Francine Shapiro Library ~ EMDR Bibliography

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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. Colelli, G. (2003, September). After the World Trade Center disaster – Use of EMDR recent events protocol. Presentation at the annual meeting of the EMDR International Association, Denver, CO.

Language: English

Format: Conference

Abstract:
The Recent Events Protocol was used extensively in the treatment of World Trade Center survivors, first responders and recovery workers. In this workshop we will review the Recent Events Protocol and discuss the utilization in treating Post Traumatic Stress Disorder (PTSD). The workshop will describe when it is appropriate to modify the Recent Events Protocol. Clinical examples for civilian and non-civilian personnel will be presented. Specific techniques will be described on how to reprocess PTSD symptoms in 5 sessions or less even when the client has significant previous traumatic memories. The contrast in using the protocol for PTSD symptoms as compared to grief will be discussed.

Keywords: 9/11 Recent Events September 11th World Trade Center WTC

Accuracy Verified: Yes

3. Pagani, M., Salmaso, D., Looi, J., & Hogberg, G. (2008, June). Brain functional and volumetric analyses post traumatic stress disorder treated by EMDR. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
Neuro-imaging investigations in PTSD have reported findings for either functional or structural modifications. Only two studies have investigated the changes in cerebral blood flow (CBF) following EMDR therapy and one single-patient study recently reported EMDR-related structural changes. The aim of this study was to analyse the structural and functional changes occurring in brain regions implicated in the patho-physiology of PTSD along with the impact on CBF and volumetric data after EMDR treatment. Thirty six train drivers having being exposed to traumatic experiences at work were assigned to different two groups: symptomatic (S, n=17) or nonsymptomatic (NS, n=19), according to PTSD diagnosis. SPECT, following administration of an individualised 35 trauma script, and MRI were performed and EMDR therapy was administered to S. According to EMDR outcome S were further subdivided in responders (R, n=11) and non-responders (NS, n=5). One patient was not treated. CBF and volumetric analyses were performed on temporal lobes, hippocampi and nuclei caudati. ANOVA showed a significantly higher CBF distribution in the left temporal lobe of S as compared to NS and the right nc.caudatus was significantly larger in S. The R group had larger hippocampi and nc.caudati as compared to NR and the size of hippocampi correctly identified 81% of R and NR. The increased left temporal lobe CBF distribution among symptomatic PTSD subjects may reflect the affective significance of higher effort in emotional episodic memory stimulation among symptomatic individuals. Hippocampi volume as measured before EMDR was shown to predict with high accuracy the therapy outcome.

Keywords: Posttraumatic Stress Disorder PSTD

Accuracy Verified: Yes

4. Kim, D., & Kim, K-I. (2004, January). A case series of eye movement desensitization and reprocessing (EMDR) in 30 psychiatric patients: Korean experience. Journal of the Korean Neuropsychiatric Association, 43(1), 113-118.

Language: English

Format: Journal

Abstract:
Objectives: Eye Movement Desensitization and Reprocessing (EMDR) is an emerging psychotherapeutic technique for posttraumatic stress disorder and other conditions associated with psychological trauma. The effectiveness of this technique has been reported among North American and European populations; however, research on it's effectiveness among other ethnocultural groups is sparse. This is the first clinical study of EMDR in Korea with 30 Korean psychiatric patients in two clinical settings. METHODS: Diagnostically heterogeneous group of 30 psychiatric patients underwent a mean of 3.13 (95%CI=2.54-3.73) sessions of EMDR. The Clinical Global Impression-Change scale (CGI-C) was administered one week and six months after the termination of treatment. Results: Participants had a mean CGI-C score of 1.80 (95%CI=1.44-2.16). We designated as 'responders' those who were 'very much improved' or 'much improved' on the CGI-C, 23 (77%) After six months, 19/23 (83%) still characterized as remaimed responders. All the patients with posttraumatic stress disorder, phobia, and grief reaction were responders, and those with personality disorder nonresponders. Results for depressive and other disorders were mixed. Conclusion: Despite methodological limitations, results from this study suggest that the EMDR can be applied to Korean psychiatric patients.

Keywords: Korea Psychiatric Patients

Accuracy Verified: Yes

5. Lipke, H. (2012). Comment on Dunne and Farrell (2011). Journal of EMDR Practice and Research, 6(2), 82. doi:10.1891/1933-3196.6.2.82.

Language: English

Format: Journal

Abstract:
I was quite pleased to see Dunne and Farrell (2011) intelligently and usefully address clinician experience incorporating eye movement desensitization and reprocessing (EMDR) into practice. I was also pleased that they could find some use for the data I accumulated in 1992 from the 443 responders to the questionnaires sent to the first 1,295 EMDR Institute trainees for whom I was able to obtain current addresses (Lipke, 1995). Dunne and Farrell (2011). {Excerpt]

Keywords: Letter

Accuracy Verified: Yes

6. Resick, P., Monson, C., Griffin, M., Rothbaum, B., Rasmusson, A., & Shalev, A. (2006, November). Cortisol pre and posttreatment with EMDR or prolonged imaginal exposure in PTSD assault survivors. In Psychobiology and Treatment of PTSD. Symposium conducted at the 22nd annual meeting of the International Society for Traumatic Stress Studies Fall Conference, Hollywood, CA.

Language: English

Format: Conference

Abstract:
Psychobiological treatment of PTSD: This symposium will examine four CBT treatment studies with regard to biological markers. The questions here are whether pretreatment psychobiology or physiological responding can be used to predict treatment outcome, or whether they themselves change as a result of effective treatment.

Cortisol pre and posttreatment with EMDR or prolonged imaginal exposure in PTSD assault survivors: Many studies have noted increased cortisol production in trauma survivors with PTSD, but it is not clear whether effective treatment alters these responses. As part of a larger study, 60 female sexual assault survivors with PTSD began one of two types of cognitivebehavioral treatment (Prolonged Exposure (PE) or EMDR). Each treatment consisted of nine sessions. Sessions 1 and 2 included information gathering, trauma education, and therapy preparation. Sessions 3 through 9 consisted of processing traumatic memories and emotions via either imaginal exposure or EMDR.To examine potential cortisol changes over the course of treatment, salivary cortisol samples were collected at three time points during treatment. A baseline sample was taken at session 1, a second sample was taken at the start of the treatment portion of therapy (session 3), and a third sample was taken at the end of treatment (session 9). Of the original sample of 60 participants, 50 women completed treatment, and ten dropped out. Cortisol responses will be examined in treatment responders and non-responders as well as in treatment completers vs. treatment dropouts.

