researchers have suggested that engaging in visuospatial tasks, such as the videogame tetris™, following a trauma may interfere with the development of intrusive images associated with posttraumatic stress disorder (ptsd). the present study attempted to replicate this finding using a trauma film paradigm. furthermore, we were interested in identifying if participants who played tetris would show changes in other symptoms associated with ptsd, such as enhanced startle responses. participants (n = 129) were asked to view a film with traumatic content and were then randomly assigned to play either tetris or to sit quietly for 10 min. psychological reactivity (positive affect, negative affect, and dissociation) and physiological reactivity (cardiac measure of sympathetic and parasympathetic activity, heart rate, and salivary alpha amylase) were examined as potential predictors of the frequency of intrusive images. our findings indicated that intrusive images occurred significantly less often amongst individuals assigned to the tetris game-play condition. we were able to identify that the frequency of intrusive images was modulated by patterns of sympathetic arousal, dissociation, and affective reactivity. furthermore, our results indicated that individuals who engaged in the tetris task showed a heightened startle response to aversive material. these findings are discussed in terms of their relevance to etiological models, and the prevention of ptsd.