Francine Shapiro Library ~ EMDR Bibliography

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1. Wilson, S., Becker, L., & Tinker, R. H. (1995, June). 15-Month follow up of EMDR treatment for traumatic memory. Presentation at the EMDR Network Conference, Santa Monica, CA.

Language: English

Format: Conference

Abstract:
We previously reported on the outcomes of a controlled study of eye movement desensitization and reprocessing (EMDR) effectiveness in the treatment of traumatic memory (Wilson, Tinker, & Becker, 1994; Wilson, Becker, & tinker, in press). In that study we found that three, 90-minute sessions of EMDR (Shapiro, 1995) "normalized the psychological functioning of the previously traumatized participants (g = 80) on all dependent measures. The present study is a 15-month follow up of those participants. I Method: The research design is shown in Table 1. Participants were randomly assigned to EMDR or to Delayed EMDR conditions. Pretreatment measurement occurred at measurement time TI. Participants in the EMDR condition received EMDR between T1 and T2; those in the Delayed EMDR condition received EMDR between T2 and T3. All participants were tested immediately following treatment and at 3 months following treatment (at T4). The 15 month, long-term follow up occurred at measurement time T5. An independent assessor collected all of the following dependent measures: Subjective Units of Disturbance Scale (SUDS; Wolpe, 1990), Impact of Events Scale (IES; Hmowitz, Wilner, & Alvarez, 1979), State/Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983), and the Symptom Checklist (SCL-90-R, Derogatis, 1992). [Table 1. The Research Design, Treatment Condition, Measurement Time: T1 T2 T3 T4 T5; EMDR Treatment: 01 x 02 03 04; Delayed EMDR Treatment 01 02 x 03 04 05; Note: T = Time of measurement; 0 = Observation; X = Treatment administered.] II. Results: Two analyses were performed to assess the impact of EMDR treatment at the 15-month follow up. First, in order to assess the overall, long-term impact of EMDR, the 15-month follow-up scores were compared with the pretreatment scores. There was significant improvement on all nine measures at the 15-month follow up: The multivariate effect was significant (Wilk's Lambda =.11, p<.0005) as were all nine of the univariate effects (all p <.0005). Second, in order to assess whether the improvement shown immediately following EMDR treatment had been maintained over the following year the immediate posttreatment scores were compared with, the 15-month follow-up scores. The multivariate test was nonsignificant (Wilk's lambda=.74, p=.079), indicating the improvement shown immediately following EMDR was maintained 15 months later. The univariate analyses indicated additional improvement for the PTSD symptoms of intrusions (IES Intrusion: F(1,56)=7.71, p=307) and avoidance (IES avoidance: F_(1,56) -4.44, p=.040). None of the nine measures showed deterioration at the 15-month follow up. Prior to EMDR treatment 45% (g= 9) of the responders had been diagnosed as PTSD, at the 15-month follow up only 7% (g = 4) were diagnosed as PTSD (chi-squareo, N=61)= .72, p < .05). III. Responders Versus Nonresponders at the 15-Month Follow up.: At the time of writing this abstract, 75% of the participants (g=61) have responded to the 15-month follow up. In general, measures taken prior to treatment did not differentiate responders fiom nonresponders. Responding at the 15-month follow up was unrelated to age, gender, marital status or years of education, although the annual income of the responders (Mdn=21,500) was higher than that of the nonresponders (Mdn = 14,750, Mann-Whitney U=372.5, p=.017). Responding or not at 15 months was unrelated to the type of trauma experienced, whether or not the participants had been in therapy prior to EMDR treatment, or how long ago the trauma had occurred. It was also unrelated to the severity of the trauma as measured by the pretreatment scores on the nine dependent variables and to whether or not the participant met the PTSD diagnosis criteria prior to treatment. A multiple regression analysis used the immediate posttreatment and 90-day posttreatment scores to predict whether or not the participant responded at the 15-month follow up. Nonrespondents were more likely to be depressed at 90-days following treatment than were respondents (R square=.O8, B=-.16, Beta = -.28, F_L1,71)=5.99, p=.017). No other variables entered into the regression model. IV Discussiona and Conclusion, Tretement effects found immediately following EMDR treatment wer maintained or improved 15 months later and thee was a significant decrease in the number of participants diagnosed as PTSD at the 15 month follow up. The comparison of responders to nonresponders at the 15 month follow up showed that the nonresponders were more depressed than the responders, raising the possiblity that the present results may be favorably biased to some extent. The discussion will include the additional, subjective impressions of participants who did not respond to the follow up. Limitations of EMDR with this population will be discussed, including the influence of comorbidity, multiple traumas, retraumatization after treatment, and spontaneous recurrence of symptoms. V. References: 1) Derogatis, L. R. (1992). SCL-90: Administration Scoring and Procedures Manual II. Baltimore: Clinical Psychometric Research. 2) Horowitz, M. J., Wilmer, N. & Alverez, W. (1979). Impact of Event Scale: A Measure of Subjective Distress. Psychosomatic Medicine, 41, 209-218. 3) Shapiro, F. (1995), Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures. 4) Speilberger, C. D., Gorsuch, R. L., Lushene, R. D., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory, Palo Alto: Consulting Psychologists Press. 5) Wilson, S. A., Tinker, R. A., & Becker, L. A. (1994, November). Efficacy of Eye Movement Desensitization and Reprocessing (EMDR)Treatment for Trauma Victims. Paper presented at the Annual Meeting of the International Society for Traumatic Stress Studies, Chicago, IL. 6) Wilson, S. A., Becker, L. A., & Tinker, R. A. (In press), EMDR, treatment for psychologically traumatized individuals, Journal of Consulting and Clinical Psychology.

