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1. Sack, M., Lempa, W., Steinmetz, A., Lamprecht, F., & Hofmann, A. (2008, October). Alterations in autonomic tone during trauma exposure using eye movement desensitization and reprocessing (EMDR) - Results of a preliminary. Journal of Anxiety Disorders, 22(7), 1264-1271. doi:10.1016/j.janxdis.2008.01.007 .
Language: English
Format: Journal
Abstract:
EMDR combines stimuli that evoke divided attention – e.g. eye movements – with exposure to traumatic memories. Our objective was to investigate psycho-physiological correlates of EMDR during treatment sessions. A total of 55 treatment sessions from 10 patients with PTSD was monitored applying impedance cardiography. Onset of every stimulation/exposure period (n = 811) was marked and effects within and across stimulation sets on heart rate (HR), heart rate variability (HRV), pre-ejection period (PEP) and respiration rate were examined. At stimulation onsets a sharp increase of HRV and a significant decrease of HR was noticed indicating de-arousal. During ongoing stimulation, PEP and HRV decreased significantly while respiration rate significantly increased, indicating stress-related arousal. However, across entire sessions a significant decrease of psycho-physiological activity was noticed, evidenced by progressively decreasing HR and increasing HRV. These findings suggest that EMDR is associated with patterns of autonomic activity associated with substantial psycho-physiological de-arousal over time. [Author Abstract]
Keywords: Adults Germans Empirical Study Impedance Cardiography Posttraumatic Stress Disorder Psychophysiology PSTD Quantitative Study Survivors Treatment Effectiveness
Accuracy Verified: Yes
2. Sack, M., Lempa, W., & Lamprecht, W. (2007). Assessment of psychophysiological stress reactions during a traumatic reminder in patients treated with EMDR. Journal of EMDR Practice and Research, 1(1), 15-23. doi:10.1891/1933-3196.1.1.15.
Language: English
Format: Journal
Abstract:
This study investigates changes of stress-related psychophysiological reactions after treatment with EMDR. 16 patients with PTSD following type I trauma underwent psychometric and psychophysiological assessment during exposure to script-driven imagery before and after EMDR and at 6-month follow-up. Psychophysiological assessment included heart rate (HR) and heart rate variability (HRV) during a neutral task and during trauma script listening. PTSD symptoms as assessed by questionnaire decreased significantly after treatment and during follow-up in comparison to pretreatment. After EMDR, stress-related HR reactions during trauma script were significantly reduced, while HRV indicating parasympathetic tone increased both during neutral script and during trauma script. These results were maintained during the follow-up assessment. Successful EMDR treatment may be associated with reduced psychophysiological stress reactions and heightened parasympathetic tone. [Author Abstract]
Keywords: Adults Germans Manual-Based Treatments Posttraumatic Stress Disorder Psychophysiology PTSD Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
3. Frustaci, A., Lanza, G. A., Fernandez, F., di Giannantonio, M., & Pozzi, G. (2010). Changes in psychological symptoms and heart rate variability during EMDR treatment: A case series of subthreshold PTSD. Journal of EMDR Practice and Research, 4(1), 3-11. doi:10.1891/1933-3196.4.1.3 .
Language: English
Format: Journal
Abstract:
Elevated psychophysiological parameters and heightened physiological reactivity to trauma-related cues
are acquired changes following trauma exposure. Measuring improvement in these variables is an appropriate
evaluation of outcome in treatment studies. Heart Rate Variability (HRV) is a computerized measure
of physiological responsivity derived from Holter ECG recording. Four female outpatients with persistent
post-traumatic symptoms and personal impairment following “small t” trauma exposure underwent a
course of EMDR treatment and were assessed at baseline, end of treatment, day 30 and day 90 of followup,
using self-report symptom scales and 90-min Holter ECG recordings. Symptom scores decreased
between baseline and end of treatment, with improvement maintained at follow-up. Several HRV measures
changed favorably in different recording intervals. HRV is a feasible and sensitive method to measure
physiological changes in the treatment of individuals distressed by “small t” trauma. Further investigation
is advisable to expand these preliminary data.
