Francine Shapiro Library ~ EMDR Bibliography

Francine Shapiro Library - EMDR Bibliography Links

Choose any combination of the search options below. If you do not wish to include an option in your search, leave the box blank, or select "Any."

Year:
Format:
Language:
Title of Article or Chapter:
Title of Book or Journal:
Author's Last Name:
Keywords:

Your Results - you searched for the keyword Comorbidity 53 Results

1. Wilson, S., Becker, L., & Tinker, R. H. (1995, June). 15-Month follow up of EMDR treatment for traumatic memory. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
We previously reported on the outcomes of a controlled study of eye movement desensitization and reprocessing (EMDR) effectiveness in the treatment of traumatic memory (Wilson, Tinker, & Becker, 1994; Wilson, Becker, & tinker, in press). In that study we found that three, 90-minute sessions of EMDR (Shapiro, 1995) "normalized the psychological functioning of the previously traumatized participants (g = 80) on all dependent measures. The present study is a 15-month follow up of those participants. I Method: The research design is shown in Table 1. Participants were randomly assigned to EMDR or to Delayed EMDR conditions. Pretreatment measurement occurred at measurement time TI. Participants in the EMDR condition received EMDR between T1 and T2; those in the Delayed EMDR condition received EMDR between T2 and T3. All participants were tested immediately following treatment and at 3 months following treatment (at T4). The 15 month, long-term follow up occurred at measurement time T5. An independent assessor collected all of the following dependent measures: Subjective Units of Disturbance Scale (SUDS; Wolpe, 1990), Impact of Events Scale (IES; Hmowitz, Wilner, & Alvarez, 1979), State/Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), and the Symptom Checklist (SCL-90-R, Derogatis, 1992). [Table 1. The Research Design, Treatment Condition, Measurement Time: T1 T2 T3 T4 T5; EMDR Treatment: 01 x 02 03 04; Delayed EMDR Treatment 01 02 x 03 04 05; Note: T = Time of measurement; 0 = Observation; X = Treatment administered.] II. Results: Two analyses were performed to assess the impact of EMDR treatment at the 15-month follow up. First, in order to assess the overall, long-term impact of EMDR, the 15-month follow-up scores were compared with the pretreatment scores. There was significant improvement on all nine measures at the 15-month follow up: The multivariate effect was significant (Wilk's Lambda =.11, p<.0005) as were all nine of the univariate effects (all p <.0005). Second, in order to assess whether the improvement shown immediately following EMDR treatment had been maintained over the following year the immediate posttreatment scores were compared with, the 15-month follow-up scores. The multivariate test was nonsignificant (Wilk's lambda=.74, p=.079), indicating the improvement shown immediately following EMDR was maintained 15 months later. The univariate analyses indicated additional improvement for the PTSD symptoms of intrusions (IES Intrusion: F(1,56)=7.71, p=307) and avoidance (IES avoidance: F_(1,56) -4.44, p=.040). None of the nine measures showed deterioration at the 15-month follow up. Prior to EMDR treatment 45% (g= 9) of the responders had been diagnosed as PTSD, at the 15-month follow up only 7% (g = 4) were diagnosed as PTSD (chi-squareo, N=61)= .72, p < .05). III. Responders Versus Nonresponders at the 15-Month Follow up.: At the time of writing this abstract, 75% of the participants (g=61) have responded to the 15-month follow up. In general, measures taken prior to treatment did not differentiate responders fiom nonresponders. Responding at the 15-month follow up was unrelated to age, gender, marital status or years of education, although the annual income of the responders (Mdn=21,500) was higher than that of the nonresponders (Mdn = 14,750, Mann-Whitney U=372.5, p=.017). Responding or not at 15 months was unrelated to the type of trauma experienced, whether or not the participants had been in therapy prior to EMDR treatment, or how long ago the trauma had occurred. It was also unrelated to the severity of the trauma as measured by the pretreatment scores on the nine dependent variables and to whether or not the participant met the PTSD diagnosis criteria prior to treatment. A multiple regression analysis used the immediate posttreatment and 90-day posttreatment scores to predict whether or not the participant responded at the 15-month follow up. Nonrespondents were more likely to be depressed at 90-days following treatment than were respondents (R square=.O8, B=-.16, Beta = -.28, F_L1,71)=5.99, p=.017). No other variables entered into the regression model. IV Discussiona and Conclusion, Tretement effects found immediately following EMDR treatment wer maintained or improved 15 months later and thee was a significant decrease in the number of participants diagnosed as PTSD at the 15 month follow up. The comparison of responders to nonresponders at the 15 month follow up showed that the nonresponders were more depressed than the responders, raising the possiblity that the present results may be favorably biased to some extent. The discussion will include the additional, subjective impressions of participants who did not respond to the follow up. Limitations of EMDR with this population will be discussed, including the influence of comorbidity, multiple traumas, retraumatization after treatment, and spontaneous recurrence of symptoms. V. References: 1) Derogatis, L. R. (1992). SCL-90: Administration Scoring and Procedures Manual II. Baltimore: Clinical Psychometric Research. 2) Horowitz, M. J., Wilmer, N. & Alverez, W. (1979). Impact of Event Scale: A Measure of Subjective Distress. Psychosomatic Medicine, 41, 209-218. 3) Shapiro, F. (1995), Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. 4) Speilberger, C. D., Gorsuch, R. L., Lushene, R. D., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory, Palo Alto: Consulting Psychologists Press. 5) Wilson, S. A., Tinker, R. A., & Becker, L. A. (1994, November). Efficacy of Eye Movement Desensitization and Reprocessing (EMDR)Treatment for Trauma Victims. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies, Chicago, IL. 6) Wilson, S. A., Becker, L. A., & Tinker, R. A. (In press), EMDR, treatment for psychologically traumatized individuals, Journal of Consulting and Clinical Psychology.

Keywords: Follow-up Traumatic Memory

Accuracy Verified: Yes

2. Vogelmann-Sine, S., Popky, A. J., Lazrove, S., Sine, L., Speare, J., Wade, D., & Wade, T. (1995, June). Advanced clinical applications of EMDR to addictive behaviors. Symposium conducted at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
This workshop addresses the application of standard and modified EMDR treatment protocols to addictive and compulsive behaviors including substance abuse/dependence, overeating, smoking, love addiction. Individuals with addictive and compulsive behaviors frequently have suffered from childhood trauma and neglect resulting in developmental arrests, as well as a variety of maladaptive behaviors which are trauma-related and serve to minimize pain. The successful implementation of EMDR to addictive behaviors requires that EMDR be used as part of an overall treatment program carefully addressing the needs of individuals who have been traumatized and are exhibiting addictive behaviors. A thorough diagnostic work up is needed aimed at assessing comorbidity, dissociation, and a detailed trauma history covering childhood traumas and traumas suffered as adults including traumas that occur as a consequence of addictive behaviors. Careful client preparation is essential to assist individuals in coping adequately with the high levels of emotion experienced during EMDR Clients' readiness to stop compulsive/addictive behaviors needs to be carefully evaluated. A decision tree aimed at determining the appropriateness of EMDR to individuals diagnosed with addictive behaviors is presented which assists clinicians in minimizing the premature use of EMDR. EMDR is a client centered method, and thus, careful pacing is needed with this population to reprocess underlying traumatic issues. This frequently implies utilizing a modified EMDR treatment protocol with only partial resolutions of underlying traumatic material. Guidelines will be discussed to assist clinicians in selecting EMDR targets for optional results which relate to the stages of recovery. EMDR can be used at all stages of recovery to neutralize the negative impact of memories contributing to problematic behaviors, such as urges to use, ambivalence about treatment, fear of facing painfull feelings from the past. EMDR also has the power to install templates for future actions which assist individuals with skill deficits in more rapidly acquiring necessary skills for a successful recovery. Examples of cognitive interweaves are presented which take into consideration clients' readiness, as well as the need to accelerate the recovery process. EMDR has a unique role in the recovery of traumatized individuals with addictive and compulsive behaviors since the accelerated processing of negative experiences and the installation of positive adaptive cognitions assist clients in more rapidly overcoming barriers throughout the recovery process. It also challenges rigid approaches to recovery which frequently stress that trauma work should not be attempted before abstinence has been accomplished for a specified period of time. EMDR is especially valuable in processing core issues which center around shame and manifest in cognitions, such as "I am defective," "There is something wrong with me," "I am not good enough," "I am not quite right," "I don't belong," "I don't deserve to live." Case examples will be given as to how such core issues can be targeted to accelerate the recovery process. A.J. Popky has developed a specialized EMDR treatment protocol which targets levels of urges of addictive/compulsive behaviors directly and installs a positive internal state of feeling empowered without relying on compulsive and addictive behaviors. Case examples fiom clinical practice indicate that when levels of urges are targeted directly, underlying traumas frequently emerge without increasing clients' usage. The symposium addresses the application of this protocol to a range of addictive and compulsive behaviors. The Wades' integrative psychotherapy combines ego-state therapy and EMDR in a psychosocial developmental context. Their substance use disorders treatment program incorporates specialized applications of their integrative psychotherapy, which includes both individual and group therapy and employs hypnosis as well as EMDR Their presentation focuses on applications of the standard EMDR protocol in individual therapy, which is limited primarily to desensitization of dysphoric affect and reprocessing negative cognitions associated with grief and trauma. Their conceptual framework of substance use disorders proceeds from a goal of reducing the harm caused by substance use and a primary distinction between functional and autonomous use (rather than the DSM conceptualizations of "dependence" or "abuse") because this guides interventions. Initial treatment planning depends upon external constraints (e.g., lack of support for positive change, hostile environment), internal limitations (e.g., severity of substance use and its effects, neurocognitive deficits, inadequate "ego strength," lack of skills, disrupted psychosocial development, psychological trauma) and the nature of the substance use disorder (i.e., functional, autonomous, or both). Methods include education about substance use disorders and processes of change, group therapy to develop skills and obtain feedback and support, individual therapy to correct disrupted development and resolve traumatic stress reactions, and exercises to apply what is learned in real-life situations. The standard EMDR protocol is applied to disrupted development involving grief and to resolve psychological trauma that lead to substance use. Case vignettes in which such applications of the standard EMDR protocol were employed are presented in detail.

Keywords: Addictions Substance Abuse Symposium

Accuracy Verified: Yes

3. Negadi, F., Pelissolo, A., Jouvent, R., & Allilaire, J. F. (2007, Septembre). Application de l’EMDR en sexotraumatologie: Évolution de la comorbidité psychopathologique à propos d'un cas d'agression sexuelle [EMDR applied to sexual traumatology: Evolution of psychopathological comorbidity in the case of sexual aggression]. Annales Médico-Psychologiques, Revue Psychiatrique, 165(7), 523-528. doi:10.1016/j.amp.2007.06.002.

Language: French

Format: Journal

Abstract:
L'accès thérapeutique des patients victimes d'agression sexuelle est souvent à travers une double perspective: celle du traitement de stress post-traumatique (SSPT) et d'évitement sexuel. En légère ou modérée cas de SSPT, il ya des formes complexes où la comorbidité est plus évident et le taux d'échec thérapeutique est plus important. À l'heure actuelle des méthodes de traitement actif, basé sur l'exposition, plus particulièrement EMDR (désensibilisation des mouvements oculaires et retraitement) considérée comme une thérapie brève et active, donnent de bons résultats dans le traitement de la symptomatologie traumatique. Peu d'études ont été menées sur l'évolution psychopathologique de patients ayant souffert d'agressions sexuelles et qui sont pris en charge par l'EMDR. Dans le cadre d'une étude de cas, les auteurs discutent des éléments indiquant une évolution rapide de la symptomatologie traumatique, l'évitement sexuel et de la régression de l'expression des signes de co-morbidité. [Auteur] Résumé

The therapeutic access of patients victims of sexual aggression is often through a double perspective: That of treating Post Traumatic Stress Disorder (PTSD) and of sexual avoidance. In light or moderate PTSD cases, there are complex forms in which co-morbidity is more evident and the rate of therapeutic failure is more important. At present active treatment methods based on exposure, more particularly EMDR (Eye Movement Desensitization and Reprocessing) considered as a brief and active therapy, give good results in the treatment of traumatic symptomatology. Few studies have been undertaken on the psychopathological evolution of patients having suffered from sexual attacks and who are being taken care of by EMDR. Within the framework of a case study, the authors discuss elements indicating a rapid evolution of traumatic symptomatology, of sexual avoidance and of regression of the expression of the co-morbidity signs. [Author Abstract]

Keywords: Brief Therapy Clinical Case Study Sexotherapy Sexual Trauma

Accuracy Verified: Yes

4. Hase, M. (2004, June). Application of eye movement desensitization and reprocessing (EMDR) on severe posttraumatic stress disorder following a single traumatic event in elderly psychiatric patients. In single trauma and grief (L. Cornil, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
Single traumatic events can lead to severe posttraumatic stress disorder (PTSD) with serious effects on some and psyche as well as on social functioning. Often our focus in diagnostics is limited on obvious traumatic experiences according to the ICD-10 or DSM-IV criteria of what a traumatic event should be. But trauma can be variant or masked by somatic illness or comorbid psychiatric disorder. Beside the straightforward PTSD cases, the clinician should pay attention to comorbidity and the effect of dysfunctionally stored, incompletely processed information in a variety of patients. PTSD seems to be underdiagnosed in elderly patients. This paper, as part of the symposium on the treatment of single traumatic events using EMDR, has it foundation in clinical practice and gives evidence on the importance if diagnosing for PTSD and applying appropriate treatment especially EMDR, in the subgroup of elderly patients. Two case examples of PTSD following a single traumatic event in the course of depressive illness and the course somatic illness illustrate important principles and give evidence of the successful application of EMDR in the treatment of PTSD following a single traumatic event with elderly patients. The guidelines for good clinical practice in the treatment of PSTD following a single traumatic event regarding EMDR standard protocol and procedural rules will be outlines. In some respects EMDR treatment has to be adapted to the special demands of the elderly. Some ideas will be formulated and discussed. The aim of the presentation is to encourage the clinician in engaging in active treatment of the sequelae of single traumatic events in general and specially to apply EMDR with elderly patients, hereby stimulating research on the application of EMDR with the elderly, a hitherto often neglected subgroup of patients.

Keywords: Elderly Grief Posttraumatic Stress Disorder PTSD Single Trauma Symposium

Accuracy Verified: Yes

5. Diehle, J., Beer, R., Boer, F., & Lindauer, R. J. L. (2011, April). Behandeleffecten van traumagerichte cognitieve gedragstherapie en eye movement desensitisation and reprocessing (EMDR) [Treatment effects of trauma-focused cognitive behavior therapy and eye movement desensitisation and reprocessing (EMDR)]. Symposia op het 39ste Voorjaarscongres Nederlandse Vereniging voor Psychiatrie, Amsterdam.

