Francine Shapiro Library - EMDR Bibliography Links

 

 

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1. Barreda-Hanson, C. (2012, Septiember). Adaptación del EMDR y terapia breve centrada en el cliente para cambiar percepciones negativas y traumaticas [EMDR adaption of brief client-centered therapy to change negative and traumatic perceptions]. Presentación en la 70 Conferencia Anual del International Council of Psychologist(ICP), Sevilla, España.

Language: Spanish

Format: Conference

Abstract:
El estrés subsiguiente después de un traumatismo, representa un trastorno disfuncional – tanto interno como externo – que se manifiesta en alteraciones en el reconocimiento cognitivo y en los comportamientos, llevando además asociados síntomas somáticos, afloramiento de problemas inconscientes y ansiedades. Pues una de las características del estrés post-traumático, es precisamente la pérdida de equilibrio entre el mundo interno y externo de quien lo sufre. Por eso, ante la complejidad de las respuestas post-traumáticas, éstas se pueden catalogar en gran medida dentro de las perturbaciones psicopatológicas. El estrés psicológico surge por una situación estresante “real”, externa, tangible y la reacción ante esta difícil experiencia, evoca un conjunto bastante universal y coherente de síntomas y respuestas que provocan reacciones primitivas relacionadas con temores inconscientes ante las amenazas a la vida, que hacen aflorar incipientemente fantasías e impulsos abrumadores. Los resultados son los pensamientos disfuncionales que conducen a las respuestas y a los comportamientos desadaptativos. Objetivos: el taller está diseñado para proporcionar a estudiantes y profesionales de la Psicología – que trabajan o desean trabajar en esta área del trauma y el cambio de comportamientos -, la habilidad para utilizar eficaz y rápidamente intervenciones breves, que puedan poner en practicar incluso en casa. En el taller se estudiará la forma inicial de evaluar, tanto al trauma como a la clientela. Se trabajará la historia del trauma y se profundizará en sus consecuencias y en cómo diseñar las intervenciones breves para hacerles frente. También se centrará en averiguar qué cambios quieren los y las clientes a través de relatos y visualizaciones, utilizando una adaptación de las terapias EMDR y la Solución Enfocada tanto a crear el cambio deseado, como a mantenerlo. En consecuencia el taller es de particular interés para quienes trabajan con personas que han sufrido cualquier tipo de trauma, o quienes perciben acontecimientos de la vida, experiencias, etc. que les afectan de forma negativa en su día a día. También es útil para las personas que sufren de TOC, sobre todo trastornos del pensamiento. Los aspectos más útiles de las dos técnicas que se han adaptado junto con otras innovaciones de la autora, guardan relación con la creación de un ambiente seguro, no-traumático, que actúa rápidamente y que además, se puede realizar en casa sin peligro de consecuencias negativas. Objetivos específicos: 1. Ser capaz de describir e identificar las manifestaciones del trauma. 2. Aprender y describir dos técnicas terapéuticas breves en el tratamiento del trauma 3. Definir una técnica breve terapéutica que puede ser utilizada para fomentar el cambio 4. Destacar el rol del o de la terapeuta durante el tratamiento de los traumatismos 5. Ser capaz de describir, diseñar y establecer metas de la terapia y promover cambios mediante el uso de técnicas de terapia breve. Métodos: la Desensibilización y Reprocesamiento por Movimientos Oculares (EMDR), es un método complejo e integrador de la psicoterapia individual, mediante el que se guía al cliente utilizando un procedimiento para acceder a sus experiencias y resolver sus problemas conductuales y emocionales. El EMDR utiliza elementos de múltiples orientaciones psicoterapéuticas tanto psicodinámicas, como cognitivo- conductuales, enfoques centrados en el cliente, gestalt y bioenergéticos. La premisa subyacente de EMDR es que las experiencias de pánico y ansiedad se procesan de forma diferente por el cerebro que las experiencias habituales. La teoría subyacente es que durante el estrés, la memoria grava en una parte del cerebro responsable de las emociones de modulación (la amígdala) y se cierra temporalmente otra parte del cerebro (el hipocampo), responsable de procesamiento de la memoria normal. La experiencia traumática queda atrapada en el exterior y potencialmente no forma parte del procesamiento normal del cerebro, y el EMDR permite a la persona acceder a la experiencia y transformarla en memoria declarativa en el hipocampo. Con el método EMDR, el hipocampo se puede abrir a las emociones evocadas por la experiencia para que el/la cliente pueda soportarlas mientras se realiza el tratamiento. La distracción y la atención a la estimulación bilateral, desempeñan un importante papel que ayuda al cliente a experimentar las emociones como tolerables. Aunque cómo la distracción bilateral en concreto, facilita el procesamiento de las experiencias dolorosas, sea algo que todavía no se termina de entender. Por otra parte, las Intervenciones Breves de Terapias enfocadas al Cliente se centran en las excepciones del problema, pensando que a continuación se desarrollará un cambio natural en el comportamiento. Es una especie de visión orientada no en las formas tradicionales, sino hacia el futuro, sin profundizar demasiado en la “patología” sino más bien centrándose en lo que el sistema puede hacer para adaptarse a ella, puesto que ambos pueden decidir si esa “patología” es un problema o no lo es. Las Intervenciones de Terapia Breve enfocadas al Cliente se utilizan para resolver una variedad de problemas de comportamientos y actitudes, mediante el uso de los propios recursos de los y las clientes y las observaciones de las estrategias que utilizan para alcanzar los resultados deseados, en sus situaciones vitales habituales. Se trata de una buena técnica para establecer y mantener un contexto de cambio en el que los pequeños, pero útiles cambios, se anticipan y se buscan. En definitiva, la combinación de ambas técnicas con algunas variaciones desarrolladas por la Dra. Barreda-Hanson, han demostrado ser una herramienta poderosa para mejorar la respuesta al tratamiento en un período de tiempo más corto, teniendo también la ventaja de permitir practicar los ejercicios en casa. Aplicaciones: la aplicación habitual del EMDR ha sido el tratamiento de trastornos emocionales relacionados con eventos muy perturbadores o traumáticos. Pero también se usa para trabajar síntomas preocupantes como la ansiedad, la depresión, la culpa y la ira. E igualmente, se puede utilizar para mejorar recursos emocionales tales como la confianza y la autoestima. Procedimientos: - El taller se impartirá en español y el alumnado recibirá amplios folletos complementarios. - Se realizará en una única jornada, en sesión de mañana para teoría y de tarde para prácticas, trabajando cada modelo por separado. - Se espera que quienes asistan lleven una cuestión-problema sobre la que trabajar utilizando las diversas técnicas, pues aunque se utilizarán múltiples ej. de casos reales, se alentará a quienes participen a traer sus propias experiencias e ideas para debatir y trabajar sobre ellas.

