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      Reducing intrusive memories after trauma via a brief cognitive task intervention in the hospital emergency department: an exploratory pilot randomised controlled trial

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          Abstract

          Intrusive memories are common after trauma, and can cause significant distress. Interventions to prevent/reduce the occurrence of this core clinical feature of posttraumatic stress disorder are needed; they should be easy to deliver, readily disseminated and scalable. A novel one-session intervention by Iyadurai et al. 2018, Molecular Psychiatry, resulted in intrusion reduction over the subsequent week. Its feasibility in a different setting and longer-term effects (>1 month) need investigation. We conducted an exploratory open-label pilot randomised controlled trial (RCT) to investigate the feasibility and effects of a brief behavioural intervention to reduce intrusive memories in trauma-exposed patients in a Swedish hospital emergency department (ED). Participants (final N = 41) were randomly allocated to either intervention (including memory reminder cue then visuospatial cognitive task “Tetris” with mental rotation instructions) or active control (podcast) condition within 72 h of presenting to the ED (both conditions using their smartphone). Findings were examined descriptively. We estimated between-group effect sizes for the number of intrusive memories post-intervention at week 1 (primary outcome) and week 5 (secondary outcome). Compared to the control condition, participants in the intervention condition reported fewer intrusive memories of trauma, both at week 1 and week 5. Findings extend the previous evaluation in the UK. The intervention was readily implemented in a different international context, with a mixed trauma sample, with treatment gains maintained at 1 month and associated with some functional improvements. Findings inform future trials to evaluate the capacity of the cognitive task intervention to reduce the occurrence of intrusive memories after traumatic events.

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          Diagnostic and Statistical Manual of Mental Disorders

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            Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

            Summary The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
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              The Hospital Anxiety and Depression Scale

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                Author and article information

                Contributors
                marie.kanstrup@ki.se
                laura.singh@psyk.uu.se
                Journal
                Transl Psychiatry
                Transl Psychiatry
                Translational Psychiatry
                Nature Publishing Group UK (London )
                2158-3188
                11 January 2021
                11 January 2021
                2021
                : 11
                : 30
                Affiliations
                [1 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, ; Stockholm, Sweden
                [2 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Functional Area Medical Psychology, Karolinska University Hospital, ; Stockholm, Sweden
                [3 ]GRID grid.8993.b, ISNI 0000 0004 1936 9457, Department of Psychology, Uppsala University, ; Uppsala, Sweden
                [4 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Emergency and Reparative Medicine Theme, Karolinska University Hospital, ; Stockholm, Sweden
                [5 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Department of Medicine Solna, Karolinska Institutet, ; Stockholm, Sweden
                [6 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, ; Glasgow, UK
                [7 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Department of Psychiatry, University of Oxford, ; Oxford, UK
                [8 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, School of Psychology, The University of New South Wales, UNSW Sydney, ; Sydney, Australia
                Author information
                http://orcid.org/0000-0003-2060-5288
                http://orcid.org/0000-0003-0148-7247
                http://orcid.org/0000-0001-7488-2841
                Article
                1124
                10.1038/s41398-020-01124-6
                7798383
                33431807
                70f7cfd3-9be2-462f-bab7-0e5ed2f3605d
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 17 July 2020
                : 10 November 2020
                : 23 November 2020
                Funding
                Funded by: FundRef https://doi.org/10.13039/501100001711, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (Swiss National Science Foundation);
                Award ID: P2BEP1_184378
                Award Recipient :
                Funded by: FO Medical Psychology grant from Karolinska Institutet and Karolinska University Hospital
                Funded by: FundRef https://doi.org/10.13039/501100000272, DH | National Institute for Health Research (NIHR);
                Categories
                Article
                Custom metadata
                © The Author(s) 2021

                Clinical Psychology & Psychiatry
                psychiatric disorders,human behaviour
                Clinical Psychology & Psychiatry
                psychiatric disorders, human behaviour

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