Language: Dutch

Format: Conference

Abstract:
Achtergrond: Dagelijks raken veel kinderen betrokken bij ongelukken, brand, (seksueel) geweld, pesten, of andere ingrijpende gebeurtenissen. Het meemaken van dergelijke gebeurtenissen kan leiden tot een posttraumatische stressstoornis (PTSS). ptss gaat gepaard met hoge comorbiditeit, slechtere schoolprestaties en heeft een negatieve invloed op het lichamelijk herstel van kinderen (Winston 2003). In internationale richtlijnen wordt traumagerichte cognitieve gedragstherapie (TG-CGT) voor de behandeling bij kinderen aanbevolen en eye movement desensitisation and reprocessing (EMDR) is beoordeeld als veelbelovend (nice 2005). Onderzoeksresultaten naar de effecten van deze behandelingen bij kinderen zijn nog steeds schaars (Stallard 2006). Doel: Binnen een pilotonderzoek worden de behandeleffecten van TG-CGT en EMDR bij kinderen vastgesteld. Methoden: Op een poliklinische afdeling zijn gegevens verzameld van 20 kinderen tussen de 8 en 18 jaar met posttraumatische stressklachten en van hun ouders. Van deze kinderen hebben 10 een behandeling met TG-CGT ondergaan en 10 een behandeling met emdr. Bij kinderen en ouders zijn zowel voor als na de behandeling behandeling de klachten in kaart gebracht met behulp van een diagnostisch interview en verschillende vragenlijsten. Voor het stellen van de diagnose ptss en comorbide diagnosen is het Anxiety Disorders Interview Schedule for dsm-iv-Child Version (adis-c) afgenomen. Tevens werden de Children’s Revised Impact of Event Scale (CRIES-13), de Revised Child Anxiety and Depression Scale-Child Version (RCADS) en de Strengths and Difficulties Questionnaire (SDQ) afgenomen om angstklachten en gedragsproblemen te meten. Resultaten: Traumaklachten zijn zowel in de EMDR-groep alsook in de TF-CBTgroep afgenomen. Gedetailleerdere resultaten worden tijdens het congres besproken. Conclusie Zowel TG-CGT als emdr blijkt effectief te zijn bij het verhelpen van ptssklachten bij kinderen.

Background: Daily affects many children involved in accidents, fires, (sexual) violence, bullying, or other major events. The experience of such events can lead to a posttraumatic stress disorder (PTSD). PTSD is associated with high comorbidity, poorer school performance and has a negative impact on the physical recovery of children (Winston 2003). International guidelines is trauma-focused Cognitive behavioral therapy (CBT-TG) recommended for the treatment of children and Eye Movement Desensitisation and Reprocessing (EMDR) has been rated as promising (Nice 2005). Research the effects of these treatments children are still scarce (Stallard 2006). Purpose: In a pilot investigation the treatment effects of TG-CBT and EMDR in children established. Methods: In an outpatient department Data were collected from 20 children between 8 and 18 years with post traumatic stress symptoms and their parents. Of these children have a treatment with 10 undergoing TG-CBT 10 and treatment with EMDR. In children and parents before and after treatment treatment complaints mapped using a diagnostic interview and several questionnaires. For the diagnosis of PTSD comorbid diagnoses and the Anxiety Disorders Interview Schedule for DSM-IV-Child Version (ADIS-C) decreased. Also, the Children's Revised Impact of Event Scale (CRIES-13), the Revised Child Anxiety and Depression Scale-Child Version (RCADS) Strengths and Difficulties Questionnaire and (SDQ) were administered to measure anxiety and behavioral problems. Results: Trauma Complaints are both in the EMDR group and the TF-CBT-groep decreased. More detailed results be discussed during the congress. Conclusion: Both TG-CBT and EMDR appear to be resolving the ptssklachten in children.

Keywords: CBT Cognitive Behavior Therapy

Accuracy Verified: Yes

6. Gomez, A. (2008, September). Beyond PTSD: Treating depression in children and adolescents using EMDR. Presentation at the annual meeting of the EMDR International Association, Phoenix, AZ.

Language: English

Format: Conference

Abstract:
Traumatized children frequently exhibit symptoms of disorders other than PTSD. There is evidence of comorbidity between PTSD, depression and other behavioral disorders and a large overlap in symptom criteria between PTSD and depression in children and adolescents. The first part of this presentation explores what current research has identified as the key factors for the development of depression in children and adolescents. The evidence linking trauma, stress and PTSD to some forms of depression and the relationship between disorders of attachment, difficulties with affect regulation and the development of depression in children and adolescents will be explored. The second part of this presentation will introduce preliminary evidence that EMDR can be a potentially effective treatment for depression in children and adolescents through a series of case studies and anecdotal reports. The presentation will conclude with an overview of strategies for working with depressed children and adolescents across the eight phases of the EMDR protocol. Even though this presentation will focus on working with pediatric depression, it will provide a foundation for understanding and treating adult depression as well. Video clips of sessions will be shown to provide a concrete and tangible experience for clinicians.

Keywords: Adolescents Children Depression

Accuracy Verified: Yes

7. Anchisi, R., Guzzi, R., Fernandez, I., Giannantonio, M., & Ziveri, D. (2001, October). Biofeedback measures in EMDR treatment. In Collegium Internationale Activitatis Nervosae Superioris; International Association for Integrative Nervous Functions, Neurobiology of behaviour and Psychosomatics, (pp 141-148). Palermo, Italy.

Language: English

Format: Conference

Abstract:
We compared the pre and post therapeutic treatment data using standard EMDR, using a lool such as biofeedback, capable of measuring certain physiologcail parameters in an objective way. The goal was to check variations in the physiological indices and subjective evaluations of well being and discomfort in the subjects. Some psychotherapists will select subjects using an initial telephone screening followed by a battery of suitable tests. Using such tools, subjects affected by PTSD without comorbidity will be chosen. Independent assessors will evaluate them again after six weeks (blind design). After this assessment, subjective data will be collected using the SUD scale and objective data will be collected using the SPR, Thermo, Heart Rate, EMG of the biofeedback channels. After exposure the subjects will be randomly assigned to an experimenta1 group, they will be going to meet in six sessions using the EMDR standard protocol and carried out by therapits recognized by the Association EMDR Italy; the other half of the sample will represent the control group in a waiting list. Once more, all the subjects will be exposed to the trauma, this time listening to the recording of their description of the traumatic event. The SUD and biofeedback values will be then measured again. The comparison of the data of the SUD scale with the data of the biofeedback channels, in particular the SPR channel, plus the evaluation of the group of independent clinicians using the above-mentioned tests, will provide the co-ordinates for an evaluation (both subjetive and physiological) of the clinical results of the EMDR therapy.

Keywords: Biofeedback Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

8. 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

9. Makinson, R. A., & Young, J. S. (2012, April). Cognitive behavioral therapy and the treatment of posttraumatic stress disorder: Where counseling and neuroscience meet. Journal of Counseling & Development, 90(2), 131-140. doi:10.1111/j.1556-6676.2012.00017.x .

Language: English

Format: Journal

Abstract:
There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well-researched cognitive interventions. The purpose of this article is to describe the neurobiological context underlying the formation and treatment of posttraumatic stress disorders, a mental disorder frequently encountered by counselors, from a cognitive therapy framework.
Recent changes to the Council for Accreditation of Counseling and Related Educational Programs (2009) accreditation standards include the need for counselors-in-training to understand the neurobiological basis of behavior, which marks a new direction for the training of professional counselors who have historically reacted ambivalently toward medical models for understanding client concerns and treatments. Yet recent findings in neuroscience actually support the verbally based interventions that counselors typically use in treatment; therefore, there is much to be gained by counselors and counselor educators in understanding the basics of human neurobiology and how commonly used counseling interventions intervene on these biological systems. The National Institute of Mental Health (2010) stated in a recent strategic plan that “Important discoveries in areas such as genetics, neuroscience, and behavioral science largely account for the substantial gains in knowledge that have helped us to understand the complexities of mental illnesses and behavioral disorders over the past 15 years” (“Introduction,” para. 4).
Given the increasingly biological focus of mental health research, the practicing counselor is faced with the task of understanding and using the emerging mental health treatments and explaining to clients, to reimbursing agencies, and to the broader public how counseling fits within the medically dominated mental health culture. Some counselors have long reacted ambivalently toward the pathologically oriented diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV;American Psychiatric Association, 1994) system and the medication-dominated world of psychiatry. For example, the contrasting viewpoints on this issue were published in the Journal of Counseling & Development between Allen and Mary Ivey (1998, 1999) and Scott Hinkle (1999). Ivey and Ivey (1998) argued for a developmental interpretation to the DSM-IV, opposing what they called the “pathological view” (p. 334) of the manual. According to Ivey and Ivey, disorders could be viewed through a positive development tradition to lie not within the individual but within the contextual systems in which a person lives. Subsequently, disorders are viewed as a “logical response to a developmental history” (Ivey & Ivey, 1999, p. 484). By contrast, Hinkle (1999) argued that because anxiety and depressive disorders “are the most common clinical symptoms associated with presentation to counseling” (p. 475), the counseling profession is weakened if counselors shy away from direct participation in the DSM nomenclature and treatment parlance. As Hinkle indicated, “mental disorders according to the medical model describe disease processes, not people” (p. 475). Regardless of the reader's philosophical perspective, practicing counselors know participation in medical and psychiatric systems is necessary at times. Also, recent discoveries in the field of neuroscience are providing evidence that interventions often used by counselors have direct physiological impact on client neurobiology (Kennedy et al., 2007; Linden, 2006). For example, Felmingham et al. (2007) demonstrated significant differences in brain activity before and after 8 weeks of exposure therapy, which correlated with a reduction in posttraumatic stress disorder (PTSD) symptom severity. Similarly, Paquette et al. (2003) found that cognitive behavioral therapy (CBT) alters the activation and metabolism of specific brain regions following successful treatment of spider phobia. These findings, along with others (for a detailed review, see Beauregard, 2007; Frewen, Dozois, & Lanius, 2008), are significant because they support the techniques, interventions, and approaches used by counselors and provide a mechanism by which counseling positively affects brain physiology. Within the emerging physiologically based treatment milieu, counselors should be prepared to articulate how cognitive counseling interventions make measurable changes to the client. Although cognitive-behavioral-based approaches are effective in the treatment of a number of psychiatric illnesses, adult PTSD is arguably one of the best understood mental disorders from a neurological perspective. It thus presents a valuable model for exploring not only the basic tenets of neurobiology but also the mechanisms behind its successful treatment. Furthermore, PTSD is a disorder that counselors will likely encounter in practice.
PTSD is a mental disorder characterized by a sudden onset of symptoms due to environmental exposure to a psychologically stressful event such as war, natural disaster, or sexual victimization. Thus, it provides a clear example of how, even in adulthood, neurological adaptation (in this case maladaptive changes) can functionally “rewire” the brain in a short period of time, resulting in a sustained array of clinical symptoms. The diagnostic criteria for PTSD are a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyperarousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning (American Psychiatric Association, 2000).
The National Comorbidity Survey Replication, conducted between February 2001 and April 2003 (Kessler et al., 2005), determined that the estimated lifetime prevalence of PTSD among American adults is 6.8%, with women (9.7%) twice as likely as men (3.6%) to have the disorder at some point in their lives. These findings are very similar to those of the first National Comorbidity Survey conducted in the early 1990s (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995), which was composed of interviews of a representative national sample of 8,098 Americans ages 15 to 54 years. In this earlier sample, the estimated prevalence of lifetime PTSD was 7.8% in the general population. As in the more recent survey, women (10.4%) were more than twice as likely as men (5%) to have PTSD at some point in their lives (Kessler et al., 2005; Kessler et al., 1995).

Keywords: CBT Cognitive Behavioral Therapy Neurobiological Basis of Behavior Neurobiology Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

10. Hogan, W. A. (2001, August). The comparative effects of eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT) in the treatment of depression. Indiana State University, Terre Haute, IN. AAT 3004753.

Language: English

Format: Dissertation/Thesis

Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) is a unique, short-term therapy shown to be effective in the treatment of Posttraumatic Stress Disorder (PTSD). Application of EMDR to the treatment of depression was considered based upon the relationship between negative life experience and symptom onset, a pattern common to both PTSD and depression. Evaluation of the efficacy of EMDR in the treatment of depression was accomplished via a comparison with cognitive behavioral therapy (CBT). Because EMDR has been shown to be effective in the treatment of PTSD, the impact of EMDR and CBT upon symptoms comorbid to depression was investigated. EMDR was also compared to CBT assessing the participants' satisfaction. The participants, 15 per treatment group, received either one session of EMDR or cognitive behavioral therapy within the first four sessions. Pre and posttreatment assessment utilized two standardized instruments evaluating self-report of depressive and global symptoms. Participant satisfaction was assessed using a rating scale at posttreatment. Both treatment groups reported significant reductions in depressive symptoms and global symptoms. There were no statistical differences between groups on the symptom measures at posttreatment. Four participants in the EMDR group reported near complete remission of depressive symptoms and large reductions in global symptoms. No participants in the CBT group exhibited this pattern of symptom reduction. Regarding participant satisfaction, participants perceived EMDR to be less negative than CBT primarily due to the increased awareness of negative thoughts common to cognitive behavioral therapy but not experienced in EMDR treatment. The similarity in symptom reduction reported for both groups suggested the undue influence of non-specific treatment effects. The marked remission of symptoms reported by the four participants in the EMDR group parallels the symptom reductions noted in EMDR studies of PTSD. (PsycINFO Database Record (c) 2008 APA, all rights reserved) Dissertation Abstracts International: Section B: The Sciences and Engineering. 62(2-B), Aug 2001, pp. 1082.

Keywords: Comorbidity CBT Cognitive Behavioral Therapy Cognitive Therapy Depression Empirical Study Major Depression Treatment

Accuracy Verified: Yes

11. Popky, A. J. (2005). DeTUR, an urge reduction protocol for addictions and dysfunctional behaviors. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 167-188). New York: W W Norton & Co.

