring professional help, and might
avoid further complications of such trauma by
delivering simple, effective measure aimed to
impair trauma consolidation and to avoid the
development of PTSD
In the Wuhan region in China, Liu et al., reported a prevalence of 7% Post Traumatic Stress
Symptoms (PTSS) after COVID (Liu, 2020). Including only the COVID-19-infected population, Bo et
al. found a PTSS prevalence of 96.2% (Bo, 2020). Identified risk factors influencing symptoms and
transition to PTSD are :
A) Pre-trauma: (1) female sex, (2) less than secondary education, (3) prior interpersonal trauma,
(4) prior mental illness
B) Peri-trauma: current exposure type (interpersonal) or severity
C) Post-trauma: (1) early symptom configuration or severity - Peritraumatic dissociation, (2)
memory of the event, (3) Heart rate measured in emergency department.
These factors could be identified easily to screen the most at-risk population, and some basic
interventions could be applied to avoid further development of PTSD
Bo, H., Li, W., Yang, Y., Wang, Y., Zhang, Q., Cheung, T., . . . Xiang, Y. (2020).
Posttraumatic stress symptoms and attitude toward crisis mental health services
among clinically stable patients with COVID-19 in China. Psychological Medicine, 1-7.
doi:10.1017/S0033291720000999
Iyadurai, L., Blackwell, S. E., Meiser-Stedman, R., Watson, P. C., Bonsall, M. B., Geddes,
J. R., ... & Holmes, E. A. (2018). Preventing intrusive memories after trauma via a brief
intervention involving Tetris computer game play in the emergency department: a
proof-of-concept randomized controlled trial. Molecular psychiatry, 23(3), 674.
Iyadurai, L., Visser, R. M., Lau-Zhu, A., Porcheret, K., Horsch, A., Holmes, E. A., & James,
E. L. (2019). Intrusive memories of trauma: a target for research bridging cognitive
science and its clinical application. Clinical psychology review, 69, 67-82.
Kavanagh DJ, Freese S, Andrade J, May J . Effects of visuospatial tasks on
desensitization to emotive memories. Br J Clin Psychol 2001; 40: 267–280.
Liu, N., Zhang, F., Wei, C., Jia, Y., Shang, Z., Sun, L., … Liu, W. (2020). Prevalence and
predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender
differences matter. Psychiatry Research, 287, 112921. doi:
10.1016/j.psychres.2020.112921
Rose, S. C., Bisson, J., Churchill, R., & Wessely, S. (2002). Psychological debriefing for
preventing post traumatic stress disorder (PTSD). Cochrane database of systematic
reviews, (2).
ABSTRACT
CONTACT
Fig 1. Tetris®, a vídeo
game requiring a visuo
spatial effort
INTRODUCTION
CONCLUSIONS
METHODS AND MATERIALS
REFERENCES
FormR (Fig 3), a survey framework allows to:
(1) chain simple surveys into long runs,
(2) screen inclusion and exclusion criteria,
(3) randomize subjects,
(4) redirect subjects to external ressources
This complex designs framework looks suitable to
implement our solution
Fig 2. Flowchart of the proposed study