The subsequent stress after trauma represents a dysfunctional disorder - internal and external - that is manifested in alterations in cognitive recognition and behavior, besides being associated somatic symptoms outcrop unconscious problems and anxieties. As one of the characteristics of post-traumatic stress, is the loss of balance between internal and external world of the sufferer. Therefore, given the complexity of post-traumatic responses, they can be categorized largely into psychopathological disturbances. Psychological stress arises from a stressful situation "real" external, tangible and reaction to this difficult experience, quite evokes a universal and consistent set of symptoms that cause reactions and responses primitive unconscious fears related to threats to life, which bring out fantasies and impulses incipiently overwhelming. The results are the thoughts that lead to dysfunctional responses and maladaptive behaviors. Objectives: The workshop is designed to provide students and psychology professionals - who work or want to work in this area of ​​trauma and behavior change - the ability to quickly and efficiently use brief interventions, which may put in practice even in house. The workshop will explore how to evaluate initial both trauma as to clients. It will work history of trauma and its consequences will deepen and how design brief interventions to address them. It will also focus on finding out what changes customers want and through stories and views, using an adaptation of EMDR therapy and Solution Focused both to create the desired change, and to keep it. Thus the workshop is of particular interest to those working with people who have suffered any kind of trauma, or who perceive life events, experiences, etc.. that negatively affect them in their day to day. Also useful for persons suffering from OCD, especially disorders of thought. The most useful of the two techniques that have adapted along with other innovations of the author, are related to the creation of a safe, non-traumatic, acting quickly and also can be done at home without fear of consequences negative. Specific objectives: 1. Be able to describe and identify the manifestations of trauma. 2. Learn and describe two brief therapeutic techniques in the treatment of trauma 3. Define a short therapeutic technique that can be used to promote change 4. Outline the role of the therapist or during treatment of injuries 5. Be able to describe, design and establish goals of therapy and promote change through the use of brief therapy techniques. Methods: Desensitization and Reprocessing Eye Movement (EMDR), is a complex and inclusive method of individual psychotherapy, which is guided by the client using a procedure to access their experiences and address their behavioral and emotional problems. The EMDR uses multiple elements of both psychodynamic psychotherapeutic approaches as cognitive-behavioral, client-centered approaches, gestalt and bioenergy. The underlying premise of EMDR is that experiences panic and anxiety are processed differently by the brain than normal experiences. The underlying theory is that during stress, gravel memory part of the brain responsible for emotions modulation (amygdala) and temporarily closes another part of the brain (hippocampus), responsible for normal memory processing. The trapped traumatic experience abroad and potentially not part of the normal brain processing, and EMDR allows people access to the experience and transform it into declarative memory in the hippocampus. With EMDR, the hippocampus can be opened to the emotions evoked by the experience that he / the client is able to bear while performing the treatment. Distraction and attention to bilateral stimulation, play an important role to help the client to experience emotions as tolerable. Although bilateral distraction how specifically facilitates the processing of painful experiences, is something that is not yet fully understood. Moreover, brief interventions focused Customer Therapies focus on the exceptions of the problem, thinking that then will develop a natural change in behavior. It is a kind of non-oriented view on traditional forms, but to the future, without going too deeply into the "pathology" but rather focus on what the system can do to adapt to it, since both can decide whether this "pathology "is a problem or not. Brief therapy interventions focused Customer are used to solve a variety of problem behaviors and attitudes, using their own resources and comments from customers and the strategies used to achieve the desired results in their situations normal life. This is a good technique to establish and maintain a context of change in that small but useful changes, anticipate and seek. In short, the combination of both techniques with some variations developed by Dr. Barreda Hanson, have proved a powerful tool for improving the response to therapy in a shorter period of time, having also the advantage of allowing in practice exercises house. Applications: the routine application of EMDR has been the treatment of emotional disorders associated with very disturbing or traumatic events. But also used to work worrying symptoms such as anxiety, depression, guilt and anger. And also, can be used to enhance emotional resources such as confidence and self-esteem. Procedures: - The workshop will be taught in Spanish and students will receive extensive additional brochures. - Will be held in a single day, in morning session and afternoon theory to practice, working each model separately. - Who are expected to attend with a question-problem on which to work using various techniques, for example, although multiple use. real cases, those involved are encouraged to bring their own experiences and ideas to discuss and work on them.

Keywords: Brief Therapy  

Accuracy Verified: Yes

2. 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

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

Language: English

Format: Conference

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

Keywords: Hippocampal Volume  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

4. Jacobs, S., de Jong, A., & Strack, M. (2007). EMDR und biofeedback in der therapie posttraumatischer belastungsstörungen: Evaluation eines neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the therapy of posttraumatic stress disorder: Evaluation of a neuropsychotherapeutic intervention]. VPP - Verhaltenstherapie & Psychosoziale Praxis, 39(4), 855-876.