Language: English

Format: Book Section

Abstract:
The Desensitization of Triggers and Urge Reprocessing (DeTUR) model and the theories involved are based on experience from personal client observation and anecdotal reports received from other therapists using this same protocol. It is an eclectic model and combines many methodologies, including but not limited to cognitive-behavioral, solution-focused, Ericksonian hypnosis, narrative, object relations, and emotional freedom techniques (EFT), to name a few. The bilateral stimulation (BLS) in the accelerated information processing model of eye movement desensitization and reprocessing (EMDR) seems to form the catalyst for rapid processing and change, the turbocharger that speeds the healing process.This protocol represents only a small part of a complete treatment model. The therapist's role is that of a case manager, orchestrating any resources necessary to aid the patient through recovery and relapse to a successful and healthy state of functioning and coping. The therapist has to assess the severity of the addiction and also determine any other diagnosis associated with the case. This overall treatment model includes outside help, such as referrals for medication, testing for physical or neurological problems, and, depending on the situation, inpatient treatment, outpatient treatment, or detox. Other outside resources include support systems, such as 12-step groups, educational programs, skills training; couples, group, or family therapy; or acupuncture. Comorbidity issues, day-to-day stressors, and survival issues are addressed. An extremely high percentage of these populations are dually diagnosed and can therefore run the full dimensional spectrum of disorders and behaviors as described in the DSM-IV. [Text, pp. 167-168] [Pilots]

Keywords: Addiction Addictions Behavior Problems Behavior Therapy Bilateral Stimulation Compulsions Craving Desensitization of Triggers Dysfunctional Behaviors Information Processing Model Psychotherapeutic Techniques Urge Reduction Protocol

Accuracy Verified: Yes

12. Hopper, J., Spinazzola, J., Blaustein, M., Yehuda, R., van der Kolk, B. A., & Simpson, W. (2003, October-November). Differential biological outcomes of EMDR and fluoxetine for 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

Keywords: Fluoxetine Posttraumatic Stress Disorder PTSD Symposium

Accuracy Verified: Yes

13. Freyberger, H. J., & Spitzer, C. (2005, Juli). Dissoziative störungen [Dissociative disorders]. Der Nervenarzt, 76(7), 893-900. doi:10.1007/s00115005-1956-z .

Language: German

Format: Magazine

Abstract:
Die dissoziative Störungen und Konversion sind mit erheblichen klassifikatorischen, diagnostische und therapeutische Schwierigkeiten, die nur in den historischen Kontext der Diskussion über die Hysterie verstanden werden kann, verbunden. Auch die Einstufung in die ICD-10 und DSM-IV ist heterogen. Prävalenzraten zwischen etwa 3% in der allgemeinen Bevölkerung und bis zu 30% in klinischen Populationen, jedoch beziehen sich auf die große klinische Bedeutung. Realtraumatisierungen eine wichtige Rolle in der Pathogenese. High Komorbiditätsraten mit anderen psychischen Störungen eine Tendenz zu chronischen somatischen Erkrankung und ein Konzept (insbesondere bei Patienten mit Erkrankungen erschweren Umwandlung) der psychotherapeutischen Behandlung. Dies erlaubt die Behandlung Ziele sind sowohl psychodynamische und kognitiv-verhaltenstherapeutischen in Abhängigkeit entwickelt, möglicherweise mit den Techniken der Trauma-Therapie, wie EMDR (Springer).

The dissociative and conversion disorders are associated with significant classificatory, diagnostic and therapeutic difficulties that can be understood only in the historical context of the discussion on hysteria. Even the classification in ICD-10 and DSM-IV is heterogeneous. Prevalence rates of between about 3% in the general population and up to 30% in clinical populations, however, refer to the great clinical significance. Realtraumatisierungen have an important role in the pathogenesis. High Komorbiditätsraten with other mental disorders, a tendency to chronic somatic disease and a concept (especially in patients with conversion disorders complicate) the psychotherapeutic treatment. This allows the treatment goals are designed both psychodynamic and cognitive-behavioral dependence in, possibly with the techniques of trauma therapy such as EMDR (Springer).

Keywords: Chronicity (Disorders) Comorbidity Conversion Disorder Diagnosis Dissociative Disorders Epidemiology Etiology Psychotherapy Somatization

Accuracy Verified: Yes

14. Kavakcı, Ö., Kaptanoğlu, E., Kuğu, N., & Doğan, O. (2010). EMDR fibromiyalji tedavisinde yeni bir seçenek olabilir mi? Olgu sunumu ve gözden geçirme [EMDR: A new choice of treatment in fibromyalgia? A review and report of a case presentation]. Klinik Psikiyatri Dergisi, 13(3), 143-151.

Language: Turkish

Format: Journal

Abstract:
Fibromiyalji Sendromu (FMS) etyolojisi belli olmayan yaygın vücut ağrıları, belirli anatomik bölgelerde hassasiyet, azalmış ağrı eşiği, uyku bozuklukları, yorgunluk ve sıklıkla psikolojik sıkıntı ile karakterize eklem dışı romatizmal bir hastalıktır. FMS'de psikiyatrik komorbidite yüksektir ve son zamanlarda FMS ve psikolojik travma ilişkisini gösteren yayınlar artmaktadır. Bu olgu sunumunun amacı psikolojik travmaya yönelik bir tedavinin FMS'nin belirtilerini yatıştırıp yatıştırmayacağını değerlendirmektir. Bu amaç doğrultusunda Fizik Tedavi ve Rehabilitasyon (FTR) kliniğinden ilaç tedavisine iyi yanıt vermemiş FMS tanısı konulan bir hastada önce travma yaşantısı olup olmadığı değerlendirilmiş, ardından saptanan travmalarına yönelik göz hareketleriyle duyarsızlaştırma ve yeniden işleme (EMDR: Eye Movement Desensitization and Reprocessing) uygulanmıştır. Hasta; Beş yıldır şikâyetleri olan 34 yaşında, evli, kadın, ilaç kullanmıyor. Visuel Ağrı Skalasında (VAS) ağrı düzeyi 9-10, hassas nokta sayısı 15/18 olarak belirlendi. Beck Depresyon Ölçeği puanı (BDÖ) 22 ve Foa Travma Değerlendirme Ölçeği (TDÖ) puanı 41 olarak saptandı. EMDR tedavisi sonrasında; VAS 3, hassas nokta sayısı 11/18, TDÖ 6, BDÖ puanı 2 olarak bulundu. Hastanın 3 ve 6 aylık takipte iyilik halinin sürdüğü tespit edildi.Bu olgunun travmalarına yönelik tedavi uygulanması sonrasında hem psikiyatrik hem de somatik yakınmalarında belirgin düzelme görülmüş ve bu iyileşmenin olası mekanizmaları tartışılmıştır. FMS'li olgularda travmatik deneyimlerin aranması ve EMDR veya başka travma yönelimli yaklaşımların uygulanması olumlu sonuçlar verebilir.

Fibromyalgia syndrome (FMS) is a nonarticular rheumatic disease with unknown etiology and is characterized by widespread pain, increased tenderness in some anatomical regions, increased pain sensitivity, sleep disorders, fatigue and frequently by psychological distress. Psychiatric comorbidity is high in FMS and reports denoting to relationship of FMS and psychologial trauma have increased recently. We aimed to assess whether or not a treatment modality concerning trauma can alleviate symptoms of FMS. One of the FMS patients who was admitted to the outpatient department of Physical Medicine and Rehabilitation was randomly assigned to the present study. After that, assessed whether patients's traumatic experiences, and the Eye Movement Desensitization and Reprocessing (EMDR) therapy was performed to the patient. A thirty-four year old female married patient, had symptoms of FMS for five years. She was not on any medication. Intensity of her pain was identfied as 10 by visuel analog scale (VAS), tender point count was 15 out of 18 and the scores of Beck Depression Scale (BDS) and The Post Traumatic Diagnostic Scale (PDS) were 22 and 41, respectively. After the EMDR treatment VAS score was 3, tender point count was 11 and the scores of BDS and PDS were 2 and 6, respectively. The recovery was sustained at the 3rd and 6th months of follow up. In this case, we observed amelioration in both psychiatric and somatic symptoms of the patient after EMDR therapy and we discussed the possible mechanisms of this recovery. Searching for traumatic experiences and treating those traumas in FMS patients by EMDR or similar methods may result in favourable results.

Keywords: Fibromyalgia

Accuracy Verified: Yes

15. Rost, C. (2003). EMDR in der behandlung von chronischen schmerzen [EMDR in the treatment of chronic pain]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 1(3), 7-15.

Language: German

Format: Journal

Abstract:
Psychologische Behandlung von traumatischen Belastungsstörungen mit EMDR
Chronische Schmerzen sind in unserer Gesellschaft weit verbreitet und machen das medizinische System immer noch große Probleme. Auffallend ist das häufige gemeinsame Auftreten von psychischen Störungen. Die Bedeutung von Emotionen in Schmerzwahrnehmung und-verarbeitung hat nur in den letzten Jahren untersucht worden. Bisher gibt es nur wenige Studien über die Rolle des Traumas in die Geschichte und das gleichzeitige Auftreten von chronischen Schmerzen und posttraumatischen Belastungsstörungen. Diese Kombination hat Versuche Behandlung von chronischen Schmerzen mit EMDR geführt. Die ersten Ergebnisse der Pilotstudien mit chronischen Schmerzen und Phantomschmerzen Mut zu tun, um diese Anwendung von EMDR am erkunden. Die persönlichen Erfahrungen von Patienten mit chronischen Schmerzen und begleitende PTSD positiv auf die Behandlung von EMDR mit einer Reduktion der Symptome und Schmerzen in Zusammenhang stehen.

Psychological treatment of traumatic stress disorders with EMDR
Chronic pain is widespread in our society and make the medical system still major problems. Striking is the frequent co-occurrence of mental disorders. The importance of emotion in pain perception and processing has been examined only in recent years. So far there are only few studies on the role of trauma in the history and the simultaneous occurrence of chronic pain and posttraumatic stress disorder. This combination has led to attempts at treatment of chronic pain with EMDR. The first results of pilot studies to do with chronic pain and phantom pain courage to explore this application of EMDR on. The personal experiences of patients with chronic pain and concomitant PTSD are positively related to the treatment of EMDR with a reduction of symptoms and pain.

Keywords: Comorbidity, Physical Pain, Posttraumatic Stress Disorder, PTSD, Treatment Effectiveness

Accuracy Verified: Yes

16. Woller, W. (2004). EMDR in der psychotherapie von persönlichkeitsstörungen - Grenzen, voraussetzungen, möglichkeiten [EMDR in the treatment of personality disorders - frontiers, conditions, possibilities]. PPmP - Psychotherapie, Psychosomatik, Medizinische Psychologie, 54, AB124.

Language: Czech

Format: Journal

Abstract:
EMDR gilt inzwischen als effizientes Verfahren in der Behandlung posttraumatischer Belastungsstörungen. Die Anwendung des Verfahrens erfordert wie jedes traumaverarbeitende Verfahren jedoch neben einer ausreichenden äußeren und inneren Stabilität die Beachtung der Komorbidität.. Da Persönlichkeitsstörungen, namentlich die Borderline-Persönlichkeitsstörung, eine häufige Komorbidität der posttraumatischen Belastungsstörung darstellen, ist die Berücksichtigung einer komorbiden Persönlichkeitsstörung für die Indikationsstellung einer EMDR-Behandlung von großer Bedeutung. Auf der Basis kasuistischer Mitteilungen in der Literatur und eigener klinischer Erfahrungen soll dargestellt werden, (1) unter welchen Voraussetzungen die Behandlung einer PTBS auch bei komorbider Persönlichkeitsstörung denkbar ist, (2) wie EMDR in einen Gesamtbehandlungsplan integriert werden kann, der neben umfassender Stabilisierung, Symptomkontrolle und Ressourcenaktivierung die Modifikation verzerrter interpersoneller Wahrnehmungsmuster und maladaptiver Interaktionsmuster umfasst, (3) welche Modifikationen des Verfahrens in Abhängigkeit vom Typ der Persönlichkeitsstörung, der Abwehrstruktur und der symptomatischen Komorbidität möglich und auch notwendig ist, (4) welche Möglichkeiten EMDR darüber hinaus für die Behandlung von Persönlichkeitsstörungen ohne die Symptomatik einer PTBS zur Bewältigung aktueller und künftiger Stressoren und zur Ressourcenstärkung bieten kann.

EMDR is now regarded as an effective method in the treatment of posttraumatic stress disorder. The application of the method requires as any trauma processing method, however, only sufficient external and internal stability, the observance of comorbidity .. Because personality disorders, especially borderline personality disorder, a common comorbidity of post-traumatic stress disorder present, the consideration of a comorbid personality disorder for the indication of EMDR treatment is of great importance. On the basis of casuistic messages in the literature and our own clinical experiences to be represented, (1) the conditions under which the treatment of PTSD is possible even with comorbid personality disorder, (2) how EMDR can be integrated into an overall treatment plan, in addition to comprehensive stabilization, symptom control and resource activation involves the modification of distorted interpersonal perceptions and maladaptive patterns of interaction patterns (3) depending on the type of personality disorder, structure and defense of symptomatic comorbid is possible and also necessary which modifications of the method, (4) the opportunity EMDR for the treatment of personality disorders without the symptoms of PTSD can offer to address current and future stressors and resources to strengthen beyond.

Keywords: Conference Abstract Practice Theory

Accuracy Verified: Yes

17. Woller, W. (2003). EMDR in der psychotherapie von persönlichkeitsstörungen [EMDR in the treatment of personality disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 17-24.

Language: German

Format: Journal

Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Die Arbeit stellt dar, (1) welche Modifikationen oder Einschränkungen sich für die Behandlung Posttraumatischer Belastungsstörungen mit EMDR durch die Präsenz komorbider Persönlichkeitsstörungen ergeben und (2) welche Möglichkeiten EMDR darüber hinaus für die Behandlung von Persönlichkeitsstörungen ohne die Symptomatik einer PTBS bieten kann. Beim Vorliegen einer Persönlichkeitsstörung muss EMDR in einen Gesamtbehandlungsplan integriert werden, der neben umfassender Stabilisierung, Symptomkontrolle und Ressourcenaktivierung die Modifikation verzerrter interpersoneller Wahrnehmungsmuster und maladaptiver Interaktionsmuster umfasst. Probleme der therapeutischen Arbeitsbeziehung können die Stabilisierungsphase schwierig und zeitaufwändig gestalten. Die EMDR-Technik muss entsprechend dem Typ der Persönlichkeitsstörung, der Abwehrstruktur und der symptomatischen Komorbidität modifiziert werden. Zusätzlich zur Behandlung von Traumatisierungen kann EMDR zur Bewältigung aktueller und künftiger Stressoren und zur Ressourcenstärkung eingesetzt werden.

EMDR has been shown to be an effective treatment method in posttraumatic stress disorder (PTSD). There is a marked comorbidity between PTSD and personality disorders, some of which have been found to be long-term sequelae of cumulative childhood physical and sexual traumatization. Personality disorders are also included in the concepts of "complex PTSD" and "DESNOS". The paper discusses (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations. Problems of therapeutic alliance due to transference phenomena and acting-out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e.g. as in dissociative identity disorder) call for a consideration of all ego-states of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.

