Francine Shapiro Library ~ EMDR Bibliography

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1. McFarlane, A. (2003, October-November). CBT vs. EMDR in the treatment of PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL .

Language: English

Format: Conference

Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment outcome studies using four different treatment modalities (CBT, EMDR, psychopharmacology and Cognitive Processing) and presents data on comparative efficacy, treatment responsiveness and resistance, effects on comorbidity, quality of life, and biological changes that accompany symptom improvement.

CBT vs. EMDR in the treatment of PTSD: 114 subjects were randomized into the study, but only 45 completed up to week 10. The subjects in the study comprise 45 sufferers of Post traumatic stress disorder as defined by the Clinician Administered PTSD Scale (CAPS) (caps score > 50, and who satisfied criteria A,B,C and D for PTSD diagnosis) and the PCL-C (PCL-C>50). All subjects were victims of a traumatic experience and were recruited through newspaper or radio advertisements, referrals from private practitioners (18 subjects) or through the State Government Insurance Commission (SGIC) (27 subjects). Subjects were randomised into one of three treatments. Fourteen subjects received EMDR, 21 received CBT and 10 were control subjects. The mean age of the sample was 41.38 (SD=11.55) with the minimum age of 19 and the maximum age of 61. Sixteen of the subjects were male and 29 were female. During the treatment period 17 of the subjects were taking antidepressants and 6 were taking anxiolytics. Approximately half of the sample was married (22 subjects 48.9%), 12 had never married, 4 were separated, 1 was defacto and 6 were divorced. The mean number of treatment sessions for the entire sample was 8.53 (SD 1.65). Out of the 45 participants in the study, 26 had suffered only one single trauma in their lives, 11 had experienced several single traumas, 3 had suffered one ongoing trauma and 5 individuals had suffered at least one ongoing and one specific trauma. The following results were performed on the treatment groups (total 35 subjects), with the control group being excluded from all analyses. All subjects, were aged between 18 and 65, lived in metropolitan Adelaide and had an adequate command of English (reading and writing).All subjects gave informed consent to the study and expressed their willingness to comply with the protocol. Subjects with a history of adult seizure disorder, organic brain disease or who were assessed to be at significant suicide risk (a score of 3 or more on suicide question in HAM-D), were excluded from the study, as were subjects taking psychotropic drugs (anticonvulsive/ antipsychotic) or sedatives more than 4 times a week. All assessment and treatment sessions were conducted at the University of Adelaide Department of Psychiatry at the Queen Elizabeth Hospital. Assessment sessions were conducted by trained research assistants and all therapy sessions were conducted by a clinical psychologist, trained in both EMDR and CBT. Subjects were assessed for suitability to enter the study via an initial screening instrument (sent out to subjects in the post) and an initial screening interview. Patients were further evaluated at week 0 (baseline/immediately prior to commencement of treatment), 3, 4, 6, 8 10, 20 (10 week followup).

Keywords: CBT Cognitive Behavioral Therapy Symposium

Accuracy Verified: Yes

2. Oh, D., & Choi, J. (2004). Changes in the regional cerebral perfusion after EMDR: A SPECT study of two cases. Journal of the Korean Society of Biological Psychiatry, 11(2), 173-180.

Language: Korean

Format: Journal

Abstract:
Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR.Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99 . In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex.These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample. [Author Abstract]

Keywords: Brain Imagining Adults Females Koreans Motor Vehicle Accidents Neurophysiology Posttraumatic Stress Disorder Psychiatric Inpatients PTSD: Rape SPECT Survivors Treatment Effectiveness

Accuracy Verified: Yes

3. Williams, K. (2006, August). A comparative experimental treatment outcome study: Female survivors of sexual assault suffering from posttraumatic stress disorder, depression, and trauma-related guilt – self-report and psychophysiological measures. Trinity Western University, Langley, British Columbia, CAN.

Language: English

Format: Dissertation/Thesis

Abstract:
Diverse psychotherapeutic approaches for treating trauma-related sequelae have emerged over the last several decades in response to the widespread prevalence of sexual assault and resultant posttraumatic stress disorder among women (PTSD). In a recent formal study (Grace, 2003), a newer treatment called one eye integration (OEI) has been shown to be effective for traumatized individuals. The purpose of this study was to build upon those findings by comparing the effectiveness of two treatments for reducing PTSD symptoms with a breathing, relaxation, autogenics, imagery, and grounding (BRAIN) control condition. Twenty-seven female rape or sexual assault survivors who met the criteria for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders-Text-Revision, (DSM-IV-TR; APA, 2000) were randomly assigned to three groups: (a) a neurologically-based therapy called OEI, (b) an information processing model referred to as cognitive processing therapy-revised (CPT-R), or (c) a control condition (BRAIN), PTSD, depression, and trauma-related guilt symptoms were assessed pretreatment, posttreatment and at 3-month follow up, and qualitative electroencephalography (qEEG) brainwave patterns of two regions of the scalp (frontal and parietal) were measured pre and posttreatment. The following dependent measures were used: Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory II (BDI-II), and t he Trauma-Related Guilt Inventory (TRGI). Though there were no significant differences in PTSD symptoms between groups from pretreatment to post treatment assessments, a significant difference occurred between pretreatment and 3-month follow up, with OEI manifesting greater reductions than CPT-R or BRAIN. There were no significant differences between groups in depression, but there was a reduction in BDI-II scores over time. Reduction in guilt-related symptoms occurred on several scales and subscales for all three groups over time from pretreatment of posttreatment assessments, though not significantly by group. A significant difference was found for the Global Guilt subscale at 3-month follow up, with greater improvement for the OEI group. Preliminary results from cortical brain activity assessments indicate typical qEEG asymmetry patterns for PTSD and depression, though there were no significant group differences apart from minor post hoc analyses. Implications of these findings for clinical work and directions for future research were discussed.