Language: German

Format: Journal

Abstract:
Eine neu entwickelte multimodale, neuropsychotherapeutic Programm für die Behandlung der Posttraumatischen Belastungsstörung (PTBS) wurde ausgewertet. Ausgehend von neueren Erkenntnissen in der Forschung neuroscienctific, so dass eine Dissoziation zwischen impliziter und expliziter Trauma-Speicher die wichtigste Grundlage der PTBS ist, verschiedene Module wurden im Rahmen der Behandlung integriert anzuzeigen. Die vereinigten Komponenten sind: spezifische Hintergrundinformationen über die Unordnung und typische PTSD-Symptome, eine pädagogische Film für Patienten, spezifische kognitive Verhaltenstherapie und Biofeedback-Techniken unterstützte Eye Movement Desensitization and Reprocessing (EMDR). Das Ziel der Biofeedback-Sitzungen während EMDR ist es, den Patienten eine direkte Rückmeldung über die implizite Prozesse während der Trauma-Exposition. Darüber hinaus Erfassung der physiologischen Daten über Biofeedback ermöglicht das Testen, ob es eine Korrelation zwischen dem Grad der subjektiven Belastung durch traumatische Erinnerungen ausgelöst (quantifiziert mit der SUD-Skala), und messbare physiologische Erregung. Elektrodermale Aktivität (EDA; Hautleitfähigkeit) wurde als eine physiologische Parameter gemessen. Die Ergebnisse einer durchgeführten Pilot-Studie (16 Patienten auf der Grundlage, mit einem wartenden Gruppe als Kontrollgruppe) zeigen verschiedene EDA-Muster während EMDR-desensitivation (fad und assoziative Wiederaufbereitung). Ein offensichtlich Reduktion der PTBS-Symptome gefunden (d = 2,27) sein, die stärker ist als in anderen Behandlungen. Die traumatischen Erinnerungen mit EMDR behandelt wurde weniger Anstrengung, die ebenfalls reflektiert in der Physiologie (verminderte autonome Erregung) und in der subjektiven Belastung fühlte sich durch die Patienten. Die Kürzungen der Erregung (d = 1,01) und subjektive Belastung (d = 2,55) zeigen, dass eine effektive Hemmung der Aktivierung der Amygdala-und damit der Angstreaktion selbst-aufgrund der Intervention geschaffen. Mit EMDR reduziert die Amygdala physiologische Erregung. Wir vermuten, dass aus diesem Grund den medialen präfrontalen Kortex und im Hippocampus kann eine kortikale Inhibition, die erfolgreich reduziert die Angst-Reaktion (Grawe, 2004) zu etablieren. Die berichteten Ergebnisse wurden durch einen dreimonatigen Follow-up-Bewertung bestätigt. Mit einer durchschnittlichen Dauer von 16 Sitzungen und einer nicht vorhandenen Drop-out-Rate (0%), die Intervention erwiesen sich ebenfalls als sehr effizient. (PsycINFO Database Record (c) 2010 APA, alle Rechte vorbehalten)

A newly developed multimodal, neuropsychotherapeutic program for the treatment of posttraumatic stress disorder (PTSD) was evaluated. Starting from recent findings in the neuroscienctific research, which indicate that a dissociation between implicit and explicit trauma-memory is the main basis of PTSD, different modules were integrated within the treatment. The combined components are: specific background information regarding the disorder and typical PTSD-symptoms, an educational movie for patients, specific cognitive behavioral intervention techniques and biofeedback-supported Eye Movement Desensitization and Reprocessing (EMDR). The aim of using biofeedback during EMDR sessions is to give patients a direct feedback about the implicit processes during trauma-exposition. In addition, recording the physiological data via biofeedback allows testing if there is a correlation between the level of subjective strain, triggered by traumatic memories (quantified with the SUD-scale), and measurable physiological arousal. Electrodermal activity (EDA; skin conductance) was measured as a physiological parameter. The results of a conducted pilot-study (based on 16 patients, with a waiting group as a control group) show different EDA-patterns during EMDR-desensitivation (bland and associative reprocessing). An evident reduction of the PTSD-symptoms could be found (d = 2.27), which is stronger than in other treatments. The traumatic memories treated with EMDR became less straining, which reflects likewise in physiology (decreased autonomous arousal) and in the subjective strain felt by the patients. The reductions of arousal (d = 1.01) and subjective strain (d = 2.55) indicate that an effective inhibition of the amygdala activation—and thereby of the anxiety reaction itself—is created due to the intervention. Using EMDR reduces the amygdala induced physiological arousal. We suppose that for this reason the medial prefrontal cortex and the hippocampus can establish a cortical inhibition, which successfully reduces the anxiety reaction (Grawe, 2004). The reported results were confirmed by a three month follow-up evaluation. With an average duration of 16 sessions and a non-existing drop-out rate (0%), the intervention also proved to be very efficient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Keywords: Biofeedback  PTSD  

Accuracy Verified: Yes

5. Herbert, C. (2003, May). Healing the “inner child” – EMDR imagery rescripting techniques with complex trauma clients. In Attachment and complex trauma. Symposium conducted at the annual meeting of the EMDR Europe Association, Rome, Italy.

Language: English

Format: Conference

Abstract:
EMDR-based imagery re-scripting techniques with a modified concept of Cognitive Schema Modes (Young, 1999). Based on clinical case examples, the use of imagery techniques, which draw on all sensory modalities (involving cognitive, emotional and somatic systems) during the auditory application of EMDR will be described, to help complex trauma clients firstly approach and recognize and subsequently attach to and nurture the image of their own “inner child”. Rather than establishing a sense of unrealistic dependency on the therapist by integrating him or her as the sole nurturer, clients are encouraged to develop an image of their own ‘healthy adult’, who can learn to take on the role of internal re-nurturing, protection and healing of the ‘inner child’. Techniques for overcoming blockages between a client’s ‘healthy adult’ and their ‘inner child’ representations are described. It is proposed that differentiating between ‘child’ and ‘adult’ modes and tuning into these through deep-level EMDR processing, allows clients to re-connect to feelings associated with their earlier experiences of helplessness and dependency during childhood, which can now be re-experienced within a safe and nurturing context. It is suggested that this will allow higher order brain systems, such as the hippocampus, to remain active and therefore enable cognitive and structural re-organization of the stored material in the brain and body cells. Once a positive attachment bond between a client’s internalised ‘inner child’ and ‘healthy adult’ modes has been achieved this can then be utilized further during direct trauma processing work. It is argued that healing of the ‘inner child’ enables healing of the adult client so that a more positive and secure sense of self can be achieved.

