Professor Emily Holmes: ‘Tetris paper’, PLoS ONE

A psychiatry paper about the power of Tetris scored highly thanks to open access

Holmes, EA, James, EL, Kilford, EJ, & Deeprose, C (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz. PLoS ONE, 5(11), e13706

What is it?

In 2010 Professor Emily Holmes and colleagues at the University of Oxford’s department of psychiatry published a paper about using the computer game Tetris as a “cognitive vaccine” against the build-up of flashbacks after trauma. It was a follow-up paper to an earlier piece of research on the subject and she chose to publish both in the open access journal PLoS ONE.

The paper describes an experimental medicine model of what might happen when people encounter a traumatic event. Three randomly assigned groups of people watched a traumatic film in a laboratory. One group were sent back out into the world afterwards and had to record in a diary how many flashback memories of the film they experienced during the week. A second group were given the computer game Tetris to play after the film, then sent out with the same diary task. The third group played a different computer game after the film – Pub Quiz, based on words and logic rather than visual, spatial and colour properties – and then sent away with the diary task. The critical results were that, compared to just having the trauma stimulus, the people who played the computer game Tetris experienced far fewer flashbacks over the subsequent week than those who played the Pub Quiz computer game.

These results suggest that that the things we do in the aftermath of a traumatic event can have an impact on the number of intrusive memories that arise later of that event. The results also suggest that, based on the scientific hypothesis about the nature of memory processing, visuo-spatial tasks compete and help reduce flashback memories whereas it is possible that other tasks either do nothing or could even be harmful.

How was it a success?

“I think that science is a really important endeavour and it’s important to make sure that our work is accessible to a broader public,” says Professor Holmes of the decision to publish this piece of research in PLoS ONE. She does not routinely publish all her work in open access journals, preferring more specialist outlets for very niche work, but felt that this experiment had a “broader interest” that meant that both scientists outside her specialism and the public more generally might find it useful to be able to read the full paper.

The decision certainly proved to be well-judged – the response to what has come to be known as the “Tetris paper” was swift and global. It caught the imagination of media around the world, resulting in coverage on TV, radio, websites and newspapers. Follow-up enquiries followed quickly, not just from academic counterparts, both nationally and internationally, but also from interested members of the public who had been able to access and read the publication in full, online, after being alerted to it by the media attention.

“We had the opportunity to talk about the nature of our experiment in various public forums, from the BBC Today programme through to international print media,” says Professor Holmes. “There were all kinds of interesting spin-offs from that, from high school students in some remote countries getting in contact with us and asking us about the experiment with a general curiosity about science, to professionals who are involved in helping people after traumatic events and are keen to consider the future implications of this kind of work for preventative services. It’s led to contacts that we wouldn’t have otherwise had with researchers from abroad.”

On Professor Holmes’s team was Ella James, a very early career researcher who was still finishing her undergraduate studies at the time that she was working on the Tetris paper.

“Surprised and thrilled” by the reaction to the open access publication of the paper, she says that it “has reinforced what I already thought about open access. Because I’m an early stage researcher I don’t have any bias or prejudice against it whereas I know that some people have. For me, the more people who can read and understand your research the better, from academics to lay people. This experience has only improved my impression of open access.”

For Professor Holmes, the open access success of the paper has prompted her to consider the responsibility that comes with publishing scientific research in an open format. “The idea of trying to write in a way that’s scientifically rigorous and yet accessible is an interesting challenge. As open access is relatively new, some of the implications are still being thought-through, such as how to report findings in such a way that they are not over-interpreted by the media. This is especially important for experiments with a clinical relevance,” she notes.

“One of the things I hadn’t expected at all was the school children who got in contact because they read about it on the internet. It made me realise that this is a way to communicate about the excitement of science more generally. I’m really passionate about thinking about how our next generation of scientists, who are perhaps teenage girls and boys at the moment, might learn about science as it evolves. Open access gives them immediate access to the story rather than finding something in their school textbooks,” says Professor Holmes.

Subject playing Tetris in lab conditions

Additional information: Media coverage resulting from PLoS ONE publications (below)

Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009). Can Playing the Computer Game ‘Tetris’ Reduce the Build-up of Flashbacks for Trauma? A Proposal from Cognitive Science. PLoS ONE, 4(1), e4153 doi:4110.1371/journal.pone.0004153
Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz. PLoS ONE, 5(11), e13706
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Radio:
1. Interview on BBC Radio 4, Fry’s English Delight. Winter special – Word Games. Aired Tuesday 28th December 2010, Aired 21:30 GMT
2. Interview on BBC Radio 4, All In The mind; 23rd November 2010: Preventing Flashbacks. Aired 21:00 GMT
3. Interview on BBC World Service, World Update, Tetris and Flashbacks. Aired 15th November 2010
4. Tetris research featured on Up All Night. UK: BBC Radio 5. Aired 1:45 GMT 15 November, 2010.
5. Interview on BBC Radio 4, The Today Programme; Thursday 25th March; Events ‘erased’ from memory, with Tom Fielden. Aired 07:47 GMT. [online] Available at http://news.bbc.co.uk/today/hi/today/newsid_8586000/8586523.stm.
6. Fielden, T. (2010) Tetris, trauma and the brain. BBC Radio 4 News Online; The Today Programme. Thursday 25 March 13:02 GMT. [online] Available at http://news.bbc.co.uk/today/hi/today/newsid_8587000/8587211.stm
7. Radio 4, Jan 24th 9am. Interview for “The Memory Experience” with Dr Mark Porter and Esther Freud.