Keywords: Depression Female Guilt Posttraumatic Stress Disorder PTSD Sexual Assault Survivors

Accuracy Verified: Yes

4. Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., Swanson, V., & Karatzias, A. (2002, August). A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring, versus waiting list in the treatment of post traumatic stress disorder. Journal of Clinical Psychology and Psychotherapy, 9(5), 299-318. doi:10.1002/cpp.341.

Language: English

Format: Journal

Abstract:
A total of 105 patients with PTSD were randomly allocated to eye-movement desensitization and reprocessing (EMDR) (n = 39) versus exposure plus cognitive restructuring (E + CR) (n = 37) versus waiting list (WL) (n = 29) in a primary care setting. EMDR and E + CR patients received a maximum of 10 treatment sessions over a 10-week period. All patients were assessed by blind raters prior to randomization and at end of the 10-week treatment or waiting list period. EMDR and E + CR patients were also assessed by therapists at the mid-point of the 10- week treatment period and on average at 15 months follow-up. Patients were assessed on a variety of assessor-rated and self-report measures of PTSD symptomatology including the Clinician Administered PTSD Scale (CAPS), the Impact of Events Scale (IOE) and a self-report version of the SI-PTSD Checklist. Measures of anxiety and depression included the Montgomery Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Scale (HAM-A), and the Hospital Anxiety and Depression Scale (HADS). A measure of social function, the Sheehan Disability Scale, was also used. Drop-out rates between the three groups were 12 EMDR, 16 E + CR, and 5 WL. Treatment end-point analyses were conducted on the remaining 72 patients. Repeated measures analysis of variance of treatment outcome at 10 weeks revealed significant time, interaction, and group effects for all the above measures. In general there were significant and substantial pre-post reductions for EMDR and E + CR groups but no change for the WL patients. Both treatments were effective over WL. The only indication of superiority of either active treatment, in relation to measures of clinically significant change, was a greater reduction in patient self-reported depression ratings and improved social functioning for EMDR in comparison to E + CR at the end of the treatment period and for fewer number of treatment sessions for EMDR (mean 4.2) than E + CR (mean 6.4) patients. At 15 months follow-up treatment gains were generally well-maintained with the only difference, in favour of EMDR over E + CR, occurring in relation to assessor-rated levels of clinically significant change in depression. However, exclusion of patients who had subsequent treatment during the follow-up period diminished the proportion of patients achieving long-term clinically significant change. In summary, at end of treatment and at follow-up, both EMDR and E + CR are effective in the treatment of PTSD with only a slight advantage in favour of EMDR. [Author Abstract]

Keywords: Adults Brief Psychotherapy British Cognitive Therapy Exposure Therapy Females Males Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Stressors Survivors Treatment Effectiveness

Accuracy Verified: Yes

5. Zhang, J. (2010, July). The effect of EMDR for children with PTSD/PTSS after the Sichaun earthquake. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
A devastating earthquake suddenly struck over Sichuan Province of China at May 12, 2008. Two weeks after the quake, over five hundreds children who lost either parents or one parent were moved to RiZhao, ShanDong province. After a through screening with MiNi, Kiddie-Sads and the diagnosed assessment with Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA), about 8 percent was diagnosed with PTSD or PTSS. 511 children were selected. The final diagnosis was made with DSM-IV. We treated these PTSD/PTSS children with Eye Movement Desensitization and Reprocessing (EMDR), which is taken as one of the most effective treatments for PTSD. 26 children with PTSD consented to receive EMDR treatment and 26 completed the treatment. They were randomized into pretreatment group and waiting group. Children enrolled in treatment completed a number of self-report measures and CAPS-CA; pre-, mid- and post-treatment and at follow-up. All children received three 45-90minute sessions of EMDR, one session a week. The total score, subscale scores and ration of decreased score were calculated for CAPS-CA. Comparing the ratio of decreased score, the rations after the three sessions’ treatment were significantly higher than that of waiting group and naturally decreased with time. The results indicate that some children with PTSD after the SiChuan earthquake were getting well after short term EMDR.

Keywords: Children Earthquake Posttraumatic Stress Disorder PTSD: PTSS Sichaun

Accuracy Verified: Yes

6. Capezzani, L. (2012, June). EMDR and cancer patients: Effetcts on PTSD and their illness coping strategies [EMDR y pacientes con cáncer: Efectos sobre el TEPT y sus estrategias de afrontamiento de la enfermedad]. Presentation at the Annual Meeting of the EMDR Europe Association, Madrid Spain.

Language: English

Format: Conference

Abstract:
The nature of this study is both observational and clinical. On the one hand it’s aimed to see how the criteria of PTSD (DSM-‐IV, 2000) are represented in traumatized cancer patients in between two different illness stages -‐ medical treatments and medical follow-‐up stages, -‐ and to see witch coping strategies are used by these patients with PTSD in each stage. On the other hand it’s aimed to know: a) whether CBT integrated with EMDR produces different effects on PTSD in between the two illness stages and their specific coping strategies; b) whether CBT with EMDR and CBT without EMDR produce different effects on PTSD and on the coping strategies within the only medical follow-‐up stage. All 31 subjects were recruited randomly, 10 for treatment stage, 11 for follow-‐up stage, both receiving CBT and EMDR, and 10 for a follow-‐up stage treaty with CBT and no EMDR. CAPS and COPE were used to assess PTSD and coping strategies respectively. Results show similar changes in between the two illness stages after CBT with EMDR, and different ones within the follow-‐up stage depending on whether CBT with EMDR or without EMDR was used. This may suggest considering PTSD such a disorder that removes specific stage demands/threats of cancer illness, just described in literature, as well as the more functional coping for each of them. You may instead claim that only CBT with EMDR allows cancer patients to overcome the PTSD and consequently retrieve selective specificity in coping strategies for each stage.