Keywords: Personality Disorders

Accuracy Verified: Yes

18. Woller, W. (2003). EMDR in der psychotherapie von persönlichkeitsstörungen [EMDR in the treatment of personality disorders]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 3, 73-78.

Language: German

Format: Journal

Keywords: Personality Disorders

Accuracy Verified: Yes

19. Hase, M. (2010, June). EMDR in the treatment of addiction - Reprocessing of the addiction memory. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
The comorbidity of PTSD and substance abuse provides sufficient reason for treating patients, who are addicted, with EMDR while focusing on the PTSD diagnosis. However, there are several pathways leading to addiction, and PTSD is only one of them. Thirty years of addiction research have provided sufficient evidence for the crucial role of memory in drug dependency.
The Addiction Memory (AM) serves as a useful concept for "obsessive-compulsive craving" to be seen in drug addicted patients. The concept of an AM, and its importance in relapse occurrence and maintenance of learned addictive behaviour, has gained growing acceptance in the field of addiction research and treatment. The AM is interpreted as an individual-acquired memory following drug consumption in some individuals. The addiction memory is based on normal memory systems and systems of central nervous information processing. This is in accordance with the experience that the addiction memory can be activated at any time by relapse-endangering complexes as well as internal and/or external situations, which are experienced as cravings by the person in question. The implicit nature of the addiction memory seems to qualify it as a target for EMDR treatment.
Without adequate therapeutic interventions, it is hardly extinguishable, as shown in the animal model where a re-imprinting of the AM facilitated by steroids extinguished craving in opiate addicted rats. Thus, altering or extinguishing the AM in human addicts could add an important component to well-established treatment modalities. The reprocessing of the AM with EMDR should, thus, lead to measurable changes in addiction symptoms, if the AM qualifies for maladaptive memory within the AIP model. As the AM includes the urge to consume the drug being abused, more aptly named craving, reprocessing of the AM should lead to a reduction in craving.
Preliminary data demonstrates the efficacy to reduce craving in alcohol-addicted patients. Anecdotal reports from clinicians seem to indicate an effect of the reprocessing of the addiction memory in patients addicted to heroin or psycho-stimulants. According to research in the animal model, the same principles should apply.
There are, however, other aspects to addiction. Is there a difference between chemical dependency and other addictive behaviour? How much do we know already? What have we yet to discover? These questions lead to the direction of developing a comprehensive EMDR approach in the treatment of addictions.

Keywords: Addiction Keynote

Accuracy Verified: Yes

20. Hase, M. (2010, June). EMDR to treat substance abuse and addiction. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
The comorbidity of PTSD and substance abuse provides sufficient reason for treating patients, who are addicted, with EMDR while focusing on the PTSD diagnosis. However, there are several pathways leading to addiction, and PTSD is only one of them. Thirty years of addiction research have provided sufficient evidence for the crucial role of memory in drug dependency. The Addiction Memory (AM) serves as a useful concept for "obsessive-compulsive craving" to be seen in drug addicted patients. The concept of an AM, and its importance in relapse occurrence and maintenance of learned addictive behaviour, has gained growing acceptance in the field of addiction research and treatment. The AM is interpreted as an individual-acquired memory following drug consumption in some individuals. The addiction memory is based on normal memory systems and systems of central nervous information processing. This neurobiological-based, imprinted, addictive behaviour seems to resist change under normal circumstances. The implicit nature of the addiction memory seems to qualify it as a target for EMDR treatment.
In a pilot-study group, 34 patients with chronic alcohol dependency in in-patient treatment for detoxification were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU+EMDR. In the TAU+EMDR group, patients received two sessions of EMDR focussing on memories of intense craving or relapse in order to activate and reprocess the addiction memory. The craving for alcohol was measured by the Obsessive-Compulsive-Drinking-Scale (OCDS) pre, post, and 1 month after treatment. The TAU+EMDR group showed a significant reduction in craving post-treatment and 1 month after treatment whereas TAU did not. The TAU+EMDR group showed lower relapse rates at the six-month follow-up. The results indicate that EMDR might be a useful approach for the treatment of addiction memory and associated symptoms of craving (Hase et al. 2008). Anecdotal reports show results with opiate and stimulant addicted patients.
This Workshop will address the EMDR treatment of comorbid PTSD and focuses on the application of EMDR as an adjunct in addiction treatment. Targets for a comprehensive EMDR treatment plan will be explained. A video demonstration, self-experience and discussion of cases shall contribute to learning.
REFERENCES Boening, J. A. (2001). Neurobiology of an addiction memory. J Neural Transm 108(6): 755-65.
Hase, M., Schallmayer, S. and Sack, M (2008). "EMDR reprocessing of the addiction memory: Pre-treatment, post-treatment, and 1-month follow-up" J EMDR 2 (3), 170-179.

Keywords: Addiction Memory Posttraumatic Stress Disorder PTSD Substance Abuse TAU Treatment As Usual

Accuracy Verified: Yes

21. de Roos, C., & de Jongh, A. (2008). EMDR treatment of children and adolescents with a choking phobia. Journal of EMDR Practice and Research, 2(3), 201-211. doi:10.1891/1933-3196.2.3.201.

Language: English

Format: Journal

Abstract:
Given the limited number of reported cases in literature, it might be concluded that it is rare to develop a choking phobia in childhood. However, it appears as though confusion in terminology and the time lapse between the onset of the disorder and treatment often results in the diagnosis being missed. In this article, we discuss a review of the clinical symptoms, differential diagnosis, comorbidity, etiology, and treatment options for choking phobia. We present a case series, describing the successful EMDR treatment of choking phobia for 4 children and adolescents, with positive outcomes achieved in 1 or 2 sessions. In addition, a detailed transcript is presented of a 15-year-old girl with a choking phobia related to an incident that occurred 5 years previously. The rapid elimination of symptoms in all 4 cases indicates that EMDR can be an effective treatment for choking phobias resulting from previous disturbing events. Randomized research on this promising intervention is strongly suggested.

Keywords: Adolescents Children Choking Phobia Specific Phobia

Accuracy Verified: Yes

22. Rougemont-Bucking, A., & Zimmermann, E. N. (2012). EMDR-based treatment of psychotraumatic antecedents in illicit drug abusers: A report of two cases. Schweizer Archiv Für Neurologie Und Psychiatrie, 163(3), 107-115.

Language: English

Format: Journal

Abstract:
The co-occurrence of PTSD and of substance use disorder (SD) is known to be very high. However the question of whether and how to treat such patients remains largely unanswered in the EMDR community. We report on two cases of EMDR-based treatment of heavily affected SD patients in whom psychotraumatic antecedents were identified. EMDR sessions focused on trauma-related material and not on the expression of cue-induced drug craving. The treatment appeared to be a difficult and challenging endeavour. However, some beneficial effects on general comfort and on drug consumption could be observed. A long stabilisation phase was mandatory and the standard EMDR protocol needed to be conducted with much flexibility. Interestingly, there was no provocation of a prolonged psychological crisis or of relapse. Experiencing of emotional stress could be limited to the sessions and dissociation could be absorbed with specific well-known techniques without permanently increasing drug craving. These observations are discussed in relation to previously published concepts of using EMDR in the field of trauma and substance abuse.

Keywords: Addiction Comorbidity Dissociation Posttraumatic Stress Disorder PSTD Substance Use Disorder

Accuracy Verified: Yes

23. Hase, M. (2007). Eye movement desensitization and reprocessing in der qualifizierten entzugsbehandlung [Eye movement desensitization and reprocessing in the treatment of qualified withdrawal]. Bundesdrogenkongresss, Mainz.

Language: German

Format: Conference

Abstract:
EMDR ist eine anerkannte Methode der speziellen Psychotraumatherapie. Bei der Komorbidität von Traumafolgestörung und Abhängigkeit liegt der Einsatz der EMDR-Methode nahe. Dabei ist unter den engen zeitlichen Grenzen des qualifizierten Entzugs eine Anwendung kritisch zu diskutieren. Anhand von Fallbeispielen wird die Praxis einer Anwendung der EMDR-Methode im qualifizierten Entzug beschrieben. Neben der Behandlung der komorbiden Traumafolgestörung bietet sich mit einer Anwendung der EMDR-Methode auf das Suchtgedächtnis eine störungsspezifische Intervention an (Wolffgramm 2000). Daten einer Pilotstudie an Alkoholabhängigen scheinen die Annahme zu bestätigen (Hase 2006).

EMDR is an accepted method of special Psycho-trauma therapy. In the comorbidity of Traumatic stress disorder and is a function of Use of the EMDR method close. It is under the tight time limits of the qualified Withdrawn an application to discuss critical. Using case examples, the practice of Application of the EMDR method in the qualified Withdrawal described. Besides the treatment of comorbid traumatic stress disorder lends itself to a Application of the EMDR method to the Addiction memory interference-specific intervention to (Wolffgramm 2000). Data from a pilot study of alcohol abusers seem to accept to confirm (Hare 2006).

Keywords: Addiction

Accuracy Verified: Yes

24. Kelley, S. D. M., & Benbadis, S. (2007, March-April). Eye movement desensitization and reprocessing in the psychological treatment of trauma-based psychogenic non-epileptic seizures. Clinical Psychology & Psychotherapy, 14(2), 135-144. doi:10.1002/cpp.525.

Language: English

Format: Journal

Abstract:
Little is known about the types of mental health treatment that are most effective for psychogenic non-epileptic seizure (PNES) patients who have high rates of comorbid post-traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non-controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure-free for 12-18 months. Copyright © 2007 John Wiley & Sons, Ltd.

Keywords: Clinical Case Study Comorbidity Emotional Trauma Empirical Study Epileptic Seizures Posttraumatic Stress Disorder Psychogeninic Non-epileptic Seizures Psychological Treatment Psychogenesis PTSD Qualitative Study Trauma

Accuracy Verified: Yes

25. Rose, B. K. (2004). Eye movement desensitization reprocessing (EMDR): A treatment protocol for addicted inmates with traumatic histories. Carlos Albizu University, Miami, FL. AAT 3102092.

Language: English

Format: Dissertation/Thesis

Abstract: S
ubstance Abuse is the use and abuse of mood and mind altering substances often having undesired effects on the lives of those addicted, and having a negative impact on the lives of others. Those addicted may expose themselves and others to physical and psychological harm; may create forensic problems; cause disintegration of the family, and problematic interpersonal relationships. Underlying reasons for addictive behavior include but are not limited to: genetic predisposition, psychosocial involvement, psychobiological complications, developmental conditions, and pre-existing psychological and environmental events. Some deficits found in those addicted include: poor coping skills, inability to problem solve, inability to function in difficult situations, and may use cognitive avoidance as a means of coping with life. The idea that children might be negatively impacted by exposure to substance abuse using parents is not a new revelation. However, the degree of damage done to these children is severe, and more is being learned about the severity of that damage. Children often are enmeshed with their dysfunctional families, and many problems arise involving their inability to maintain intimate relationships with others. Attachment issues may develop in infancy and early stages of maturation, and adversely affect children's ability to function as adults. Abusive pasts and traumatic incidents often may hinder the psychological growth and maturity of those who have experienced trauma and abuse.Eye Movement Desensitization Reprocessing (EMDR) is a fairly new concept of treatment. It was first designed to address therapy with those who had been exposed to trauma. However, over the past 22 years since its inception, it has been adapted to treat many other types of Axis I disorders. It has been determined that EMDR is useful in addressing substance abuse and other Axis I diagnoses, especially PTSD. Hiller, Knight, and Simpson completed a study with 161 persons who resided at a residential halfway house for newly released inmates. Their results found: 80% of the sample of had psychological problems; 72% had significant drug abuse problems; 58% had concurrent psychopathology and drug abuse problems. Research indicates prison confinement is increasing, and the idea of therapy in the forensic setting is gaining in popularity. Thus, the purpose of this dissertation is to design a substance abuse program to address the difficulties of substance abuse treatment for the dual diagnosed clients. The data collected from this program will help provide much needed information in order to further research and increase our understanding of the needs of this underserved population. [Author Abstract]

Keywords: Comorbidity Drug Abuse Prison Inmates Psychiatric Disorders Stressors Survivors Therapeutic Community

Accuracy Verified: Yes

26. Frustaci, A., Pozzi, G., Aurigemma, C., La Rosa, C., Lanza, G., Fernandez, I., & Ruggeri, G. (2006, Febbraio). Indicatori di cambiamento in pazienti con disturbi da eventi stressanti: Impiego della heart rate variability [Indicators of change in patients with disorders of stressful events: Use of heart rate variability]. Poster presentato al XI Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Introduzione: i pazienti traumatizzati presentano alterazioni sintomatiche quali intrusività, evitamento ed aumentato arousal, che ostacolerebbe la possibilità di elaborazione/integrazione delle tracce mnesiche, oltre ad esprimersi a livello periferico. Tecniche specifiche di trattamento sembrano promuovere l’elaborazione/integrazione delle memorie traumatiche, tra cui la Eye Movement Desensitization and Reprocessing (EMDR). Nella ricerca valutativa è quindi necessario affiancare alle scale psicologiche un appropriato indicatore biologico di attivazione neurovegetativa. La variabilità della frequenza cardiaca (Heart Rate Variability – HRV) esprime l’integrità funzionale del sistema neurovegetativo in risposta allo stress e può essere misurata nei domini di tempo o di frequenza. Lo studio della HRV è stato applicato in psichiatria ai disturbi d’ansia (panico, DOC, PTSD) e dell’umore (depressione unipolare) in ricerche trasversali (confronto con controlli sani) e longitudinali di trattamento farmacologico (triciclici, SSRIs) ma in pochi casi a trattamenti psicoterapici. Gli AA. valutano l’impiego della HRV come indicatore biologico nel trattamento psicoterapeutico di pazienti con Disturbo dell’adattamento erdurante da oltre un mese dopo l’esposizione ad eventi vitali stressanti (EVS). Metodi: sono stati reclutati 6 soggetti (M/F = 1/5, età 40,5 ± 11,0) esposti ad EVS ed avviati a ciclo di trattamento psicoterapico breve (4-6 sedute a cadenza settimanale) di tipo specifico (EMDR) o generico (colloqui supportivi). Costituivano criteri di esclusione: età < 18 o > 65 anni; comorbilità psichiatrica, neurologica e cardiologica; uso di farmaci interferenti. Le valutazioni psicopatologiche sono state eseguite al reclutamento (TBASE: colloquio anamnestico, MINI, Brief COPE), a inizio e fine ciclo di trattamento (TINI, TFINE: IES, SCL-90-R), a uno e tre mesi di follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Le registrazioni Holter sono state effettuate ad ogni intervallo valutativo coprendo: 60 min. attività libera, 10 min. tilt-test, 3-5 min. ascolto dell’evento traumatico, 30-45 min. seduta psicoterapica. Sono stati impiegati test statistici non parametrici per l’analisi delle correlazioni (Spearman) e delle differenze (Wilcoxon). Risultati preliminari: vengono valutate le correlazioni a TINI e le variazioni T90 vs. TINI. Sono significative le seguenti correlazioni: ansia fobica SCL e SDNN (dev. standard intervalli R-R) [r = + 0,9; p = ,037]; collera-ostilità SCL e SDNN [r = -0,95; p =.014]; depressione SCL e r-MSSD (radice media somma quadrati diff. R-R) [r = + 0,9; p = ,037]; sint. intrusivi IES e LF (basse frequenze) [r = -0,9; p = ,037]. Sono risultate statisticamente significative le seguenti variazioni: IES totale [Z = -1,99; p = ,046], sintomi intrusivi IES [Z = -2,21; p = ,027], sintomi di evitamento IES [Z = -1,99; p = ,046], ideazione paranoide SCL [Z = -2,21; p = ,027]; R-R, LF e LF/HF (rapporto basse/alte frequenze) durante ascolto evento [Z = -2,02; p = ,043]. Discussione: a livello basale gli indicatori HRV di distress vegetativo correlano positivamente con collera-ostilità e sintomi intrusivi, negativamente con ansia e depressione. Anche dopo tre mesi dalla fine del trattamento gli interventi psicoterapeutici tendono a ridurre i punteggi sintomatici, e migliorano il bilancio simpato-vagale durante il riascolto dell’evento traumatico.