Keywords: Follow-up Traumatic Memory

Accuracy Verified: Yes

2. Jordan, J., Titscher, G., & Kirsch, H. (2011, September). Behandlungsmanual zur psychotherapie von akuten und posttraumatischen belastungsstörungen nach ICD-mehrfachschocks [Treatment manual for psychotherapy of acute and posttraumatic stress disorders after multiple ICD shocks]. Herzschrittmachertherapie + Elektrophysiologie, 22(3), 189-201. doi:10.1007/s00399-011-0148-8.

Language: German

Format: Journal

Abstract:
Angesichts der steigenden Zahl implantierter Defibrillatoren in allen Industrienationen wächst auch die Zahl derjenigen Menschen, die sog. Mehrfachschocks („electrical storm“, ES) erleiden. Häufige Beschwerden sind starke und ständig wiederkehrende massive Ängste, Panikattacken, Todesangst, Hilf- und Hoffnungslosigkeit, Depressionen, Nervosität und Gereiztheit, sowie Rückzugs- und ausuferndes Vermeidungsverhalten, Intrusionen, Albträume, Flashbacks, Schlaflosigkeit und die Unfähigkeit der Gefühlsempfindung sowie eine eingeschränkte Zukunftsperspektive. Da Menschen mit einem ICD häufig körperlich (sehr) krank und nach den ICD-Mehrfachschocks zusätzlich massiv verunsichert sind, scheint es wesentlich, dass die stationäre Behandlung in einer Einrichtung durchgeführt wird, die über eine enge Anbindung an und räumliche Nähe zu einer kardiologischen Abteilung verfügt. Basis der Diagnostik ist die klinische Anamnese und die systematische Exploration der traumatischen Situation und der resultierenden Beschwerden. Als zusätzliche diagnostische Elemente sollten testpsychologische Verfahren zur Erfassung der Kernsymptomatik zum Einsatz kommen (Angst, Depression, Traumasymptome). Zur Diagnostik sollte eine testpsychologische Untersuchung gehören, damit am Ende der Behandlung auch für den Patienten sichtbar wird, welche Veränderungen eingetreten sind. Im Mittelpunkt der stationären Behandlung steht die tägliche intensive Psychotherapie. In ihrem Rahmen finden Elemente tiefenpsychologisch fundierter Psychotherapie und verhaltenstherapeutisch orientierte Angsttherapie sowie kognitive Umstrukturierung und Elemente des EMDR ihren Platz. Eine Nachuntersuchung innerhalb von 4 Monaten nach den Mehrfachschocks ist angeraten, weil PTSD Symptome zuweilen erst mit großer Latenz auftreten.

In view of the inceasing number of implanted defibrillators in all industrial nations, the number of people who have suffered so-called multiple shocks (electrical storm, ES) also increases. Common complaints are severe and continuously recurrent massive anxiety, panic attacks, fear of death, helplessness and hopelessness, depression, nervosity and irritability as well as reclusive and uncontrollable avoidance behaviour, intrusions, nightmares, flashbacks, sleeplessness and the inability to show feelings and limitation of future perspectives. Because people with an ICD are often physically (very) ill and after multiple ICD shocks are additionally very insecure, it would seem logical if the inpatient treatment would be carried out in an institution which has close connections and is also spatially close to a cardiology department. The basis of the diagnostics is the clinical anamnesis and a systematic exploration of the trauma situation and the resulting complaints. As an additional diagnostic element psychological test procedures should be implemented to determine the core symptomatic (anxiety, depression, trauma symptoms). Psychological test procedures should be included in the diagnostics so that at the end of treatment it is obvious even to the patient which alterations have occurred. The core element of inpatient treatment is daily intensive psychotherapy and includes deep psychologically well-founded psychotherapy and behavioral therapeutic-oriented anxiety therapy as well as cognitive restructuring and elements of eye movement desensitization and reprocessing (EMDR). A follow-up examination within 4 months of the multiple shocks episode is recommended because symptoms of posttraumatic stress disorder often occur after a long latent time period.

Keywords: Acute Stress Disorder Anxiety ASD Cardiology Depression ICD Shocks Internal Medicine Posttraumatic Stress Disorder PTSD Treatment Manual

Accuracy Verified: Yes

3. Jayatunge, R. M. (2008). Combating tsunami disaster through EMDR. Journal of EMDR Practice and Research, 2(2), 140-145. doi:10.1891/1933-3196.2.2.140.

Language: English

Format: Journal

Abstract:
After the 2004 tsunami devastation in Sri Lanka, many citizens experienced severe psychological reactions. The effectiveness of EMDR is illustrated in the treatment of 7 of these individuals: 3 children and 2 adults with PTSD symptoms and 2 adults with depressive symptoms. After 3-8 sessions of EMDR the symptoms were eradicated and these clients were free from their depressive feelings, anxieties, intrusions, and nightmares, were able to function normally, and were able to lead productive lives. These outcomes replicate those in the research literature demonstrating that EMDR is an efficacious treatment for PTSD in general, with specific utility for disaster-related PTSD. It is recommended that future controlled studies be conducted to evaluate the effectiveness of EMDR in the immediate aftermath of disasters and to assess its effectiveness with major depressive disorder. [Author Abstract]

Keywords: Adults Children Disaster Recent Events South Asia Sri Lanka Tsunami

Accuracy Verified: Yes

4. de Keijser, J., Denderen, M., & Verster-Bosman, M. (2013, April). Complicated grief and PTSD after murder, etiology and treatment: Research into treatment with EMDR and CBT in relatives of murder [Complexe rouw en PTSS na moord, etiologie en behandeling: Onderzoek naar behandeling met EMDR en CGT bij nabestaanden van moord]. Presentatie op het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.