Keywords: Case Series Heart Rate Variability HRV IES Small T Trauma
Accuracy Verified: Yes
4. Hase, M. (2012, June). EMDR in the treatment of burnout [EMDR en el tratamiento de burnout [desgaste profesional]. Presentation at the annual meeting of EMDR Europe Association, Madrid, Spain.
Language: English
Format: Conference
Abstract:
EMDR
en
el
tratamiento
de
burnout
[desgaste
profesional]
El
estrés
representa
una
de
las
principales
causas
de
pérdida
de
productividad,
deterioro
del
funcionamiento
y
problemas
graves
de
salud
en
el
dominio
somático
y
psicosomático
(Salonen
et
al.
2008).
Aún
así,
el
burnout
parece
constituir
un
tema
altamente
polémico
en
el
campo
de
la
medicina
psicosomática.
Con
gran
frecuencia,
la
génesis
de
esta
dolencia
está
relacionada
con
el
lugar
de
trabajo
y
el
ejercicio
profesional,
si
bien,
ha
de
considerarse
la
predisposición
individual.
El
desarrollo
de
este
trastorno
parece
derivarse
de
episodios
críticos
que
dejan
al
individuo
incapaz
de
completar
un
ciclo
de
actuación.
Hobfoll
(2004)
postula
una
naturaleza
común
del
estrés
traumático
y
los
acontecimientos
vitales
estresantes
que
acaban
por
provocar
un
proceso
de
burnout.
Este
desgaste
profesional
ejerce
un
impacto
profundo
sobre
la
mente
y
el
cuerpo
y
guarda
relación
con
un
estado
somático
en
particular.
La
coherencia
neurobiológica
promete
mucho
como
concepto
global
de
la
salud
y
bienestar.
La
variabilidad
de
la
frecuencia
cardiaca
(HRV,
por
sus
siglas
en
inglés)
supone
una
medida
sencilla
para
la
monitorización
de
la
coherencia
neurobiológica
y
es
idónea
para
monitorizar
la
terapia.
EMDR
se
revela
como
una
herramienta
idónea
en
un
plan
terapéutico
completo
encontrando
recuerdos
de
episodios
críticos
en
la
formación
del
proceso
de
burnout.
Esta
conferencia
aborda
la
probabilidad
de
la
psicoterapia
y
terapia
adyuvante
en
un
entorno
psicosomático.
La
desensibilización
y
el
reprocesamiento
por
movimientos
oculares
–
EMDR
(Shapiro,
2001)
se
perfila
como
una
herramienta
idónea
en
un
plan
terapéutico
completo.
Existe
cada
vez
más
evidencia
de
la
eficacia
del
EMDR
en
el
tratamiento
del
desgaste
profesional.
Dado
que
con
frecuencia
EMDR
se
tolera
bien
y
goza
de
gran
aceptación,
se
espera
contar
con
otra
opción
adicional
en
el
tratamiento
del
burnout.
Michael
Hase
MD
explicará
la
planificación
del
tratamiento,
con
especial
énfasis
en
la
secuencia
y
técnicas.
Se
hablará
de
la
investigación
actual
y
una
casuística.
Las
demostraciones
a
partir
de
grabaciones
en
vídeo
presentarán
un
esquema
de
los
puntos
más
importantes
y
capacitarán
a
los
participantes
a
integrar
este
planteamiento
en
su
práctica
clínica.
Keywords: Burnout
Accuracy Verified: Yes
5. Frustaci, A., Pozzi, G., Aurigemma, C., La Rosa, C., Lanza, G., Fernandez, I., & Ruggeri, G. (2006, Febbraio). Indicatori di cambiamento in pazienti con disturbi da eventi stressanti: Impiego della heart rate variability [Indicators of change in patients with disorders of stressful events: Use of heart rate variability]. Poster presentato al XI Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia.
Language: Italian
Format: Conference
Abstract:
Introduzione: i pazienti traumatizzati presentano alterazioni sintomatiche quali intrusività, evitamento ed aumentato arousal, che ostacolerebbe la possibilità di elaborazione/integrazione
delle tracce mnesiche, oltre ad esprimersi a livello periferico. Tecniche specifiche di trattamento sembrano promuovere
l’elaborazione/integrazione delle memorie traumatiche, tra cui la Eye Movement Desensitization and Reprocessing
(EMDR). Nella ricerca valutativa è quindi necessario affiancare alle scale psicologiche un appropriato indicatore
biologico di attivazione neurovegetativa. La variabilità della frequenza cardiaca (Heart Rate Variability – HRV) esprime
l’integrità funzionale del sistema neurovegetativo in risposta
allo stress e può essere misurata nei domini di tempo o di frequenza. Lo studio della HRV è stato applicato in psichiatria ai disturbi
d’ansia (panico, DOC, PTSD) e dell’umore (depressione unipolare) in ricerche trasversali (confronto con controlli sani) e longitudinali di trattamento farmacologico (triciclici,
SSRIs) ma in pochi casi a trattamenti psicoterapici. Gli AA. valutano l’impiego della HRV come indicatore biologico nel trattamento psicoterapeutico di pazienti con Disturbo dell’adattamento erdurante da oltre un mese dopo l’esposizione ad eventi vitali stressanti (EVS). Metodi: sono stati reclutati 6 soggetti (M/F = 1/5, età 40,5 ± 11,0) esposti ad EVS ed avviati a ciclo di trattamento psicoterapico
breve (4-6 sedute a cadenza settimanale) di tipo
specifico (EMDR) o generico (colloqui supportivi). Costituivano criteri di esclusione: età < 18 o > 65 anni; comorbilità psichiatrica, neurologica e cardiologica; uso di farmaci interferenti. Le valutazioni psicopatologiche sono state eseguite al reclutamento
(TBASE: colloquio anamnestico, MINI, Brief
COPE), a inizio e fine ciclo di trattamento (TINI, TFINE: IES, SCL-90-R), a uno e tre mesi di follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Le registrazioni Holter sono state effettuate ad ogni intervallo valutativo coprendo: 60 min. attività libera, 10 min. tilt-test, 3-5 min. ascolto dell’evento traumatico, 30-45 min. seduta psicoterapica. Sono stati impiegati test statistici non parametrici per l’analisi
delle correlazioni (Spearman) e delle differenze
(Wilcoxon). Risultati preliminari: vengono valutate le correlazioni a TINI e le variazioni T90 vs. TINI. Sono significative le seguenti correlazioni: ansia fobica SCL e SDNN (dev. standard intervalli R-R) [r = + 0,9; p = ,037]; collera-ostilità
SCL e SDNN [r = -0,95; p =.014]; depressione SCL e
r-MSSD (radice media somma quadrati diff. R-R) [r = + 0,9; p = ,037]; sint. intrusivi IES e LF (basse frequenze) [r
= -0,9; p = ,037]. Sono risultate statisticamente significative le seguenti variazioni:
IES totale [Z = -1,99; p = ,046], sintomi intrusivi IES [Z = -2,21; p = ,027], sintomi di evitamento IES [Z = -1,99; p = ,046], ideazione paranoide SCL [Z = -2,21; p = ,027]; R-R, LF e LF/HF (rapporto basse/alte frequenze) durante ascolto evento [Z = -2,02; p = ,043].
Discussione: a livello basale gli indicatori HRV di distress vegetativo correlano positivamente con collera-ostilità e sintomi intrusivi, negativamente con ansia e depressione. Anche dopo tre mesi dalla fine del trattamento gli interventi psicoterapeutici tendono a ridurre i punteggi sintomatici, e migliorano il bilancio simpato-vagale durante il riascolto dell’evento traumatico.
Introduction: trauma patients have symptomatic changes such as intrusiveness, avoidance and increased arousal, which hampers the development / integration
of memory traces, as well as speak at the peripheral level. Specific techniques of treatment seem to promote
the formulation and integration of traumatic memories, including eye movement desensitization and reprocessing
(EMDR). In evaluation research is therefore necessary to combine psychological scales appropriate indicator
organic autonomic activation. The heart rate variability (Heart Rate Variability - HRV) expresses
functional integrity of the autonomic nervous system in response
stress and can be measured in time or frequency domains. The study of HRV has been applied in psychiatric disorders
anxiety (panic, DOC, PTSD) and mood (unipolar depression) in cross-disciplinary (compared with healthy controls) and longitudinal drug treatment (tricyclic
SSRIs), but in a few cases in psychotherapeutic treatment. The AA. evaluate the use of HRV as a biological indicator in the psychotherapeutic treatment of patients with adjustment disorder erdurante more than a month after exposure to stressful life events (EVS). Methods: 6 subjects were recruited (M / F = 1 / 5, age 40.5 ± 11.0) exposed to EVS and initiated treatment cycle psychotherapeutic
short (4-6 sessions weekly) type
specific (EMDR) or generic (hearing supported). Exclusion criteria were: age <18 or> 65 years, psychiatric comorbidity, neurological and cardiological, use of drugs interfering. Psychopathological assessments were performed at recruitment
(TBASE: anamnestic interview, MINI, Brief
COPE) at the beginning and end of treatment cycle (TINI, TFINE: IES, SCL-90-R) in a three-month follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Holter recordings were made at each interval evaluation covering: 60 min. free activity, 10 min. tilt-test, 3-5 min. listening to the traumatic event, 30-45 minutes. psychotherapy session. Were used nonparametric statistical tests for analysis
correlations (Spearman) and differences
(Wilcoxon). Preliminary results: the correlations are evaluated and changes TINI vs. T90. TINI. Significant correlations are the following: SCL phobic anxiety and SDNN (standard dev. RR intervals) [r = + 0.9, p =, 037]; anger-hostility
SCL SDNN [r = -0.95, p =. 014]; SCL depression
r-mssd (root mean square sum diff. RR) [r = + 0.9, p =, 037]; sint. IES intrusive and LF (low frequency) [r
= -0.9, P =, 037]. Were statistically significant, the following changes:
IES total [Z = -1.99, p =, 046], IES intrusive symptoms [Z = -2.21, p =, 027], symptoms of avoidance IES [Z = -1.99, p =, 046] , SCL paranoid [Z = -2.21, p =, 027], RR, LF and LF / HF ratio (low / high frequencies) while listening event [Z = -2.02, p =, 043].
Discussion: At baseline HRV indicators of distress correlated positively with growing anger-hostility, and intrusive symptoms, negatively with anxiety and depression. Even after three months of the end of psychotherapeutic treatment interventions aimed at reducing symptom scores and enhance sympathetic vagal balance during the playback of the traumatic event.
Keywords: Heart Rate Variability Poster Stress Disorders
Accuracy Verified: Yes
6. Schellong, J. (2010, June). Psychophysiological responsivity to trauma and internal resources in patients with PTSD and healthy subjects. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
This study aims to measure psychophysiological
parameters during activation of internal resources k g .
positive memories) and to compare these to activated traumatic
internal networks.
Antecedent studies show that traumatic stimulation on patients
with posttraumatic stress disorder (PTSD) finalizes in various
psychophysiological correlates. During therapy of these patients
a strong demand for activation of internal resources, i.e. activation
of fortitude and positives thoughts, exists. Especially EMDR
therapy uses resource stimulating elements such as position of
power and absorption in preparation for exposure. In this study
standardized EMDR protocols establish a solid basis to explore
individual internal resources.
Researches on trauma stimuli in EMDR- patients show effects
on parasympathetic tonus (Sack 2006) as well as increased cerebral
blood flow in defined brain regions (Levin 1999. Lamprecht
2000). Especially the heart rate variability (HRV) may describe
the sympatheticovagal balance (Cohen, 2002, Porges 1991). This
study focuses on psychophysiological effects and neurobiological
regulative mechanisms of stabilizing methods and activation of
internal resources in PTSD patients and healthy control group.
Methods: Healthy subjects and patients with diagnosed PTSD
(DIAX) listened to a commonly neutral script, an individual
trauma script and an individual absorption script. Following
each script measurements of heart rate variability (HRV), respiratory
flow, skin conductance responses (SCR) and skin blood
flow (LCF, TU50%) took place.
Results: Preliminary results revealed a significant reduced heart
rate variability in patients compared to the healthy controls in
reaction to the stress script as well as to the positive and the
neutral scripts.
Conclusion: To our knowledge this is the first time to be proven
that altered autonomous functions are found in PTSD not only
in reaction to traumatic reminders, but even to a positive, resource
activation situation. This provides our basement for further
research. Detailed analysis of different effects to each script
on both groups are currently underway.
Keywords: Posttraumatic Stress Disorder PTSD Research Responsivity Symposium Trauma
Accuracy Verified: Yes
7. Sack, M., Nickel, L., Lempa, W., & Lamprecht, F. (2003). Psychophysiologische regulation bei patienten mit PTSD: Veränderungen nach EMDR-behandlung [Psychophysiological regulation in patients with PTSD: Improvement after EMDR-treatment]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 47-57.
Language: German
Format: Journal
Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Uns interessierte die Frage, ob die EMDR-Behandlung bei Patienten mit Posttraumatischer Belastungsstörung (PTSD) neben einer Symptomreduktion auch mit einer verbesserten psychophysiologischen Regulationsfähigkeit einhergeht. 15 Patienten (9 w, 6 m) mit PTSD nach Einzeltraumatisierung wurden vor und nach einer EMDR- Behandlung sowie in einer 6-Monate Katamnese per Fragebogen (PDS, IES, STAI, SCL-90-R) sowie mit psychophysiologischen Parameter (HR, HRV) während Konfrontation mit der individuellen traumatischen Erinnerung (Traumaskript) untersucht. Im Vergleich Prä-/Post, sowie Prä-/Katamnese kam es zu einer signifikanten Abnahme der Beschwerden in allen Symptombereichen. Gleichzeitig konnte nach Behandlung und in der Katamnese eine signifikante Verminderung des Anstiegs der Herzfrequenz während Konfrontation mit dem Traumaskript beobachtet werden. Der HF-Anteil der Herzratenvariabilität als Indikator für den Parasympathikotonus nahm im Vergleich Prä-/Katamnese unter Ruhebedingungen sowie während Traumaskript signifikant zu. Die EMDR-Behandlung erwies sich als wirksam hinsichtlich einer Reduktion der traumaassoziierten Symptomatik und einer Reduktion des psychophysiologischen Arousals bei Konfrontation mit der belastenden Erinnerung. Die Zunahme der HRV im Behandlungsverlauf im Sinne eines höheren Parasympathikotonus lässt auf eine Verbesserung der psychophysiologischen Regulationsfähigkeit schließen.
Our question was whether PTSD-patients would show a decrease of trauma associated symptoms as well as improved psychophysiological regulatory capacities after EMDR-treatment. 15 patients (9 female, 6 male) with PTSD after single traumatizations underwent psychometric assessment including questionnaires (PDS, IES, STAI, SCL-90-R) and psychophysiological variables (HR, HRV) during presentation of their individual trauma script before and after treatment and in a 6-month follow-up. Pre-/post as well as pre-/follow-up comparison showed significant decreases in all symptom measures. At the same time HR acceleration during trauma script decreased significantly after treatment. HF-HRV, an indicator for parasympathetic tone, increased significantly during baseline as well as during trauma script in pre-/post comparison. EMDR treatment led to an effective and lasting symptom reduction as well as to a reduction of the psychophysiological arousal associated with the traumatic memory. Enhancement of HRV after treatment in terms of a higher parasympathetic tone might be the result of improved psychophysiological regulatory capacities after successful EMDR treatment. [Author Summary]
Keywords: Adults Effects Posttraumatic Stress Disorder Psychophysiology PTSD Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
8. 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
9. 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
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 Sematic Association
Accuracy Verified: Yes