Keywords: Attachment Theory  Complex PTSD  Imagery  Inner Child  Rescripting  Symposium  

Accuracy Verified: Yes

6. Flumeri, F., Salmaso, D., & Pagani, M. (2008, 26-28 Settembre). Impatto dell'EMDR sulle fuzioni e sulla neurobiologia cerebrali [Impact on EMDR and neurobiological brain functions]. In T. Farma (Chair), Simposio, Il modello psicotraumatologico: Un ponte tra indicatori neurobiologici e Psicoterapia. VII Congresso SPR Italia, Modena.

Language: Italian

Format: Conference

Abstract:
Introduzione:negli ultimi anni il numero di studi condotti nell’ambito dei disturbi causati da eventi traumatici ha subito una forte accelerazione rilevando l’esistenza di alterazioni fisiologiche e morfologiche in specifiche aree cerebrali associate sia alla risposta emotiva al trauma che alla insorgenza dei sintomi della sindrome da stress post-traumatico (PTSD). L’impiego delle tecniche di neuroimmagine ha consentito di fare luce sui correlati neurali della psicoterapia, rivelando i suoi effetti neurobiologici sulla funzione cerebrale. Nell’ambito dei diversi approcci psicoterapeutici, l’EMDR (Eye Movement Desensitization and Reprocessing therapy) è emerso come promettente risorsa per il trattamento del trauma e di altri disturbi d’ansia, sebbene ancora non sia stata completamente chiarita la sua modalità di azione sui circuiti neurali. Molte ricerche sono state effettuate per valutare l’efficacia dell’EMDR, ma solo un numero esiguo di esse ha indagato il substrato neurobiologico di questa psicoterapia. Le metodiche di neuroimmagini utilizzate finora per studi sull’EMDR sono la Single Photon Emission Computed Tomography (SPECT) e la Magnetic Resonance Imaging (MRI). La prima raccoglie dati sull’attivita’ cellulare cerebrale mentre la seconda riporta dati anatomici strutturali. Gli studi funzionali condotti con SPECT consentono di identificare le variazioni del metabolismo e del flusso ematico cerebrale, suggerendo un ruolo specifico per ciascuna area cerebrale coinvolta nel complesso meccanismo che sottende il processamento delle emozioni; la MRI consente invece di rilevare la presenza di variazioni morfologiche e volumetriche di specifiche strutture cerebrali. Negli ultimi anni, studi SPECT e MRI, volti ad esaminare gli effetti dell’EMDR sulla fisiopatologia cerebrale in pazienti affetti da disturbi d’ansia, hanno riscontrato sostanziali variazioni del flusso ematico ed alterazioni strutturali di alcune regioni cerebrali in seguito a terapia. L’efficacia dell’EMDR nel trattamento del PTSD è stata confermata da uno studio SPECT su sei soggetti ( Lansing et al.) (1) che ha evidenziato dopo terapia una diminuzione del flusso ematico nel lobo occipitale bilateralmente e nel lobo parietale sinistro e un aumento di flusso nel giro frontale inferiore sinistro. Sempre utilizzando la SPECT Oh e Choi (2) hanno riportato una significativa modificazione del flusso cerebrale in seguito ad EMDR, prevalentemente riscontrabile nell’area limbica e nella corteccia prefrontale. Un recente studio con utilizzo di MRI (3) ha inoltre messo in evidenza un aumento di volume dell’ippocampo in seguito a trattamento con EMDR, aumento invece non riportato in un lavoro di Lindauer et al. su 9 soggetti con PTSD, nonostante il successo clinico della psicoterapia eclettica eseguita (4). Obiettivi: il nostro gruppo ha studiato gli effetti a breve e lungo termine dell’EMDR (5, 6) dimostrando la sua efficacia nel trattamento di soggetti traumatizzati sul lavoro, e una stabilità del miglioramento clinico ottenuto in risposta alla terapia, ancora presente a distanza di tre anni. Nell’ambito dello stesso progetto sono state anche studiate le variazioni del flusso ematico cerebrale e della volumetria di alcune strutture cerebrali in relazione alla terapia con EMDR. Un primo studio SPECT ha analizzato la variazione della distribuzione di flusso in 11 soggetti guariti clinicamente da PTSD in seguito a EMDR messi a confronto con 5 soggetti nei quali la terapia non ha avuto effetto (7). Risultati: è stato evidenziato nei soggetti con remissione sintomatologica significative differenze di flusso in 4 aree corticali, alla disfunzione delle quali sono ascrivibili alcuni sintomi presenti in corso di PTSD. Diminuzioni di flusso post-terapia sono state registrate nell’ippocampo, nella corteccia parieto-occipitale e nella corteccia visiva primaria. L’ippocampo e’ sede della memoria a breve termine; la corteccia parieto-occipitale processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattivita’ di queste regioni nel PTSD sono responsabili della rivisitazione patologica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Inoltre la corteccia frontale dorsolaterale ha dimostrato un aumento di flusso nei soggetti che hanno risposto positivamente alla terapia. Questa regione chiave oltre ad essere deputata ad inibire la risposta patologica a stimoli che ricordano l’evento traumatico e’ essenziale per i processi di attenzione e di autostima, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In ulteriori studi che combinano indagini funzionali e strutturali utilizzando SPECT e MRI abbiamo messo in evidenza il valore predittivo delle dimensioni dell’ippocampo riguardo all’efficacia della terapia con EMDR (Pagani et al. sottomesso). Conclusioni: gli effetti della terapia con EMDR sono risultati, unitamente ad un consistente miglioramento della sintomatologia e ad una riduzione della iperreattività a stimoli di carattere emotivo, in una normalizzazione funzionale di alcune aree specifiche e in un aumento del volume ippocampale probabilmente ascrivibile a neo-neurogenesi. Questi risultati sono in linea con la pregressa letteratura e con le attuali conoscenze sul PTSD e suggeriscono basi neurobiologiche dell’effetto terapeutico dell’EMDR confermandone l’impatto funzionale su strutture cerebrali coinvolte in patologie ansiogene. Bibliografia: 1. Lansing et al. (2005). J Neuropsych Clin Neurosci;17(4):526-532. 2. Ho DH and Choi J. (2007). J EMDR Pract Res;1(1):24-30. 3. Bossini et al. (2007). J Neuropsych Clin Neurosci; 19(4):475-476. 4. Lindauer et al. (2005). Psychol Med ; 35 :1-11. 5. Hogberg et al. (2007). Nord J Psych; 61(1):54-61. 6. Hogberg et al. (2008). Psych Res; doi:10.1016/j.psychres.2007.10.019. 7. Pagani et al. (2007). Nuc Med Comm; 28(10):757-65. [Pagani abstract]