Language: Dutch

Format: Conference

Abstract:
Directe nabestaanden van slachtoffers van moord krijgen vaak te maken met een PTSS en gecompliceerde rouw. De Rijksuniversiteit Groningen is, met medefinanciering door het Fonds Slachtofferhulp, een onderzoek gestart naar de vraag of professionele hulp effectief is. Het onderzoek kent twee doelstellingen: In hoeverre draagt een behandeling bestaande uit EMDR en CGT voor familieleden en partners van een vermoord persoon bij aan het verminderen van symptomen van gecompliceerde rouw. Daarnaast hoopt het onderzoek inzicht te krijgen in de mate waarin het effect van de behandeling met EMDR en CGT gemedieerd wordt door een afname van intrusies, vermijdingsgedrag, extreme woede en disfunctionele cognities. In de presentatie komen drie sprekers aan het woord: - Jos de Keijser, klinisch psycholoog/psychotherapeut en projectleider van het onderzoek, zal een theoretisch kader schetsen over gecompliceerde rouw en PTSS bij nabestaanden na moord, inclusief implicaties voor de praktijk. - Mariette van Denderen, criminologe en promovendus, zal de resultaten van de behandelingen met EMDR en CGT tot nu (dan) toe presenteren. - Moniek Verster, een van de behandelaren in het onderzoek, zal over de praktijk van het toepassen van EMDR en CGT bij nabestaanden van moord vertellen. Casuïstiek komt aan bod, indien mogelijk met gebruikmaking van videofragmenten.

Immediate relatives of murder victims often have to deal with PTSD and complicated grief. The University of Groningen, with co-financing by the Fund Victim, launched an investigation into whether professional help is effective. The study has two objectives: To what extent does a treatment consisting of EMDR and CBT for family members and partners of a murdered person to reducing symptoms of complicated grief. Additionally this study aims to understand the extent to which the effect of the treatment with EMDR and CBT is mediated by a decrease of intrusions, avoidance behavior, extreme anger and dysfunctional cognitions. During the presentation, three speakers to talk: - Jos de Keijser, clinical psychologist / psychotherapist and leader of the research, a theoretical framework sketches about complicated grief and PTSD in survivors after murder, including implications for practice. - Mariette of Denderen, criminologist and researcher, the results of the treatment with EMDR and CBT until now (then) to present. - Moniek Verster, one of the practitioners in the study, will the practice of using EMDR and CBT in relatives of murder tell. Casuistry is discussed, where possible using video clips.

Keywords: CBT Cognitive Behavior Therapy Complicated Grief Murder Posttraumatic Stress Disorder PTSD Violence

Accuracy Verified: Yes

5. Wagner, F. (2004). Die wirksamkeit von eye movement desensitization and reprocessing (EMDR) bei der posttraumatischen belastungsstorung im vergleich zu kontrollbedingungen und kognitiv-behavioralen therapien: Eine metaanalytische untersuchung [Efficacy of eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder compared with control conditions, and cognitive-behavioral therapies]. Zugl: Heidelberg. doi:volltextserver/volltexte/2005/5803 . --.

Language: German

Format: Book

Abstract:
Das Ziel der vorliegenden Metaanalyse war es, die Wirksamkeit von EMDR und kognitiv-behavioralen Therapieverfahren bei der posttraumatischen Belastungsstörung mit dem aktuellen Stand an Publikationen metaanalytisch zu untersuchen. In einer umfassenden Literaturrecherche wurden hierfür sowohl publizierte Originalarbeiten als auch unpublizierte Manuskripte recherchiert. Insgesamt gingen 32 Originalstudien in die Metaanalyse ein. 13 der Studien waren reine EMDR-Studien; 7 untersuchten sowohl eine Gruppe mit EMDR als auch eine Gruppe mit kognitiv-behavioraler Therapie. 12 Studien waren reine kognitiv-behaviorale Therapiestudien. Darüber hinaus sollte die Wirksamkeit unter dem Gesichtspunkt der verschiedenen PTSD- und komorbiden Symptomatiken betrachtet werden. In einem weiteren Schritt wurde EMDR direkt mit kognitiv-verhaltenstherapeutischen Behandlungsmethoden verglichen. Effektstärken wurden sowohl für die PTSD-Symptomkategorien Intrusionen, Vermeidung und erhöhtes Arousal als auch für die komorbiden Symptome Angst und Depression berechnet. Die Berechnung der Effektstärken erfolgte anhand von standardisierten Mittelwertsvergleichen. Neben dem direkten Vergleich von EMDR mit kognitiv-behavioralen Therapieansätzen bzw. von EMDR und kognitiv-behavioraler Therapie mit Kontrollgruppen (Post-/Post-Vergleich) wurden auch die Veränderungen innerhalb der Behandlungsgruppen berechnet (Prä-/Post-Vergleich). In den Post-/Post-Vergleich gingen nur kontrollierte und randomisierte Originalstudien ein. In den Prä-/Post-Vergleich hingegen wurden auch Ein-Gruppen-Studien aufgenommen. Als Effektmaß wurde Hedges´d verwendet. Die Ergebnisse legen nahe, dass sowohl EMDR als auch die kognitiv-behaviorale Therapie wirksam in der Behandlung der posttraumatischen Belastungsstörung sind. Beide Verfahren reduzieren in klinisch bedeutsamem Umfang, sowohl unmittelbar als auch lang anhaltend, die PTSD-Symptomatiken Intrusionen, Vermeidung und erhöhtes Arousal. Darüber hinaus führen beide Behandlungsmethoden auch zu einer Reduktion der komorbiden Symptomatiken Angst und Depression. Die Effektivität beider Verfahren zeigt sich hierbei sowohl im Prä-/Post-Vergleich als auch im direkten Post-/Post-Vergleich mit einer Kontrollbedingung. Darüber hinaus ergibt sich eine ähnlich hohe Wirksamkeit von EMDR und kognitiv-behavioraler Therapie, sowohl im Vergleich der Prä-/Post-Effektstärken als auch im direkten Post-/Post-Vergleich. Dennoch scheint es unterschiedliche Einflussfaktoren zu geben, welche die Therapieeffektivität sowohl bei EMDR als auch bei kognitiv-behavioraler Therapie beeinflussen. Aufgrund der geringen Studienzahl lassen sich diese Faktoren jedoch nicht näher untersuchen. Des Weitern zeichnen sich Unterschiede hinsichtlich der Effizienz der beiden Therapieformen ab: So beträgt die durchschnittliche Behandlungsdauer bei EMDR 5 Sitzungen, bei der kognitiv-behavioralen Therapie hingegen 8 Sitzungen. Darüber hinaus ist die Expositionsdosis bei den kognitiv-behavioralen Therapien höher als bei EMDR.
Die Befunde zur Wirksamkeit der bilateralen Stimulation sind hingegen weniger eindeutig. Allerdings sind Studien, welche den Versuch unternehmen, die Augenbewegungen bei Personen mit PTSD isoliert zu betrachten, oftmals von erheblichen methodischen Mängeln gekennzeichnet. Einzelne Befunde und Modellvorstellungen zur Rolle der bilateralen Stimulation beim EMDR werden im Diskussionsteil erörtert.