Introduction: trauma patients have symptomatic changes such as intrusiveness, avoidance and increased arousal, which hampers the development / integration of memory traces, as well as speak at the peripheral level. Specific techniques of treatment seem to promote the formulation and integration of traumatic memories, including eye movement desensitization and reprocessing (EMDR). In evaluation research is therefore necessary to combine psychological scales appropriate indicator organic autonomic activation. The heart rate variability (Heart Rate Variability - HRV) expresses functional integrity of the autonomic nervous system in response stress and can be measured in time or frequency domains. The study of HRV has been applied in psychiatric disorders anxiety (panic, DOC, PTSD) and mood (unipolar depression) in cross-disciplinary (compared with healthy controls) and longitudinal drug treatment (tricyclic SSRIs), but in a few cases in psychotherapeutic treatment. The AA. evaluate the use of HRV as a biological indicator in the psychotherapeutic treatment of patients with adjustment disorder erdurante more than a month after exposure to stressful life events (EVS). Methods: 6 subjects were recruited (M / F = 1 / 5, age 40.5 ± 11.0) exposed to EVS and initiated treatment cycle psychotherapeutic short (4-6 sessions weekly) type specific (EMDR) or generic (hearing supported). Exclusion criteria were: age <18 or> 65 years, psychiatric comorbidity, neurological and cardiological, use of drugs interfering. Psychopathological assessments were performed at recruitment (TBASE: anamnestic interview, MINI, Brief COPE) at the beginning and end of treatment cycle (TINI, TFINE: IES, SCL-90-R) in a three-month follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Holter recordings were made at each interval evaluation covering: 60 min. free activity, 10 min. tilt-test, 3-5 min. listening to the traumatic event, 30-45 minutes. psychotherapy session. Were used nonparametric statistical tests for analysis correlations (Spearman) and differences (Wilcoxon). Preliminary results: the correlations are evaluated and changes TINI vs. T90. TINI. Significant correlations are the following: SCL phobic anxiety and SDNN (standard dev. RR intervals) [r = + 0.9, p =, 037]; anger-hostility SCL SDNN [r = -0.95, p =. 014]; SCL depression r-mssd (root mean square sum diff. RR) [r = + 0.9, p =, 037]; sint. IES intrusive and LF (low frequency) [r = -0.9, P =, 037]. Were statistically significant, the following changes: IES total [Z = -1.99, p =, 046], IES intrusive symptoms [Z = -2.21, p =, 027], symptoms of avoidance IES [Z = -1.99, p =, 046] , SCL paranoid [Z = -2.21, p =, 027], RR, LF and LF / HF ratio (low / high frequencies) while listening event [Z = -2.02, p =, 043]. Discussion: At baseline HRV indicators of distress correlated positively with growing anger-hostility, and intrusive symptoms, negatively with anxiety and depression. Even after three months of the end of psychotherapeutic treatment interventions aimed at reducing symptom scores and enhance sympathetic vagal balance during the playback of the traumatic event.

Keywords: Heart Rate Variability Poster Stress Disorders

Accuracy Verified: Yes

27. Pereira, I. (2012, Novembro). Intervenção psicoterapêutica no tratamento de paciente com a síndrome de fibromialgia [Psychotherapeutic intervention in the treatment of patients with fibromyalgia syndrome]. In EMDR e fibromialgia. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.

Language: Portuguese

Format: Conference

Abstract:
Objetivo: Compartilhar a remissão dos sintomas da Síndrome da Fibriomialgia, com a Intervenção Psicoterapêutica EMDR – Dessensibilização e Reprocessamento através de movimentos oculares. R.M.S. iniciou seu tratamento psicoterapêutico em Outubro de 2010, na Abordagem Cognitiva Comportamental. R.M.S. nasceu em 23/06/1957, estava com 53 anos, viúva, tem duas filhas, uma solteira a outra casada. Sofria um luto há mais de três anos porque não aceitava a morte do marido. Apresentava Depressão e Ansiedade, e outras comorbidades: Anorexia Nervosa, Lúpus, Síndrome de Fibriomialgia. De Outubro de 2010 a Dezembro de 2011, a Intervenção Psicoterapêutica em TCC foi associada à medicação psicotrópica com a qual conseguiu redução dos sintomas depressivos. Fazia uso de outros medicamentos para a Síndrome da Fibriomialgia, Lúpus, assim como recorrentes internações em hospital de Clinica Médica Geral para a realização de procedimentos para a redução da dor intensa no corpo (Síndrome da Fibriomialgia) e de intervenção aos sintomas da Anorexia. Após um período de férias, entraram em contato comigo informando que a paciente estava hospitalizada permanecendo duas semanas com a hipótese diagnóstica de câncer, o que na sequência não foi confirmado, tendo recebido alta hospitalar. A dor intensa no corpo, a dificuldade para respirar permaneciam iguais. Solicitou o retorno para a psicoterapia, quando foi sugerido sobre a Intervenção Psicoterapêutica EMDR. As sessões foram realizadas conforme protocolo do EMDR. Para o Planejamento das Sessões o foco incial era a Síndrome de Fibriomialgia. Foi pedido à paciente para definir onde ela sentia mais dor no corpo, e de imediato mencionou a dificuldade para respirar, com a queixa de dor no peito. Nesta primeira sessão, ocorreram dessensibilização e reprocessamento rapidamente, tendo a mesma solicitado para trabalhar os braços. As sessões foram realizadas duas a três vezes na semana, e ao longo deste processo podem ser ouvidas frases tais quais: “Como pode passei por tantos médicos e estou sendo curada com por uma psicóloga” (sic); “Gastei com tanto medicamento, aqui com você não tomo remédio e não estou sentindo mais dor no meu corpo” (sic). A terapia prossegue a Intervenção Psicoterapêutica EMDR.

Objective: Share remission Syndrome Fibriomialgia, Psychotherapeutic Intervention with EMDR - Desensitization and Reprocessing through eye movements. R.M.S. began her psychotherapeutic treatment in October 2010, Cognitive Behavioral Approach. R.M.S. born on 06.23.1957, he was 53 years old, a widow, has two daughters, one married another maiden. He suffered a bereavement for over three years because they did not accept her husband's death. Presented Depression and Anxiety, and other comorbidities: Anorexia Nervosa, Lupus, Fibriomialgia Syndrome. From October 2010 to December 2011, Psychotherapeutic Intervention in CBT was associated with psychotropic medication which could reduce depressive symptoms. Made use of other medications for Fibriomialgia Syndrome, Lupus, as well as recurrent hospital admissions in Medical Clinic General to carry out procedures for the reduction of pain in the body (Fibriomialgia Syndrome) and intervention for symptoms of Anorexia. After a vacation, contacted me stating that the patient was hospitalized two weeks remaining in the diagnosis of cancer, which as a result was not confirmed, having been discharged. Severe pain in the body, difficulty breathing remained the same. Requested the return for psychotherapy, when it was suggested on EMDR Psychotherapeutic Intervention. The sessions were performed according to the protocol of EMDR. Planning sessions for the initial focus was Fibriomialgia Syndrome. The patient was asked to define where she felt more pain in the body, and immediately mentioned the difficulty breathing, complaining of chest pain. In this first session, desensitization and reprocessing occurred rapidly, with the same request to work the arms. The sessions were held two to three times a week, and during this process can be heard phrases such as: "How can so many doctors and I'm being healed by a psychologist with" (sic), "I spent with both medicine here I do not take medication with you and I'm not feeling more pain in my body "(sic). The therapy continues Psychotherapeutic Intervention EMDR.

Keywords: Comorbidity Fibromyalgia

Accuracy Verified: Yes

28. Woller, W. (2004, June). Is there a place for EMDR in the treatment of personality disorders?. In complex traumatisation and EMDR (K. Linder, Chair). Symposium conducted at the EMDR Europe Association annual meeting, Stockholm, Sweden .

Language: English

Format: Conference

Abstract:
There is substantial evidence that EMDR is an effective treatment method un posttraumatic stress disorder (PTSD). However, comorbid disorders have to be taken into account when treating PTSD with EMDR. Personality disorders are a frequent comorbid disorder of PTSD, and a high prevalence of childhood traumatization has been found in personality disorders as well. Given this background, the paper to be presented discussed (1) modifications and limitations of EMDR technique required for treatment of posttraumatic stress disorder with comorbid personality disorders, and (2) further applications of EMDR in the treatment of personality disorders without PTSD. If comorbid personality disorder is present, EMDR has to be integrated into a complex treatment plan which includes stabilization, symptom control, resource installation, identification of distorted interpersonal perceptions, and modification of maladaptive interpersonal interactions. Because of the central role of generalized negative beliefs in maintaining cyclical maladaptive patterns, EMDR is regarded a valuable tool to modify negative beliefs along with processing traumatic memories and body sensations, Problems of therapeutic alliance due to transference phenomena and acting out can make stabilization difficult and time-consuming. EMDR technique should be subjected to important modifications depending on personality disorder subtype, defence structure and symptomatic comorbidity. Structural dissociations of the personality (e. g., as in dissociative identity disorder) call for a consideration of all ego-sates of the personality system before planning EMDR treatment. In addition to unresolved trauma, current and future interpersonal stressors can be chosen as EMDR targets.

Keywords: Personality Disorders Symposium Trauma

Accuracy Verified: Yes

29. Zillhardt, P. (2007, Juin). La thérapie EMDR avec les troubles des comportements alimentaires [EMDR therapy with eating disorders]. Document présenté lors de la réunion de l'Institut Français d'EMDR, Paris, France.

Language: French

Format: Conference

Abstract:
Si les troubles des comportements alimentaires (TCA) sont considérés par de nombreux auteurs comme une pathologie addictive du fait de schémas comportementaux et d’un support neurobiologique comparables aux autres dépendances (substances ou comportements), l’accord paraît unanime pour y voir une réponse spécifique à un modèle biopsychosocial. Un tel modèle implique : des facteurs inducteurs et déclencheurs, et des facteurs facilitants et de pérennisation. Par exemple, des travaux récents mettent l’accent sur la prépondérance de facteurs socio-culturels indissociables des forces médiatiques actuelles. L’importance de ces derniers facteurs se fait particulièrement ressentir depuis la seconde moitié du 20ème siècle et pourrait aller « crescendo ». En outre, la problématique des TCA est rendue plus complexe par l’existence d’une lourde comorbidité dont les éléments pathologiques sont autant causes que conséquences. Notons que 40% des patients souffrant de TCA ont eu, à un moment de leur vie, un PTSD. Nous, praticiens, ne sommes pas étonnés de constater que bon nombre de ces patients souffrent d’une altération notable de leur identité. Le caractère dit « synclétique » de la thérapie EMDR permet une approche intégrative dans le traitement des TCA : un aspect cognitif indéniable, le processus associatif induit par les stimulations alternées met souvent en lumière des matériaux reflétant des conflits intrapsychiques plus ou moins archaïques. Le travail portant sur l’imagerie mentale ou les états dissociés du moi peut aussi être associé dans les cas difficiles de patients souffrant de TCA. Le travail d’anamnèse et l’approche phénoménologique jouent un rôle primordial dans l’approche EMDR des TCA. L’un des aspects forts de la thérapie EMDR est l’identification de « clusters possibles » représentatifs des thématiques inductrices des souffrances et des symptômes inhérents à l’expérience de vie tragique de ces patients. Le plan de la thérapie est bien sûr personnalisé pour chaque patient.

If the eating disorders (TCA) are considered by many authors pathology as a result of addictive patterns behavioral and neurobiological support comparable to other addictions (substances or behavior), the agreement seems unanimous see a specific response to a biopsychosocial model. Such a model implies: inducing factors and triggers, and facilitating factors and sustainability. For example, recent studies emphasize on the balance of socio-cultural factors inseparable forces current media. The importance of these factors is particularly experience since the second half of the 20th century and could go "crescendo". In addition, the problem of TCA is made more complex by the existence of a heavy comorbidity whose elements are all pathological causes the consequences. Note that 40% of patients with TCA had, at some point in their lives, PTSD. We practitioners are not surprised to note that many of these patients suffer a significant change of their identity. The character says "Syncletica" of EMDR provides an integrative approach in the treatment CAW: a cognitive undeniable, the process associative stimulation induced by alternating often sheds light reflecting materials intrapsychic conflicts more or less archaic. The work on mental imagery or statements dissociated ego can also be associated in the case difficult patients with TCA. Work history and the phenomenological approach play an important role in the approach EMDR CAW. One of the strengths of EMDR is identifying "clusters possible" representative inducing themes of suffering and symptoms inherent in the tragic experience of life of these patients. The plan of therapy is of course customized for each patient.