Keywords: Cortisol Posttraumatic Stress Disorder Prolonged Imaginal Exposure Assault PSTD Survivors Symposium

Accuracy Verified: Yes

7. Gerardi, M., Rothbaum, B. O., Astin, M.C., & Kelley, M. (2010, June). Cortisol response following exposure treatment for PTSD in rape victims. Journal of Aggression, Maltreatment & Trauma, 19(4), 349-356. doi:10.1080/10926771003781297.

Language: English

Format: Journal

Abstract:
This study examined changes in salivary cortisol levels pre-to-post-treatment in adult female rape victims diagnosed with post traumatic stress disorder (PTSD) randomly assigned to be treated with either Prolonged Exposure Therapy or Eye Movement Desensitization and Reprocessing. Salivary cortisol was collected at baseline, session 3, and session 9. A significant decrease in salivary cortisol levels was observed in individuals classified as treatment responders in both treatment conditions. Findings suggest that successful exposure-based treatments for PTSD which result in trauma-related and depressive symptom reduction may impact the action of the hypothalamic-pituitary-adrenal axis as measured by changes in level of salivary cortisol from pre-to-post-treatment.

Keywords: Rape Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

8. McCammon, S. L., & Allison, E. J. (1995). Debriefing and treating emergency workers. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 115-130). New York: Brunner/Mazel.

Language: English

Format: Book Section

Abstract:
Chapter 6 emphasizes the importance of promoting trauma resolution and healthy coping strategies in emergency workers. Strategies that can be implemented before, during, and after a traumatic event are summarized. Pretrauma interventions include the use of a stress audit, training regarding stress and its management, and policy development.During a traumatic event, interventions include orientation to the trauma site, on-scene support, demobilization, and debriefing. Common elements among the several debriefing models described include the structuring of opportunities to review the events of the traumatic situation and to ventilate feelings, the learning of skills for integrating and mastering the event, and obtaining assistance in identifying, enlisting, and accepting help from one's support system. Post-trauma activities include individual follow-up sessions, the use of experimental procedures such as eye movement desensitization and reprocessing, and attention to anniversaries of traumatic events. A decade of anecdotal reports testifies to the effectiveness of debriefing and provides helpful insights into working with emergency responders. Currently, research efforts are under way to assess systematically the impact of debriefing. Future research should address the mediating effect of emergency workers' coping behaviors and cognitions. [Introduction, p. xix]

Keywords: Adults Critical Incidence Stress Debriefing CISD Education Medical Personnel Prevention Emergency Personnel Self-Help Techniques Vicarious Traumatization

Accuracy Verified: Yes

9. Lansing, K. (2012, Novembro). Depois que baixa a poeira! Estratégias de tratamento de TEPT induzido pelo cumprimento do dever para combatentes e pessoal de salvamento [After low dust! Strategies for treatment of PTSD-induced greeting duty for fighters and rescue personnel]. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.

Language: Portuguese

Format: Conference

Keywords: Fire Fighters First Responders Posttraumatic Stress Disorder PTSD Treatment

Accuracy Verified: Yes

10. Quinn, G. (2010, July). Early interventions. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
EMDR is a well-established therapy for the treatment of Post Traumatic Stress Disorder (PTSD). PTSD can be reduced or prevented if treated during the first month after a trauma when a person displays Acute Stress Disorder (ASD). Although usually used later, EMDR has also been used effectively in the immediate period following trauma. Victims of immediate trauma often exhibit “silent terror” or extreme stress .The Emergency Response Procedure (ERP), described in the Humanitarian Assistance Program’s (HAP) Disaster Manual and Marilyn Luber’s : EMDR Scripted Protocols: Basic and Special Situations.(2009) was developed to deal with victims of natural and man made disaster within hours of exposure to trauma. Participants in this workshop will learn how to respond to clients in the immediate aftermath of trauma, utilizing ERP. This will be understood within the overall context of the principles of Psychological First Aid. This same basic approach can be applied in the event of strong abreaction during the initial phase of History-taking, and prior to the Preparation Phase of EMDR or at other times of treatment when patients exhibit strong emotional reactions. Similarly, treatment with ERP may also be considered for patients exhibiting this “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in ambulances en route to medical facilities. Case examples will be presented to illustrate the successful treatment of Acute Stress Disorder (ASD) with survivors the Tsunami in Thailand, and with victims of terror and war. In this presentation the Recent Events Protocol will be examined, with particular emphasis on modifying the Positive Cognitions (PC) in the face of continuing ongoing danger. EMD (Eye Movement Desensitization), the original protocol developed by Dr. Francine Shapiro in 1989, will be described and compared to the standard EMDR protocol with emphasis as used in emergency settings where multiple patients need rapid treatment. The EMDR Group Protocol will be presented as utilized in the Tsunami of 2004 and during war. A practicum will follow.

Keywords: Early Interventions

Accuracy Verified: Yes

11. Kutz, I., Dekel, R., Schreiber, S., Resnick, V., Dolberg, O. T., Barkai, G., Leor, A., Rapoport, E., & Bloch, M. (2008, November). The effect of a single session of EMDR on intrusive distress in acute stress syndromes. Symposium/panel conducted at the 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.

Language: English

Format: Conference

Abstract:
Early diagnosis and intervention in mass casualty events: Since September 2000, Israeli and Palestinian societies suffered great losses. on the Israeli side, civilians of all ages, and ethnic groups, have been exposed to various types of terrorist attacks. This symposium examines issues of diagnosis and interventions

The effect of a single session of EMDR on intrusive distress in acute stress syndromes: Purpose: To examine the efficacy of a single session of a modified abridged EMDR protocol in reducing Acute Stress Syndromes (ASS) following accidents and terrorist bombing attacks. Methods: Treatment was provided, in a general hospital inpatient and out-patient setting to 86 patients with ASS. Friday: 11:00 a.m. – 12:15 p.m. Presenters are underlined and discussants are italicized. If serving in both roles, they are both underlined and italicized. Findings: Fifty percent reported immediate fading of their intrusive symptoms and general alleviation of their distress, 27% described partial alleviation of their symptoms, while 23% reported no improvement. Four week and six month follow-up, in the terror victims group only, showed that the immediate responders remained symptom free, while half of the non-responders, who also received subsequent additional interventions modalities, were still symptomatic. Conclusions: The difference in response may be attributed, in part, to the fact that immediate responders tended to have an uncomplicated ASS with fewer risk factors for PTSD, while the non-responders had higher exposure to former traumas and endorsed more risk factors for PTSD. These results support other anecdotal reports on the rapid effects of brief EMDR intervention in uncomplicated cases and offer a psycho-physiological hypothesis for immediate response. While additional controlled studies are essential, this immediate symptomatic relief may be a potential addition for focused interventions in acute trauma victims.