The aim of this meta-analysis was to investigate the efficacy of EMDR and cognitive-behavioral therapy for posttraumatic stress disorder with the current meta-analysis of publications. In a comprehensive literature search for this original work, both published and unpublished manuscripts were researched. A total of 32 original studies were included in the meta-analysis. 13 of the studies were pure EMDR studies; 7 examined both a group and a group with EMDR with CBT. 12 studies were purely cognitive-behavioral therapy studies. Moreover, the effectiveness should be considered in the light of various PTSD and comorbid symptomatology. In a further step EMDR was compared directly with cognitive-behavioral treatment methods. Effect sizes were calculated for both the PTSD symptom categories intrusions, avoidance and increased arousal as well as the comorbid symptoms of anxiety and depression. The calculation of effect sizes was based on standardized mean comparisons. In addition to the direct comparison of EMDR with cognitive-behavioral therapy approaches and EMDR and CBT with control groups (Post-/Post-Vergleich) and the changes within the treatment groups were calculated (Prä-/Post-Vergleich). In the only controlled and randomized Post-/Post-Vergleich original studies were submitted. In contrast Prä-/Post-Vergleich also single-group studies were included. Hedges'd was used as a measure of effect. The results suggest that both the EMDR and cognitive-behavioral therapy are effective in the treatment of post-traumatic stress disorder. Both methods reduce in clinically relevant extent, both immediate and long lasting, the PTSD symptomatology intrusions, avoidance and increased arousal. In addition, both treatments lead to a reduction in comorbid anxiety and depression symptomatology. The effectiveness of both methods is shown here both in Prä-/Post-Vergleich as well as direct Post-/Post-Vergleich with a control condition. Moreover, there is a similar level of effectiveness of EMDR and CBT, both in comparison to the Prä-/Post-Effektstärken as well as direct Post-/Post-Vergleich. Nevertheless, there seems to be different factors that influence the effectiveness of both EMDR therapy as well as cognitive-behavioral therapy. Due to the small number of studies, these factors can, however, examine in detail. Weitern the distinguished differences in the efficiency of the two forms of therapy from: Thus, the average duration of treatment with EMDR is 5 sessions in cognitive-behavioral therapy, however, 8 sessions. In addition, the exposure dose in the cognitive-behavioral therapies is higher than EMDR. The findings on the effectiveness of bilateral stimulation, however, are less clear. However, studies that attempt to isolate the eye movements with PTSD in persons often characterized by significant methodological flaws. Individual findings and concepts on the role of bilateral stimulation in EMDR are discussed in the discussion section.

Keywords: Posttraumatic Stress Disorder PTSD Trauma

Accuracy Verified: Yes

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

Language: English

Format: Journal

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

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

Accuracy Verified: Yes

7. Bumke, P. J., & Sodemann, U. (2010, July). The efficacy of EMDR in a new context: Some findings from the ACEH survey. Symposium (Carolyn L. Neunuebel, Chair) conducted at the 1st EMDR Asia Conference, Bali, Indonesia.

Language: English

Format: Conference

Abstract:
Context: As a response to the Tsunami in 2004 the Aceh Project organized by TraumaAid and sponsored byTDH and the BMZ from 2007 to 2009 treated more than 3200 clients for psychic disorders related to traumatic experiences .The treatment was given by Indonesian therapists who against the background of a lack of local therapists trained in psychotraumatology had to be trained within the project under the auspices of TraumaAid. This combination of EMDR-Training and EMDR-Therapy in an extremely challenging context also offered an unique opportunity for a parallel and wide ranging monitoring and evaluation of the social and diagnostic parameters involved. Methodology: To guide the therapeutic process and to check on its long term efficacy 1200 adults and 1000 children were at the outset of their therapies asked to contribute detailed diagnostic data. While for adults the Hopkins Anxiety and Depression scales along with a 42-item Harvard Trauma Questionnaire was administered, children and adolescents up to age of 17 were given an adapted version of the CBCL. At the conclusion of their therapies 20 % of all respondents were rechecked with the same diagnostic scales, another group of 5 % again after 6 months. Results: The diagnostic data indicate a dramatic improvement after therapies that involved a range of therapeutic techniques including stabilising and EMDR protocols. The relation between diagnostic dimensions (intrusions, somatic reactions, social relations, expression of feelings and attention problems) and social factors (gender, age) was further explored.

Keywords: ACEH Survey

Accuracy Verified: Yes

8. Lytle, R. A., Hazlett-Stevens, H., & Borkovec, T. D. (2002). Efficacy of eye movement desensitization in the treatment of cognitive intrusions related to a past stressful event. Journal of Anxiety Disorders, 16(3), 273-288. doi:10.1016/S0887-6185(02)00099-3.