La naturaleza de este estudio es tanto observacional como clínica. Por un lado, pretende ver como se representan los criterios del TEPT (DSM-‐IV, 2000) en pacientes con cáncer traumatizados entre dos fases diferentes de la enfermedad – fases de tratamientos médicos y seguimientos médicos -‐ , y ver qué estrategias de afrontamiento son usadas por estos pacientes con TEPT en cada una de estas fases. Por otro lado, pretende saber: a) si la TCC integrada con EMDR produce efectos diferentes sobre el TEPT entre las dos fases de la enfermedad y sus estrategias de afrontamiento específicas; b) si la TCC con EMDR y la TCC sin EMDR producen efectos diferentes sobre el TEPT y sobre las estrategias de afrontamiento tan sólo dentro de la fase de seguimiento. Cada uno de los 31 sujetos fueron seleccionados aleatoriamente, 10 para la fase de tratamiento, 11 para la fase de seguimiento, ambos grupos recibiendo TCC y EMDR, y 10 para la fase de seguimiento con TCC y sin EMDR. Se utilizaron CAPS y COPE para evaluar el TEPT y las estrategias de afrontamiento respectivamente. Los resultados muestran cambios similares entre las dos fases de la enfermedad después de la TCC con EMDR, y cambios diferentes en la fase de seguimiento en función de si se utilizaba la TCC con o sin EMDR. Esto puede sugerir que se ha de considerar al TEPT como un trastorno que quita específicas demandas/amenazas de cada una de las fases de la enfermedad del cáncer, tal y como se describe en la literatura, así como el afrontamiento más funcional para cada una de ellas. En vez de eso, se puede afirmar que tan sólo la TCC con EMDR permite a los clientes superar el TEPT y consecuentemente recuperar especificidad selectiva en estrategias de afrontamiento para cada fase.

Keywords: Cancer Coping Strategies Illness

Accuracy Verified: Yes

7. van Nijnatten, A. (2012). EMDR bij getraumatiseerde asielzoekers en vluchtelingen: Verschil in effectiviteit tussen visuele en auditieve stimulatie [EMDR with traumatized asylum seekers and refugees: difference in effectiveness between visual and auditory stimulation]. Utrecht, Nederlands: Universiteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
Objective: Recent studies suggest that eye movements are the most effective form of stimulation in EMDR, but this assertion is based primarily on studies using the general population. This study evaluated whether tones and eye movements in EMDR are equally effective in reducing symptoms of trauma, anxiety and depression among asylum seekers and refugees, who are diagnosed with PTSD. As a control the entire EMDR condition was compared with a waiting list condition, who received no treatment. Method: In the present study 43 asylum seekers and refugees in the age of 20 to 73 years, who were indicated for treatment at Stichting Centrum ’45, participated. They were assigned to three different conditions: EMDR with eye movements, EMDR with tones or no treatment. The patients were not randomly assigned to the three conditions. Trauma symptoms were measured with the CAPS and HTQ and anxiety and depression symptoms with the HSCL-25. Results: Both tones and eye movements in EMDR lead to a reduction in symptoms of trauma, according to the HTQ. When trauma symptoms are reported according to the CAPS both conditions do not lead to a significant reduction in complaints. Concerning symptoms of anxiety and depression both conditions lead to a reduction in symptoms. Again there is no difference between tones and eye movements. It appears that EMDR is not significantly better in reducing symptoms of trauma, compared to the waiting list condition. Both EMDR and no treatment do not lead to a significant reduction in symptoms of anxiety and depression and there is no distinction between the conditions. Conclusion: Eye movements and tones lead to a significant reduction in symptoms of trauma, anxiety and depression, but this reduction is insufficient compared to the control condition. This is probably due to the small sample size of the present study. The present study implies that the theory that eye movements are more effective than tones in EMDR may not be generalizable to a complex group of patients, namely asylum seekers and refugees diagnosed with PTSD.

Keywords: Asylum Seekers Auditory Stimulation Refugees Visual Stimulation

Accuracy Verified: Yes

8. Arnone, R., Orrico, A., D'Aquino, G., & Di Munzio, W. (2012, March-April). EMDR e terapia psicofarmacologica nel trattamento del disturbo da stress post-traumatico [EMDR and psychopharmacological therapy in the treatment of the post-traumatic stress disorder]. Rivista di Psichiatria, 47(2), 8-11. doi:10.1708/1071.11732 .

Language: Italian

Format: Journal

Abstract:
Questo studio si propone di valutare l’efficacia di due diversi trattamenti nella cura del disturbo da stress post-traumatico (PTSD): la terapia psicofarmacologica, attraverso l’utilizzo di serotoninergici, e l’EMDR. Metodo. Sono stati utilizzati due gruppi indipendenti ai quali venivano somministrati due trattamenti differenti: il trattamento con sertralina per il gruppo assegnato alla terapia psicofarmacologica; il trattamento con sedute monosettimanali di EMDR per l’altro gruppo. Per la valutazione dei sintomi del PTSD è stata utilizzata la Clinician-Administered PTSD Scale (CAPS). L’assegnazione dei soggetti ai due gruppi è stata randomizzata. Risultati. I risultati confermano precedenti studi riportati in letteratura, evidenziando l’efficacia sia dell’EMDR sia della sertralina nel migliorare la sintomatologia post-traumatica e i livelli di sofferenza soggettiva. Tuttavia il numero di soggetti che al termine della condizione sperimentale non rientrava più nei criteri diagnostici del PTSD è risultato nettamente superiore nel gruppo trattato con EMDR. Conclusioni. Data la differenza nei due gruppi, a favore di quello trattato con EMDR, del numero di soggetti che possono essere considerati responder e che, come tali, non soddisfano più i criteri del PTSD al termine della condizione sperimentale, possiamo affermare che l’ipotesi per cui l’EMDR è un trattamento più efficace rispetto al trattamento psicofarmacologico è stata confermata. Questo dato potrebbe stimolare ricerche future con campioni più numerosi che indaghino anche l’efficacia a lungo termine.

