Francine Shapiro Library ~ EMDR Bibliography

Francine Shapiro Library - EMDR Bibliography Links

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Your Results - you searched for the keyword Extinction 19 Results

1. Hornsfeld, H. (2005, June). Cue exposure and EMDR, a new protocol description of procedure and demonstration of clinical application in the treatment of binge eating. In EMDR and eating disorders. Symposium conducted at the annual meeting of the EMDR Europe Association, Brussels, Belgium.

Language: English

Format: Conference

Abstract:
In this presentation a new protocol will be described which combines EMDR and cue exposure in the treatment of binge eating disorder. Reason to adjust the cue exposure protocol by Jansen (1997) is that it is primarily aimed at extinction of the conditioned response pattern, but misses the opportunity to specifically address the processing of emotional and cognitive reactions. Two years of experience with this new procedure show results. The protocol will be presented and will be illustrated by video fragments. Specific issues like target selection, NC, PC and future templates will be discussed.

Keywords: Cue Exposure Eating Disorders Symposium

Accuracy Verified: Yes

2. Hornsveld, H. (2005, June). Cue exposure and EMDR, A new protocol description of procedure and demonstration of clinical application in the treatment of binge eating. Presentation at the annual meeting of the EMDR Europe Association, Brussels, Belgium.

Language: English

Format: Conference

Abstract:
In this presentation a new protocol will be described which combines EMDR and cue exposure in the treating of binge eating disorder. Reason to adjust the cue exposure protocol by Jansen (1997) is that it is primarily aimed at extinction of the conditioned response pattern, but misses the opportunity to specifically address the processing of emotional and cognitive reactions. Two years of experience with this new procedure show positive results. The protocol will be presented and will be illustrated by video gragments. Specific issues like target selection, NC, PC and future templates will be discussed.

Keywords: Binge Eating Cue Exposure Treatment

Accuracy Verified: Yes

3. Kaden, P. (1996). Cue extinction via EMDR in smoking cessation. Argosy University, Chicago, IL.

Language: English

Format: Dissertation/Thesis

Keywords: Smoking Cessation Cigarettes

Accuracy Verified: Yes

4. Capezzani, L. (2010, Novembre). Dati preliminari del progetto: Valutazione degli esiti medico- clinici e psicologici in seguito all’applicazione dell’EMDR in pazienti oncologici con disturbi dello spettro post traumatico da stress [Preliminary data of the project: Evaluation of medical-clinical and psychological outcomes following the application of EMDR in cancer patients with autism spectrum post-traumatic stress disorder]. Presentazione al "Convegno La psicotraumatologia Oncologica, Roma, Italia.

Language: Italian

Format: Conference

Abstract:
La ricerca ha lo scopo di indicare se l’intervento con EMDR produce significativi cambiamenti dei parametri medico-clinico, oltre che psicologici, in pazienti oncologici che abbiamo ricevuto una diagnosi di PTSD o di un disturbo dello spettro post-traumatico da stress durante ciascuna delle fasi dell’evoluzione della malattia. In particolare si vuole verificare se dopo trattamento con EMDR: - i valori baseline di cortisolo nel sangue cambiano e riproducono anche in pazienti oncologici l’andamento dimostrato in letteratura: in presenza di un PTSD acuto generalmente i livelli sono alti, quando invece il PTSD è cronico i livelli di cortisolo sono bassi ma in ambedue i casi un trattamento con EMDR produce una normalizzazione di suddetti valori. - si osserva una riduzione della quantità di citochine che rappresentano gli indicatori immunologici correlati a stati di depressione ed ansia sia sottosoglia che non, quasi sempre presenti tra i disturbi dello spettro PTSD e quindi anche nella malattia oncologica (Cantelmi, 2008 in preparazione). Lo studio consente inoltre di osservare - per quali delle fasi della malattia il trattamento con EMDR produce la migliore estinzione dei disturbi post-traumatici da stress, - se le modalità di coping, cioè le strategie di adattamento alla malattia e sua gestione migliorano dopo il trattamento con EMDR