Introduction In recent years the number of studies in disorders caused by traumatic events has been greatly accelerated by detecting the existence of morphological and physiological changes in specific brain areas associated with both the emotional response to trauma to the onset of symptoms Post-traumatic stress syndrome (PTSD). The use of neuroimaging techniques has allowed to shed light on the neural correlates of psychotherapy, revealing the neurobiological effects on brain function. Under the different psychotherapeutic approaches, EMDR (eye movement desensitization and reprocessing therapy) has emerged as a promising resource for the treatment of trauma and other anxiety disorders, although still not been fully elucidated its mode of action on neural circuits. Many studies have been carried out to assess the effectiveness EMDR, but only a small number of them have investigated the neurobiological substrate of this psychotherapy. The methods used so far for neuroimaging studies on EMDR are Single Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI). The first collects data on 'brain cells while the second contains structural anatomical data. The functional studies performed with SPECT to identify changes in metabolism and cerebral blood flow, suggesting a specific role for each brain area involved in the complex mechanism underlying the processing of emotions, instead of MRI allows detection of morphological changes and volume of specific brain structures. In recent years, MRI and SPECT studies, aimed to examine the effects of EMDR on brain pathophysiology in patients with anxiety disorders, have found substantial variations in blood flow and structural alterations of some brain regions after treatment. The effectiveness of EMDR in the treatment of PTSD was confirmed by a SPECT study in six subjects (Lansing et al.) (1) showed that after treatment reduced blood flow in the occipital lobe bilaterally and in left parietal lobe and a increase of flow in left inferior frontal gyrus. Always using SPECT Oh and Choi (2) reported a significant change of cerebral blood flow after EMDR, mainly found in limbic and prefrontal cortex. A recent study using MRI (3) has also highlighted an increase in volume of the hippocampus after treatment with EMDR, but no increase in reported work of Lindauer et al. on 9 subjects with PTSD, despite the clinical success of eclectic psychotherapy performed (4). Objectives: Our group has studied the effects of short and long term EMDR (5, 6) demonstrating its effectiveness in treating traumatized individuals at work, and stability of clinical improvement obtained in response to therapy, yet this distance three years. Within the same project were also studied changes in cerebral blood flow and volume of certain brain structures in relation to treatment with EMDR. A first SPECT study analyzed the change in flow distribution in 11 subjects clinically recovered from PTSD after EMDR compared with 5 subjects in whom treatment had no effect (7). Results: It was shown in patients with symptomatic remission, significant differences in flow in 4 cortical areas, which are attributable to dysfunction of some symptoms of PTSD being present. Flow decreases post-treatment were recorded in the hippocampus, cortex parietal-occipital and primary visual cortex. The hippocampus and 'seat of short-term memory, the parietal-occipital cortex processes the recognition of faces, bodies and words, the primary visual cortex preserves the visual memory of events. The lack of inhibition and / or 'hyperactivity' of PTSD in these regions are responsible for the pathological review of the traumatic event and the presence of flashbacks and hallucinatory images. Moreover, the dorsolateral frontal cortex showed an increase in flow in subjects who responded positively to therapy. This key region in addition to being appointed to inhibit the pathological response to stimuli that recall the traumatic event and 'essential for the processes of attention and self-esteem, decreased in the course of PTSD and recovered following the remission of the disease. In further studies that combine functional and structural investigations using SPECT and MRI have shown the predictive value of the size of the hippocampus on the effectiveness of EMDR therapy (Pagani et al. Submitted). Conclusion: the effects of EMDR therapy were coupled with a significant improvement in symptoms and a reduction of hyperreactivity to stimuli, emotional, functional in a normalization of some specific areas and an increase in hippocampal volume probably due to neo- neurogenesis. These results are consistent with previous literature and with current knowledge about PTSD and suggest a neurobiological basis of therapeutic EMDR confirming the functional impact on brain structures involved in anxiety-disorders. Bibliography: 1. Lansing et al. (2005). J Neuropsych Clin Neurosci, 17 (4) :526-532. 2. I DH and J. Choi (2007). J EMDR pract Res, 1 (1) :24-30. 3. Bossini et al. (2007). J Neuropsych Clin Neurosci, 19 (4) :475-476. 4. Lindauer et al. (2005). Psychol Med, 35 :1-11. 5. Högberg et al. (2007). Nord J Psych, 61 (1) :54-61. 6. Högberg et al. (2008). Psych Res, doi: 10.1016/j.psychres.2007.10.019. 7. Pagani et al. (2007). NUC Med Comm, 28 (10) :757-65. [Pagani abstract]

Keywords: Brain Functions  Neurobiology  

Accuracy Verified: Yes

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

Language: Italian

Format: Conference

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

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

Keywords: Hippocampal Volume  Plenary  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

8. Bossini, L., Fagiolini, A., & Castrogiovanni, P. (2007, November). Neuroanatomical changes after eye movement desensitization and reprocessing (EMDR) treatment in posttraumatic stress disorder. Journal of Neuropsychiatry and Clinical Neuroscience, 19(4), 475-476.