This study evaluates the efficacy of two different treatment for post-traumatic stress disorder (PTSD): the psychopharmacological therapy, with a SSRI drug, and EMDR. Method. Two indipendent groups have been administered two different treatments: the treatment with sertraline to the group for psychopharmacological therapy; the treatment with one-week sessions of EMDR to the other group. For the evaluation of the symptoms of PTSD has been used the Clinician-Administered PTSD Scale (CAPS). The inclusion of the subjects in the two groups has been absolutely random. Results. The results confirm previous studies available in literature, pointing out the efficacy of EMDR and of sertraline in improving the post-traumatic symptomatology and the levels of subjective sufference. But the number of subjects which at the end of the study didn't satisfy any more the criteria for PTSD has been absolutely greater in the group treated with EMDR. Conclusions. The study confirms the hypothesis of EMDR as a more efficacious treatment for PTSD compared to psychopharmacological therapy. This result could be a stimolous for further research with greater groups to investigate also the long term efficacy.

Keywords: CAPS Clinician-Administered PTSD Scale Efficiacy PTSD, Sertraline

Accuracy Verified: Yes

9. Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N. L., & Muroaka, M. Y. (1995, June). EMDR in combat-related PTSD: A controlled study. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
In view of potential, but largely undocumented benefits of eye movement desensitization and reprocessing (EMDR) as an intervention for PTSD in combat veterans, in our laboratory a study of EMDR treatment included (1) randomized patient assignment, (2) clinically appropriate comparison (treatment and control) groups, (3) a 12-session EMDR protocol administered by experienced, EMDR trained clinicians, and (4) extensive clinical assessment, including physiological evaluation at pre-treatment, post-treatment, and 3-month follow-up. Thirty-five veterans who met DSM-IV criteria for PTSD completed an extensive multimodal assessment protocol. Assessment instruments included: The Mississippi Scale for Combat-Related PTSD, the Impact of Events Scale (IES), the Clinician Administered PTSD Scale (CAPS), a self-rating of overall severity of "PTSD symptoms," the Beck Depression Inventory, and the Spielberger State and Trait Anxiety Inventories (STAI). In addition, each subject completed a Stressful Scene Construction Questionnaire (SSCQ) in which scripts of specific traumatic combat incidents were prepared for presentation during psychophysiological assessment. Following pre-assessment, a subset of the subjects constituted a waiting list control (CON, N = 12). Routine clinical care for these subjects was available at the VA Medical Center. Seven of these subjects also participated in group sessions for discussion of PTSD designed as an attentional control. There were no differences between the two control subgroups and their data was combined for all subsequent analyses. For the treatment groups, subjects assigned to the EMDR (EMD, N = 10) and relaxation (RXT, N = 13) groups were seated in a semi-reclined chair and continuous measures were taken of muscle tension levels (four sites), hand temperature, skin conductance levels, heart rate, and blood pressure. For all subjects, there were 20 minutes in each of the baseline sessions with no additional stimuli presented. At the end of session 2 of baseline, the patients remained in the experimental room and were assessed for an additional 20 minutes (pre-treatment) during which the SSCQ scripts also were presented. There were two sessions per week with a minimum of one day between sessions. Each subsequent treatment session for the EMD and RXT subjects was approximately 60 minutes in duration, allowing for set-up time and briefing. In the EMD group, a standard protocol for the EMDR interventions was administered, including periodic SUDS ratings and VoC scaling of combat and related images and cognitions (cf Shapiro, 1995). In the RXT group, home relaxation tapes and biofeedback on four sites (face, neck, arm, and back) to assist lowered muscle tension were provided. Following 12 treatment sessions (post-treatment), and again after three months (follow-up) the psychometric instruments and psychophysiological assessment were readministered using the format outlined above. Relative to the other conditions, the EMDR treatment produced substantially more positive clinical effects at post-treatment and follow-up. Comparing the EMD group to the CON group, significant effects (p<.05 or better) were obtained on measures of PTSD including the Mississippi and PTSD symptoms self-rating, and on the Beck and STAI-Trait. Comparing the EMD group to the RXT subjects, significant differences were found on the Mississippi, the IES-Intrusion scale, the CAPS, PTSD symptoms ratings, and the STAI-Trait scale. No differences were obtained on any of the physiological measures. Therefore, the present results support the effectiveness of EMDR with combat veterans with chronic PTSD. The data strongly suggest that some previous negative results obtained when EMDR was applied to chronic and severe combat PTSD may have resulted from methodological artifacts, such as inadequate amount of treatment and therapist inexperience. While the failure to find physiological effects is consistent with results of other controlled treatment exposure trials in PTSD, this finding raises clinical and conceptual questions with respect to the arousal component of the disorder.

Keywords: Combat Controlled Study

Accuracy Verified: Yes

10. van den Berg, D. P. G. (2011, August-September). EMDR in patients with psychotic disorders and PTSD: A pilot study. In PTSD in patients with psychotic disorders. Symposium conducted at the 41st EABCT Annual Congress, Reykjavík, Iceland.

