Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study

Behav Res Ther. 2017 Jul:94:36-47. doi: 10.1016/j.brat.2017.03.018. Epub 2017 Apr 6.

Abstract

Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game 'Tetris' via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: -0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention "rather" to "extremely" acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child.

Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513.

Keywords: Acute stress disorder; Childbirth; Cognitive; Computerized; Early intervention; Posttraumatic stress disorder; Proof-of-principle randomized controlled study; Universal intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / psychology*
  • Cognitive Behavioral Therapy*
  • Female
  • Humans
  • Mental Recall*
  • Psychotherapy, Brief
  • Stress Disorders, Post-Traumatic / therapy*
  • Video Games / psychology*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02502513