Keywords: Acute Stress Disorder ASD Bombings Israel Palenstine Panel Symposium Terrorists

Accuracy Verified: Yes

12. Kutz, I., Resnik, V., & Dekel, R. (2008). The effect of single-session modified EMDR on acute stress syndromes. Journal of EMDR Practice and Research, 2(3), 190-200. doi:10.1891/1933-3196.2.3.190.

Language: English

Format: Journal

Abstract:
A single session of a modified, abridged EMDR protocol was provided in a general hospital inpatient and outpatient setting to 86 patients with acute stress (AS) syndrome suffering from intrusion distress following accidents and terrorist bombing attacks. Fifty percent reported immediate fading of intrusive symptoms and general alleviation of distress, 27% described partial alleviation of their symptoms and distress, while 23% reported no improvement. Partial and nonresponders were provided with or referred for more comprehensive treatment. At 4-week and 6-month follow-up, the immediate responders in the terror victims group remained symptom free. The immediate responders tended to have uncomplicated AS symptoms with fewer risk factors for posttraumatic stress disorder (PTSD), while the nonresponders had higher exposure to former traumas and endorsed more risk factors for PTSD. These results support other anecdotal reports on the rapid effects of brief EMDR intervention on intrusive symptoms in early uncomplicated posttraumatic cases. Although more controlled studies are essential, this immediate method for symptomatic relief may be a potential addition for focused interventions in acute trauma victims.

Keywords: Acute Stress Disorder ASD Intrusions Mass Casualty Event MCE Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

13. Pagani, M., Hogberg, G., Salmaso, D, Tarnell, B., Nardo, D., Sundin, Ö., Jonsson, C., Soares, J., Aberg-Wistedt, A., Jacobsson, H., Larsson, S.A., Hällström, T. (2007, October). Effects of EMDR psychotherapy on 99mTc-HMPAO distribution in occupation-related post-traumatic stress disorder. Nuclear Medicine Communications, 28(10), 757-765. doi:10.1097/MNM.0b013e3282742035.

Language: English

Format: Journal

Abstract:
Background: Post-traumatic stress disorder (PTSD) is a derangement of mood control with involuntary, emotionally fraught recollections that may follow deep psychological trauma in susceptible individuals. This condition is treated with pharmacological and/or cognitive therapies as well as psychotherapy with eye movement desensitization and reprocessing (EMDR). However, only a very limited number of studies have been published dealing with work-related PTSD, and investigations on the effect of treatment on cerebral blood flow represent an even smaller number. Aim: To investigate the short-term outcome of occupation-related PTSD after EMDR therapy by 99mTc-HMPAO SPECT. Method: Fifteen patients, either train drivers suffering from PTSD after having been unintentionally responsible for a person-under-train accident or employees assaulted in the course of duty, were recruited for the study. 99mTc-HMPAO SPECT was performed on these patients both before and after EMDR therapy while they listened to a script portraying the traumatic event. Tracer distribution analysis was then carried out at volume of interest (VOI) level using a three-dimensional standardized brain atlas, and at voxel level by SPM. The CBF data of the 15 patients were compared before and after treatment as well as with those of a group of 27 controls who had been exposed to the same psychological traumas without developing PTSD. Results: At VOI analysis significant CBF distribution differences were found between controls and patients before and after treatment (P=0.023 and P=0.0039, respectively). Eleven of the 15 patients responded to treatment, i.e., following EMDR they no longer fulfilled the DSM-IV criteria for PTSD. When comparing only the eleven responders with the controls, the significant group difference found before EMDR (P=0.019) disappeared after treatment. Responders and non-responders showed after therapy significant regional differences in frontal, parieto-occipital and visual cortex and in hippocampus. SPM analysis showed significant uptake differences between patients and controls in the orbitofrontal cortex (Brodmann 11) and the temporal pole (Brodmann 38) both before and after treatment. A significant tracer distribution difference present before treatment in the uncus (Brodmann 36) disappeared after treatment, while a significant difference appeared in the lateral temporal lobe (Brodmann 21). Conclusion: Significant 99mTc-HMPAO uptake regional differences were found, mainly in the peri-limbic cortex, between PTSD patients and controls exposed to trauma but not developing PTSD. Tracer uptake differences between responders and patients not responding to EMDR were found after treatment suggesting a trend towards normalization of tracer distribution after successful therapy. These findings in occupational related PTSD are consistent with previously described effects of psychotherapy on anxiety disorders. [PubMed]

Keywords: 99mTc-HMPAO Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

14. Pagani, M., Hogberg, G., Salmaso, D., Nardo, D., Jonsson, C., Danielsson, A.M., Engelin, L., Jacobsson, H., Larsson, S. A., Hallstrom, T., & Sundin, Ö. (2006, September). Effects of EMDR therapy on 99mTc-HMPAO distribution in Post-traumatic stress disorder. Presentation at the European Assocation of Nuclear Medicine Congress, Athens, Greece. European Journal of Nuclear Medical and Molecular Imaging, 33, S169.

Language: English

Format: Conference

Abstract:
Background Post-traumatic stress disorder (PTSD) is a derangement of mood control with emotional trauma recollections that may follow psychological trauma. It is treated with pharmacological and cognitive therapies as well as with eye movement desensitization and reprocessing (EMDR). However, a limited number of studies have been published dealing with job related PTSD, and an even smaller number have assessed the effects of treatment on CBF. The aim of this study was to investigate the short term outcome of occupation based PTSD after EMDR therapy by 99mTc-HMPAO SPECT. Methods Fifteen patients suffering PTSD after having experienced a person under train accident or having been assaulted at work were included into the study. 99mTc-HMPAO SPECT was performed before and after EMDR therapy while listening to a script portraying the traumatic event. Tracer distribution analysis was performed at VOI level using a 3D standardised brain atlas and at cluster of voxel level by SPM and was subjected to an analysis of treatment as well as contrasted to a group of 27 subjects exposed to the same psychological trauma and not developing PTSD. Results Eleven of 15 patients responded to treatment, i.e. they did no longer fulfil the DSM-IV criteria for PTSD after EMDR. Overall VOI analysis showed significant differences between, both before and after treatment conditions and controls (p<0.05) but no effect of period, i.e. treatment. However, when contrasting responders to controls the significant group difference present after treatment disappeared, indicating a normalization effect due to successful EMDR treatment. SPM analysis showed significant uptake differences in orbitofrontal cortex (Brodmann 11) and temporal pole (Brodmann 38) before as well as after treatment as compared to controls. A significant tracer uptake group difference present before treatment in uncus (Brodmann 36) disappeared after treatment while a significant difference appeared in lateral temporal lobe (Brodmann 21). No tracer uptake differences were found by SPM as an effect of treatment, nor between the 11 responders and controls. Conclusion Significant 99mTc-HMPAO uptake differences, mainly in peri-limbic cortex, between PTSD patients investigated before and after EMDR and subject exposed to trauma not developing PTSD were found. Differences between the tracer distribution in patients before and after therapy were not significant neither at SPM nor at VOI analyses but the latter showed at group level an effect of symptom remission on tracer distribution. The findings underscore the validity of psychotherapy in anxiety disorders and confirm the efficacy of SPECT in psychiatry. [EANM]

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

15. Pagani, M., Hogberg, G., Salmaso, D., Nardo, D., Jonsson, C., Danielsson, A. M., Engelin, L., Jacobsson, H., Larsson, S. A., Hallstrom, T., & Sundin, Ö. (2006, September-October). Effects of EMDR therapy on 99mTc-HMPAO distribution in Post-traumatic Stress Disorder. Presentation at the European Assocation of Nuclear Medicine Congress, Athens, Greece.