Language: English

Format: Journal

Abstract:
Several authors have found smaller hippocampal volumes in patients with PTSD and some have suggested that psychotropic drugs may promote hippocampus neurogenesis and reverse the decrease in hippocampus volume.1 However, the only study that has investigated the effects of psychotherapy on hippocampus volume failed to show a volumetric increase after effective psychotherapy. The authors evaluated the hippocampus volumetric changes after successful EMDR treatment of a 27-year-old man with a chronic PTSD related to the suicide of his mother. After 8 weeks of EMDR treatment the patient had an increase in both left and right hippocampus volumes.[Adapted from Text] [Pilots]

Keywords: Adults  Brain Imaging  Brain Volume  Brain Size  Case Report  Clinical Case Study  Death of Parent  Death by Suicide  Effectiveness Evaluation  Hippocamal Volume  Hippocampus  Letter  Males  Neuroanatomy  Posttraumatic Stress Disorder  Psychotherapy  PTSD  Survivors  Treatment  Treatment Effectiveness  Treatment Outcome/Clinical Trial  

Accuracy Verified: Yes

9. 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

10. Bergmann, U. (2009, June). Neurobiology of information processing. Presentation at the annual meeting of the EMDR Europe Association, Amsterdam, the Netherlands.

Language: English

Format: Conference

Abstract: Given that EMDR originated as an empirically driven method, there has been a persistent need for a more defined theoretical and neurobiological model of EMDR's reported robust effects. This presentation will synthesize the existing research on information processing, as well as memorial, perceptual, cognitive and somatosensorial integration. Specific attention will be given to recent empirical findings, involving the hippocampus and thalamus in information processing and integration. EMDR’s DAS/BLS will be shown to activate REM-systems, as well as areas of the thalamus and frontal lobes, reduced in activation by PTSD, thereby allowing for the repair of perceptual, cognitive, memorial, somatosensory and inter-hemispheric functioning.

Keywords: Neurobiology  

Accuracy Verified: Yes

11. Bergmann, U. (2009, August). The neurobiology of information processing and EMDR: Recent findings and insights. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Given that EMDR originated as an empirically driven method, there has been a persistent need for a more defined theoretical and neurobiological model of EMDR's reported robust effects. This presentation will synthesize the existing research on information processing, as well as memorial, perceptual, cognitive and somatosensorial integration. Specific attention will be given to recent empirical findings, involving the hippocampus and thalamus in information processing and integration. EMDR’s DAS/BLS will be shown to activate REM-systems, as well as areas of the thalamus and frontal lobes, reduced in activation by PTSD, thereby allowing for the repair of perceptual, cognitive, memorial, somatosensory and inter-hemispheric functioning.

Keywords: Neurobiology  

Accuracy Verified: Yes

12. Bergmann, U. (2010, September/October). The neurobiology of information processing: Recent findings and insights. Presentation at the annual meeting of EMDR International Association, Minneapolis, MN.

Language: English

Format: Conference

Abstract:
This presentation will synthesize the existing neurobiological research on information- processing. Specific attention will be given to recent empirical findings, involving the hippocampus and thalamus in perceptual, memorial, emotional, cognitive, and somatosensory integration. This data will be reviewed in reference to the organizing constructs of the Parallel Distributed Processing/Connectionism and the Thalamo-Cortical-Temporal-Binding models of information processing. Given that EMDR's application has historically been guided by information processing theory, this presentation will illustrate the neurobiological underpinnings of this foundation.

Keywords: Information Processing  Neurobiology  

Accuracy Verified: Yes

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

Language: Italian

Format: Conference

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

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

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

14. van der Kolk, B. A., Burbridge, J. A., & Suzuki, J. (1997, June). The psychobiology of traumatic memory:  Clinical implications of neuro imaging studies. Annals of the New York Academy of Sciences, 821, 99-113. doi:10.1111/j.1749-6632.1997.tb48272.x .

Language: English

Format: Journal

Abstract:
Whereas most patients with PTSD construct a narrative of their trauma over time, it is a characteristic of PTSD that sensory elements of the trauma itself continue to intrude as flashbacks and nightmares, altered states of consciousness in which the trauma is relived, unintegrated with an overall sense of self. Because traumatic memories are so fragmented, it seems reasonable to postulate that extreme emotional arousal leads to failure of the central nervous system (CNS) to synthesize the sensations related to the trauma into an integrated whole. Earlier models for a biological substrate of these phenomena have become rapidly outdated with the availability of new information derived from neuroimaging studies of patients with PTSD. The emerging body of knowledge from these studies has stimulated a gradual shift in emphasis away from the neurochemicals involved in the organisms' response to overwhelming threat to a focus on the neuronal filters concerned in the interpretation of sensory information: the interactions between the various parts of the CNS that process and interpret the meaning of incoming information, such as the amygdala, hippocampus, corpus callosum, anterior cingulte, and prefrontal cortex. [Text, p. 99]
Review Article: 58 references. This volume of the Annals was published as "Psychobiology of posttraumatic stress disorder," edited by Rachel Yehuda and Alexander C. McFarlane (New York: New York Academy of Sciences, 1997; ISBN 1-57331-078-6). These papers are the result of a conference entitled "Psychobiology of Posttraumatic Stress Disorder" sponsored by the New York Academy of Sciences, New York, 1996 September 7-10.

Keywords: Brain Imaging  Dissociative Amnesia  Etiology  Literature Review  Neuroanatomy  Neuroendocrinology  Psychobiology  PTSD  Stressors  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes

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

Language: Italian

Format: Conference

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

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

Keywords: Hippocampal Volume Poster  Sertraline  

Accuracy Verified: Yes

16. Pagani, M. (2008, Novembre). Sub-strato neurobiologico della sindrome da stress post-traumatico e relativo impatto funzionale e strutturale della terapia con EMDR [Neurobiological substrate of post-traumatic stress syndrome and impact on functional and structural therapy with EMDR]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Recenti studi hanno dimostrato come la sindrome da stress post-traumatico (PTSD) possa causare nel cervello cambiamenti sia strutturali che funzionali. Studi di imaging funzionale tramite tomografia ad emissione di fotone singolo (SPECT) e ad emissione di positrone (PET) hanno evidenziato significative variazioni del flusso cerebrale in pazienti con PTSD durante la rivisitazione del trauma. A questo proposito sono stati riportati aumenti e diminuzioni di flusso nell’ippocampo, nell’amigdala, nella corteccia prefrontale mediale, nel cingolo anteriore e posteriore e nella corteccia temporale. Il modello prevalente collega i sintomi del PTSD ad una mancata inibizione dell’ amigdala, iperattivata dalla sensazione di incombente minaccia, da parte della corteccia prefrontale. E’ stato anche proposto che i cambiamenti strutturali dell’ippocampo e del cingolo anteriore rivelati dalla risonanza magnetica strutturale (RM) siano causati dalla risposta neuronale allo stress. L’obiettivo delle nostre ricerche e’ stato quello di analizzare la risposta funzionale e le variazioni strutturali in due gruppi di soggetti esposti a trauma occupazionale che hanno sviluppato (S=sintomatici, n=20) o no (NS=non sintomatici, n=27) il PTSD. Una parte dei S (n=16) è stata trattata con EMDR. La diagnosi di PTSD prima e dopo la terapia è stata basata sia sui criteri del DSM-IV sia su vari test neuropsicologici mirati. La SPECT (n=47) e la RM (n=33) sono state eseguite da 3 mesi a sei anni dal trauma e la prima è stata ripetuta dopo EMDR. I sintomi sono stati provocati da uno script individualizzato che ha riportato alla memoria il trauma e durante il quale è stato iniettato il tracciante di flusso cerebrale. Le analisi eseguite hanno mostrato differenze significative tra S e NS nella risposta del flusso cerebrale allo script. Nei 33 soggetti in cui sono state eseguite sia la SPECT che la RM sono state trovate differenze significative sia funzionali che strutturali nella corteccia temporo-parietale sinistra e nell’ippocampo, regioni nelle quali gli score dei test neuropsicologici correlano significativamente con il flusso cerebrale. Nei soggetti con remissione sintomatologica dopo EMDR (R; n=11) sono state trovate rispetto ai soggetti che non hanno risposto alla terapia (NR; n=5) significative differenze di flusso in 4 aree corticali che processano funzioni deteriorate in corso di PTSD. Diminuzioni di flusso dopo la terapia sono state registrate nei R rispetto ai NR nell’ippocampo, nel giro fusiforme (corteccia parieto-occipitale) e nella corteccia visiva primaria. L’ippocampo è sede della memoria episodica ed autobiografica; il giro fusiforme processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattività di queste regioni nel PTSD sono responsabili della rivisitazione patologica figurata e somatica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Viceversa la corteccia frontale dorsolaterale ha mostrato un aumento di flusso nei R. Questa regione oltre ad essere deputata ad inibire nel sistema limbico la risposta patologica a stimoli che ricordano l’evento traumatico è essenziale per i processi di attenzione e del “senso di sé”, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In questi soggetti la RM ha inoltre messo in evidenza il valore predittivo delle dimensioni dell’ippocampo rispetto all’efficacia della terapia con EMDR. I nostri risultati confermano il coinvolgimento della corteccia temporo-parieto-occipitale nel PTSD e sottolineano il valore delle neuroimmagini sia nello svelare gli effetti neurobiologici dell’EMDR che determinare il valore delle indagini strutturali nel predirne l’efficacia.

Recent studies have shown that the post-traumatic stress syndrome (PTSD) may result in both structural and functional brain changes. Imaging studies using functional Single photon emission tomography (SPECT) and positron emission tomography (PET) shown significant changes in cerebral blood flow in patients with PTSD during revisiting the trauma. In this regard have been reported increases and decreases in flow hippocampus, amygdala, medial prefrontal cortex, the anterior cingulate and posterior and temporal cortex. The dominant model linking the symptoms of PTSD to a no inhibition of 'amygdala hyperactivity disorder by the sense of impending threat by the prefrontal cortex. E 'was also proposed that the structural changes of the hippocampus and anterior cingulate revealed by structural magnetic resonance imaging (MRI) are caused by the response neuronal stress. The aim of our research and 'was to analyze the response functional and structural variations in two groups of subjects exposed to occupational trauma that have developed (S = symptomatic, n = 20) or not (NS = non-symptomatic, n = 27) PTSD. Part of S (n = 16) was treated with EMDR. The diagnosis of PTSD before and after the therapy was based on both DSM-IV has on several neuropsychological tests targeting. SPECT (n = 47) and MRI (n = 33) are were performed from 3 months to six years from the trauma and the first was repeated after EMDR. Symptoms were caused by a script individual who reported to the memory of the trauma and during which were injected with a tracer of cerebral blood flow. The analysis performed showed significant differences between S and NS in the response of flow brain to the script. In the 33 subjects in which they were performed both SPECT and MRI were found significant differences in both functional and structural temporo-parietal cortex left hippocampus, regions in which the scores of neuropsychological tests correlate significantly with the flow in the brain. In subjects with symptomatic remission after EMDR (R; n = 11) were found compared with subjects who did not respond to therapy (NR, n = 5) significant differences in flow in 4 cortical areas that process functions deteriorated in the course of PTSD. Decreases in flow after treatment were recorded in R than NR hippocampus, within fusiform (parieto-occipital cortex) and in the primary visual cortex. The hippocampus is the seat of episodic memory and autobiographical, and the processes around the fusiform recognition of faces, bodies and words, the primary visual cortex preserves the memory visual events. The non-inhibition and / or 'hyperactivity of these regions in PTSD are responsible for pathological figured revisiting the traumatic event and physical and presence of flashbacks and hallucinatory images. Contrast, the dorsolateral frontal cortex has showed an increase of flow in R. This region in addition to being deputies to inhibit the system limbic response to pathological stimuli that recall the traumatic event is essential for processes of attention and the "sense of self, decreased in the course of PTSD and recovered following remission. In these subjects, MRI has also highlighted the predictive value the size of the hippocampus compared the efficacy of EMDR therapy. Our results confirm the involvement of the temporo-parietal-occipital cortex in PTSD and emphasize the value of neuroimaging in revealing both the neurobiological effects of EMDR that determine the value of the structural surveys in predicting effectiveness.

Keywords: Neurobiology  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

17. Unfried, N. (2003). Trauma und entwicklung: Physiologische und biologische veränderungen nach frühen kindlichen traumata und deren behandlungsmöglichkeit [Trauma and development: Physiologic and biologic variations after early infant traumatisations and attendance of them]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 59-71.