Language: English

Format: Conference

Abstract:
Introduction: Mueser at al. (2008) showed that a treatment program that was predominantly based on cognitive restructuring was effective and safe in treating PTSD in patients with Serious Mental Illness. However, only 15.7% of the participants in this study had a psychotic disorder. Frueh et al. (2009) conducted a pilot study into PTSD treatment in patients with schizophrenia and schizoaffective disorders (n=20). At three month follow-up twelve out of thirteen completers no longer met criteria for PTSD. Treatment caused no adverse events. Unfortunately psychosis measures were not included in this study. A third therapy with strong empirical support for its efficacy in treating PTSD is Eye Movement Desensitization and Reprocessing (EMDR, Bisson et al., 2007; Bradley, Greene, Russ, Dutra, & Westen, 2005; Seidler & Wagner, 2006). In this presentation the results of a feasibility trial (n=27) of EMDR in patients with psychosis and comorbid PTSD will be presented. Method: An open pilot trial of EMDR in treating PTSD symptoms in participants with a diagnosis of schizophrenia or an other psychotic disorder. Participants were all outpatients from community mental health centres in the Netherlands. After referral to the study patients were screened for PTSD with the Clinician Administered PTSD Scale (CAPS, Blake et al., 1990). If PTSD was diagnosed baseline measurements were performed after which an informed consent was obtained. Treatment consisted of a maximum of six weekly EMDR sessions, after which post measurements were taken. Results: EMDR was effective in alleviating PTSD symptoms. Out of the 25 completers, only 7 still met criteria for PTSD at post measurement. Treatment did not result in adverse events. In fact, other symptoms, such as delusions, auditory verbal hallucinations, anxiety and depression decreased significantly, e.g. only four out of the nine participants that reported voices at baseline still reported voices at end of treatment. Conclusions: The preliminary conclusion is that treating PTSD in patients suffering from psychosis with EMDR is feasible, is safe and has a positive influence on other symptoms.

Keywords: Pilot Study Postraumatic Stress Disorder PTSD Psychotic Disorders Symposium

Accuracy Verified: Yes

11. Bossini, L., Tavanti, M., & Costrogiovanni, P. (2008, June). EMDR treatment for PTSD: Effect on hippocampal volume. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
Animal and human subjects studies have shown that psychotropic drugs promote hippocampus neurogenesis and block or modulate the effects of stress on the hippocampus. However, the only study that has investigated the effects of psychotherapy on hippocampus volume failed to show any volumetric increase (1). Purpose of the Study: Aim of the study is to assess the effects of Eye Movement Desensitization and Reprocessing (EMDR) treatment on hippocampal volume and on PTSD symptoms in ten drug-free patients with Post Traumatic Stress Disorder (PTSD). Methods Used: First, we have compared hippocampal volumes of 10 drug-free patients with chronic PTSD to 10 case-matched non-PTSD comparison subjects. PTSD diagnosis and severity were established by the administration the Clinician Administered Posttraumatic Stress Disorder Scale (CAPS) (Phase 1). Second, we have assessed the effect of three months of EMDR treatment on hippocampal volumes and on PTSD symptoms of 10 outpatients with PTSD (Phase 2). Results: Phase 1 -A p less than .05 was chosen to indicate statistical significance. The results showed that patients had significantly smaller hippocampal volumes at baseline compared to the control subjects. Phase 2 - EMDR treatment resulted in a significant increase of right and left hippocampal volumes and in a significantly decrease of CAPS total score. Conclusions: The first part of this study confirmed that PTSD patients have smaller hippocampal volumes if compared to comparison subjects. The second part suggests that EMDR treatment is associated with a significant improvement of PTSD symptoms and an increase in hippocampal volumes.

Keywords: Hippocampal Volume Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

12. Cerone, M. R. (2000). Eye movement desensitization and reprocessing in the psychological treatment of combat-related guilt: A study of the effects of eye movements. Temple University, Philadelphia, PA. AAT 9990301.

Language: English

Format: Dissertation/Thesis

Abstract:
The purpose of this study was to investigate the role of eye movements in eye movement desensitization and reprocessing (EMDR), and to test the efficacy of EMDR in the treatment of guilt associated with combat trauma. EMDR was compared to a non-eye movement (NEM) analog, which entailed the full EMDR procedure minus the eye movements. A single-case multiple component cross-over design across 7 participants was utilized.Participants were combat veterans who were receiving inpatient treatment for PTSD at the Coatesville Veterans Administration Medical Center. 4 participants were introduced first to the EMDR condition and 3 participants were introduced first to the NEM analog condition. Each participant was exposed to both conditions. Dependent measures included: (1) pre- and post-treatment scores on the Clinician Administered PTSD Scale for DSM-IV - One Week Symptom Status Version (CAPS-SX), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and Trauma Related Guilt Inventory (TRGI), (2) self-monitoring data on the frequency and intensity of intrusive thoughts, disturbing dreams, and guilt, and (3) measures of participants' subjective level of distress within sessions and pre- and post-treatment using the Subjective Units of Distress Scale (SUDS). As measured by SUDS ratings, EMDR resulted in a greater decrease in dyphoric affect within-session than the NEM analog. EMDR also resulted in a significant decrease in mean SUDS ratings from pre- to post-treatment. EMDR resulted in significant decreases in combat-related PTSD symptomatology, as measured by pre- and post-treatment scores on the CAPS-SX, BDI, and IES. EMDR also resulted in significant decreases in mean pre- and post-treatment frequency of self-reported intrusive thoughts and mean pre- and post-treatment intensity of intrusive thoughts, disturbing dreams, and guilt. Additionally, EMDR resulted in a significant decrease in pre- and post-treatment scores on one scale and two subscales of the TRGI. No differences in the mean frequency and intensity of self- reported intrusive thoughts, disturbing dreams, and guilt were detected between EMDR and the NEM analog. Results of the present study support the role of eye movements in attaining treatment gains with EMDR. Additionally, this study supports the efficacy of EMDR in the treatment of combat-related guilt. [Author Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. 61(10-B), Apr 2001, pp. 5555.

