Francine Shapiro Library - EMDR Bibliography Links
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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. (2005, November). Alterations in autonomic tone during trauma therapy with EMDR. In S. Woodword, J. Hopper, M. Sack, R. Pitman, & D. Kaloupek (Chairs), Respiratory Sinus Arrhythmia: Insights into Autonomic Function in PTSD. Symposium conducted at the 21st annual meeting of the International Society for Traumatic Stress Studies, Toronto, ON.
Language: English
Format: Conference
Abstract:
Respiratory Sinus Arrhythmia: Insights into Autonomic Function in PTSD: Studies of cardiac responses to trauma-related cues have defined the mainstream of laboratory research in posttraumatic stress disorder. Examinations
of respiratory sinus arrhythmia now challenge the view that exaggerated sympathetic tone and reactivity provide a sufficient account of the autonomic abnormalities seen in this diagnosis.
Alterations in autonomic tone during trauma therapy with EMDR: It has been hypothesized that EDMR, by pairing stimuli that evoke divided
attention with exposure to trauma memories, elicits repetitive orienting
responses followed by enhanced parasympathetic tone, resulting in significant
within-session psychophysiological de-arousal. We monitored 10 standard
EMDR treatments for PTSD (55 sessions) with impedance cardiography.
Heart rate (HR), parasympathetic tone (RMSSD), sympathetic tone (PEP), and
respiration rate (RESP) were assessed. Markers were set at the onset of every
stimulation/exposure period (N = 811). Effects within and across stimulation
sets were examined. An orienting response, with associated sharp increase
of parasympathetic tone and significant decrease of HR, was found at stimulation
onsets. During ongoing stimulation, sympathetic arousal increased
while parasympathetic tone decreased, responses consistent with stressrelated
arousal during trauma exposure. However, across entire sessions
there was a significant pattern of psychophysiological de-arousal, evidenced
by progressively decreasing HR and increasing RMSSD.
These findings suggest EMDR is associated with distinct patterns
Keywords: Autonomic Tone Symposium
Accuracy Verified: Yes
3. Sack, M., Lempa, W., & Lamprecht, F. (2005, September 24). Empirische befunde zu wirkmechanismen des EMDR [Empirical evidence of mechanisms of action of EMDR]. In A. Karl & W. Lempa, (Moderators), Symposium 2 Traumaspezifische Interventionen in Forschung und Praxis, Jahrestagung der deutschsprachigen Gesellschaft für Psychotraumatologie DeGPT, Dresden .
Language: German
Format: Conference
Abstract:
Das Traumabearbeitungsverfahren EMDR (Eye Movement Desensitization and Reprocessing) kombiniert die imaginäre Exposition mit der traumatischen Erinnerung mit repetitiver Stimulation durch Augenbewegungen oder durch taktile bzw. auditive Reize. Während die Wirksamkeit des EMDR gut belegt ist, sind die spezifischen Wirkungen der bilateralen Stimulation noch weitgehend unbekannt. Wir führten ein psychophysiologisches Monitoring mittels Impedanzkardiographie aller EMDR-Behandlungssitzungen ( N= 55) bei 10 Patienten mit PTSD durch. Aufgezeichnet wurden Herzfrequenz (HR), Parasympathikotonus (RMSSD), Sympathikotonus (PEP), und Atemfrequenz (RESP). Beginn und Ende der Stimulationsperioden (N = 811) wurden markiert. Es fand sich ein steiler Anstieg des Parasympathikotonus verbunden mit einem signifikanten Abfall der Herzfrequenz zu Beginn der Stimulationsperioden, entsprechend dem psychophysiologischen Reaktionsmuter einer deutlich ausgeprägten Orientierungsreaktion. Im weiteren Verlauf der Stimulation nahm der Parasympathikotonus wieder ab und der Sympathikotonus nahm zu, was sich als Stresseffekt während der Exposition interpretieren lässt. Im Sitzungsverlauf zeigte sich jedoch eine signifikante Abnahme der Herzfrequenz und eine Zunahme des Parasympathikotonus. Unsere Befunde weisen darauf hin, dass es während EMDR-Sitzungen zu einem signifikanten psychophysiologischen Dearousal kommt. Die Stimulation durch Augenbewegungen scheint eine Orientierungsreaktion auszulösen, die über eine passagere Erhöhung des Parasympathikotonus eine Entspannungsreaktion auslöst. Es stellt sich die Frage, inwieweit die von uns beobachteten psychophysiologischen Reaktionen mit dem Therapieerfolg korrelieren.[Author abstract]
