Highfield Julie, Iyadurai Lalitha, Holmes Emily A
Intensive Care Society, Breams Buildings, London, UK.
P1vital Products Ltd, Wallingford, Oxfordshire, UK.
Discov Ment Health. 2025 May 27;5(1):78. doi: 10.1007/s44192-025-00205-6.
Psychological trauma for those utilising and delivering healthcare is common, and in particular the experience of repeated and unwanted intrusive memories (IM) of the trauma can occur. There are several psychological interventions that have been shown to be effective with the full syndrome of Post Traumatic Stress Disorder (PTSD), but researchers have only recently explored targeted interventions for IMs. This review provides a summary of a body of work on a behavioural technique called "Imagery Competing Task Intervention" (ICTI) for intrusive memories after trauma by Holmes and colleagues. The papers presented outline the underlying cognitive science, the historical development of the intervention, and its application to various different populations in healthcare settings including clinical tests of efficacy. Settings and populations include traumatic events experienced by emergency department patients and emergency caesarean section patients, as well as after work-related trauma experienced by intensive care staff and wider healthcare staff. Timing of ICTI intervention delivery has included the same day of trauma, within 72 h and for older memories weeks, months (or years) post-trauma. The intervention has been delivered with a guided session, which in some studies is in person and some remotely via digital health application. There is a brief overview of other related interventions. The ICTI approach shows potential scalability in trauma laden environments such as healthcare, where exposure is unlikely to be limited or managed and symptoms such as subclinical IMs are common. As such the intervention could be used in a preventing-and-treating approach and in subclinical-to-clinical samples who have IMs after exposure to psychological trauma. Future research would be needed to test ICTI as an intervention for the full syndrome of PTSD.
对于那些接受和提供医疗保健服务的人来说，心理创伤很常见，尤其是创伤的反复且不受欢迎的侵入性记忆（IM）可能会出现。有几种心理干预措施已被证明对创伤后应激障碍（PTSD）的全症状有效，但研究人员直到最近才开始探索针对侵入性记忆的针对性干预措施。本综述总结了 Holmes 及其同事关于一种名为“意象竞争任务干预”（ICTI）的行为技术用于创伤后侵入性记忆的一系列研究工作。所呈现的论文概述了其 underlying 认知科学、干预措施的历史发展，以及它在医疗保健环境中的各种不同人群中的应用，包括疗效的临床试验。环境和人群包括急诊科患者和急诊剖宫产患者经历的创伤事件，以及重症监护人员和更广泛的医护人员经历的与工作相关的创伤后情况。ICTI 干预的时机包括创伤当天、72 小时内以及针对较旧的记忆在创伤后数周、数月（或数年）。干预是通过引导课程进行的，在一些研究中是面对面进行，而在一些研究中是通过数字健康应用程序远程进行。还简要概述了其他相关干预措施。ICTI 方法在诸如医疗保健等充满创伤的环境中显示出潜在的可扩展性，在这种环境中，暴露不太可能受到限制或管理，并且亚临床 IM 等症状很常见。因此，该干预措施可用于预防和治疗方法，以及针对暴露于心理创伤后有 IM 的亚临床到临床样本。未来需要进行研究以测试 ICTI 作为 PTSD 全症状的干预措施。