Keywords: Eating Disorders

Accuracy Verified: Yes

30. Brewerton, T. D. (2008, May 1). The links between PTSD and eating disorders. Psychiatric Times, 25(6), 1-7.

Language: English

Format: Magazine

Abstract: D
espite an abundance of studies linking both traumatic experiences and anxiety disorders with eating disorders, relatively little has been reported on the prevalence of associated posttraumatic stress disorder (PTSD) or partial PTSD in patients with eating disorders. The National Women's Study, dating back more than 10 years, remains the only detailed study of crime victimization histories, resultant PTSD, and associated psychiatric comorbidity, including eating disorders, in a representative sample of women in the United States.1 This article presents the case for a link between PTSD and eating disorders. The prevalence of comorbid PTSD and eating disorders is discussed with an explanation of a mechanism that may explain the connection, followed by treatment options and reasons for caution.

Keywords: Eating Disorders Posttrauamtic Stress Disorder PTSD

Accuracy Verified: Yes

31. McLean, P. D., & Woody, Sheila, R. (2001). Posttraumatic stress disorder. In P. D. McLean & S. R. Woody (Eds.), Anxiety disorders in adults: An evidence-based approach to psychological treatment (pp. 205-241). New York: Oxford University Press.

Language: English

Format: Book Section

Abstract:
Description and conceptualization (phenomenology; diagnostic trends; prevalence and course); Theoretical perspectives; Assessment (diagnosis; assessment of symptoms; assessing contextual factors: social support, cognitive distortions, avoidant coping, multiple trauma history, occupational adjustment, physical history/pain/litigation; case formulation); Treatment models and guidelines (cognitive behavioral therapy for PTSD: education, exposure, cognitive control, cognitive restructuring, relaxation training; specific types of trauma: sexual assault, motor vehicle accident, combat; pharmacological treatment for PTSD; eye movement desensitization and reprocessing [EMDR]; client-treatment matching; minimal vs. optimal interventions; common problems: noncompliance due to fear and avoidance, comorbidity, medical and litigation complications; treatment outcome evaluation and life planning). [Pilots]

Keywords: Adults Evidence Based Treatment Posttraumatic Stress Disorder Psychotherapy PTSD

Accuracy Verified: Yes

32. Herbert, J. D., & Forman, E. M. (2006). Posttraumatic stress disorder. In J. E. Fisher & W. T. O'Donohue (Eds.), Practitioner's Guide to Evidence-Based Psychotherapy (pp. 555-566). New York: Springer.

Language: English

Format: Book Section

Abstract:
What is Posttraumatic Stress Disorder? Posttraumatic Stress Disorder (PTSD) is a syndrome characterized by persistent anxiety-related symptoms provoked by a traumatic event. These symptoms are comprised of three clusters: Re-experiencing symptoms such as recurrent intrusive thoughts about the trauma, nightmares, and flashbacks, numbing symptoms such as detachment from others and loss of interest in usual activities, and a third cluster of miscellaneous symptoms including an exaggerated startle response, sleep disturbance, and memory impairment. Estimates of the prevalence of PTSD vary widely; the National Comorbidity Survey found rates of 8.2% among men and 20.4% among women (Kessler et al., 1995). The National Vietnam Veterans Readjustment Study (NVVRS, Kulka et al., 1990) reported that 30.9% of American soldiers who served in Vietnam developed PTSD; this figure rose to 50% if subsyndromal PTSD was counted. Although these figures continue to be widely cited, the NVVRS has been widely criticized on several grounds, including reliance on undocumented, retrospective self-reports of trauma, lack of measurement of impairment, and most importantly the simple fact that only 15% of those serving in Vietnam were actually in combat units.

Keywords: Posttraumatic Stress Disorder PSTD

Accuracy Verified: Yes

33. Kennedy, J. E., Jaffee, M. S., Leskin, G. A., Stokes, J. W., Leal, F. O., & Fitzpatrick, P. J. (2007). Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury. Journal of Rehabilitation Research and Development, 44(7), 895-920. doi:10.1682/JRRD.2006.12.0166.

Language: English

Format: Journal

Abstract:
In this article, we review the literature on posttraumatic stress disorder (PTSD) and PTSD-like symptoms that can occur along with mild traumatic brain injury (TBI) and concussion, with specific reference to concussive injuries in the military. We address four major areas: (1) clinical aspects of TBI and PTSD, including diagnostic criteria, incidence, predictive factors, and course; (2) biological interface between PTSD and TBI; (3) comorbidity between PTSD and other mental disorders that can occur after mild TBI; and (4) current treatments for PTSD, with specific considerations related to treatment for patients with mild TBI or concussive injuries.

Keywords: Biological Factors Blast Concussion Clinical Course Comorbidity Concussion Incidence Mild Traumatic Brain Injury Posttraumatic Stress Disorder PTSD Rehabilitation TBI Traumatic Brain Injury Treatment

Accuracy Verified: Yes

34. Davidson, J. R. T., Stein, D. J., Shalev, A.Y., & Yehuda, R. (2004, Spring). Posttraumatic stress disorder: Acquisition, recognition, course, and treatment. Journal of Neuropsychiatry and Clinical Neuroscience, 16(2), 135-147. doi:10.1176/appi.neuropsych.16.2.135.

Language: English

Format: Journal

Abstract:
Following exposure to trauma, a large number of survivors will develop acute symptoms of posttraumatic stress disorder (PTSD), which mostly dissipate within a short time. In a minority, however, these symptoms will evolve into chronic and persistent PTSD. A number of factors increase the likelihood of this occurring, including characteristic autonomic and hypothalamic-pituitary-adrenal axis responses. PTSD often presents with comorbid depression, or in the form of somatization, both of which significantly reduce the possibilities of a correct diagnosis and appropriate treatment. Mainstay treatments include exposure-based psychosocial therapy and selective serotonin reuptake inhibitors, such as paroxetine and sertraline, both of which have been found to be effective in PTSD. This paper looks at the course of PTSD, its disabling effect, its recognition and treatment, and considers possible new research directions.

Keywords: Comorbidity Posttraumatic Stress Disorder PTSD Recognition and Treatment SSRIs

Accuracy Verified: Yes

35. Ross, C. (2012, October). Principles of trauma model therapy: Integration with EMDR. Presentation at the annual meeting of the EMDR International Association, Arlington, VA.

Language: English

Format: Conference

Abstract:
In this workshop, Dr. Ross will build on his plenary talk. He will describe the structural model of dissociation and how it can be expanded to integrate the wide range of comorbidity frequently seen in trauma survivors. From there he will describe the core principles of his Trauma Model Therapy: the problem of attachment to the perpetrator; the locus of control shift; the problem is not the problem; just say ‘no’ to drugs; addiction is the opposite of desensitization; and the victim-rescuer-perpetrator triangle. He will spend quite a bit of the workshop discussing how Trauma Model Therapy can be integrated with EMDR. Time will be left for questions and discussions.

Keywords: Trauma Model Therapy

Accuracy Verified: Yes

36. Montefiore, D., Mallet, L., Lévy, R., Allilaire, J-F., Pélissolo, A. (2007, Juin). Pseudo-démence conversive et état de stress post-traumatique [Pseudo-dementia conversion and post-traumatic stress disorder]. L'Encéphale, 33(3), 352-355. doi:10.1016/S0013-7006(07)92050-3.

Language: French

Format: Journal

Abstract:
Les états de stress post-traumatique (ESPT) sont souvent associés à d’autres troubles psychiatriques, mais la comorbidité avec les troubles somatoformes est peu étudiée. Le cas décrit dans cet article concerne un patient souffrant d’un ESPT déclenché par une agression sexuelle vécue à l’âge de 8 ans. Le déroulement de son histoire est néanmoins très particulier puisque l’agression a eu lieu plus de trente ans avant l’apparition des troubles. Pendant la plus grande partie de sa vie, entre 13 et 43 ans, le patient avait complètement occulté l’événement traumatique. Puis, pour des raisons inconnues, il développa un syndrome conversif pseudo-neurologique mimant un état démentiel inquiétant, qui persista plus d’un an. La disparition des symptômes neurologiques et la remémoration du traumatisme furent brutales, après que le patient ait vu, au cinéma, un film relatant l’histoire d’un homme victime d’une agression sexuelle. Apparurent alors les symptômes typiques d’un ESPT, puis d’un état dépressif sévère compliqué d’une tentative de suicide par pendaison. Les liens entre ESPT et conversion devraient faire l’objet d’études plus approfondies, d’un point de vueépidémiologique, clinique et de neuro-anatomie fonctionnelle.

The posttraumatic stress disorder (PTSD) are often associated with other psychiatric disorders, but comorbidity with somatoform disorders is poorly studied. The case described in this article concerns a patient suffering from PTSD triggered by a sexual assault experienced at the age of 8 years. The course of its history is still very special because the assault occurred more than thirty years before the onset of disorders. During most of his life, between 13 and 43 years, the patient had completely obscured the traumatic event. Then, for reasons unknown, he developed a neurological syndrome conversive pseudo-dementia mimicking a state concern, which lasted over a year. The disappearance of neurological symptoms and recall of trauma were brutal, after the patient has seen the film, a film which tells the story of a male victim of sexual assault. Appeared while the typical symptoms of PTSD, then a severe depression complicated by attempted suicide by hanging. The relationship between PTSD and conversion should be further studied, a point vueépidémiologique, clinical and neuro-functional anatomy.

Keywords: Amnesia Conversion Posttraumatic Stress Disorder PTSD Sexual Abuse

Accuracy Verified: Yes

37. van Loey, N. E. E., & van Son, M. J. M. (2003). Psychopathology and psychological problems in patients with burn scars: Epidemiology and management. American Journal of Clinical Dermatology, 4(4), 245-272. doi:10.2165/00128071-200304040-00004.

Language: English

Format: Journal

Abstract:
Burn injury is often a devastating event with long-term physical and psychosocial effects. Burn scars after deep dermal injury are cosmetically disfiguring and force the scarred person to deal with an alteration in body appearance. In addition, the traumatic nature of the burn accident and the painful treatment may induce psychopathological responses. Depression and PTSD, which are prevalent in 13-23% and 13-45% of cases, respectively, have been the most common areas of research in burn patients. Risk factors related to depression are pre-burn depression and female gender in combination with facial disfigurement. Risk factors related to PTSD are pre-burn depression, type and severity of baseline symptoms, anxiety related to pain, and visibility of burn injury. Neuropsychological problems are also described, mostly associated with electrical injuries. Social problems include difficulties in sexual life and social interactions. Quality of life initially seems to be lower in burn patients compared with the general population. Problems in the mental area are more troublesome than physical problems. Over a period of many years, quality of life was reported to be rather good. Mediating variables such as low social support, emotion and avoidant coping styles, and personality traits such as neuroticism and low extraversion, negatively affect adjustment after burn injury. Few studies of psychological treatments in burn patients are available. From general trauma literature, it is concluded that cognitive (behavioral) and pharmacological (selective serotonin reuptake inhibitors) interventions have a positive effect on depression. With respect to PTSD, exposure therapy and eye movement reprocessing and desensitization [EMDR] are successful. Psychological debriefing aiming to prevent chronic post-trauma reactions has not, thus far, shown a positive effect in burn patients. Treatment of problems in the social area includes cognitive-behavioral therapy, social skills training, and community interventions. Sexual health promotion and counseling may decrease problems in sexual life. In conclusion, psychopathology and psychological problems are identified in a significant minority of burn patients. Symptoms of mood and anxiety disorders (of which PTSD is one) should be the subject of screening in the post-burn phase and treated if indicated. A profile of the patient at risk, based on pre-injury factors such as pre-morbid psychiatric disorder and personality characteristics, peri-traumatic factors and post-burn factors, is presented. Finally, objective characteristics of disfigurement appear to play a minor role, although other factors, such as proneness to shame, body image problems, and lack of self-esteem, may be of significance. [Author Abstract]

Keywords: Burns Comorbidity Epidemiology Literature Review Posttraumatic Stress Disorder Predisposition PTSD Survivors Treatment

Accuracy Verified: Yes

38. Tavanti, M., Bossini, L., Calossi, S., Lombardelli, A., Polizzotto, N., Vatti, G., Galli, R., Pieraccini F., & Castrogiovanni, P. (2008, Febbraio). Sertralina vs EMDR: Effetti sul volume ippocampale [Sertraline vs. EMDR: Effects on hippocampal volume]. Poster presentato al XII Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Molti dati sperimentali hanno mostrato che la terapia farmacologica con SSRI può incrementare il volume dell’ippocampo, invece il solo studio che ha investigato gli effetti di un tipo di psicoterapia (TEB, Terapia Eclettica Breve) non ha evidenziato alcuna efficacia sul volume ippocampale 1. Scopo del nostro studio è valutare gli effetti del trattamento con EMDR (Eye Movement Desensitization and Reprocessing) sul volume ippocampale, sui sintomi e sulle performances mnesiche di pazienti con Disturbo Post-Traumatico da Stress (DPTS). La EMDR è una terapia la cui efficacia nel DPTS è stata dimostrata in numerosi studi sperimentali. Sono stati selezionati 12 soggetti drug-free con diagnosi di DPTS alla SCID-P, senza comorbidità psichiatrica. Ogni soggetto reclutato è stato sottoposto alla prima visita (Tempo 0, Drug-Free) ad una indagine psicometrica (tramite DTS), ad una indagine neuropsicologica (tramite una batteria di test) e alla misurazione dei volumi cerebrali tramite Risonanza Magnetica. Successivamente, i 12 soggetti sono stati attribuiti in maniera random a due diversi protocolli terapeutici. Sei soggetti hanno effettuato 12 sedute di EMDR della durata di 1,5 ore, mentre sei soggetti sono stati trattati con 100 mg di sertralina. Dopo il trattamento (Tempo 1, Post-Terapia) i soggetti sono stati nuovamente sottoposti alle indagini effettuate al Tempo 0. La seconda valutazione al Tempo 1 è stata effettuata dopo tre mesi nei soggetti trattati con EMDR e dopo 6 mesi nei soggetti trattati con la sertralina, in base ai tempi medi necessari per la remissione cilinica del DPTS riportati in letteratura per i due presidi terapeutici. In questo studio verranno presentati i dati relativi alle differenze volumetriche, ai miglioramenti clinici e alla performance mnesica nei due gruppi di soggetti (soggetti sottoposti ad EMDR e soggetti trattati con sertralina) e un dettagliato confronto dei risultati ottenuti.

