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Session Overview
Short Presentation7: Reducing childbirth-related intrusive memories and PTSD symptoms via a single-session behavioural intervention including a visuospatial task: A proof-of-principle study (Deforges, Camille; Fort, Déborah; Holmes, Emily; Horsch, Antje)
Thursday, 01/Sept/2022:
1:00pm - 2:00pm

Location: CHUV auditorium Auguste Tissot

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Reducing childbirth-related intrusive memories and PTSD symptoms via a single-session behavioural intervention including a visuospatial task: A proof-of-principle study

Camille Deforges1, Déborah Fort1, Emily Holmes2, Antje Horsch1,3

1Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland; 2Department of Psychology, Uppsala University, Uppsala, Sweden; 3Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland

Background: Childbirth-related intrusive traumatic memories (CB-ITM) are involuntary and distressing sensory impressions of the birth, and a key symptom of childbirth-related posttraumatic stress disorder (CB-PTSD). Laboratory studies suggest that ITM and PTSD symptoms could be reduced via exposure to trauma-related reminder cues combined with a task hypothesized to interfere with trauma memory reconsolidation. However, this has never been tested for old and real-life single-event trauma, nor in the perinatal context. This translational proof-of-principle study aimed at testing the efficacy of a single-session behavioural intervention, based on memory reconsolidation processes, to reduce CB-PTSD symptoms, particularly ITM.

Methods: In this translational pre-post study, we included 18 mothers suffering from CB-ITM, whose traumatic childbirth had occurred between seven months and 6.9 years earlier. They received a behavioural intervention consisting of a combination of the traumatic childbirth evocation with a visuospatial task (the video game Tetris) assumed to interfere with childbirth memory reconsolidation. Mothers daily reported their CB-ITM during the two weeks before the intervention (diary 1; primary outcome), the two weeks after (diary 2), and the 5th and 6th weeks post-intervention (diary 3). CB-PTSD symptoms were assessed with the PCL-5 just before and one month after the intervention.

Results: Compared to diary 1, 15 out of 18 participants had ≥ 50% fewer CB-IMs in diary 2. The median (IQR) reduction of the number of CB-IMs was 81.89% (39.58%) in diary 2, and persisted in diary 3 (n = 17). At one month post-intervention, CB-PTSD symptom severity was reduced by ≥ 50% in 10 out of 18 participants. Total CB-PTSD symptom severity was, on average, reduced by 56.76% (SD = 28.97) (n = 17). All the effect sizes were large. Of the 8 participants with a CB-PTSD diagnosis pre-intervention, none met diagnostic criteria post-intervention. The intervention was rated as highly acceptable, all participants would have been willing to participate in a second session.

Discussion: This innovative single-session behavioural intervention seems promising but the design, although appropriate given the very innovative nature of the tested intervention, limits the causal interpretation of observed improvement. Thus, our results justify the launch of a large randomized controlled trial. Encouragingly, there are strong reasons to believe that such a brief intervention could benefit to anyone having PTSD symptoms and ITM, even beyond the perinatal context.

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