Language: English

Format: Journal

Abstract:
Much of the Eye Movement Desensitization and Reprocessing (EMDR) efficacy research has been widely criticized, limiting scientific understanding of its therapeutic components. The present investigation of Eye Movement Desensitization (EMD) effectiveness included undergraduate students reporting current intrusive cognitions concerning a traumatic event. Forty-five participants received a single treatment session of either: (a) EMD, as described by Shapiro [J. Behav. Ther. Exp. Psychiatry 20 (1989b) 211], (b) an identical procedure which employed eye fixation on a stationary target, or (c) non-directive counseling. Standardized self-report, subjective rating, Daily Diary, and intrusive thought sampling measures were collected before and after treatment. Results indicated that participants in the eye fixation group reported marginally (p<.052) fewer cognitive intrusions than the non-directive group 1 week following treatment. No significant differences between the EMD and non-directive conditions or between the EMD and eye fixation conditions on this measure were found. During the treatment session, both desensitization groups were superior to the non-directive group in reducing reported vividness of the mental image of the original event. However, the non-directive group improved to the level of the two other groups by the following week. Rapid saccadic eye movements were therefore unrelated to immediate treatment effects for this sub-clinical sample, and non-directive treatment largely yielded eventual outcomes equivalent to the two desensitization conditions (Pilots).

Keywords: Biologic Markers College Students Intrusive Thoughts Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Stressors Survivors Treatment Effectiveness Witnesses

Accuracy Verified: Yes

9. Kapoula, Z., Yang, Q., Bonnet, A., Bourtoire, P., & Sandretto, J. (2010, May). EMDR effects on pursuit eye movements. PLoS ONE, 5(5), 1-11, e10762. doi:10.1371/journal.pone.0010762.

Language: English

Format: Journal

Abstract:
This study aimed to objectivize the quality of smooth pursuit eye movements in a standard laboratory task before and after an Eye Movement Desensitization and Reprocessing (EMDR) session run on seven healthy volunteers. EMDR was applied on autobiographic worries causing moderate distress. The EMDR session was complete in 5 out of the 7 cases; distress measured by SUDS (Subjective Units of Discomfort Scale) decreased to a near zero value. Smooth pursuit eye movements were recorded by an Eyelink II video system before and after EMDR. For the five complete sessions, pursuit eye movement improved after their EMDR session. Notably, the number of saccade intrusions—catch-up saccades (CUS)—decreased and, reciprocally, there was an increase in the smooth components of the pursuit. Such an increase in the smoothness of the pursuit presumably reflects an improvement in the use of visual attention needed to follow the target accurately. Perhaps EMDR reduces distress thereby activating a cholinergic effect known to improve ocular pursuit.

Keywords: Eye Movements Mechanism of Action

Accuracy Verified: Yes

10. van Rood,Y., & de Roos, C. (2010, June). EMDR in the treatment of body dysmorphic disorder. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
Body dysmorphic disorder (BDD) is defined in the Diagnostic and Statistical Manual IV-TR (DSM-IV-TR) as a disorder characterised by a preoccupation with an imagined defect in one's appearance (American Psychiatric Association (APA), 1994). BDD can be treated effectively with selective serotonin reuptake inhibitors (SSRls) or cognitive behaviour therapy (CBT) (Williams et al.. 2006). CBT interventions which are most often described in the literature are exposure and response prevention (ERP) and cognitive techniques. These interventions successfully weaken the catastrophic expectations of the patients. However, they do not affect the negative valence of patients' appearance. This negative meaning is not inborn but acquired during life through association with distressful or even traumatic events. Patients with BDD often report stressful events as the starting point of their complaints (Buhlmann et al., 2007) as well as PTSS like symptoms. i.e. intrusions (Osman et al.. 2004). Processing of these unprocessed memories might free the way to the development of a more positive meaning of their appearance. Indeed, case series have been described in which EMDR has been successfully applied in the treatment of BDD (Brown et al , 1997). In the first part of this workshop background information will be presented which might help identifying BDD patients who might profit from EMDR and planning subsequent EMDR treatment. In the second part of the workshop we share our experiences treating BDD patients with EMDR. Clinical issues will be analysed using videotaped cases of patients for illustration. The goal of this workshop is to increase knowledge and understanding of the use of EMDR in the treatment for BDD. American Psychiatric Association (APA) (1994). Diagnostic and statistical manual of mental disorders. (4th ed.) Washington DC. American Psychiatric Association. Brown, K. W., McGoldrick, T., & Buchanan, R. (1997). Body dysmorphic disorder: Seven cases treated with eye movement desensitization and reprocessing. Behavioural and Cognitive Psychotherapy. 25(2), 203-207 Buhlmann, U., Cook, L. M., Fama, 1. M., & Wilhelm, 5. (2007). Perceived teasing experiences in body dysmorphic disorder. Body Image. 4, 381-385. Osman. S., Cooper, M., Hackmann, A,, & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder Memory, 12, 428-436. Williams, J., Hadjistavropoulos, T., & Sharpe, D. (2006). A meta- analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder. Behaviour Research and Therapy. 44, 99-111.

Keywords: Body Dysmorphic Disorder

Accuracy Verified: Yes

11. Burkhardt, L. (2010, June). The EMDR-treatment of traumatisation in World War 2 in an elderly patient: The story of Luise. In Complex trauma. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
Goals: How to deal with medical and psychological problems of patient aged over 70 and encourage colleagues to work with older patients. To show how war traumatization may shake up a live as long as 60 years after the end of war. To understand the shock of mass-bombing on a person. In this presentation I would like to present the biography and the treatment with EMDR of an old women suffering from PTSD since 1945 after surviving three mass-bombings and two attacks of strafers in WW 2. She came in treatment after the attack on W C on 9/11/2001 witch had increased her intrusions to a very high level. The practical part of the presentation will show a video of her EMDR-treatment and the necessity to use cognitive interweaves in this particular situation.

Keywords: Elderly Patient Symposium World War II

Accuracy Verified: Yes

12. Pitman, R., Orr, S., Altman, B., Longpre, R., Poire, R., Macklin, M., Michaels, M. J., & Steketee, G. S. (1996, November-December). Emotional processing and outcome of imaginal flooding therapy in Vietnam veterans with chronic posttraumatic stress disorder. Comprehensive Psychiatry, 37(6), 409-418. doi:10.1016/S0010-440X(96)90025-5.