Keywords: Adults Americans Empirical Study Guilt Posttraumatic Stress Disorder PTSD Treatment Effectiveness War Veterans

Accuracy Verified: Yes

13. Bossini, L., Tavanti, M., Calossi, S., Marino, G., Pieraccini, F., Vatti, G., & Castrogiovanni, P. (2008, Novembre). Le modificazioni del volume hippocampale dopo una terapia con EMDR nel PTSD [EMDR treatment for PTSD: effect on hippocampal volume]. Plenaria presentato le applicazioni cliniche di EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Molti studi di Risonanza Magnetica (RM) hanno mostrato che in pazienti con Disturbo Post-Traumatico da Stress (DPTS) è presente un volume ippocampale più piccolo se confrontato con i controlli sani. Allo stesso tempo altre indagini hanno mostrato che i farmaci psichiatrici bloccano gli effetti dello stress nell’ippocampo e promuovano la neurogenesi a livello ippocampale. Comunque il solo studio che ha investigato gli effetti di un tipo di psicoterapia non ha evidenziato modificazioni volumetriche significative (1). Scopo dello Studio: Scopo dello studio è indagare gli effetti del trattamento con EMDR (Eye Movement Desensitization and Reprocessing) sul volume ippocampale e sui sintomi clinici di un gruppo di pazienti con DPTS. Metodologia: Abbiamo paragonato gli ippocampi di 9 pazienti con DPTS cronico e mai sottoposti ad alcun tipo di terapia (farmacologica e/o psicoterapica) a 9 soggetti sani accoppiati per sesso, età e scolarità. La diagnosi e la severità del DPTS è stata misurata tramite la Clinician-Administered PTSD Scale (CAPS) (Fase 1). Successivamente tutti i soggetti con DPTS sono stati sottoposti a 12 sedute settimanali di EMDR della durata di 90 minuti ciascuna e nuovamente sottoposti a valutazione clinica e RM (Fase 2). Risultati: Fase 1 - E’ stata scelta una p inferiore di .05 per indicare la significatività statistica. L’analisi della covarianza (ANCOVA) con l’emisfero (ippocampo sinistro vs. ippocampo destro) come fattore ripetuto, il volume totale cerebrale come covariata ha mostrato che i soggetti con DPTS hanno il volume ippocampale più piccolo rispetto ai controlli (F=12.53, d.f=1,15, p=.003). La media del punteggio della CAPS nei soggetti con DPTS era 55.78 ± 21.74. Fase 2 - Il trattamento con EMDR è associate ad un incremento del volume ippocampale sia a destra (5.9 %) (t=-3.34, df=8, p=.010) sia a sinistra (6.1 %) (t=-3.27, df=8, p=.011). I risultati indicano anche che il trattamento con EMDR produce un significativo decremento del punteggio totale della CAPS (da 55.78±21.74 a 19.33±15.49; t=4.78, df=8, p=.001 Conclusioni: La prima parte dello studio conferma i dati che mostrano che i soggetti con DPTS hanno un ippocampo più piccolo dei controlli sani La seconda parte suggerisce che il trattamento con EMDR può essere associato ad un miglioramento sintomatologico e ad un incremento del volume degli ippocampi. Questi risultati suggeriscono l’opportunità di continuare ad indagare gli effetti biologici delle psicoterapie.

Many studies of Magnetic Resonance Imaging (MRI) showed that in patients with Post-Traumatic Stress Disorder (PTSD) is a smaller hippocampal volume compared with healthy controls. At the same time other studies have shown that psychiatric drugs block the effects of stress and promote hippocampus neurogenesis in the hippocampus. However, the only study that investigated the effects of a type of psychotherapy showed no significant volume changes (1). Objective: The purpose of this study is to investigate the effects of treatment with EMDR (eye movement desensitization and reprocessing) on hippocampal volume and clinical symptoms of a group of patients with PTSD. Methods: We compared the hippocampi of nine patients with chronic PTSD and never subjected to any kind of treatment (pharmacological and / or psychotherapy) in 9 healthy subjects matched for sex, age and education. The diagnosis and severity of PTSD was measured by the Clinician-Administered PTSD Scale (CAPS) (Phase 1). Then all subjects with PTSD were subjected to 12 weekly sessions of EMDR lasting 90 minutes each and again subjected to clinical evaluation and MRI (Phase 2). Results: Step 1 - E 'was chosen p less than .05 to indicate statistical significance. The analysis of covariance (ANCOVA) with hemisphere (left vs. hippocampus. Right hippocampus) as repeated factor, the total brain volume as covariate showed that individuals with PTSD have smaller hippocampal volume than controls (F = 12:53 , df = 1.15, p =. 003). The average score of the CAPS in subjects with PTSD was 55.78 ± 21.74. Step 2 - Treatment with EMDR is associated with an increase in both right hippocampal volume (5.9%) (t =- 3:34, df = 8, p =. 010) and left (6.1%) (t =- 3.27, df = 8, p =. 011). The results also indicate that treatment with EMDR produces a significant decrease in the CAPS total score (from 21.74 to 55.78 ± 19:33 15:49 ± t = 4.78, df = 8, p =. 001 Conclusion: The first part of the study confirms the data showing that individuals with PTSD have a smaller hippocampus of healthy controls The second part suggests that treatment with EMDR may be associated with symptomatic improvement and an increase in the volume of the hippocampus. These results suggest the desirability of continuing to investigate the biological effects of psychotherapy.