Many experimental data have shown that drug therapy with SSRIs may increase the volume of the hippocampus, Instead the only study that has investigated the effects of a type psychotherapy (TEB, Brief Therapy Eclectic) showed no no effect on hippocampal volume 1. Purpose of our study was to evaluate the effects of treatment with EMDR (Eye movement desensitization and reprocessing) on hippocampal volume, symptoms and performance mnesic of patients with Post-Traumatic Stress Disorder (PTSD). The EMDR is a therapy whose efficacy in PTSD is been demonstrated in numerous experimental studies. Were selected 12 subjects with a diagnosis of drug-free PTSD in the SCID-P, without psychiatric comorbidity. Each recruited subject was submitted to the first visit (Time 0, Drug-Free) at a psychometric investigation (by DTS), a neuropsychological investigation (using a battery test) and measurement of brain volume through Magnetic Resonance Imaging. Subsequently, 12 subjects have been allocated random to two different treatment protocols. Six subjects have carried out 12 sessions of EMDR duration of 1.5 hours, while six patients were treated with 100 mg of sertraline. After treatment (Time 1, Post-Therapy) subjects are were again subjected to the investigations made at the time 0. The second evaluation at Time 1 was made after three months in subjects treated with EMDR and after 6 months in subjects treated with sertraline, based on the average time needed cylinder for the remission of PTSD reported in the literature for the two therapeutic aids. In this study will be presented data on differences displacement, the clinical improvements and performance mnesic in the two groups of subjects (subjects EMDR for patients treated with sertraline) and a detailed comparison of results. Listen Read phonetically Dictionary - View detailed dictionaryGoogle Translate for my:SearchesVideosEmailPhoneChatBusinessAbout Google TranslateTurn off instant translationPrivacyHelp ©2010Business ToolsTranslator ToolkitAbout Google TranslateBlogPrivacyHelp►

Keywords: Hippocampal Volume Poster Sertraline

Accuracy Verified: Yes

39. Bossini, L., Casolaro, I., Santarnecchi, E., Caterini, C., Koukouna, D., Fernandez, I., & Fagiolini, A. (2012, March-April). Studio di valutazione dell'efficacia clinica e neurobiologica dell'EMDR in pazienti affetti da disturbo da stress post-traumatico [Evaluation study of clinical and neurobiological efficacy of EMDR in patients suffering from post-traumatic stress disorder]. Rivista di Pschiatria, 47(Supplement 1), 12S-15S. doi:10.1078/1071.11733.

Language: Italian

Format: Journal

Abstract:
Un forte supporto all'uso prove di EMDR nei pazienti affetti da disturbo post-traumatico da stress (PTSD). Obiettivo. Per valutare l'efficacia clinica e neurobiologica-strutturale di EMDR alla droga naïve PTSD senza comorbidità. Materiali e metodi. Abbiamo fatto una valutazione clinica e la misurazione del volume ippocampale da MRI su 29 soggetti affetti da PTSD e su 30 soggetti sani di controllo. Quindi, i pazienti sono stati trattati con EMDR e dopo tre mesi di psicoterapia della valutazione clinica e l'esame di risonanza magnetica sono state risposto. Risultati e discussione. I nostri risultati hanno dimostrato che la diagnosi di PTSD non era più possibile su tutti i pazienti che hanno terminato la psicoterapia (n = 18). Allo stesso tempo, tutti i pazienti hanno mostrato un aumento medio del 6% dei volumi dell'ippocampo. Conclusioni. La reaserach suggerisce che il trattamento EMDR correla non solo con un miglioramento significativo dei sintomi di PTSD, ma anche con un significativo aumento del volume dell'ippocampo.

Strong evidence support use of EMDR in patients suffering from post-traumatic stress disorder (PTSD). Aim. To evaluate clinical and neurobiological-structural efficacy of EMDR on drug-naïve PTSD without comorbidity. Materials and methods. We made clinical evaluation and hippocampal volume measurement by MRI on 29 subjects suffering from PTSD and on 30 healthy control-subjects. Then, patients were treated with EMDR and after three months of psychotherapy the clinical evaluation and the MRI exam were replied. Results and discussion. Our results demonstrated that the diagnosis of PTSD was no more possible on all the patients who terminated the psychotherapy (n=18). At the same time, all the patients showed an average increase of 6% in hippocampal volumes. Conclusions. Our reaserach suggests that EMDR treatment correlates not only with a significant improvement of symptoms of PTSD, but also with a significant increase of hippocampal volumes.

Keywords: Neurobiology Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

40. Mosca, D., & Lescano, R. (2010, Agosto). TEPT y sus comorbilidades. Clínica y tratamientos eficaces: EMDR [PTSD and its comorbidities. Clinical and effective treatments: EMDR]. Presentación en el VII Congreso Mundial de Estados Depresivos y Simposium Internacional de Trastorno por Estrés Postraumático, Mendoza, Argentina.

Language: Spanish

Format: Conference

Keywords: Comorbidity Posttraumatic Stress Disorder PTSD Treatment

Accuracy Verified: Yes

41. Kapfhammer, H.-P. (2008, December). Therapeutische möglichkeiten nach traumatischen erlebnissen [Therapeutic possibilities after traumatic experiences]. Psychiatria Danubina, 20(4), 532-545.

Language: German

Format: Journal

Abstract:
Acute Belastungsstörung (ASD) und Posttraumatische Belastungsstörung (PTSD) sind häufige, aber nicht zwingend psychologische Folgeerscheinungen nach einem Trauma. Eine wichtige Untergruppe der Patienten vor einer chronischen Verlauf der Erkrankung mit einem erhöhten psychiatrischen Komorbidität und erhebliche Beeinträchtigungen in psychosozialen Anpassung assoziiert. Der typische psychopathologische Symptome von ASD und PTSD werden am besten in einem multifaktoriellen Modell der Integration sowohl neurobiologische und psychosoziale Einflüsse beschrieben. Die komplexen Ätiopathogenese von akuten und posttraumatischen Belastungsstörung begünstigt multimodalen Ansätzen in der Behandlung. Differential psychotherapeutische und pharmakologische Strategien zur Verfügung stehen. In einer kritischen Studie über empirische Studien, können psychologische Debriefing nicht als einen positiven Ansatz betrachtet werden, als allgemeine vorbeugende Maßnahme in der unmittelbaren posttraumatischen Phase empfohlen werden. Positive Auswirkungen der kognitiv-verhaltenstherapeutischen Interventionen kann für ASD eingerichtet werden. Psychodynamische Psychotherapie, kognitive Verhaltenstherapie und EMDR zeigen viel versprechende Ergebnisse bei der Behandlung von PTSD. Wesentliche klinische Einschränkungen der Patienten innerhalb von speziellen Probenahmen Forschungseinrichtungen, jedoch nicht gestatten, eine bedingungslose Verallgemeinerung dieser Daten zu psychiatrischen Routineversorgung. In einer empirischen Analyse der SSRIs sind die meisten und am besten untersuchten Medikamente für ASD und PTSD. Im Vergleich zu trizyklischen Antidepressiva SSRIs zeigen ein breiteres Spektrum an therapeutischen Wirkungen und sind besser verträglich. Die Substanzklassen der SNRI, DAS, SARI und NaSSA sind als Medikamente der zweiten Wahl angesehen werden. Sie versprechen eine therapeutische Wirksamkeit der SSRI gleichwertig, wobei bisher nur in offenen Studien untersucht. MAO-Hemmer können eine positive therapeutische Potenzial verfügen, müssen ihr Profil der Nebenwirkungen geachtet, jedoch werden. Mood-Stabilisatoren und atypische Neuroleptika können in Anspruch genommen werden und vor allem im Add-On-Strategien. Benzodiazepine sollten nur mit Vorsicht erhöht für eine kurze Zeit in den Staaten der akuten Krise eingesetzt werden. In frühen Interventionen, die blockierende Substanzen norepinephric Hyperaktivität scheinen vielversprechende Alternativen. Stress Dosen von Hydrocortison kann als experimentelle pharmakologische Strategie betrachtet so weit sein. [PubMed]

Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are frequent, but not obligatory psychological sequelae following trauma. A major subgroup of patients face a chronic course of illness associated with an increased psychiatric comorbidity and significant impairments in psychosocial adaptation. The typical psychopathological symptoms of ASD and PTSD are best described within a multifactorial model integrating both neurobiological and psychosocial influences. The complex etiopathogenesis of acute and posttraumatic stress disorder favours multimodal approaches in the treatment. Differential psychotherapeutic and pharmacological strategies are available. In a critical survey on empirical studies, psychological debriefing cannot be considered as a positive approach to be recommended as general preventive measure during the immediate posttraumatic phase. Positive effects of cognitive-behavioral interventions can be established for ASD. Psychodynamic psychotherapy, cognitive-behavioral therapy and EMDR show promising results in the treatment of PTSD. Major clinical restrictions of patient sampling within special research facilities, however, do not allow an unconditional generalization of these data to psychiatric routine care. In an empirical analysis the SSRIs are the most and best studied medications for ASD and PTSD. In comparison to tricyclic antidepressants SSRIs demonstrate a broader spectrum of therapeutic effects and are better tolerated. The substance classes of SSNRI, DAS, SARI and NaSSA are to be considered as drugs of second choice. They promise a therapeutic efficacy equivalent to the SSRIs, being investigated so far only in open studies. MAO-inhibitors may dispose of a positive therapeutic potential, their profile of side effects must be respected, however. Mood stabilizers and atypical neuroleptics may be used first and foremost in add-on strategies. Benzodiazepines should be used only with increased caution for a short time in states of acute crisis. In early interventions, substances blocking the norepinephric hyperactivity seem to be promising alternatives. Stress doses of hydrocortisone may be considered as an experimental pharmacological strategy so far.[PUBMED]

Keywords: Acute Stress Disorder ASD Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

42. Siracusano, A., & Niolu, C. (2006, Settembre-Dicembre). Trattamento farmacologico del - Disturbo post-traumatico da stress [Drug treatment of - post-traumatic stress disorder]. NÓOς, 12(3), 243-276.

Language: Italian

Format: Journal

Abstract:
Complesso caratteristiche sintomatologiche del disturbo. Qui troviamo, mescolati tra loro, i sintomi di ansia, panico, depressione, dissociazione, evasione, deterioramento della memoria. La Società per traumatica Stress Studies (ISTSS) le linee guida suggeriscono alcuni passi: da un debriefing psicologico top e la terapia cognitivo-comportamentale (CBT), seguita dal trattamento farmacologico e di alcuni altri approcci: tecniche psico-sociale e riabilitativo, il movimento degli occhi desensibilizzazione e rielaborazione (EMDR), ipnosi, psicoterapia di coppia e di gruppo, psychothery psicoanalitico. Nel ultimi anni, molti dati dalla ricerca fornire consulenza per l'avvio forte CBT e farmacologiche trattamento subito dopo il trauma (entro 72 ore) solo per gestire dissociazione peritraumatico, ad alto rischio fattore per lo sviluppo di PTSD. Inoltre, quando si avvicina al trattamento del PTSD, è importante prendere in considerazione altre comorbidità con asse I e II e con disturbi abuso di sostanze.

Complex symptomatological features of the disorder. Here we find, mixed up together, symptoms of anxiety, panic, depression, dissociation, avoidance, memory impairment. The Society for Traumatic Stress Studies (ISTSS) guidelines suggest some steps: on the top psychological debriefing and cognitive-behavioral therapy (CBT), followed by pharmacological treatment and some other approaches: psychosocial and rehabilitative tecniques, eye movement desensitization and reprocessing (EMDR), hypnosis, couple and group psychotherapies, psychoanalitic psychothery. In the last years, many data from the research give strong advice for starting CBT and pharmacological treatment soon after trauma (within 72 hours) just to manage peritraumatic dissociation, high risk factor for the development of PTSD. Moreover, when approaching to the treatment of PTSD, it’s important to consider comorbidity with other axis I and II disorders and with substance abuse.

Keywords: Acute Stress Disorder ASD Cognitive-Behavioral Therapy Comorbidity Hypnosis Peritraumatic Dissociation Psychological Debriefing Trauma

Accuracy Verified: Yes

43. Nijdam, M., Pol, M. V. D., Dekens, R., Olff, M., & Denys, D. (2013). Treatment of sexual trauma dissolves contamination fear. European Journal of Psychotraumatology, 3(0). doi:10.3402/ejpt.v4i0.19157.

Language: English

Format: Journal

Abstract:
Background: In patients with co-morbid obsessive−compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), repetitive behavior patterns, rituals, and compulsions may ward off anxiety and often function as a coping strategy to control reminders of traumatic events. Therefore, addressing the traumatic event may be crucial for successful treatment of these symptoms.
Objective: In this case report, we describe a patient with comorbid OCD and PTSD who underwent pharmacotherapy and psychotherapy.
Methods: Case Report. A 49-year-old Dutch man was treated for severe PTSD and moderately severe OCD resulting from anal rape in his youth by an unknown adult man.
Results: The patient was treated with paroxetine (60 mg), followed by nine psychotherapy sessions in which eye movement desensitization and reprocessing (EMDR) and exposure and response prevention (ERP) techniques were applied. During psychotherapy, remission of the PTSD symptoms preceded remission of the OCD symptoms. Conclusions: This study supports the idea of a functional connection between PTSD and OCD. Successfully processing the trauma results in diminished anxiety associated with trauma reminders and subsequently decreases the need for obsessive−compulsive symptoms.

Keywords: Combined Treatment Comorbidity Obsessive Compulsive Disorder OCD Pharmacological Treatment Posttraumatic Stress Disorder Psychotherapy PTSD

Accuracy Verified: Yes

44. Oras, R., de Ezpeleta, S. C., & Ahmad, A. (2004, June). Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 58(3), 199-203. doi:10.1080/08039480410006232.

Language: English

Format: Journal

Abstract:
This study examines the effects of a psychodynamic approach of Eye Movement Desensitization and Reprocessing (EMDR) in treatment of traumatized refugee children. Among a child psychiatric outpatient refugee team, 13 children with post-traumatic stress disorder (PTSD), were treated by EMDR incorporated in a traditional psychodynamic therapeutic approach. The Posttraumatic Stress Symptom Scale for Children (PTSS-C) and the Global Assessment of Functioning (GAF) were administered before and after the treatment, to measure the effects. After treatment, a significant improvement was noticed in the functioning level and all PTSS-C scales, mostly in re-experiencing and least in the avoidance symptoms. The improvement in the functioning level was significantly correlated with the reduction of the PTSD-non-related and the depression, but not with that of the PTSD-related symptoms. Used in a psychodynamic context, EMDR is suggested to be effective treatment for traumatized refugee children. Our findings support the hypothesis of child-specific criteria for PTSD.

Keywords: Children Comorbidity Depressive Disorders Empirical Study Posttraumatic Stress Disorder PTSD Quantitative Study Refugees School Age Children Adolescents Stressors Survivors Trauma Treatment Effectiveness

Accuracy Verified: Yes

45. 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

46. Zillhart, P. (2007, Juin). Troubles du comportement alimentaire et EMDR [EMDR and eating behavioral disorders]. Présentation à la réunion annuelle de l'Association EMDR Europe, Paris, France.