Language: English

Format: Journal

Abstract:
This study examined emotional processing and outcome in 20 Vietnam veterans with chronic posttraumatic stress disorder (PTSD) who underwent imaginal flooding therapy. Results supported the occurrence of emotional processing, as manifest in significant activation, within-session habituation, and partial across-session habituation of physiologic and self-reported process variables. The flooding therapy produced only modest overall improvement, which was statistically significant for avoidance symptomatology measured by the Impact of Events Scale (TOES) and number of intrusions per day recorded by the subject in a log. Symptomatic improvement appeared to generalize from a treated to an untreated experience. Heart rate activation during the first flooding session predicted a decrease in daily number of intrusive combat memories across the therapy. Otherwise, there was little association between extent of emotional processing and therapeutic outcome. The results provide limited support for the notion that mobilization of phychophysiologic arousal during exposure therapy predicts improvement. [Author Abstract]

Keywords: Emotional Processing Flooding Therapy Posttraumatic Stress Disorder PTSD Vietnam Veterans

Accuracy Verified: Yes

13. Lytle, R. A. (1993). An investigation of the efficacy of eye-movement desensitization in the treatment of cognitive intrusions related to memories of a past stressful event. Pennsylvania State University. AAT 9334778.

Language: English

Format: Dissertation/Thesis

Abstract:
A novel clinical technique, referred to as "eye-movement desensitization," has recently been reported to rapidly achieve significant reductions in the frequency and intensity of the two primary symptoms of PTSD; cognitive intrusions and the behavioral and emotional avoidance of trauma related fear cues. The current study was intended to provide an experimentally controlled replication of this procedure. The 45 students with the highest scores on a self-report questionnaire were selected for participation in the study and randomly assigned to one of three treatment conditions. These conditions included "eye-movement desensitization," "eye-fixation desensitization," and a non-directive control condition.Sessions One and Three consisted of pretest and posttest assessment respectively, administered by questionnaire and behavioral measures of cognitive intrusions relating to the reported trauma. Session Two, consisted of immediate pretest and posttest assessment of information regarding subjective discomfort, perceived validity of adaptive cognitions, and vividness of images related to the reported trauma. The results of this experiment indicated that treatment-related pretest to posttest change was limited to (a) a relative reduction in cognitive intrusions for the eye-fixation group compared to the other treatment conditions, and (b) initial superiority of both desensitization techniques in immediately reducing subject distress, vividness of the initial image (and for eye-fixation, improved validity of an adaptive cognition) in comparison to the non-directive condition. The latter condition, however, then achieved equivalent gains by one-week follow-up. It was concluded that: (a) the relative efficacy of the eye-movement desensitization technique, was not supported in this non-clinical population, (b) to the degree that the outcomes resulting from the two desensitization conditions were at variance from those of the more traditional non-directive technique, those differences appear to have been predominantly transient in character, and (c) the induction of saccadic eye-movements did not demonstrably function as an active component of treatment within this experimental context. It was additionally concluded that further research will be required to satisfactorily resolve the discrepant findings of experimentation and case reports regarding the efficacy of this technique. Specific suggestions for further research were presented. [Truncated Author Abstract] [Pilots]

Keywords: Biologic Markers College Students Intrusive Thoughts Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Stressors Survivors Treatment Effectiveness Witnesses

Accuracy Verified: Yes

14. Veerbeek, H. (2013, June). Processing anger and revenge with EMDR. Presentation at the annual meeting of the EMDR Europe Association, Geneva, Switzerland.

Language: English

Format: Conference

Abstract:
Until now, best practise regarding treatment of anger seems to be mostly focused on improving control over angry outbursts. The treatment as usual is cognitive and behaviour oriented. For trauma related internalizing symptoms (anxiety, panic, nightmares, avoidance, intrusions), we know that EMDR is much more effective than a standard cognitive behavioural approach. Anger, embitterment and revenge are, more often than we think, also trauma-related symptoms and can be viewed as externalizing reactions to severe maltreatment, powerlessness and/or humiliation. A lot of our veterans have to deal with a permanent elevated arousal and an aggressive response style after they return from war. These externalizing symptoms can have devastating effects on marriage, work and daily live. In trauma-literature, there has been a lack of attention to this debilitating and externalizing side of PTSD.
In the workshop, after a brief review of the literature on anger and revenge, a new perspective will be presented in understanding anger and revenge. An EMDR-based protocol will be demonstrated, which can be used as a cognitive interweave and also as a “stand-alone” tool to process anger- and revenge symptoms. Extensive video footage will be used to illustrate the effect of this treatment on a patient with severe, dangerous and obsessive revenge symptoms. The question, when this add-on tool can be used and when it will be preferable to stick to the standard EMDR protocol, will be discussed. In conclusion, questions from the audience will hopefully lead to an inspiring discussion.
Learning objectives: Being able to apply the theoretical framework of Posttraumatic Anger in understanding anger symptoms in clients; Being able to detect which experiences en people from the past contributed to current anger – and anxiety symptoms and know when to apply the standard EMDR protocol or the Rage, Resentment and Revenge Protocol; and Being able to apply the Rage, Resentment and Revenge Protocol to process and resolve the anger symptoms.

Keywords: Anger Revenge

Accuracy Verified: Yes

15. Janssen, W. C., & van der Beek, J. (2010). Prospectieve intrusies worden minder levendig en onaangenaam door oogbewegingen [Prospective intrusions are less vivid and uncomfortable by eye movements]. Utrecht, Nederlands: Universteit Utrecht.