Language: English

Format: Conference

Keywords: 99mTc-HMPAO Distribution Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

16. Quinn, G. (2012, June). EMDR & acute stress syndrome/EMDR in early intervention - Immediate ERP treatment following trauma. Presentation at the annual meeting of the EMDR Europe Association, Madrid, Spain.

Language: English

Format: Conference

Abstract:
Victims of immediate trauma often exhibit “silent terror” or extreme stress and often are likely to develop PTSD. The Emergency Response Procedure (ERP), described in the Humanitarian Assistance Program’s (HAP) Disaster Manual and Marilyn Luber’s: EMDR Scripted Protocols: Basic and Special Situations (2009) was developed to deal with victims of natural and manmade disaster within minutes to hours of exposure to trauma. Learning objectives: Participants in this workshop will learn how to respond to clients in the immediate aftermath of trauma, utilizing ERP. This will be understood within the overall context of the principles of Psychological First Aid. This same basic approach can be applied in the event of strong abreaction during the initial phase of history-‐ taking and prior to the Preparation Phase of EMDR or at other times of treatment when patients exhibit strong emotional reactions. Similarly, treatment with ERP may also be considered for patients exhibiting this “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in ambulances en route to medical facilities. A pilot study (in press) will be presented showing effectiveness at possibly preventing PTSD 2 years later compared to “treatment as usual”

Las víctimas del trauma inmediato frecuentemente exhiben “terror silencioso” o estrés extremo y a menudo son susceptibles de desarrollar TEPT. El Procedimiento de Respuesta en Emergencia (ERP), descrito en el Manual de Catástrofes de los Programas de Asistencia Humanitaria (HAP) y en el libro de EMDR Scripted Protocols: Basic and Special Situations (2009) ha sido desarrollado para lidiar con víctimas de desastres naturales y causados por el hombre a los minutos u horas de haber sido expuesto al trauma. Objetivos de aprendizaje: Los participantes de este taller aprenderán cómo responder a los clientes en los momentos siguientes al trauma, utilizando PRE. Esto se entenderá en el contexto general de los principios de los Primeros Auxilios Psicológicos. Este mismo enfoque básico se puede utilizar en el caso de una abreacción fuerte durante la fase inicial en la que se realiza la historia del paciente y antes de la Fase de Preparación de EMDR o en otras ocasiones durante el tratamiento cuando los pacientes muestran reacciones emocionales fuertes. De manera similar, el tratamiento con PRE puede considerarse también para pacientes que muestran este “terror silencioso” o estrés extremo durante el tratamiento inicial llevado a cabo por los servicios de asistencia en emergencias en la escena del accidente o en las ambulancias de camino a las instalaciones médicas. Un estudio piloto (en prensa) será presentada mostrando la efectividad de la posibilidad de prevenir el TEPT 2 años después comparándolo con “tratamiento habitual.”

Keywords: Acute Stress Syndrome Early Intervention

Accuracy Verified: Yes

17. Gilman, S., & Marshall, J. (2011, August). EMDR & the first responder: Bringing hope and healing to those suffering in silence with hidden symptoms. Presentation at the annual meeting of the EMDR International Association, Orange County, CA.

Language: English

Format: Conference

Abstract:
First Responders” (Police Officers, Firefighters, Emergency Medical Technicians (EMT), Paramedics, Dispatchers), live with cumulative stress while intervening in traumatic human experiences. While most of us believe they are psychologically ‘tough’ and resilient, enabling them to tolerate repeat exposure, many suffer in silence. This presentation will expose the hidden stress-filled world of First Responders, the ongoing stigmas which block appropriate interventions, how psycho-education and EMDR treatment can result in healthier, more productive first response teams. EMDR Case examples will enlighten and inspire those who attend.

Keywords: First Responders

Accuracy Verified: Yes

18. Quinn, G. (2011, June). EMDR emergency treatment for manmade and natural disasters. Presentation at the annual meeting of the EMDR Europe Association, Vienna, Austria.

Language: English

Format: Conference

Abstract:
EMDR is a well-established therapy for the treatment of Post Traumatic Stress Disorder (PTSD). PTSD can be reduced or prevented if treated during the first month after a trauma when a person displays Acute Stress Disorder (ASD). Although usually used later, EMDR has also been used effectively in the immediate period following trauma. Victims of immediate trauma often exhibit “silent terror” or extreme stress .The Emergency Response Procedure (ERP), described in the Humanitarian Assistance Program’s (HAP) Disaster Manual and Marilyn Luber’s: EMDR Scripted Protocols: Basic and Special Situations (2009) was developed to deal with victims of natural and manmade disaster within hours of exposure to trauma. Learning objectives: Participants in this workshop will learn how to respond to clients in the immediate aftermath of trauma, utilizing ERP. This will be understood within the overall context of the principles of Psychological First Aid. This same basic approach can be applied in the event of strong abreaction during the initial phase of History-taking, and prior to the Preparation Phase of EMDR or at other times of treatment when patients exhibit strong emotional reactions. Similarly, treatment with ERP may also be considered for patients exhibiting this “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in ambulances en route to medical facilities. Case examples will be presented to illustrate the successful treatment of Acute Stress Disorder (ASD) with survivors the Tsunami in Thailand, and with victims of terror and war. In this presentation the Recent Events Protocol will be examined, with particular emphasis on modifying the Positive Cognitions (PC) in the face of continuing ongoing danger. EMD (Eye Movement Desensitization), the original protocol developed by Dr. Francine Shapiro in 1989, will be described and compared to the standard EMDR protocol with emphasis as used in emergency settings where multiple patients need rapid treatment. The EMDR Group Protocol will be presented as utilized in the Tsunami of 2004 and during war. A practicum will follow.

