创伤后应激障碍（Post-traumatic stress disorder，PTSD）因创伤事件的普遍性成为现代社会中的高发心理障碍之一，其中创伤后“闪回”作为PTSD的侵入型症状，会持续影响创后个体的心理健康。由于传统线下心理诊疗资源的可及性有限，导致PTSD个体的心理干预与康复支持的有效性是初步且局限的。电子游戏作为一种深度交互的数字化信息载体，其对促进心理健康的功能属性易被忽视。面向PTSD的数字游戏化疗法的理论研究虽然初步开始，但游戏的相关实践还较少。故本文研究目的是设计一套针对创后闪回的游戏化干预模型，并实践落地到严肃游戏《旅者》，从而有效降低PTSD“闪回”症状对个体的伤害。研究基于工作记忆理论，围绕闪回抑制问题，包含了三个子研究：研究一拆解了“眼动脱敏再加工”这一PTSD典型干预疗法的原理机制，以工作记忆理论为基础构建以视觉空间型任务为核心的游戏干预模型，并给出完整的设计流程；研究二基于游戏引擎技术、游戏美术设计、情感曲线设计等功能游戏设计框架进行游戏设计开发，并在局内通过数据埋点的方式实时捕捉个体数据，生成动态化数据图表以反馈实时干预结果；研究三提出以创伤电影范式实验为依据的随机对照测试方法，通过对游戏数据的统计分析得出合理严谨的实验结论，以验证游戏干预方案的可用性和易用性。主要研究结果为：游戏疗法的综合干预能力相较于无干预行为提升了61.75%，相较传统书面暴露疗法提升了30.48%。其中在抑制创后闪回症状方面相较书面疗法提升了56.16%，表现在闪回频率更低、创伤对自己生活影响更小等；在促进创后记忆遗忘方面相较书面疗法提升6.31%，表现在对创伤画面的记忆更模糊；在抑制创伤后画面厌恶情绪方面相较书面疗法提升了6.26%，表现在对创伤画面的抵触情绪更弱、接受度更高。本文的主要贡献为：提出“基于工作记忆理论的视觉空间型任务”的游戏化解决方案，一定程度上可缓解创后闪回症状、促进闪回的消退，并拓宽了心理干预的形式；针对于“早期预防”这一命题，重视和尊重个体的自我干预能力，充分关切被创伤性事件伤害的群体。
Post-traumatic stress disorder has become one of the prevalent psychological disorders in modern society due to the ubiquity of traumatic events. Among its symptoms, "Flashbacks" are intrusive and can continuously affect an individual‘s mental health after a traumatic event. Traditional face-to-face psychological interventions are limited in accessibility, leading to preliminary and limited effectiveness in the psychological intervention and recovery support of individuals with PTSD. Video games, as a deeply interactive digital medium, have often overlooked their potential for promoting mental health. Although there has been some initial research into digital game-based therapies for PTSD, there is still a lack of practical applications. The purpose of this study is to design a game-based intervention model for post-traumatic flashbacks and apply it to the serious game "Traveler" to effectively reduce the harm caused by PTSD flashbacks to individuals.Based on Working Memory theory and focusing on flashback inhibition, this study consists of three sub-studies: Study 1 deconstructs the mechanism of the typical PTSD intervention method "Eye Movement Desensitization and Reprocessing", constructs a game intervention model centered on visual-spatial tasks based on Working Memory theory, and provides a complete design process; Study 2 involves game design and development based on game engine technology, game art design, emotional curve design, and other serious game design frameworks, capturing individual data in real-time through data tracking within the game to generate dynamic data charts to provide real-time intervention feedback; Study 3 proposes a randomized controlled trial method based on the trauma film paradigm, drawing rigorous and reasonable experimental conclusions through statistical analysis of game data to verify the usability and ease of use of the game intervention plan.The main research results show that the comprehensive intervention ability of game therapy has increased by 61.75% compared to no intervention and by 30.48% compared to traditional written exposure therapy. Specifically, the inhibition of post-traumatic flashback symptoms improved by 56.16% compared with written therapy, which was manifested in lower flashback frequency and less impact of trauma on life. In terms of promoting post-traumatic memory forgetting, it improved by 6.31% compared with written therapy, which showed that the memory of traumatic images was more ambiguous. Compared with written therapy, the inhibition of post-traumatic image aversion was improved by 6.26%, which was manifested in weaker aversion to traumatic images and higher acceptance.The main contributions of this study are: proposing a game-based solution for "visual-spatial tasks based on Working Memory theory" that can alleviate post-traumatic flashbacks to some extent, promote flashback extinction, and expand the forms of psychological intervention; focusing on the proposition of "early prevention," valuing and respecting individual self-intervention capabilities, and paying full attention to the groups affected by traumatic events.