Language: Dutch

Format: Dissertation/Thesis

Abstract:
In eerder onderzoek werd aangetoond dat intrusieve herinneringen aan het verleden minder levendig en onaangenaam worden wanneer deze worden opgehaald tijdens het maken van oogbewegingen. Dit zou kunnen komen doordat beide taken beslag leggen op de capaciteit van het werkgeheugen. Sommige mensen gaan echter gebukt onder verontrustende voorstellingen van de toekomst. In dit onderzoek wordt geprobeerd vast te stellen of ook deze zogenoemde prospectieve intrusies minder levendig en onaangenaam worden wanneer deze worden opgehaald tijdens het maken van oogbewegingen. Methode 28 gezonde deelnemers werd gevraagd twee prospectieve intrusies op te halen en deze op levendigheid, onaangenaamheid en toegankelijkheid te beoordelen. Alle deelnemers werden toegewezen aan een controleconditie, waarin deze intrusie enkel hoefde te worden opgehaald en vastgehouden, en een experimentele conditie, waarin de proefpersonen gevraagd werd tijdens het vasthouden van de intrusie horizontale oogbewegingen te maken. Na iedere conditie werd de herinnering opnieuw opgehaald en gescoord. Resultaten In de experimentele conditie namen de levendigheid en onaangenaamheid van prospectieve intrusies af, terwijl de levendigheid in de controleconditie juist toenam en de onaangenaamheid gelijk bleef. Discussie De resultaten suggereren dat het maken van oogbewegingen tijdens het ophalen van prospectieve intrusies de levendigheid en onaangenaamheid van deze beelden vermindert. De implicaties van deze bevinding worden besproken.

Earlier research has shown that intrusive memories of the past are less vivid and unpleasant when they are retrieved when making eye movements. This could be because both tasks seize the capacity of working memory. Some people, however, suffer from disturbing images of the future. This study attempted to determine whether these prospective intrusions known as less vivid and unpleasant when they are retrieved while making eye movements. Methods 28 healthy participants were asked to pick two prospective intrusions and the liveliness, unpleasantness and accessibility assessment. All participants were assigned to a control condition in which these intrusions just have to be picked up and detained, and an experimental condition in which the subjects were asked during the intrusion of horizontal eye movements hold it. After each condition, the memory retrieval and scored. Results In the experimental condition took the vibrancy and unpleasantness of prospective intrusions, while the liveliness in the control condition just increased and remained constant discomfort. Discussion The results suggest that making eye movements prospective intrusions while getting the vibrancy and reduces discomfort of these images. The implications of this finding are discussed.

Keywords: Prospective Intrusions Working Memory Theory

Accuracy Verified: Yes

16. Engelhard, I. M., van den Hout, M. A., Dek, E. C. P., Giele, C. L., van der Wielen, J.-W., Reijnen, M. J., & van Roij, B. (2011, May ). Reducing vividness and emotional intensity of recurrent “flashforwards” by taxing working memory: An analogue study. Journal of Anxiety Disorders, 25(4), 599-603. doi:10.1016/j.janxdis.2011.01.009.

Language: English

Format: Journal

Abstract:
Several studies have found that making eye movements while retrieving visual images about past negative events reduces their vividness and emotional intensity. A working memory account states that eye movements tax working memory and interfere with visual imagery, thus degrading images. This study examined whether eye movements also affect recurrent, intrusive visual images about potential future catastrophes (“flashforwards”) in a sample of female undergraduates who had indicated on a screening-scale that they suffer from such intrusions. They were asked to recall two intrusive images with or without making eye movements. Before and after each condition, participants retrieved the image, and rated its vividness and emotionality. Results showed that vividness of intrusive images was lower after recall with eye movement, relative to recall only, and there was a similar trend for emotionality. Potential implications are discussed.

Keywords: Flashforwards Intrusive Images PTSD Working Memory

Accuracy Verified: Yes

17. Twombly, J. H. (2001, December). Safe place imagery: Handling intrusive thoughts and feelings. EMDRIA Newsletter, 6(Special Edition), 35-38.

Language: English

Format: Newsletter

Abstract:
This paper will expand on the EMDR protocol of Safe Place Imagery (SPI) making it useful to a wider range of clients. Clients with overt and covert trauma histories will frequently experience traumatic intrusions in to the Safe Place or not be able to find one. Knowledge of trance both explains these phenomena and informs the process of teaching these clients to block out intrusions. Use of SPI with clients with complex ego states and Dissociative Disorders will also be discussed.

Keywords: Dissociative Disorders Safe Place Imagery SPI

Accuracy Verified: Yes

18. Walker, N. (2012, October). Temporal sequencing as a multipurpose aid in preparing for and facilitating EMDR with complex trauma or severe PTSD. Presentation at the at the 4th Autumn EMDR Workshop Conference, Sheffield, UK .

Language: English

Format: Conference

Abstract:
This workshop describes the various uses of chronological autobiographical memory cues (temporal sequencing) to restore the sense of ‘continuity of being’ disrupted by trauma: 1. To facilitate readiness for EMDR processing when a client is avoidant to accessing memory, or is likely to become hyper-aroused, by creating felt distance in time from the time of the trauma to the present. 2. To securely close an incomplete EMDR session. 3. To improve the clients’ present groundedness both in the session, and to improve their general level of groundedness, making them less vulnerable to intrusions and avoidance. 4. To build sufficient ego-strength and empowerment for secure processing and integration of traumatic memory.

Keywords: Complex Trauma Posttraumatic Stress Disorder PTSD Temporal Sequencing

Accuracy Verified: Yes

19. Gelinas, D. (2006, September). Treating complex PTSD with EMDR. Presentation at the annual EMDR International Association Conference, Philadelphia, PA.