Keywords: Acute Trauma Emergency Treatment Man-Made Disasters Natural Disaasters

Accuracy Verified: Yes

19. Shapiro, F. (2012, September). EMDR Humanitarian Assistance Programs: Building sustainable mental health resources worldwide. ISTSS Traumatic StressPoints, 26(5), 2-3.

Language: English

Format: Newsletter

Abstract:
EMDR Humanitarian Assistance Programs (HAP) began in 1995 as a response to the Oklahoma City bombing. An FBI agent who had previously received EMDR therapy called requesting help, stating that the local mental health professionals were overwhelmed by the task. After a needs assessment, approximately 100 volunteer clinicians trained in EMDR therapy were rotated in to provide pro bono treatment for the bombing victims and front-line responders. A program evaluation indicated that over 80 percent achieved beneficial treatment effects within three sessions, and, in the same year, a study using a delayed treatment control group also showed positive results (Wilson, Becker & Tinker, 1995). Subsequently, free trainings in EMDR therapy were offered and provided to 290 clinicians in collaboration with local agencies. The feedback was so positive that a 501(c)3 organization was soon established. [Excerpt]

Keywords: EMDR-HAP

Accuracy Verified: Yes

20. Quinn, G. (2013, June). EMDR immediate emergency treatment for manmade and natural disasters. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland.

Language: English

Format: Conference

Abstract:
EMDR is a well-established therapy for the treatment of Post Traumatic Stress Disorder (PTSD). PTSD can be reduced or prevented if treated during the first month after a trauma when a person displays Acute Stress Disorder (ASD). Although usually used later, EMDR has also been used effectively in the immediate period following trauma. Victims of immediate trauma often exhibit “silent terror” or extreme stress. The Emergency Response Procedure (ERP) was developed to deal with victims of natural and manmade disaster within hours of exposure to trauma.
Participants in this workshop will learn how to respond to clients in the immediate aftermath of trauma, utilizing ERP. This will be understood within the overall context of the principles of Psychological First Aid. This same basic approach can be applied in the event of strong abreaction during the initial phase of History-taking and prior to the Preparation Phase of EMDR or at other times of treatment when patients exhibit strong emotional reactions. Similarly, treatment with ERP may also be considered for patients exhibiting this “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in ambulances en route to medical facilities.
Case examples will be presented to illustrate the successful treatment of Acute Stress Disorder (ASD) with survivors the Tsunami in Thailand, and with victims of terror and war.
In this presentation the Recent Events Protocol will be examined, with particular emphasis on modifying the Positive Cognitions (PC) in the face of continuing ongoing danger. EMD (Eye Movement Desensitization), the original protocol developed by Dr. Francine Shapiro in 1989, and modified by Elan Shapio and Brurit Laub in R-TEP will be described and compared to the standard EMDR protocol with emphasis as used in emergency settings where multiple patients need rapid treatment.
A practicum will follow on ERP.
Learning objectives: Within the overall context of the principles of Psychological First Aid, to learn how to respond to clients in the immediate aftermath of trauma utilizing ERP; To apply ERP in the event of strong abreaction during the initial phase of History-taking, prior to the Preparation Phase of EMDR or at other times of treatment when patients exhibit strong emotional reactions; To learn when and how to use ERP for patients exhibiting “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in an ambulance en route to medical facilities; How to utilize the Recent Events Protocol in the face of ongoing danger; To understand EMDR methods that may be used in emergency settings where multiple patients need rapid treatment

Keywords: Disaster Emergency Response Procedure ERP Extreme Stress Silent Terror

Accuracy Verified: Yes

21. Jarero, I., Amaya, C., Givaudan, M., & Miranda, A. (2013). EMDR individual protocol for paraprofessional use: A randomized controlled trial with first responders. Journal of EMDR Practice and Research, 7(2), 55-64. doi:10.1891/1933-3196.7.2.55.

Language: English

Format: Journal

Abstract:
The eye movement desensitization and reprocessing (EMDR) individual protocol for paraprofessional use in acute trauma situations (EMDR-PROPARA) is part of a project developed at the initiative of Dr. Francine Shapiro. This randomized clinical trial examined the effectiveness of the protocol administered by experienced EMDR therapists. There were 39 traumatized first responders on active duty randomly assigned to receive two 90-min sessions of either EMDR-PROPARA or of supportive counseling. Participants in the EMDR-PROPARA group showed benefits immediately after treatment, with their scores on the Short PTSD Rating Interview (SPRINT) showing further decreases at 3-month follow-up. In comparison, supportive counseling participants experienced a nonsignificant decrease after treatment and an increase in the SPRINT scores at the second follow-up. The significant difference between the two treatments provides preliminary support for EMDR-PROPARA's effectiveness in reducing severity of posttraumatic symptoms and subjective global improvement. More controlled research is recommended to evaluate further the efficacy of this intervention.

Keywords: Acute Trauma Early Psychological Intervention First Responders Peer Support

Accuracy Verified: No

22. Quinn, G. (2013, May). EMDR: Immediate emergency treatment for manmade and natural disasters. Presentation at the annual EMDR Canada Conference, Banff, Alberta CAN.

Language: English

Format: Conference

Keywords: Disasters Emergency Treatment

Accuracy Verified: Yes

23. Quinn, G., & Zucker, D. (2008, June). Emergency EMDR & ERP (Emergency Response Procedure): Treatment following natural man made disasters for victims experiencing immediate high stress and including the period of ASD. Presentation at the annual meeting of the EMDR Europe Association, London, England.

Language: English

Format: Conference

Abstract:
EMDR is a well established therapy for the treatment of Post Traumatic Stress Disorder (PTSD). It is believed that PTSD can be reduced or prevented if treated early. Although usually used at a later time, EMDR has also been used effectively in the immediate period following trauma. Victims of immediate trauma often exhibit “silent terror” or extreme stress .The Emergency Response Procedure (ERP), described in the Humanitarian Assistance Programs (HAP) Disaster Manual, was developed to deal with victims of natural and man made disaster within hours of exposure to trauma. Participants in this workshop will learn how to respond to these clients in the immediate aftermath of trauma, utilizing Debriefing and ERP. This same basic approach can be applied in the event of strong abreaction during the initial phase of History-taking, and prior to the Preparation Phase of EMDR. Similarly, treatment with ERP may also be considered for patients exhibiting this “silent terror” or extreme stress during initial treatment by first responders at the scene of an accident or in ambulances en route to medical facilities. Case examples will be presented to illustrate the successful treatment of Acute Stress Disorder (ASD) with survivors of the earthquake in Turkey and the Tsunami in Thailand, and with victims of terror and war in Israel. In this presentation the Recent Events Protocol will be examined, with particular emphasis on modifying the Positive Cognitions (PC) in the face of continuing ongoing danger. The EMDR Group Protocol will be presented and followed by a practicum. [There are 2 PDF files.]