Keywords: Hippocampal Volume Plenary Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

14. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano come lo stress causi atrofia ippocampale e inibizione della neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di atrofia ippocampale è dovuto ad un’alterazione dell’asse Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa increzione di glucocorticoidi che determina un aumento del feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale. Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale indotta dallo stress nell’animale 5 e nell’uomo sono in grado di ridurre i sintomi del PTSD, incrementare le dimensioni dell’ippocampo e ridurre i deficit mnesici tipici della patologia 6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono: – valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free); – valutare l’effetto della terapia: farmacologica con SSRI e psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico, che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di Siena affetti da PTSD e un gruppo di controllo di soggetti sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi i gruppi sono stati sottoposti ad uno studio morfovolumetrico computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici e scale psicometriche per approfondire il quadro psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di terapia psicofarmacologica sono stati ripetuti i test neuropsicologici, le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM. Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati dopo 8 sedute (due mesi). Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento medio dei volumi ippocampali pari a 338,25 mm3 per l’ippocampo DX e 357,93 mm3 per l’ippocampo SN. Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%). L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi; è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR. Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia diretta alla struttura cerebrale.

Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.

Keywords: Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

15. Karatzias, A., Power, K., McGoldrick, T., Brown, K., Buchanan, R., Sharp, D., & Swanson, V. (2007, February). Predicting treatment outcome on three measures for post-traumatic stress disorder. European Archives of Psychiatry and Clinical Neuroscience, 257(1), 40-46. doi:10.1007/s00406-006-0682-2.

Language: English

Format: Journal

Abstract:
The aim of the present study was to investigate predictors of treatment outcome for Posttraumatic Stress Disorder (PTSD) after treatment completion and at 15-months follow-up (n = 48), in a trial of Eye Movement Desensitisation and Reprocessing (EMDR) versus Imaginal Exposure and Cognitive Restructuring (E+CR). Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three assessor and self-rated PTSD symptomatology measures, including the Clinician-Administered PTSD Scale (CAPS), the Impact of Events Scale (IES) and the PTSD Symptom Checklist (PCL) from pre- to post-treatment and pre-treatment to follow-up as the dependent variables and demographics, trauma, clinical and personality measures as independent variables. Irrespective to outcome measures and assessment points it was found that four variables were able to predict significantly treatment outcome. These included baseline PTSD symptomatology, number of sessions, gender and therapy type. Overall, our results showed that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome, as significant predictors were found to be sample-specific and outcome measure-specific. Clinical relevance of the present results and directions for future research are discussed.

Keywords: Empirical Study Postraumatic Stress Disorder Predictors PTSD Quantitative Study Treatment Outcome

Accuracy Verified: Yes

16. Obenchain, J., Rogers, S., Silver, S., & Goss, J. (1999, November). Preliminary results of data comparing EMDR to flooding. Poster presented at the annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.

Language: English

Format: Conference

Abstract:
Preliminary Data was collected on a group of Vietnam veterans from10/20/97 to 9/1/98. All Subjects met criteria for PTSD according to DSM IV utilizing the CAPS scale. Patients were then randonly assigned to either the EMDR group or the Flooding group. One therapist completed one EMDR session on the patient’s Primary Combat Image; another therapist completed one session on the PCI using Flooding technique. The head nurse, blind to the treatment provided, met with each subject prior to group assignment and measured their Blood pressure and pulse using DINAMAP Blood Pressure Monitor. He then asked the subjects to keep a SUDS Scale on their PCI noting frequency and intensity for the next week. He also asked them to complete an Impact of Event Scale on their PCI. Subjects then received one session of EMDR or Flooding and were asked to keep a SUDS Scale on their PCI for another week. Subjects then returned to the head nurse, were asked to recall their PCI and blood pressure, pulse and SUDS and IES were again measured. Because of small cell sizes (EMDR =8, Flooding =10) treatment effects did not always reach Statistical significance. Nonetheless several differences were found between the two groups. ANOVA’s were performed using the changes in blood pressure and heart rate measured at a final assessment period during a baseline period and while recalling their PCI. For systolic blood pressure the EMDR group showed no change while the Flooding group increased by 9.2. For diastolic blood pressure the EMDR group declined an average of 3.3 while the Flooding group increased by 7.6. For heart rate, the EMDR group remained essentially unchanged while the Flooding group increased an average of 6.6. This difference was significant at the (p<.05). The EMDR group reported their PCI memories were less severe during the week following treatment while the Flooding group showed little change. ANOVA analysis found these differences to tend toward statistical significance (p=.10). The EMDR group showed improvement on the SUDS scale amd some subscales of the IES.With prelimiary data suggesting that EMDR is more effective than flooding,further research needs to be pursued.

Keywords: Flooding Poster

Accuracy Verified: Yes

17. Zandvoort, J. (2013, April). Traumagerichte psychotherapie bij kinderen en jongeren: een gerandomiseerde vergelijking (RCT) tussen EMDR en Trauma-focused Cognitive Behavioural Therapy bij kinderen en jongeren met posttraumatische stress klachten [Trauma-focused psychotherapy for children and adolescents: a randomized comparison (RCT) between EMDR and Trauma-focused cognitive behavioural therapy for children and adolescents with post-traumatic stress symptoms]. In Onderzoek track 1 and 2. Presentatie op Het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.