Language: English

Format: Conference

Abstract:
Research has demonstrated that EMDR is efficacious in treating PTSD. Many clinicians however treat clients with more complicated forms of PTSD resulting from early, repeated trauma experiences. This workshop will provide a framework for beating complex PTSD using EMDR. It will first summarize the clinical picture of complex PTSD, including it's bi-phasic numbing/constricting interspersed with repetitive intrusions, chronic physiological hyperarousal, distortions of the self, and the presence of dissociation, which includes for some clients, the presence of ego states. This information will be used to demonstrate EMDR Case Conceptualizations and several approaches to target selection, depending upon the characteristics of the clinical situation. The workshop will provide a number of EMDR methods for stabilizing clients early in treatment then will focus on Assessment and Desensitization. Complex PTSD frequently calls for extensive use of cognitive interweaves because of the significant distortions in sense of self, and so their use will be reviewed. As they emerge in the different phases of EMDR, different types of dissociation present the clinician with choice points about how to proceed. The workshop will provide sevcral ways to recognize the emergence of dissociation during each of the 8 phases of EMDR and the choice points this represents. It will discuss several ways to manage dissociation as it emerges, including ego states, so that EMDR can proceed productively. Present triggers and future considerations will be included. Time will be included for questions and for focused discussion.

Keywords: Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Posttraumatic Stress Disorder PTSD

Accuracy Verified: Yes

20. Ferrie, R. (2009, May). Treating disordered sleep with EMDR. Presentation at the EMDR Canada Conference, Vancouver, British Columbia Canada.

Language: English

Format: Conference

Abstract:
Evidence from sleep laboratories shows that disordered sleep is a prominent feature of PTSD. The Pittsburg Sleep Quality Index will be illustrated. Evidence will be presented for the hypothesis that a third state of brain activity, neither waking nor sleeping is accessed during the eye movement portion of EMDR. How best to facilitate a positive outcome by changing the story line of nightmares and intrusions will be illustrated, and finally a review of other current therapy for sleep disorders will be given.

Keywords: Pittsburg Sleep Quality Index Sleep

Accuracy Verified: Yes

21. Ferrie, R. (2009, August). Treating disordered sleep with EMDR. Presentation at the annual meeting of the EMDR International Association, Atlanta, GA.

Language: English

Format: Conference

Abstract:
Evidence will be presented for the hypothesis that a third state of brain activity, neither waking nor sleeping, is accessed during REM sleep, as well as during the eye movement portion of EMDR. Sleep research has shown that disordered sleep is a prominent feature of PTSD, yet EMDR therapists seldom document this disorder. The Pittsburg Sleep Quality Index is a useful instrument for this purpose and will be demonstrated. How best to facilitate a positive outcome in therapy by changing the story line of nightmares and intrusions will be illustrated. Participants are encouraged to bring dream scripts to the discussion.

Keywords: Sleep Disorders

Accuracy Verified: Yes

22. Mosquera, D., & Gonzalez, A. (2010, June). Understanding dissociative language. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
In order to get a complete and comprehensive case conceptualization in Phase 1 of the EMDR protocol, it is important to explore dissociative symptomatology. But the cinicai picture of dissociation may be difficult to identify for inexperienced clinicians; some symptoms can be difficult to observe even for experienced therapist who haven't seen severe cases. in consultation we often find therapist who bring a 'complex case' for supervision and quite frequently this 'complexity' has to do with dissociation. Our goal with this presentation is to show the many different ways dissociation can be manifested during EMDR sessions. Another goal is to give practical examples of interventions with dissociative patients during EMDR processing. Many examples of subtle manifestations (what we call 'dissociative language') will be illustrated with video cases. Severely traumatized people don't communicate in a direct and clear way, they have their 'own language' and in order to understand the patient's inner world, we need to understand the silences, the somatic symptoms the subtle (and not so subtle) intrusions; all of these are frequent symptoms that the patient can't detect, understand or disclose to us (not directly). It is widely known that EMDR clinicians must be careful when dealing with dissociative patients; techniques that can be used during the stabilization phase have been developed for the treatment of dissociative disorders (Knipe, Forgash .......). These techniques are complementary to the basic protocols and are very useful but the problem arises when therapists are not able to identify and/or understand what we call the 'dissociative language'. We must keep in mind that most dissociative patients have grown in an early environment where their needs were not taken into account. Many never had the possibility to express their feelings openly. For this, it is important to focus and under^ stand the indirect, complex and ambivalent communication of these people especially during an EMDR session. The approach to these difficulties is not only a question of protocol modifications. but a complex learning from the therapist of the 'dissociative language'. Several examples from videos of therapy sessions and case descriptions will be presented.

Keywords: Dissociation

Accuracy Verified: Yes

23. Seidler, G. H., Feurer, D. C., Wagner, F. E., & Micka, R. (2003). Zur frage der anwendung von EMDR beischädel-hirn-traumatisierten [On the question of EMDR in the treatment of brain-injury patients]. Zeitschrift für Psychotraumatologie und Psychologische Medizin, 1(3), 35-45.

Language: German

Format: Journal

Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Literaturbefunde und eigene klinische Erfahrungen zeigen, dass bei einer großen Anzahl von Schädel- Hirn-Traumatisierten die komorbide Diagnose einer ASD oder einer PTSD vergeben werden muss. Die Entstehung von Intrusionen kann unterschiedlich plausibilisiert werden. Die Autoren schlagen als Erweiterung bestehender Ansätze dazu die Möglichkeit "phantasmatischer Intrusionen" vor, als Ausdruck bildhafter Ausgestaltungen der erlebten Todesgefahr. Kasuistisch wird die erfolgreiche Anwendung von EMDR gezeigt. Es werden bestimmte Modifikationen vorgeschlagen, mit denen ein möglicherweise für diese Gruppe von Patientinnen und Patienten charakteristischer Assoziationsprozess in Gang kommen kann.

Literary findings as well as our own clinical experiences show that a large number of patients with head injuries had to be additionally diagnosed with either ASD or PTSD. The formation of intrusions can be interpreted differently. The authors propose possible "phantasmatic intrusions" as an enhancement of current approaches for the pictorial forms of the experienced life-threatening danger. A case report shows the successful use of EMDR. Certain modifications are proposed in which the characteristic association process for this group of patients can be launched. [Author Summary]

Keywords: Acute Stress Disorder ASD Head Injuries Posttraumatic Stress Disorder PTSD Survivors

Accuracy Verified: Yes