Keywords: Emergency Response Procedure ERP

Accuracy Verified: Yes

24. Friedberg, F. (2004, November). Eye movement desensitization in fibromyalgia: A pilot study. Complementary Therapies in Nursing and Midwifery, 10(4), 245-249. doi:10.1016/j.ctnm.2004.06.006.

Language: English

Format: Journal

Abstract:
The purpose of this study was to investigate the effectiveness of eye movement desensitization (EMD) for the relief of pain, fatigue and anxiety and depression in fibromyalgia patients. Six Caucasian female patients (mean age=43.2 yr) participated in two treatment sessions. Outcome assessments included the Fibromyalgia Impact Questionnaire, Fatigue Scale, Beck Anxiety Inventory, and Beck Depression Inventory. In-session process measures included thermal biofeedback monitoring and subjective units of discomfort ratings of pain, stress, and fatigue. Four out of six subjects were considered treatment responders. Thermal biofeedback monitoring revealed an average increase in hand temperature of 5.4 degrees indicating a relaxation effect. At treatment termination, average scores decreased on the measures of anxiety (28.6%), depression (29.9%), fibromyalgia impact (12.6%), and fatigue (11.5%). At the 3-month follow-up assessment, total reductions in average scores from pre-treatment baseline reflected further improvements on measures of anxiety (45.8%), depression (31.6%), fibromyalgia impact (19.2%), and fatigue (26.7%). Because EMD produced a somewhat automatic relaxation response with minimal patient participation, it may be especially useful when standard relaxation techniques fail.

Keywords: Fibromyalgia Pilot Study

Accuracy Verified: Yes

25. Pagani, M., Nardo, D., Höberg, G., & Larson, S. (2009, November). Gray matter changes in limbic cortex in PTSD are associated with trauma load and EMDR outcome. Presentation at the 25th annual meeting of the International Society for Traumatic Stress Studies, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Psychophysiological Research
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM reduction in PTSD in relation to trauma load, and to assess the volumetric differences between responders (R) and non-responders (NR) to EMDR therapy. Magnetic Resonance Imaging scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were compared by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. Within S, further comparisons were made between 10 R and 5 NR. A regression analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects. Results showed a highly significant GM volume reduction in S as compared to NS, bilaterally in posterior cingulate and in the left hemisphere in precuneus, lingual and parahippocampal gyri. Moreover, NR showed a highly significant GM volume reduction as compared to R in bilateral posterior cingulate, as well as insula, parahippocampal gyrus and amygdala in the right hemisphere. Regression analysis showed that GM volume reductions positively correlated with trauma load in bilateral anterior and posterior cingulate and right parahippocampal gyrus. In conclusion, GM volume reductions in posterior cingulate and parahippocampal cortex were associated with PTSD diagnosis, trauma load, and EMDR treatment outcome.

Keywords: Limbic Cortex Posttraumatic Stress Disorder PTSD Outcome Trauma Load

Accuracy Verified: Yes

26. Nardo, D., Hogberg, G., Looi, J. C., Larsson, S., Hallstrom, T., & Pagani, M. (2010, May). Gray matter density in limbic and paralimbic cortices is associated with trauma load and EMDR outcome in PTSD patients. Journal of Psychiatric Research, 44(7), 477-485. doi:10.1016/j.jpsychires.2009.10.014.

Language: English

Format: Journal

Abstract:
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM density in PTSD in relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy. Magnetic Resonance Imaging (MRI) scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were compared by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. Within S, further comparisons were made between 10 R and 5 NR. A regression analysis between GM density and the Traumatic Antecedents Questionnaire (TAQ) was also performed on all 43 subjects. Results showed a significantly lower GM density in S as compared to NS in the left posterior cingulate and the left posterior parahippocampal gyrus. Moreover, NR showed a significantly lower GM density as compared to R in bilateral posterior cingulate, as well as anterior insula, anterior parahippocampal gyrus and amygdala in the right hemisphere. Regression analysis showed that GM density negatively correlated with trauma load in bilateral posterior cingulate, left anterior insula, and right anterior parahippocampal gyrus. In conclusion, a GM lower density in limbic and paralimbic cortices were found to be associated with PTSD diagnosis, trauma load, and EMDR treatment outcome, suggesting a view of PTSD characterized by memory and dissociative disturbances.[Pubmed]

Keywords: Limbic Cortex Posterior Cingulate Posttraumatic Stress PTSD

Accuracy Verified: Yes

27. Pagani, M. (2010, June). Gray matter density is associated with EMDR outcome in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder patients. Eye Movement Desensitization Reprocessing (EMDR) is currently used to treat PTSD but its neurobiological implications are still unknown. The aim of this study was to evaluate GM density in PTSD relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy. Structured clinical interviews for DSM-IV Axis I Disorders were carried out before and after EMDR treatment. Those who no longer fulfilled the DSM-IV criteria for PTSD were classified as R and those who still met the diagnostic criteria of PTSD after treatment were classified as NR. Two scales 0f self-related Trauma Antecedent Questionnaire (‘trauma and neglect’ TAQ-, and ‘resilience factors’ TAQ+), were administered to assess lifelong trauma load and resilience. Magnetic Resonance Imaging (MRI) scans 10 R and of 5 NR were compared before therapy by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. For group analysis, a threshold of p<0.05 corrected for multiple comparisons at cluster level and an uncorrected threshold of p <0.001 at voxel-level were used. NR subjects showed no significant differences nor in TAQ- scores neither in TAQ+ as compared to R(t=0.140, p+0.891). The contract R>NR exhibited a significant GM lower density in NR as compared to R in three different cluster: the first bilaterally located over posterior cingulate (Brodmann Areas, Bas 23 and 31); the second centered over the left precentral (BA 4), middle and medial frontal gyri (BA 6); the third including anterior insula (BA 13), and the complex anterior parahippocampal gyrus/amygdala, over the right hemisphere. To our knowledge, this is the first study investigating GM alterations with a VBM approach in a sample of PTSD patients respond and non responding to EMDR therapy. Posterior cingulate, parahippocampal and insular lower GM concentrations have been found to relate to responsiveness to EMDR therapy suggesting a high vulnerability of these structures to the effects of stress and trauma. These regions are well known to be implicated in processes such as: integration, encoding and retrieval of autobiographical and episodic memories; emotional processing, interoceptive awareness and sefl-referential conscious experience. Thus, our study supports lower GM densities in limbic and paralimbic cortices as a potential structural basis for memory and dissociative dysfunction in PTSD. Using such methodological approach can contribute to better understand the neurostructural basis for traumatic responses and their treatment. The goals for the audience are: 1. To understand the methodological research principles; 2. To be updated on neurobiological research in EMDR; 3. to be informed on the neural basis of EMDR.