The EMDR trauma processing method (Eye Movement Desensitization and Reprocessing) combines the imaginary exposure to the traumatic memory with repetitive stimulation of eye movements or tactile or auditory stimuli. While the effectiveness of EMDR is well documented, the specific effects of bilateral stimulation are still largely unknown. We conducted a psycho-physiological monitoring using impedance cardiography of EMDR treatment sessions (N = 55) of 10 patients with PTSD. Recorded were heart rate (HR), parasympathetic tone (RMSSD), sympathetic (PEP) and respiratory rate (RESP). Beginning and end of the stimulation periods (N = 811) were selected. There was a steep increase in parasympathetic tone associated with a significant decrease in heart rate at the beginning of the stimulation periods, according to the psycho-physiological Reaktionsmuter a clearly marked orientation reaction. In the course of the stimulation of the parasympathetic tone took off again and the sympathetic tone increased, which can be interpreted as a stress effect during exposure. During the session, however, showed a significant decrease in heart rate and an increase in parasympathetic tone. Our findings indicate that occurs during EMDR sessions to significant psychophysiological Dearousal. The stimulation of eye movements seems to trigger a policy response that triggers a transient increase in parasympathetic tone a relaxation response. This begs the question of the extent to which we have observed psychophysiological responses correlate with treatment success. [Author abstract]
Keywords: Mechanism of Action
Accuracy Verified: Yes
4. Sack, M., Hofmann, A, Wizelman, L., & Lempa, W. (2007, June). Psychophysiological changes during EMDR - Are they related to treatment outcome?. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
Objective: Dual attention stimulation seems to provoke orienting response like patterns of psychophysiological deactivation during “real-life” EMDR treatment sessions (Sack et al, in review). Objective of this study was to investigate the association of psych-physiological effects during dual attention stimulation with treatment outcome as measured by questionnaire and by psychophysiological reactions during presentations of an individualized trauma script.
Methods: A total of 24 EMDR treatment sessions from 10 patients with PTSD were monitored applying impedance Cardiography. The onset of every stimulation/exposure period was marked and effects within and across stimulation sets on heart rate (HR), heart rate variability (RMSSD), pre-ejection period (PEP) and respiration rate were examined. Heart rate reactivity during presentation of an audiotaped trauma script was measured at beginning of every session and additionally one week before the first session and one week after the last treatment session. Statistical correlations between both subjective (Impact of Event Scale, SUD) and objective (heart rate reactivity) measures of treatment outcome with psychophysiological changes during session (orienting response at beginning of stimulation, slope of HR) were computed.
Results: A significant reduction of trauma-related symptoms was noticed over the course of EMDR treatment: (IES one week pre: 61.2(SD 10.9), IES pre: 55.4(SD 19.0), IES post: 13.3(SD 12.2), F(2,27); 32.6, p < .001). Subjective distress during trauma script decreased significantly (SUD one week pre: 6.6(SD 1.4), SUD pre: 6.9(SD1.4), SUD post: 2.1(SD 1.7); F(2, 27); 31.5, p < .001). The statistical analysis of physiological variables is currently in process. Results will be presented at the conference.
Conclusions: The results of this study will allow further insights into the working mechanism of EMDR.
This study was co-sponsored by EMDREA and EMDRIA-Germany.
Keywords: Medical Treatment Outcome
Accuracy Verified: Yes