Visuospatial imagery-competing task interventions for reducing intrusive memories following real-world trauma: a systematic review and meta-analysis

Background

Intrusive memories are a hallmark of PTSD and predict its course, making the early post-trauma period a critical window for prevention. Visuospatial imagery-competing task interventions (ICTI) - brief Tetris-like gameplay after a memory reactivation cue - are grounded in the working memory interference hypothesis and show strong laboratory effects. The only prior RCT synthesis in real-world trauma identified three eligible studies, all rated low certainty. No pre-registered review has synthesised RCT evidence for visuospatial ICTI exclusively in real-world trauma using intrusive memory frequency as the primary outcome.