Print/Internet/Newspapers:
8. Graham-Rowe, D., & MacKenzie, D. (2010). When it comes to traumatic flashbacks, Tetris blocks. New Scientist Online. [online] available at http://www.newscientist.com/article/dn19710-when-it-comes-to-traumatic-flashbacks-tetris-blocks.html. 22:00 GMT. 10 November 2010
9. Playing the computer game Tetris can reduce trauma flashbacks. The Daily Telegraph, p. 20. 11 November, 2010
10. Dennis Rijnvis (2010) ‘Tetris kan traumatische herinnering deels voorkomen’ 11th November. [online] Available at http://www.nu.nl/games/2376543/tetris-kan-traumatische-herinnering-deels-voorkomen.html
11. Playing Tetris can help you get over traumatic events. Metro.co.uk. [online] available at http://www.metro.co.uk/tech/846876-playing-tetris-can-help-you-get-over-trauma. 11 November, 2010
12. Klein, S. (2010). Traumatized? Playing Tetris may reduce flashbacks. CNN.com, [online] available at http://pagingdrgupta.blogs.cnn.com/2010/11/10/traumatized-playing-tetris-may-reduce-flashbacks/. 10 November
13. Song, S. (2010). Study: Playing Tetris to Prevent PTSD. Time Magazine Healthland, [online] available at http://healthland.time.com/2010/11/10/study-playing-tetris-to-prevent-ptsd-flashbacks/. 10 November
14. Heussner, K. (2010). Why does playing Tetris help reduce trauma? ABC News. com, [online] available at http://abcnews.go.com/Technology/playing-tetris-reduce-trauma-flashbacks/story?id=12099590. 10 November
15. Weir, W. (2010). Tetris Reduces PTSD; Pub Quiz Makes It Worse. LAtimes.com, [online] available at http://www.latimes.com/health/hc-weir-story-tetris-1110-20101110,0,5960212.column. 10 November, 12:00pm
16. Bates, T. (2010). Study: Playing Tetris can help reduce flashbacks. AOLnews.com, [online] available at http://www.aolnews.com/2010/11/11/study-playing-tetris-can-help-reduce-flashbacks/. 11 November, 4:48pm
17. Alderman, N. (2010). The player: Tetris may stop trauma flashbacks. [online] available at Guardian.co.uk, http://www.guardian.co.uk/technology/2010/nov/17/tetris-may-stop-trauma-flashbacks. 21.59 GMT 17 November
18. PLoS ONE Blog Pick of the Month for November 2010: Holmes, E. A., James, E. L., Killford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz. PLoS ONE. 5(11), e13706. doi:10.1371/journal.pone.0013706 was the subject of the PLoS ONE Blog Pick of the Month for November 2010 for the post “Tetris could prevent post-traumatic stress disorder flashbacks (but quiz games make them worse)” by Ed Young.
19. Daily Telegraph (2010). Tetris may help erase memories of trauma. Friday 26 March. The Daily Telegraph, p. 15.
20. New York Times Magazine: The 9th Annual Year in Ideas, 12th Dec; Thompson, C. Treating PTSD with Tetris. p 67. [view online at; http://www.nytimes.com/projects/magazine/ideas/2009/#social_science-13]
21. NHS Choices, (2009). Does Tetris beat trauma? NHS Choices: Behind the Headlines. 7th Jan.
22. BBC News (2009), Tetris helps to reduce trauma. BBC News. 7th January.
23. New Scientist (2009) Tetris to treat the terror of trauma. New Scientist, 17th Jan. 201(2691) p.12.
24. Los Angeles Times. (2009). Healy, R. Playing Tetris: Prescription for traumatic memories. 7th Jan.
25. Times Online. (2009). Young, E. & Fishburn, A. How to forget fear. London: News Intl Group. 7th Jan
26. Reuters. (2009). Tetris top for PTSD. News 24 8th Jan. 08:28 GMT.

Television:
27. University Challenge-2010/2011, Episode 13 [aired 27th September 2010; 20:00GMT. BBC2]. ‘Based on research at Oxford University, a study published in 2009 suggested that the treatment of Post Traumatic Stress Disorder might be aided by playing what computer game?’
University of the Arts London answer correctly ‘Tetris’!

Additional of interest:
http://letheinstitute.com/

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