Keywords: Gray Matter Posttraumatic Stress Disorder PTSD Research Symposium

Accuracy Verified: Yes

28. Watson, P. J., Friedman, M. J., Ruzek, J. I., & Norris, F. (2002, August). Managing acute stress response to major trauma. Current Psychiatry Reports, 4(4), 247-253. doi:10.1007/s11920-996-0043-x.

Language: English

Format: Journal

Abstract:
In this article, the authors review the current empiric literature on early interventions. Findings on the effects, course, help-seeking, and recovery from disasters are first reviewed, with recommendations given that are pertinent to intervention following mass casualties. In reviewing the most commonly used interventions, it is clear that evidence from well-controlled studies showing that early intervention can help prevent longer-term problems is limited. The authors discuss the approaches that have received the most attention or empiric support as early interventions following trauma, which include psychologic debriefing, cognitive-behavioral interventions, eye movement desensitization and processing (EMDR) and other neoteric approaches, and psychopharmacology. At this time, the most promising results for prevention of psychopathology have been achieved with brief four- or five-session cognitive-behavioral therapy. In contrast, randomized clinical trials on psychologic debriefing currently suggest that this approach is either ineffective at preventing psychopathology, or contributive to PTSD symptoms. Research support is currently lacking for EMDR and pharmacotherapy as early interventions. A major challenge to the field is to integrate the practical experience and knowledge of professional responders with well-controlled, timely intervention research, and to effectively disseminate these findings to practitioners in the field. [Author Abstract]

Keywords: Critical Incident Stress Debriefing Effects Literature Review Negative Research Needs Review Posttraumatic Stress Diorder Psychological Debriefing PTSD Stressors Survivors Therapeutic Reaction Treatment Effectiveness

Accuracy Verified: Yes

29. Pagani, M., Flumeri, F., Salmaso, D., Nardo, D., Sanchez-Crespo, A., Danielsson, A. M., Brolin, F., Jacobsson, H., Larsson, S. A., & Hogberg, G. (2008, October). Neurobiological changes in post traumatic stress disorder following treatment with eye movement desensitisation reprocessing. Presentation at the European Association of Nuclear Medicine Congress, Munich, Germany, European Journal of Nuclear Medical and Molecular Imaging, 35(Supp 2).

Language: English

Format: Conference

Abstract:
Background: Only few studies have reported functional or structural modifications in Post Traumatic Stress Disorder (PTSD) patients following pharmacological treatment or psychotherapy. Eye movement desensitization and reprocessing (EMDR) is a novel eclectic psychotherapy utilising, among other techniques, relaxation and safe place exercises, cognitive restructuring, future projections, and imaginal exposure of the trauma combined with sensory stimulation. The aim of the study was to analyse the differences in regional cerebral blood flow (rCBF) distribution and in brain volumetry before and after EMDR therapy. Subjects and Methods: Fifteen subjects with chronic PTSD following occupational health hazards were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before and directly after treatment. SPECT, during administration of an individualised trauma script, was performed using 99mTc-HMPAO. After EMDR, the subjects were subdivided into responders (R, n=10) and non-responders (NS, n=5), based on the absence or presence, respectively, of full PTSD diagnosis. SPECT and volumetric data (MRI) analyses were carried out by Statistical Parametric Mapping (SPM2). SPECT and MRI data were covaried by age and by time elapsed from trauma to SPECT. SPECT data were further covaried by the amount of grey matter normalised by the total intracranial volume. Results: Immediate significant post-treatment changes towards normality in all scales measuring psychological status were found in responders. As compared to NR, R showed a significantly decreased tracer uptake in parieto-occipital (Brodmann Area, BA, 37, fusiform gyrus) and in primary visual cortex (BA17) and in the hippocampus (p<0.001). The opposite comparison highlighted an increased tracer uptake in left frontal cortex (BA 44; p<0.05). Structural grey matter modifications were found in visual, posterior cingulate and parieto-temporal cortex, paralleling the functional changes. Conclusion: The positive EMDR outcome corresponded to increased 99mTc-HMPAO uptake in the left dorsolateral frontal cortex, processing attention and self confidence and exerting an inhibitory effect on the amygdala whose firing is supposed to be responsible for PTSD. After successful treatment significant decreases were found in primary visual cortex, processing images of traumatic memories and flashbacks; in fusiform gyrus, processing the memories of faces, bodies and words and in the hippocampi, involved in episodic and autobiographical memories. Volumetric changes paralleled the ones in tracer uptake in all regions Taken as a whole these findings suggest that the positive clinical outcome following EMDR therapy causes functional and structural neurobiological changes towards normality.

Keywords: Brain Volumetry Neurobiological Changes Posttraumtic Stress Disorder PTSD rCBF Regional Cerebral Blood Flow

Accuracy Verified: Yes

30. Nisi, A. (2003, May). Non conventional EMDR protocols in treatment of resistant OCD patients (Non or poor responders). In Anxiety disorders. Symposium conducted at the annual meeting of the EMDR Europe Assocation, Rome, Italy.

Language: English

Format: Conference

Keywords: Anxiety Disorders Obsessive Compulsive Disorder OCD Symposium Treatment

Accuracy Verified: Yes

31. Park, S.-C., Park, Y.-C., Lee, M.-S., & Chang, H. S. (2012, March). Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: A pilot study. Acta Neuropsychiatrica. doi:10.1111/j.1601-5215.2011.00623.x.

Language: English

Format: Journal

Abstract:
We investigated the relationship between plasma levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) and responses to eye movement desensitisation and reprocessing (EMDR) in complex PTSD. Before and after EMDR, plasma levels of neurotrophic factors and scores in the indices of self-questionnaires were obtained for 8 men with complex PTSD. Baseline plasma levels of BDNF and NGF of responders and of non-responders were compared. The plasma BDNF levels of responders were higher than those of non-responders. However, plasma NGF levels did not differ in two groups. Plasma BDNF level might contribute to the therapeutic response to EMDR in trauma-related psychiatric disorders, such as complex PTSD. [Text]

Keywords: Pilot Study Plasma Brain-Derived Neurotrophic Factor Level Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

32. Hurley, E. C., & Colelli, G. (2006, September). Post-Katrina disaster response: EMDR Humanitarian Assistance Program (HAP) volunteers discuss post-Katrina recovery work and its comparison with the 9/11 New York City response. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
This presentation provides a collective body of knowledge helpful for EMDR clinicians in understanding disaster response at sites both in post-Katrina operations in Louisiana and 911 operations in New York City. The presentation will include information learned by EMDR Humanitarian Assistance Program (HAP) volunteers in establishing an on-site network for trauma recovery clinicians serving in Louisiana. Lessons learned include establishing initial onsite networks, noting key contact persons, and networking with local agencies in providing EMDR services. EMDR Consultation and the importance of daily debriefings of the clinical work will be discussed. Differences in protocols such as EMD, Recent Events Protocol, and EMDR, as they relate to the timing of the trauma will be outlined. The importance of practicing healthy self-care and avoiding burnout will be noted. A summation will include the similarities and differences between the EMDR community-based intervention project in New York City with responders and civilian following 9/11 and the post-Katrina HAP project with first responders in Louisiana.