Language: German

Format: Journal

Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Die Entwicklung des Kindes ist heutzutage als Prozess zu verstehen. Ein Kind ist dementsprechend zu jedem Zeitpunkt seiner Entwicklung "reif", einschließlich seines intrauterinen Lebens, d.h. es verfügt über die für die jeweilige Zeit notwenige Ausstattung. Von Beginn an erfolgt dieses mehr oder weniger störanfällige Geschehen mit anderen im aktiven intra- und interagierenden informativen, energetischen und stofflichen Austausch. An diesem Entwicklungsprozess nimmt der gesamte Körper, jede Zelle, einschließlich des Gehirns als Organ der sensomotorischen und psychophysischen Verarbeitung teil. Die Stressreaktion und Stress auf bewältigbarem Niveau hilft dem Kind kritische Phasen zu überstehen (Hüther, 1999). Jedoch führt nicht bewältigbarer Stress zu tiefgreifenden Veränderungen funktionell bis strukturell, wenn der Organismus keine neue Lösungsmöglichkeit findet. Mehrere Autoren belegen, dass traumatische Erlebnisse Veränderungen im limbischen System und Cortex zeigen können (Hüther, 1999; van den Kolk, 1998; Roth, 1998). Bei unkontrolliertem Stress (frühzeitig) kommt es zur Daueraktivierung der Amygdala und über die Amygdala zur Aktivierung mehrerer Systeme, unter anderem auch der Hypothalamus-Hypophysen-Nebennieren- Achse mit einem Ausschütten von Stresshormonen. Diese Daueraktivierung löst körperlich die Notfallreaktion im Sinne einer Schockreaktion aus, gleichzeitig führt sie zur Störung der Einspeicherung von Informationen in den Hippocampus. Die imaginativ-methodische Herangehensweise scheint für frühtraumatisierte Kinder und Jugendliche eine Möglichkeit zu sein, die dissoziierten Anteile der traumatischen Szene abzurufen und somit einen Weg zur Integration zu finden. Die therapeutische Beziehung ermöglicht das Wiedererleben der Schmerzen, der Angst, aber auch die Beendigung der traumatischen Situation. Es konnte gezeigt werden, wie die triggerabhängigen Projektionen bei den Kindern endeten und Veränderungen der Persönlichkeitsentwicklung nachweisbar waren. Der Erfahrungsbericht stellt ein vorläufiges Ergebnis dar.

Psychosocial treatment of traumatic stress disorders with EMDR
Children’s development is now understood as a process. Balance and imbalance are said to alternate with one another, and impaired functioning is to be seen as an inducement for further development. Even the early organism has the opportunity of finding a new level of organisation. Right from the beginning, this process, which is susceptible to disruption to a greater or lesser extent, takes place with others in an intra- and interactive exchange of energy and material. This developmental process involves the entire body, every cell, including the brain as the organ of sensomotoric and psychophysical processing. The stress reaction and stress at a manageable level help the child to survive critical periods (Hüther, 1999). However, stress that is not manageable leads to far-reaching changes, in both functional and structural terms, unless the organism finds new solutions. There are sensitive stages during prenatal development that give the brain a high degree of adaptability; however, they also make the embryo, foetus and young infant receptive for disruptive or even hostile influences can lead to changes in the limbic system and the cortex (Hüther 1999; van den Kolk 1998; Roth, 1998). In the event of (early) uncontrolled stress, the amygdala becomes permanently activated, and via the amygdala, several systems are also activated, including the hypothalamic-pituitary-adrenal axis, by the secretion of stress hormones. This permanent activation triggers a physical emergency reaction in the sense of a shock reaction and at the same time leads to a disruption of the storage of information in the hippocampus. The imaginative approach to be a way for children and adolescents with early traumas to recall the dissociated parts of the traumatic scene and hence to find a way of integrating them. The therapeutic relationship allows the pain and fear to be reenacted, but also enables the traumatic situation to be brought to a close. It was able to be shown how the trigger-dependent projections stopped in the children, and changes in personality development were able to be observed. The report presents preliminary results.

Keywords: Attachment  Chidlren  Biologic Variations  Psysiologic Variations  Trauma  

Accuracy Verified: Yes

18. Davis, N. (2002). The use of multi-sensory trauma processing to treatpost-traumatic stress disorder in law enforcement officers. In C. R. Figley (Ed.), Brief treatments for the traumatized:  A project of the Green Cross Foundation (pp. 173-206). Westport, Connecticut:  Greenwood Press.

Language: English

Format: Book Section

Abstract:
Multi-sensory Trauma Processing (MTP) is a short-term treatment technique designed to deal with many common problems that arise in more long-term therapeutic interventions. Eyemovement Desensitization and Reprocessing (EMDR) is a critical element of this therapy; however, it varies in several ways from the standard EMDR protocol used in research. Referring to it as MTP helps to distinguish the more global approach of this therapy from that of EMDR. MTP uses the alternating stimulation that is the foundation of EMDR; however, MTP simultaneously uses three alternating stimulations consisting of alternating sounds and tapping, as well as eye movement. Although it is unclear exactly how this alternating stimulation creates positive change, there are two credible theories which seek to explain its efficacy. One is that stress hormones released during exposure to a traumatic incident cause the memory of the incident to become "frozen" or unprocessed in the right brain, particularly the hippocampus. This frozen memory apparently leads to the symptoms of PTSD. Alternating stimulation may enable both hemispheres of the brain to process the traumatic memory, moving it from being "stuck" to an appropriate memory of the past. Other theorists have noted the eye movement commonly used in EMDR is similar to the back-and-forth movement of eyes in REM sleep; one symptom of PTSD is disturbed REM sleep and a change in eye movement accompanying this type of sleep. By replicating what the brain does naturally in REM sleep, the natural ability of the brain to process a memory may be reactivated. [Adapted from Text, pp. 180-181] [Pilots]

Keywords: Brief Psychotherapy  Police Personnel  Posttraumatic Stress Disorder  PTSD  Stressors  Survivors  

Accuracy Verified: Yes