The research is intended to indicate whether the intervention with EMDR produces significant changes in clinical parameters and medical as well as psychological, in cancer patients who have received a diagnosis of PTSD or a spectrum disorder post-traumatic stress disorder during each of the stages of the disease. In particular, we want to check if after treatment with EMDR: - The values of baseline cortisol in the blood change and reproduce even in cancer patients the trend shown in the literature: in the presence of an acute PTSD generally the levels are high, when instead the PTSD is chronic cortisol levels are low but in both cases treated with EMDR produces a normalization of these values. - There is a reduction in the amount of cytokines representing the immunological indicators related to states of depression and subthreshold anxiety is that, almost always present between the spectrum disorders PTSD and therefore also in the oncological disease (Cantelmi, 2008 in preparation). The study also allows you to observe - For which of the stages of the disease treatment with EMDR produces the best extinction of the symptoms of post-traumatic stress, - Whether the method of coping, ie the strategies of adaptation to the disease and its management to improve after treatment with EMDR.

Keywords: Autism Cancer Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

5. Khalfa, S. (2012, June). Effects of EMDR on cognition, psychophysiology and cerebral mechanisms in PTSD [Efectos del EMDR en cognición, psicofisiología y mecanismos cerebrales en TEPT]. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Despite the emergence of many theories on biological EMDR mechanisms, research is still needed to understand the healing processes of EMDR. We conducted four experiments to explore the effects of EMDR on PTSD with 17 to 22 patients suffering from one unique trauma. The first experiment evidenced attentional bias in PTSD towards negative words that disappeared after successful EMDR Therapy. The second experiment has shown a less efficient control of emotion in PTSD as compared to healthy controls. This altered emotional suppressing measured through psychophysiological responses was restored after symptoms disappearance following EMDR. The third experiment also using psychophysiological measures confirmed the increased fear sensitization and delayed fear extinction in PTSD and again the restoration of a normal fear conditioning and extinction processes after EMDR. The last experiment explored the negative emotional cerebral mechanisms using functional magnetic resonance imagery in PTSD. Activities in prefrontal structures were modified in PTSD as compared to healthy controls. After the EMDR treatment accompanied by symptoms removal, the prefrontal responses were not different between PTSD patients and their controls. Theoretical issues of these results will be discussed in order to integrate cognitive, psychophysiological and cerebral mechanisms observations.

A pesar del emerger de muchas teorías sobre los mecanismos biológicos del EMDR, la investigación aún necesita entender el proceso de curación que se produce en EMDR. Hemos realizado 4 experimentos para explorar los efectos del EMDR en TEPT de 17 a 22 pacientes que sufrieron un único trauma. El primer experimento evidencia un sesgo atencional del TEPT ante las palabras negativas que desaparecen después de una terapia exitosa de EMDR. El Segundo experimento mostró una baja eficiencia del control de las emociones en los TEPT comparados con el control de individuos sanos. Esta alterada supresión emocional medida a través de respuestas psicofisiológicas fue restaurada después de una desaparición de los síntomas realizando EMDR. El tercer experimento también confirma mediante medidas psicofisiológicas el aumento de la sensación de miedo y un retraso en la extinción del mismo en el TEPT. De nuevo tras administrar una terapia EMDR se produjo una restauración a una condición normal de miedo y un proceso de extinción. El último experimento explica los mecanismos negativos emocionales cerebrales usando resonancia funcional magnética en TEPT. La actividad en las estructuras prefrontales fue modificada en el TEPT comparado con el control. Después del tratamiento de EMDR acompañado de una remisión de los síntomas, las respuestas prefrontales no fueron diferentes entre los pacientes con TEPT y los controles. Cuestiones teoréticas sobre estos resultados serán discutidas con el fin de integrar cognitivamente, psicofisiológicamente y observar los mecanismos cerebrales del EMDR.

Keywords: Cognition, Psychophysiology and Cerebral Mechanisms Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

6. Becker, L., Black-Tanski, D., Nugent, N., & Thede, L. (1999, November). The effects of eye movement on the stream of consciousness. Poster presented at the annual meeting of the International Society for Traumatic Stress Studies, Miami, FL.

Language: English

Format: Conference

Abstract:
A recent meta-analysis of PTSD treatments (van Etten & Taylor, 1998) found EMDR to be as efficacious as behavioral and drug treatments. There is considerable controversy, but little research, on the underlying mechanisms of EMDR. A conditioning model by Dyck (1993) suggests that eye movements (EM) effect a distraction from trauma related thoughts, causing an extinction trial. According to this model, the distraction of EM should cause thoughts to be directed outward. A psychodynamic model by Allen and Lewis (1996) suggests that EM facilitate the formation of new associations to traumatic memories and allow the client to “remain in the present while thinking of the past.” This model postulates that EM cause thoughts to be directed inward. We report two experiments in which thought processes were studied using a stream of consciousness (SOC) technique (Singer, 1993). In both studies, undergraduate participants wrote down a sad (or happy) target event from their life. They then thought about the target event and let their thoughts go where they may for 10 minutes. At approximately 1-minute intervals they were asked to report their thoughts. The baseline study (n = 42) looked at SOC with eyes closed; the second study (n = 27) compared SOC with eyes open, eyes closed, and with EM. Relative the to the eyes-open condition, EM tended to keep the SOC internally focused. During the last 4 minutes of the SOC, eyes open participants were externally focused (thoughts about the surroundings) about 50% of time; EM participants were externally focused 25% of the time; and eyes closed participants were externally focused 3% of the time, F(1, 11) = 6.08, p = .017. Eye movements produced a blend of external (eyes open) and internal (eyes closed) thoughts, offering support to the psychodynamic model.

Keywords: Eye Movement Poster Stream of Consciousness

Accuracy Verified: Yes

7. Solomon, R. M., & Shapiro, F. (2008). EMDR and the adaptive information processing model - Potential mechanisms of change. Journal of EMDR Practice and Research, 2(4), 315-325. doi:10.1891/1933-3196.2.4.315.

Language: English

Format: Journal

Abstract:
Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach guided by the adaptive information processing (AIP) model. This article provides a brief overview of some of the major precepts of AIP. The basis of clinical pathology is hypothesized to be dysfunctionally stored memories, with therapeutic change resulting from the processing of these memories within larger adaptive networks. Unlike extinction-based exposure therapies, memories targeted in EMDR are posited to transmute during processing and are then again stored by a process of reconsolidation. Therefore, a comparison and contrast to extinction-based information processing models and treatment is provided, including implications for clinical practice. Throughout the article a variety of mechanisms of action are discussed, including those inferred by tenets of the AIP model, and the EMDR procedures themselves, including the bilateral stimulation. Research suggestions are offered in order to investigate various hypotheses.

Keywords: Adaptive Information Processing Model AIP Information Processing Mechanism of Change Psychotherapy

Accuracy Verified: Yes

8. Kennert, G. (2008). EMDR und biofeedback in der behandlung von posttraumatischen belastungsstörungen [EMDR and biofeedback in the treatment of post traumatic stress disorder]. Forum Psychotherapeutische Praxis, 8(1), 45-46. doi:10.1026/1860-7357.8.1.45b.

Language: German

Format: Journal

Abstract: rezensiert von Gabriele Kennert, In dem von Stefan Jacobs und Anna de Jong vorgestellten Behandlungskonzept werden die kognitive Verhaltenstherapie, das EMDR-Verfahren sowie Biofeedback miteinander kombiniert, um die Angstreaktion im Rahmen traumatisierender Erinnerungen zu verringern bzw. zu hemmen und somit auch die Symptomatik der posttraumatischen Belastungsstörung abzubauen. Im ersten Teil des Buches gehen die Autoren eingehend auf den theoretischen Hintergrund (Neurophysiologie, Hirnfunktionen) ein, die mit der neuronalen Bahnung von traumatisierenden Erinnerungen einhergehen. Hierbei vertreten sie die These, dass sich die neuronalen Bahnungen der Traumata nicht löschen lassen, dass sozusagen die Angstreaktion in der Amygdalaregion im Gehirn löschungsresistent ist und es somit in der Konsequenz im Therapieziel nur um die Verringerung der Angstreaktion, bzw. Hemmung der Angstreaktion gehen könne. Konkret modifizieren die Autoren innerhalb des kognitiv, verhaltenstherapeutischen Vorgehens das Modell von Ehlers und Clark, ebenso das EMDR-Verfahren von Shapiro. Das Biofeedbackverfahren nutzen die Autoren als diagnostisches Instrument, um die subjektiven Bewertungen seitens der Patienten und Patientinnen auch objektiv überprüfbar zu machen mit Hilfe der Messung der elektrodermalen Aktivität (EDA). Im zweiten Teil des Buches beschreiben sie detailliert eine wissenschaftliche Studie an 16 Patienten und Patientinnen, die an dem Behandlungsprogramm an der Universität Göttingen teilgenommen haben. Hierbei sei bei allen Patienten und Patientinnen eine signifikante positive Symptomveränderung der PTB nachzuweisen gewesen. Im weiteren Teil des Buches stellen sie ihr ausführliches Therapiekonzept und Behandlungsprotokoll vor. Es wird eingehend auf die Diagnostik (psychologische Testverfahren sowie Biofeedback eingegangen, ein wichtiger Teil ist die Informationsvermittlung sowie Stabilisierung für die Patienten und Patientinnen. Danach erfolgt die Traumabehandlung mit Konfrontation und Integration. Wert wird hierbei in Abgrenzung zu Shapiro auf die frühzeitige Verbindung zur positiven Kognition gelegt in Verbindung mit Hausaufgaben, die die Patienten zwischen den Sitzungen bekommen mit eingehenden Verhaltensübungen. Die Autoren grenzen ein, dass ihre Methode nicht für alle Patienten und Patie tinnen geeignet ist, sondern dissoziative Störungen und Persönlichkeitsstörungen sowie Suchtproblematik explizit ausgeschlossen seien. Die Stabilisierungsübungen werden praktisch beschrieben (Sicherer Ort, Tresor), ebenso die praktische Anwendung des Biofeedbackverfahrens sowie das Behandlungsprotokoll für EMDR. Gegen Ende des Bandes schließen sich Fallstudien aus der Arbeit der Autoren an, um die Praxis zu verdeutlichen. Im Anhang gibt es Adressenverzeichnisse über den Bezug von Tests, Biofeedbackgeräten oder Lehrfilmen. Zusammenfassend kann man sagen, dass der Band kurzgefasst, sehr übersichtlich und konkret sowie praxisnah das neuropsychotherapeutische Behandlungsprogramm darstellt, so dass dies hilfreich für die psychotherapeutische Praxis in Bezug auf Traumabehandlungen erscheint. Das Buch richtet sich an Fachleute und ist für Laien eher weniger geeignet.

In the presented text by Stefan Jacobs and Anna de Jong, the treatments approached are the cognitive-behavioral therapy, the EMDR method and biofeedback combined to the fear reaction Framework to reduce traumatic memories or to inhibit and thus the symptoms of reduce post-traumatic stress disorder. In the first part of the book, the authors detail to the theoretical background (neurophysiology, Brain functions, a), the facilitation of the neuronal accompanied by traumatic memories. Here, they argued that the neuronal Facilitations of trauma can not be cleared, so to speak, that the fear response in the Amygdalaregion Brain is resistant to extinction and thus in consequence the goal of therapy just to reduce the fear response, and inhibiting the fear response could. Specifically, the authors modify within the cognitive, behavioral approach, the model by Ehlers and Clark, as well as the method of EMDR Shapiro. The biofeedback method, the authors use as a diagnostic tool for the subjective evaluation on the part of the patients also making objectively verifiable by measuring electrodermal activity (EDA). In the second part of the book they describe in detail a scientific study of 16 male and female patients, where the treatment program at the University Göttingen participated. Here is at all patients, and patients had a significant positive Detect symptom change the PTB have been. In another part of the book they put their detailed Therapeutic approach and treatment protocol first. It will detail the psychological diagnosis ( Test procedures and biofeedback received an important Part is to communicate information and stabilization for male and female patients. Thereafter the confrontation with trauma treatment and integration. Value in this case in contrast to Shapiro on down early connection to the positive cognition in conjunction with homework, the patients who get between meetings with incoming Behavioral exercises. The authors of a frontier that their method is not for All male and female patients is appropriate, but dissociative And personality disorders and addiction are explicitly excluded. The stabilization exercises are described practically (Safe Place, Safe), as well as the practical Application of biofeedback procedure and the treatment protocol for EMDR. Towards the end of the tape to close case studies from the work of the authors in order to clarify the practice. In the appendix, there are records of the address Terms of testing, biofeedback devices or educational films. In summary, one can say that the band concise, very clear and concrete and practical the neuro-psychological treatment program represents, so this is helpful for the psychotherapeutic Practice in relation to trauma treatment appears. The book is aimed at professionals and is for Lay less suitable.

Keywords: Biofeedback Posttraumatic Stress Disorder PTSD Treatment

Accuracy Verified: Yes

9. Solomon, R. M., & Shapiro, F. (2010). EMDR y el modelo de procesamiento adaptativo de la informacion (PAI) mecanismos potenciales de cambio [EMDR and adaptive model of information processing (AIP) potential mechanisms of change]. Revista de Psicopterapia, 20(80), 17-37.

Language: Spanish

Format: Journal

Abstract:
La desensibilización y reprocesamiento mediante movimientos oculares (EMDR) es un abordaje terapéutico que está guiado por el modelo de procesamiento adaptativo de la información (PAI). Este artículo proporciona una breve visión de conjunto de algunos de los principales preceptos del PAI. Se plantea la hipótesis de que la base de la patología clínica radicaría en los recuerdos almacenados disfuncionalmente, derivándose los resultados terapéuticos obtenidos del procesamiento de tales recuerdos dentro de redes adaptativas mayores. A diferencia de las terapias de exposición basadas en la extinción, se postula que los recuerdos considerados como diana en el EMDR pueden sufrir la transmutación durante el procesamiento para ser luego almacenados nuevamente durante el proceso de reconsolidación. Por ello, se proporciona una comparación y un contraste con los modelos de procesamiento de la información basados en la extinción como así también el tratamiento, que incluye las repercusiones que puede tener para la práctica clínica. A lo largo del artículo se comenta una diversidad de mecanismos de acción, incluidos aquellos que se deducen de los principios del modelo PAI como de los propios procedimientos del EMDR, entre los que figura la estimulación bilateral. A fin de investigar las diversas hipótesis, se ofrecen sugerencias de investigación.

"Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach guided by the adaptive information processing (AIP) model. This article provides a brief overview of some of the major precepts of AIP. The basis of clinical pathology is hypothesized to be dysfunctionally stored memories,with therapeutic change resulting from the processing of these memories within larger adaptive networks. Unlike extinction-based exposure therapies, memories targeted in EMDR are posited to transmute during processing and are then again stored by a process of reconsolidation. Therefore, a comparison and contrast to extinction-based information processing models and treatment is provided, including implications for clinical practice. Throughout the article a variety of mechanisms of action are discussed, including those inferred by tenets of the AIP model, and the EMDR procedures themselves, including the bilateral stimulation. Research suggestions are offered in order to investigate various hypotheses."

Keywords: Adaptive Information Processing AIP Mechanisms of Change

Accuracy Verified: Yes

10. Leeds, A. M. (2010, February). Extinction or reconsolidation differences between suppression and transformation in how we recover from traumatic experiences. Author.

Language: English

Format: Other

Abstract:
Memory is central to all learned behavior, and in humans to one’s sense of identity. Sleep and memory processes are deeply entwined. Both are central to our sense of well-being.

Keywords: Adaptive Information Processing AIP Extinction, Prolonged Exposure Reconsolidation

Accuracy Verified: Yes

11. Leeds, A. (2010, June). The future of EMDR. Keynote presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
In less than 20 years, EMDR achieved international acceptance as an empirically supported treatment for posttraumatic stress disorder. In achieving this recognition, EMDR has raised fundamental questions, both about the essential mechanisms of action of existing treatments and what the foundational principles should be for future approaches to psychotherapy. Can EMDR best be explained as a variant on the exposure-extinction model of imaginal exposure? Will EMDR turn out to be an equally or more effective treatment for other anxiety disorders, for depressive disorders and for personality disorders, than other methods such as Cognitive Behavioural and Interpersonal Therapy? Is the Adaptive Information Processing model essential to the current use and the future of EMDR or is it merely an unproven and extraneous model? How will EMDR evolve over the next 20 years? For what conditions will it turn out to be most successful? How will the emergence of new technologies impact the delivery of psychotherapy in general and of EMDR? A glimpse of what lies ahead.

Keywords: History Keynote

Accuracy Verified: Yes

12. Rogers, S. (2002, June). Latest findings in EMDR process research and component analyses. In L. Beutler, Discussant, EMDR research and its future: Ecological validity, process research, outcome findings, and socio-political context (Panel Discussion, June 24) (SPR) Society for Psychotherapy Research, International Conference, Santa Barbara, CA .

Language: English

Format: Conference

Abstract:
EMDR has gained recognition as an effective PTSD treatment, with effects comparable to prolonged exposure or combinations of exposure with cognitive restructuring. Attempts to dismantle EMDR have led some reviewers to conclude that the eye movements are an inert treatment component and that EMDR is simply a form of exposure therapy. However, several studies have shown that eye movements are associated with decreased subjective distress during treatment sessions, decreased vividness and emotionality of mental imagery, decreased physiological arousal and enhanced episodic memory. These findings have implications for clinicians who are interested in ‘ease of useEas well as treatment outcome. They also have implications for the habituation/extinction model of anxiety reduction. Limitations of the group design approach to the dismantling of psychotherapies will be discussed, along with the results of two recently completed studies.

Keywords: CBT Cognitive Behaviorial Therapy Component Analysis Process Research

Accuracy Verified: Yes

13. Suzuki, A., Josselyn, S. A., Frankland, P. W., Masushige, S., Silva, A. J., & Satoshi, K. (2004). Memory reconsolidation and extinction have distinct temporal and biochemical signatures. Journal of Neuroscience, 24(20), 4787–4795. doi:10.1523/jneurosci.5491-03.2004.

Language: English

Format: Journal

Abstract:
The article explores the differences between memory reconsolidation and extinction. This new area of investigation is worthy of additional attention. Reconsolidation may prove to be the underlying mechanism of EMDR, as opposed to extinction caused by prolonged exposure therapies. “Memory reconsolidation after retrieval may be used to update or integrate new information into long-term memories . . . Brief exposure … seems to trigger a second wave of memory consolidation (reconsolidation), whereas prolonged exposure . . leads to the formation of a new memory that competes with the original memory (extinction).”

Keywords: Consolidation Extinction Fear Conditioning Reconsolidation Protein Synthesis Spatial Memory

Accuracy Verified: Yes

14. Gersons, B., Schnyder, U., Rothbaum, B., & McFarlane, A. (2006, November). The need for new directions in psychotherapy for PTSD. Panel presentation at the 22nd annual meeting of the International Society for Traumatic Stress Studies Fall Conference, Hollywood, CA.

Language: English

Format: Conference

Abstract:
The trauma field can be proud of having evidence-based effective psychotherapy protocols for PTSD. Especially CBT and EMDR have been recognized as first choice treatments (NICE Guidelines 2005). However, having these protocols available new questions that need to be answered are emerging. There is no large scale evidence yet on phase 4 implementation showing its effectiveness. Too many patients drop out of treatment. Many patients suffer from comorbid conditions. The question on how research outcomes on the biology of PTSD should be translated into different psychotherapeutic approaches is a rather new one. Especially, is habituation still the correct fundament of exposure in PTSD, or should it be replaced by the concept of extinction? A third question is the mixed feeling in many societies about the concept of PTSD and it´s consequences in the need for treatment. Especially after disasters, but also after domestic violence, treatment can be seen as the avoidance of society to punish the responsible ones or to ask for material compensation. These questions will lead to find new directions for the psychotherapy protocols, for the combination with biological routes of intervention and for the societal acceptance of treatment for PTSD.

Keywords: CBT Cognitive Behavioral Therapy Panel

Accuracy Verified: Yes

15. Tryon, W. W. (2005, January). Possible mechanisms for why desensitization and exposure therapy work. Clinical Psychology Review, 25(1), 67-95. doi:10.1016/j.cpr.2004.08.005.

Language: English

Format: Journal

Abstract:
Rosen and Davison [Rosen, G.M. and Davison, G.C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27, 300–312] recommended that empirically supported principles be listed instead of empirically supported treatments because the latter approach enables the creation of putatively new therapies by adding functionally inert components to already listed effective treatments. This article attempts to facilitate inquiry into empirically supported principles by reviewing possible mechanisms responsible for the effectiveness of systematic desensitization and exposure therapy. These interventions were selected because they were among the first empirically supported treatments for which some attempt was made at explanation. Reciprocal inhibition, counterconditioning, habituation, extinction, two-factor model, cognitive changes including expectation, self-efficacy, cognitive restructuring, and informal network-based emotional processing explanations are considered. Logical problems and/or available empirical evidence attenuate or undercut these explanations. A connectionist learning-memory mechanism supported by findings from behavioral and neuroscience research is provided. It demonstrates the utility of preferring empirically supported principles over treatments. Problems and limitations of connectionist explanations are presented. This explanation warrants further consideration and should stimulate discussion concerning empirically supported principles.

Keywords: Systematic Desensitization Exposure Therapy Learning-Memory Mechanism

Accuracy Verified: Yes

16. Chang, S. H. (2007, September). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. Presentation at the annual meeting of the EMDR International Association Conference, Dallas, Texas. (NSC 93-2413-H-002-002-).

Language: English

Format: Conference

Abstract:
Research background & aims: This study examined possible therapeutic mechanisms of eye movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989, 1995, 2001) in terms of exposure and information processing model. While exposure model contended process of extinction and response habituation, Stickgold (2002) proposed that sleep induced change in associative memory via activation of weak association during REM state and EM functioned as REM sleep to integrate the episodic memory of trauma into general semantic memory. In this study, the effect of EM compared to that of Exposure-Only (non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along with outcome measures were examined. Specifically, the degree of return of fear and response habituation was explored. Methods: Thirty-six college students with cockroach phobias were recruited as participants and invited after informed consent for 4 1-week interval treatment sessions and a 1 month follow-up session. The instruments for outcome measures included Cockroach Phobia Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic relationship rating, and physiological measures such as HR, HRV, EOG, served as process measures. Due to space limitations, the results of cognitive task and physiological measures were reported elsewhere. The participants were randomly assigned to one of the four groups: EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2 (order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the 4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with time serving as within Ss factor and the other two variables serving as between Ss factors. There were 20 trials in each therapeutic session. The duration of each trial was 30s for both the EM and Exposure-Only conditions. Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) × 2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of valence presentation) × 9 (time) ANOVAs were performed for EM condition and Exposure-Only condition, respectively. The results showed that for EM condition, only time effect was significant (p < .006); while for Exposure-Only condition, there were a significant time effect (p < .001) and an approaching significant valence presentation order effect (p < .065), with the SUDs being higher in negative cognition presented first condition compared to positive cognition presented first condition; whereas the effect was not significant for the EM condition. Using trend analyses and inspection of time effect showed that significant within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise comparisons for the 9 time points indicated salient phenomena of return of fear among several of the 5 sessions for this condition when comparing the pre-assessment of each session with post-assessment of its previous session. Whereas for EM condition the return of fear between sessions was small and the trend analysis showed a reduction with linear trend. Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of sufferings while participants encountering negative theme which in turn might facilitate further processing of negative memory. In addition, EM might add something beyond the mechanism of pure exposure. The less return of fear indicating that information processing in addition to response inhibition might take place between sessions. The results echoed Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative memory systems by activating different strength of associations of negative semantic nodes for different semantically related words. Given that previous research showed that EM decreased emotionality and also generate greater amount of associations for negative stimuli, the implications of the present results from theoretical and therapeutic point of views and future research possibilities are discussed.

Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Semantic Association

Accuracy Verified: Yes

17. Chang, S. H. (2009). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. National Taiwan University, Taipei, Taiwan.

Language: English

Format: Dissertation/Thesis

Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Sematic Association

Accuracy Verified: Yes

18. Zantvoord, J. (2012, November). Trauma focused psychotherapies from a neurodevelopmental perspective: fMRI and physiological pilot outcome data from a RCT conducted in the Netherlands with children suffering from PTSD. Symposium conducted at the 28th annual meeting of the ISTSS, Los Angeles, CA.

Language: English

Format: Conference

Abstract:
Neurobiological treatment outcome studies in adults with PTSD have shown that successful treatment is associated with changes in activity of frontal brain areas and the amygdala, brain areas which are involved in fear conditioning and extinction. Frontal brain regions undergo considerable maturation during childhood and adolescence and only reach anatomical and functional maturity well within the third decade of life. In this light, results obtained in neurobiological studies in adults can’t be readily translated to children and adolescents. Neurobiological treatment outcome studies in children with PTSD are thus required, yet are almost nonexistent to date. Neurobiological treatment outcome studies addressing the mechanism involved in treatment response or non response can contribute to improve treatment strategies for non responders especially for treatment non responders and in time help clinicians to tailor treatment for individuals with PTSD. In this part of the symposium we will present treatment outcome data of our neurobiological pilot study conducted in children with PTSD in the Netherlands. Children aged 8 to 18 with PTSD were randomly assigned to receive either 8 sessions of manualized Trauma Focus cognitive behavioral therapy or EMDR. fMRI data of a working memory task with emotional distracters and physiological data obtained during script driven imagery will be presented. Treatment outcome results will be placed in a neurodevelopmental framework.

Keywords: Children, fMRI Netherlands Neurodevelopment Pilot Posttraumatic Stress Disorder PTSD Random Control Trial RCT

Accuracy Verified: Yes

19. Zantvoord, J. B., Diehle, J., & Lindauer, R. J. (2013, March). Using neurobiological measures to predict and assess treatment outcome of psychotherapy in posttraumatic stress disorder: Systematic review. Psychotherapy and Psychosomatics, 82, 142-151. doi:10.1159/000343258.

Language: English

Format: Journal

Abstract:
Background: Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. Methods: Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. Results: We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. Conclusion: TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice. Copyright © 2013 S. Karger AG, Basel.

Accuracy Verified: Yes