Language: Dutch

Format: Conference

Abstract:
Trauma en posttraumatische stress klachten komen ook bij kinderen en jongeren (hierna kinderen) frequent voor. Trauma gerelateerde symptomen bij deze leeftijdsgroepen kunnen leiden tot verminderde schoolprestaties, problemen in het sociale functioneren en een verstoring van (hersen) ontwikkeling. In de afgelopen decennia zijn er talloze onderzoeken uitgevoerd naar de behandeling van trauma klachten bij kinderen. Trauma gerichte cognitieve gedragstherapie (TF-CBT) en EMDR zijn het meest onderzocht. In het merendeel van de kinderen dat wordt behandeld met één van de therapieën verminderen de traumaklachten aanzienlijk of verdwijnen de klachten in het geheel, echter bij een deel van de kinderen persisteren klachten ook na behandeling. Studies waarin TF-CBT en EMDR direct met elkaar worden vergeleken zijn zeer schaars. Dit terwijl de resultaten van dergelijke vergelijkende studies op de lange termijn een belangrijke bijdrage kunnen leveren aan het vooraf bepalen welke behandeling bij welk kind de meeste kans van slagen heeft. In de afgelopen twee jaar zijn kinderen tussen de 8 en 18 jaar, die met een (partiële) posttraumatische stressstoornis werden gediagnosticeerd bij het trauma centrum van de Bascule, gevraagd om deel te nemen aan een vergelijkende behandelstudie (INTACT studie). Onderzoeksdeelnemers werden at random toegewezen aan ofwel 8 geprotocolleerde TF-CBT sessies ofwel 8 geprotocolleerde EMDR sessies. In totaal werden 48 kinderen gerandomiseerd. Uitgebreide traumadiagnostiek vond plaats voor behandeling, 1 week na behandeling, 6 maanden na behandeling en 1 jaar na behandeling. In de huidige voordracht zullen de behandelresultaten worden gepresenteerd. De presentatie zal zich toespitsen op behandeleffecten op postraumatische stress symptomen gemeten door middel van de CAPS-CA. Er zal verder worden stilgestaan bij het potentiële belang van de onderzoeksresultaten voor de klinische praktijk en vooruitgekeken worden op toekomstig (neurobiologisch) vervolgonderzoek.

Trauma and posttraumatic stress symptoms also occur in children and adolescents (hereafter children) frequently. Trauma-related symptoms in these populations may lead to decreased school performance, problems in social functioning and disruption (brain) development. In recent decades there have been numerous studies on the treatment of trauma symptoms in children. Trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR are the most studied. In the majority of children being treated with any of the therapies significantly reduce trauma symptoms or the symptoms disappear altogether, however, some of the children symptoms persist even after treatment. Studies in which TF-CBT and EMDR directly be compared are very scarce. This while the results of such comparative studies on the long term a significant contribution to the pre-treatment to determine which child the best chance of success. During the past two years, children between 8 and 18 years, with a (partial) post-traumatic stress disorder were diagnosed in the trauma center of the Bascule, asked to participate in a comparative treatment study (INTACT study). Research participants were randomly assigned to either 8 protocolled TF-CBT sessions or 8 protocolled EMDR sessions. A total of 48 children were randomized. Extensive trauma diagnosis occurred before treatment, 1 week after treatment, 6 months after treatment and 1 year after treatment. In the current proposal, the treatment results are presented. The presentation will focus on treatment effects on post-traumatic stress symptoms measured by the CAPS-CA. There will also be given to the potential importance of the findings for clinical practice and are looking ahead to future (neurobiological) follow-up study.

Keywords: Adolescents Chidren Posttraumatic Stress Disoreder PTSD Trauma-Focused Cognitive Behavioural Therapy

Accuracy Verified: Yes

18. Honda, M. (2005, February). Treatment of a PTSD victim of attempted murder-robbery by eye movement desensitization and reprocessing (EMDR): A case report. Japanese Journal of Traumatic Stress, 3(1), 91-106.

Language: English

Format: Journal

Abstract:
Reports both in Japan and in the U.S. indicate that Eye Movement Desensitization and Reprocessing (EMDR) can be effective for the treatment of PTSD and traumatic memory. This report summarizes the treatment of an attempted murder-robbery victim using EMDR. Although she responded rather poorly to the medications, the patient showed a rapid improvement with the introduction of six 90-minute EMDR sessions, as measured by the Impact of Event Scale - Revised (IES-R) and Clinician Administered PTSD Scale (CAPS). Of particular interest was that the intrusion and hyperarousal symptoms disappeared in the early stage of the treatment; in contrast, the avoidance symptoms needed several sessions for management. Given the current controversies surrounding EMDR for the treatment for PTSD, more empirical evidence is needed to establish its efficacy. [Author Abstract]

Keywords: Case Report Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Robbery Survivors

Accuracy Verified: Yes

19. Tarrier, N., & Sommerfield, C. (2004, Spring). Treatment of chronic PTSD by cognitive therapy and exposure: 5-year follow-up. Behavior Therapy, 35(2), 231-246. doi:10.1016/S0005-7894(04)80037-6.

Language: English

Format: Journal

Abstract:
Patients who had taken part in a randomized clinical trial of the treatment of chronic PTSD by either cognitive therapy or imaginal exposure were reassessed after 5 years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure emerged, although there had been no difference between the two treatment groups up to 12 months posttreatment. The cognitive therapy group showed significant differences on the primary outcome measures: total PTSD symptoms on the CAPS and percentage of PTSD cases. At 5 years no patients who received cognitive therapy were diagnosed with full PTSD compared to 29% of those who received imaginal exposure. All secondary outcomes showed lower scores for cognitive therapy, of which 3 were significant. Those who were not assessed at 5 years scored significantly higher on assessment measures, especially avoidance, at posttreatment.

Keywords: Cognitive Therapy Exposure Therapy, Posttraumatic Stress Disder PTSD

Accuracy Verified: Yes

20. van der Kolk, B. A., Hopper, J., Spinazzola, J., Blaustein, M., Hopper, E., & Simpson, W. (2003, October/November). Treatment outcome of fluoxetine vs. EMDR in PTSD. Symposium conducted (B. A. van der Kolk, Chair) at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.

Language: English

Format: Conference

Keywords: Fluoxetine Posttraumatic Stress Disorder PTSD Symposium

Accuracy Verified: Yes