Keywords: HAP Katrina

Accuracy Verified: Yes

33. Fay, J., Kamena, M. D., Benner, A., & Buscho, A. (2006, September). A residential milieu treatment approach for first-responder trauma. Traumatology, 12(3), 255-262. doi:10.1177/1534765606294991.

Language: English

Format: Journal

Abstract:
First responders, which include police officers, firefighters, correctional officers, emergency medical technicians, and dispatchers, face unique challenges in dealing with and recovering from critical incidents. In their work with emergency responders at the West Coast Post-Trauma Retreat (WCPR), the authors have found that short-term residential treatment is an effective treatment component. In this article, the authors discuss the WCPR residential treatment model.

Keywords: First Responders Peer Support Posttraumatic Stress Disorder PTSD Residential Treatment Trauma

Accuracy Verified: Yes

34. Devilly, G. J. (2001, January). The successful treatment of PTSD through overt cognitive behavioral therapy in non-responders to EMDR. Behavioural and Cognitive Psychotherapy 29(1), 57-70. doi:10.1017/S1352465801001072.

Language: English

Format: Journal

Abstract:
This research investigated the efficacy of an operantly cognitive-behavioural trauma treatment protocol (TTP) in two cases that had previously been treated unsuccessfully with EMDR. In line with previous research, both participants improved following TTP, to the extent where one of the participants was asymptomatic at post-treatment and 3 month follow-up. These cases also demonstrate the ability of a cognitive-behavioural intervention to successfully treat childhood sexual abuse victims later in life. (Cambridge Journals)

Keywords: Battery Case Report CBT Child Clinical Case Study College Students Cognitive Behavioral Therapy Cognitive Therapy Death of Child Empirical Study Females Follow-up Study Homicide Incest Middle Aged Posttraumatic Stress Disorder PTSD Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial Young Adults

Accuracy Verified: Yes

35. 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

36. Gelbach, R. A. (2008). Trauma, research, and EMDR: A disaster responder's wish list. Journal of EMDR Practice and Research, 2(2), 146-155. doi:10.1891/1933-3196.2.2.146.

Language: English

Format: Journal

Abstract:
Disasters, both natural and "man-made", affect a large portion of the Earth's population and can be expected to increase in intensity over the coming decades. The impact of disasters on mental health of affected populations is substantial and likely to be insufficiently addressed in the overall context of disaster response. While successful mental health intervention has been demonstrated in a variety of cases, including through the use of EMDR treatment, this problem needs more attention. Effective mental health response will be greatly supported by increased research on questions related to the incidence, form, and prognosis of disaster-generated traumatic stress, as these are affected by type of disaster, culture of affected population, sociological conditions, and neuropsychological factors, and the interactions among these. A brief summary of desirable research is presented that could help responders meet these challenges. [Author Abstract]

Keywords: Disaster Disaster-Response Posttraumatic Stress Disorder PTSD Trauma

Accuracy Verified: Yes

37. Cohena, J. A., Mannarino, A. P., & Rogal, S. (2001, January). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25(1), 123-135. doi:10.1016/S0145-2134(00)00226-X.

Language: English

Format: Journal

Abstract:
Objective: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. Method: An anonymous survey was mailed to 207 child psychiatrists ("medical") [members of the American Academy of Child and Adolescent Psychiatry] and 460 nonphysician ("non-medical") therapists [members of the International Society for Traumatic Stress Studies] inquiring about current interventions used to treat children with PTSD. Results: 247 responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. 95% of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. Conclusions: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR. [Author Abstract]

Keywords: Adolescents Arousal Avoidance Children Drug Therapy Mental Health Personnel Reexperiencing Posttraumatic Stress Disorder PTSD Treatment Effectiveness

Accuracy Verified: Yes

38. Keenan, P., & Royle, L. (2007, Fall). Vicarious trauma and first responders: A case study utilizing eye movement desensitization and reprocessing (EMDR) as the primary treatment modality. International Journal of Emergency Mental Health, 9(4), 291-298 .

Language: English

Format: Journal

Abstract:
Traumatic events can occur and adversely affect people during their lifetime. Natural disasters such as the earthquake in Pakistan in 2005 or the Tsunami in Asia in 2004, terrorist atrocities around the world, or personal events such as physical or sexual assault, can result in psychological difficulties for those people directly affected by these events. The diagnostic term PTSD is generally used to explain the often-severe psychological sequelae that people may exhibit when directly affected by trauma. However, what of those people not directly involved in the trauma, but those who have borne witness to it, either by listening to the stories of survivors, or in the case of the helping professionals (such as police officers, nurses, doctors, psychotherapists, fire-fighters), actively working with survivors in psychological distress? This paper examines the potential psychological consequences for those in helping professions who are working with traumatized clients. This paper then focuses on a specific treatment intervention, EMDR, utilizing a case study by way of explanation. [Author Abstract]

Keywords: Case Report Clinical Case Study Cognitive Schemas Depressive Disorders Helping Professionals Males Police Officers Police Personnel Psychotherapeutic Processes Stressors Stigma Treatment Effectiveness Vicarious Trauma

Accuracy Verified: Yes

39. Bergmann, U., & Forgash, C. (1998, July). Working successfully with apparent EMDR non-responders: Diagnostic and treatment considerations. Presentation at the annual meeting of the EMDR International Association, Baltimore, MD.

Language: English

Format: Conference

Abstract:
Participants will: 1) understand the diagnostic and treatment considerations that are the necessary prerequisites for successful work with apparent EMDR non-responders; 2) understand the different application of shorter vs. longer term EMDR; 3) gain an understanding regarding the use of devleopmental blueprinting as an aid in the choice of EMDR targets and cognitions; 4) gain knowledge regarding the range of dissociative phenomena in both traumtized, as well as non-PTSD individuals; and 5) gain an understanding of the concept of internal conflict resolution via the focus on the integrative interaction among the discrete inner selves.

Keywords: Non-responders

Accuracy Verified: Yes