Language: French

Format: Conference

Abstract:
Défaut d’intériorsation des objets dans la théorie des relations objectales ou véritable pathologie de la consommation et du changement au carrefour des domains environnementaux et socio-culturels, les TCA constituent un probleme de santé sociale. Leur nature addictive est discutée.
Le problematique des TCA est rendue plus complexe par l’existence d’une lourde comorbidité dont les éléments pathologiques sont autant causes que conséquences. Notons que 40% des patients souffrant de TCA ont eu, à un moment de leur vie, un psychotraumatisme.
La thérapie EMDR permet une approche intégrative dans le traitement des TCA: un aspect cognitif indéniable, le processus associatif unduit par les stimulations alternées met souvent en lumuiere des matériaux reflétant des conflits intrapsychiques plus ou moins archaiques.
Le travail portant sur l’imagerie mentale ou les états dissociés du moi peut aussi etre associé dans les cas difficiles de patients souffrant de TCA Le présent atelier a pour but :
- D’éclairir les points clef des classifications nosographiques actuelles, notamment dans leur incidence thérapeutique, sans oublier les cas l’urgences.
- De présenter les aspects les plus récents du modèle bio-psychosocial des TCA, véritable clef de voute des interventions thérapeutiques, notommanent concernant la therapie EMDR. La therapie EMDR se veut indvidualisée selon l’histoire de vie de chaque patient.
La connaissance profounde de l’histoire de vie des patients avec leurs thématiques existentielles permet la construction de "clusters" multiples. Ceux-ci offrent un mode d’induction privilégié des processus associatifs de restructuration cognitive, émotionnelle, et corporelle proper à la thérapie EMDR.
- Des protocoles sont proposés selon cas et illustrés par quelques exemples et vignettes cliniques.
- De répondre à un maximum de questions durant l’atelier.

Failure intériorsation objects in the theory of object relations or true pathology of consumption and change at the junction of domains environmental and socio-cultural, the CAW is a social health problem. Their addictive nature is discussed. The problematic CAW is complicated by the existence of a significant comorbidity with pathological elements are all causes than consequences. Note that 40% of patients with ABI had, at some point in their life, a psychological trauma. EMDR allows an integrative approach in the treatment of TCA, a cognitive undeniable, the associative process unduit by alternating stimulation is often lumuiere materials reflecting intrapsychic conflicts more or less archaic. The work on mental imagery or dissociated ego states may also be involved in difficult cases of patients with ABI This workshop aims to: - To explain the key points nosographic current classifications, particularly in their therapeutic effect, without forgetting the emergency cases. - Present the most recent aspects of the biopsychosocial model CAW real keystone of therapeutic interventions notommanent on EMDR therapy. The EMDR therapy is meant indvidualisée by life history of each patient. Profound knowledge of the history of life of patients with their existential issues allows the construction of clusters multiple. They offer a privileged mode of induction of associative processes of cognitive restructuring, emotional, and physical Proper to EMDR. - Protocols are proposed under event and illustrated by some examples and clinical vignettes. - To answer many questions as possible during the workshop.

Keywords: Eating Disorders

Accuracy Verified: Yes

47. McFarlane, A. (2010, June). Understanding traumatic stress reactions - The linking of phenomenology, aetiology and treatment plan. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
One of the most intriguing aspects of traumatic stress has been the repeated learning and forgetting of lessons about its importance as a cause of psychopathology. It remains the case that the broader body of psychiatry and psychology has an ambivalent relationship with the field of traumatic stress and the nature of posttraumatic stress disorder. The origins of this ambivalence and their impact will be discussed. It is important that practitioners in the field of traumatic stress be aware of these barriers and how to address them in a research setting and clinical practice.
The underlying phenomenology of posttraumatic stress disorder will be explored and its neurobiological origins will be highlighted. It is important to deconstruct posttraumatic stress disorder into the different symptom components, as they have substantially different mechanisms underpinning their intensity and presentation. Posttraumatic stress disorder is a dynamic condition in which symptoms fluctuate with time and are substantially influenced by the environmental demands placed upon the individual.
It is often forgotten that somatic symptoms are a core element of the experience of individuals with PTSD. The nature of these somatic dimensions of distress and their significance will be discussed.
The epidemiology of posttraumatic stress disorder highlights how the prevalence of these conditions is seemingly increasing. However, this reflects the developments in the measurement of the effects of trauma in research settings. This has major implications for clinicians as to how best take a history about exposures to traumatic events. The evidence is that systematic investigation is critical and that unless questions are asked, symptoms will frequently go unreported. Recent evidence suggests that PTSD may be in fact more common than major depressive disorders. Equally, it should not be forgotten that depression is an important dimension of posttraumatic reactions. There is also an associated comorbidity with substance abuse. The risks associated with trauma exposure have a long tale of effect and these will be described.
The challenges of treatment will be discussed in the context of early intervention and workplace intervention. Treatment needs to be a sequential process where there are a variety of strategies, including EMDR, which can be used in treatment. The sequence of these strategies in treatment is a challenging question that has not been systematically addressed in research.
It remains the case that one of the primary issues in treatment is early identification, and this raises questions about the importance of screening in at-risk populations. Again, there are significant differences in opinion; however, the militaries around the world are now regularly screening populations returning from deployment. A recent novel approach to considering the issues of treatment is whether a staging approach should be used for conditions such as PTSD.
In summary, it is critical that clinicians have an explicit model of the mind and its neurobiology. Posttraumatic stress disorder can best be understood as an information processing disorder, which both impacts upon an individual's ability to engage with their day to day environment as well as integrate past experiences as a source of information to influence current behaviour. The integration and modulation of neural systems that manage environmental input is critical to adaptive functioning. The ways that these systems become dysregulated in PTSD will be highlighted and how these underlying deficits can be addressed in treatment will be focused upon.
A further issue that needs to be considered in the treatment of PTSD is the long-term risk of individuals, who have developed this condition, to have relapses after a successful intervention. Some long-term treatment outcome data will be presented.

Keywords: Posttraumatic Stress Disorder PTSD Traumatic Stress

Accuracy Verified: Yes

48. Ross, C., & Rouanzoin, C. (2012, October). Uses of EMDR in complex dissociative disorders. Presentation at the 29th annual meeting of the International Society for the Study of Trauma and Dissociation, Long Beach, CA.

Language: English

Format: Conference

Abstract:
EMDR can be used in the treatment of complex dissociative disorders. Both presenters have been treating dissociative disorders for decades and one is an approved EMDR trainer. This workshop will not include instruction on specific techniques: these can be learned from approved EMDR trainings which require six full days of workshop teaching, assigned readings, and 10 hours of supervision. Instead, the presenters will explain how EMDR is based on a trauma-dissociation model and is therefore highly suited to the treatment of complex dissociative disorders including DID. A brief description of EMDR will be provided, including its 8 phases, of which only one involves eye movements or other forms of bilateral stimulation. EMDR is consistent with three-stage models of trauma therapy: the eye movements are used in stage two, the active working phase of therapy. In EMDR this is called Phase 4. The work in trauma stage one (EMDR phases 1-3), in patients with DID or DDNOS, involves grounding, stabilization, system mapping, building co-consciousness, orientation of parts to the body and the present, and other elements from the dissociative disorders literature. The bilateral stimulation phase of EMDR should not be used until this phase one work is complete, or at least well underway. The presenters will then go on to provide case examples of how EMDR can be used in the psychotherapy of DID, DDNOS and the complex comorbidity that usually accompanies both.
Learning Objectives: Participants will be able to describe how EMDR can be used in complex dissociative disorders. Participants will be able to describe how EMDR is based on a trauma-dissociation model of mental disorders and addictions. Participants will be able to describe the basic feaures of EMDR.

Keywords: Dissociative Disorders

Accuracy Verified: Yes

49. Friday, S. (2005, September). Using EMDR as an intervention for symptom severity in ADD. Presentation at the annual meeting of the EMDR International Association, Seattle, WA.

Language: English

Format: Conference

Abstract:
This study investigated the intervention effects of EMDR on the trauma and behavior symptom severity of ten children, ages 8 to 11, diagnosed with Attention Deficit Disorder (ADD). ADD is a common childhood disorder with increasing prevalence rates that raise questions concerning overdiagnosis, misdiagnoses, and possible inadequate assessment of primary, comorbid, and diffential diagnoses. ADD and trauma have comorbid symptoms that often inhibit an accurate diagnosis. Accurate assessments for ADD and trauma-related attention problems have important behavioral implications for diagnostic intervention and treatment planning. The purpose of this research was to investigate if a three-phased treatment intervention, including EMDR, would show a reduction in the trauma and behavior symptom severity in children with ADD and trauma symptoms.

Keywords: Attention Deficit Disorder ADD Comorbidity Disruptive Behavior Disorders Elementary School Posttraumatic Stress Disorder PTSD School Age Children Stressors Students Treatment Effectiveness

Accuracy Verified: Yes

50. Friday, S. (2004, September). Using EMDR as an intervention for symptom severity in attention deficit disorder. Presentation at the annual meeting of the EMDR International Association, Montréal, Ontario Canada.

Language: English

Format: Conference

Abstract:
This study investigated the intervention effects of Eye Movement Desensitization Reprocessing (EMDR) on the trauma and behavior symptom severity of ten children, ages 8 to 11, diagnosed with Attention Deficit Disorder (ADD). ADD is a common childhood disorder with increasing prevalence rates that raise questions concerning over diagnoses, misdiagnoses, and possible inadequate assessment, of primary, comorbid and differential diagnoses. Accurate assessments for ADD and trauma related attention problems have important implications for diagnostic intervention and treatment planning. The purpose of this research was to investigate if a three-phased treatment intervention, including EMDR, would show a reduction in the trauma and behavior symptom severity in children with ADD and trauma symptoms.

Keywords: Comorbidity Disruptive Behavior Disorders Elementary School Students Posttraumatic Stress Disorder PTSD School Age Children Stressors Treatment Effectiveness

Accuracy Verified: Yes

51. Friday, S. (2003). Using eye movement desensitization and reprocessing as an intervention for trauma and behavior symptom severity in attention deficit hyperactivity disorder. Capella University, Minneapolis, MN. AAT 3093820.

Language: English

Format: Dissertation/Thesis

Abstract:
This study investigated the intervention effects of Eye Movement Desensitization Reprocessing (EMDR) on the trauma and behavior symptom severity of 10 children, ages 8 to 11, diagnosed with Attention Deficit Hyperactive Disorder (ADHD). ADHD is a common childhood disorder with increasing prevalence rates that raise questions concerning overdiagnoses, misdiagnoses, and possible inadequate assessment of primary, comorbid, and differential diagnoses. Accurate assessments for ADHD and trauma-related attentional problems have important implications for diagnostic intervention and treatment planning. The purpose of this research was to investigate if a three-phased treatment intervention including EMDR, a therapy method proven effective in the reduction of PTSD, would show a reduction in the trauma and behavior symptom severity in children with ADHD and trauma symptoms. Evaluation of the efficacy of EMDR in the treatment of ADHD was examined using a multiple-component case study and a repeated measure design for evidence of trauma. Two of the three treatment phases were randomly adjusted from one to three sessions in length, with the intervention method, EMDR, remaining constant for a total of three sessions. Outcome measures were the Subjective Units of Disturbance Scale (SUDS), the Behavioral Assessment of Children Scales (BASC), (teacher and parent forms), and repeated assessments of trauma using the Lifetime Incidence of Traumatic Events Scales (LITE-P&S, parent and student forms), the Child and Parent Reports of Post-Traumatic Symptoms Scales (PROPS & CROPS), and the Problem Rating Scales (PRS). The results from quantitative analysis suggested that the intervention method incorporating EMDR affected a decrease in Externalizing and Internalizing behavior symptom severity and trauma symptom severity in the ADHD children that were studied. Qualitative data suggested that trauma and behavioral symptom severity decreased as a result of the intervention method incorporating EMDR. The results underscore the need for further research to distinguish between the symptom presentation of ADHD and comorbid trauma and behavioral symptoms. A continuous refining of the method of diagnosis and determination of the comorbid disorders is warranted. [Author Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. 64(6-B), 2003, pp. 2901

Keywords: Comorbidity Disruptive Behavior Disorders Elementary School Students Posttraumatic Stress Disorder PTSD Empirical Study Quantitative Study School Age Children Stressors Treatment Effectiveness

Accuracy Verified: Yes

52. Lovell, C. (2005). Utilizing EMDR and DBT techniques in trauma and abuse recovery groups. In R. Shapiro (Ed.), EMDR solutions: Pathways to healing (pp. 263-282). New York: W W Norton & Co.

Language: English

Format: Book Section

Abstract:
Marsha Linehan's dialectical behavior therapy (DBT) is a wonderfully effective treatment for people with borderline personality. It is a non-blaming, compassionate, therapeutic approach, based solidly on research data about what borderline personality disorder (BPD) is and how to treat it effectively. I have used the techniques of DBT for the past 9 years in trauma and abuse recovery groups for women. DBT provides a solid foundation for the group. EMDR, adjunct therapies, and other trauma related resources complete DBT by including the treatment of trauma within the group setting. The groups are successful in that the intensity of symptoms decreases and the group members report feeling increased competency regulating their emotions. [Adapted from Text, p. 263] [Pilots]

Keywords: Adults Borderline Personality Disorder Cognitive Therapy Comorbidity DBT Dialectical Behavior Therapy Females Group Psychotherapeutic Processes Posttraumatic Stress Disorder Psychotherapy PTSD Stressors Survivors

Accuracy Verified: Yes

53. van Minnen, A., Hendriks, L., & Olff, M. (2010, April). When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors. Behaviour Research and Therapy, 48(4), 312-320. doi:10.1016/j.brat.2009.12.003.

Language: English

Format: Journal

Abstract:
To investigate when and why therapists opt for or rule out imaginal exposure (IE) for patients with posttraumatic stress disorder (PTSD), 255 trauma experts were randomized to two conditions in which they were presented with four cases in which the patients’ comorbidity and treatment preferences were manipulated. The results confirmed IE to be an underutilized approach, with the majority of professionals being undertrained in the technique. As predicted, the patient factors influenced the expert’s choice of therapy: in case of a comorbid depression, IE was significantly less preferred than medication. Also, IE was significantly more likely to be offered when patients expressed a preference for traumafocused treatment. The therapist factors were also found to be importantly related to treatment preferences, with high credibility in the technique being positively related to the therapists’ preference for IE. Perceived barriers to IE, such as a fear of symptom exacerbation and dropout, were negatively related to the perceived suitability of the treatment when patients had suffered multiple traumas in childhood. The results are discussed in the light of clinical implications and the need of exposure training for trauma professionals.

Keywords: Controlled Study: Exposure Therapy Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes