Francine Shapiro Library - EMDR Bibliography Links
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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. Tarrier, N., Liversidge, T., & Gregg, L. (2006, November). The acceptability and preference for the psychological treatment for PTSD. Behaviour Research and Therapy, 44(11), 1643-1656. doi:10.1016/j.brat.2005.11.012.
Language: English
Format: Journal
Abstract:
The acceptability and preference of psychological treatments is important in understanding patient treatment seeking, choice, engagement and attrition and possibly treatment response in health care. The acceptability of, and preference for, 14 different types of psychological treatment for PTSD were investigated in a student population through invitation to participate in a web-based survey. Respondents were asked to rate each treatment on 10 scales and to rank the treatments in order of preference. Respondents were also asked whether they would seek treatment themselves, recommend treatment to friends and family, feel stigmatised by suffering from PTSD, had any prior knowledge of the treatments and if this had been positive or negative, and whether they had a history of psychological problems or treatment. A total of 330 respondents completed the survey. A past or current history of psychological problems and treatment was surprisingly high. Almost all respondents indicated that they would seek or recommend treatment in spite of high levels of stigmatisation. Factor analysis of the 10 scales indicated two factors: Endorsement and Discomfort. Rank ordering on preference and Endorsement scores was highly consistent. The highly preferred and endorsed treatments involved cognitive therapy, exposure, or psycho-education in spite of high levels of discomfort anticipated with exposure. Treatments involving new technologies, EMDR, and psychodynamic psychotherapy received the lowest Endorsement and preference. There was a modest influence of prior knowledge of a treatment. [Author Abstract]
Keywords: Cognitive-Behaviour Therapy Cognitive Therapy Exposure Therapy College Students Computer Assisted Psychotherapy Empirical Study Family Therapy Group Psychotherapy Posttraumatic Stress Disorder Preference Psychoanalytic Psychotherapy Psychological Treatment Psychotherapeutic Processes PTSD Quantitative Study Relaxation Therapy Treatment Acceptability Virtual Reality Exposure Web-Based Survey
Accuracy Verified: Yes
3. Devilly, G. J. (2004, December). An approach to psychotherapy toleration: The Distress/Endorsement Toleration Scale (DEVS) clinical outcome studies. Journal of Behavior Therapy and Experimental Psychiatry, 35(4), 319-336. doi:10.1016/j.jbtep.2004.08.001.
Language: English
Format: Journal
Abstract:
The issue of treatment tolerance within the field of psychotherapy is, at best, a nebulous construct and has been commonly evaluated via rates of subject attrition and homework compliance. This research presents the psychometric properties of a ten-item scale which endeavours to measure treatment distress and participant endorsement of therapy protocols used in clinical research. Two factors emerged and the subscales of Distress and Endorsement were derived. These subscales displayed good reliability with acceptable inter-item correlations within each subscale. The subscales were also able to differentiate the perspectives of male Vietnam veterans from their spouses on a lifestyle management course at the termination of intervention. However, this scale also displayed a cognitive behavioural trauma treatment protocol and eye movement desensitisation and reprocessing to be equivalent in treatment distress and participant endorsement in the treatment of PTSD. Preliminary findings suggest that the relationship between these two subscales and outcome may, to some extent, be population specific. First evidence suggests that intervention distress ratings may be influenced by severity of presentation, whilst endorsement ratings are more influenced by symptomatic improvement over time. Suggestions for future research are presented and the full questionnaire is attached as an appendix. [Author Abstract]
Keywords: Adults Australians Cognitive Therapy Distress Family Therapy Endorsement Females Males Outcome Psychotherapeutic Processes Questionnaire Self Report Instruments Spouses Tolerance Treatment Treatment Effectiveness Veterans Vietnam War
Accuracy Verified: Yes
4. Sack, M., Lempa, W., & Lamprecht, W. (2007). Assessment of psychophysiological stress reactions during a traumatic reminder in patients treated with EMDR. Journal of EMDR Practice and Research, 1(1), 15-23. doi:10.1891/1933-3196.1.1.15.
Language: English
Format: Journal
Abstract:
This study investigates changes of stress-related psychophysiological reactions after treatment with EMDR. 16 patients with PTSD following type I trauma underwent psychometric and psychophysiological assessment during exposure to script-driven imagery before and after EMDR and at 6-month follow-up. Psychophysiological assessment included heart rate (HR) and heart rate variability (HRV) during a neutral task and during trauma script listening. PTSD symptoms as assessed by questionnaire decreased significantly after treatment and during follow-up in comparison to pretreatment. After EMDR, stress-related HR reactions during trauma script were significantly reduced, while HRV indicating parasympathetic tone increased both during neutral script and during trauma script. These results were maintained during the follow-up assessment. Successful EMDR treatment may be associated with reduced psychophysiological stress reactions and heightened parasympathetic tone. [Author Abstract]
Keywords: Adults Germans Manual-Based Treatments Posttraumatic Stress Disorder Psychophysiology PTSD Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
5. Leiner, A. S., Kearns, M. C., Jackson, J. L., Astin, M. C., & Rothbaum, B. O. (2012, January). Avoidant coping and treatment outcome in rape-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology,80(2), 317-321. doi: 10.1037/a0026814.
Language: English
Format: Journal
Abstract: Objective: This study investigated the impact of avoidant coping on treatment outcome in rape-related posttraumatic stress disorder (PTSD). Method: Adult women with rape-related PTSD (N = 62) received 9 sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). The mean age for the sample was 34.7 years, and race or ethnicity was reported as 67.7% Caucasian, 25.8% African American, 3.2% Latina, and 3.2% other. PTSD was assessed with the PTSD Symptom Scale–Self-Report (Foa, Riggs, Dancu, & Rothbaum, 1993), and avoidant coping was assessed using the Coping Strategies Inventory–Disengagement subscale (CSI-D; Tobin, Holroyd, Reynolds, & Wigal, 1989). Results: Pretreatment avoidant coping was negatively associated with posttreatment PTSD symptom severity even when controlling for initial severity of total PTSD symptoms and when removing PTSD avoidance symptoms from the analysis to account for potential overlap between avoidant coping and PTSD avoidance symptoms: ΔR2 = .08, b = −0.31, 95% CI [−0.17, −0.01], t(60) = −2.27, p = .028. The CSI-D pretreatment mean score of 100 predicted a 96% likelihood of experiencing clinically significant change (CSC) during treatment. A CSI-D pretreatment score of 61 was associated with a 40% likelihood of experiencing CSC. Conclusions: PE and EMDR appear to be beneficial for women who frequently engage in avoidant coping responses following rape. A small subset of women with initially low levels of avoidant coping are unlikely to experience a therapeutic response from PE or EMDR. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Keywords: Rape Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
6. Wesselmann, D., & Potter, A. E. (2009). Change in adult attachment status following treatment with EMDR: Three case dtudies. Journal of EMDR Practice and Research, 3(3),178-191. doi:10.1891/1933-3196.3.3.178.
Language: English
Format: Journal
Abstract:
Three case studies illustrate pre- and post-eye movement desensitization and reprocessing (EMDR) adult attachment status as measured by the Adult Attachment Interview (AAI). Two adult males and one adult female presented for outpatient therapy; all of them were categorized with an insecure or disorganized attachment status at pretreatment. All presented with symptoms of depression and anxiety and complaints regarding problems in their current marital and family relationships. The three patients received 10 to 15 EMDR sessions over the course of approximately 1 year, interspersed with talk therapy sessions for the purpose of debriefing and psychoeducation. The EMDR approach utilized all eight phases of treatment within the three-pronged approach. Following EMDR therapy, all three patients made positive changes in attachment status as measured by the AAI, and all three reported positive changes in emotions and relationships. This article provides an overview of the literature related to adult attachment categories and summarizes the effect of adult attachment status on emotional and social functioning. The rationale and scoring procedures for the AAI are explained.
Keywords: Adult Attachment Interview Attachment Outcome Trauma
Accuracy Verified: Yes
7. Grimmett, J. (2012). Clinician experiences with EMDR: Factors influencing attrition and retention. University of the Rockies, Colorado Springs. UMI 3517361.
Language: English
Format: Dissertation/Thesis
Abstract:
This study investigated factors contributing to clinician attrition from eye movement desensitization and reprocessing therapy. The primary areas under investigation were factors contributing to attrition and retention, as well as the quest to obtain information pertaining to training experiences. A sample of 239 clinicians was purposefully obtained. Several patterns emerged within the data, highlighting the issues of attrition: Loyalty to other treatment modalities and discomfort with using EMDR, either through lack of confidence, inadequate training, or discomfort with client distress, were both correlated with clinician attrition. Treatment efficacy and ongoing consultation were remarkable for retention. Practice setting surfaced as statistically significant, and operating in private practice was positively correlated with greater participation in EMDR support activities. Additionally, the adequacy of the training format was presented, as well as how prepared the participants felt after completion of EMDR training. A number of findings were consistent with earlier studies and the converging results of loyalty to previous modalities and discomfort using EMDR gave rise to recommendations for future training and support of newly trained clinicians. The limitations of the current study were presented, in addition to directions for future research.
Keywords: Attrition Clinician Experiences Retention Training
Accuracy Verified: Yes
8. Grimmett, J., Hartung, J., Galvin, M. D., & Gray, S. (2012, October). Clinician experiences with EMDR: Factors influencing attrition and retention. Poster presented at the annual meeting of the EMDR International Association, Arlington, VA.
Language: English
Format: Conference
Abstract:
Over 70,000 clinicians worldwide have participated in extensive EMDR training in the past 20 years, but, as with other therapies, not all trained clinicians continue to practice newly acquired techniques.
Whether or not a clinician uses a given treatment modality seems to be a complicated issue, the literature can be organized along the lines of five themes: (a) therapists' pre-training factors, (b) the training itself, (c) clients' experiecnes before and during EMDR, (d) post-training skill development, and (e) socio-enviromental contributors to therapist attrition and retention
Keywords: Attrition Clinician Experiences Retention Training
Accuracy Verified: Yes
9. van Etten, M. L., & Taylor, S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy, 5(3), 126-144. doi:10.1002/(SICI)1099-0879(199809).
Language: English
Format: Journal
Abstract:
A meta-analysis was conducted on 61 treatment outcome trials for PTSD. Conditions included drug therapies (TCAs, carbamazepine, MAOIs, SSRIs, and BDZs), psychological therapies (behaviour therapy, Eye-Movement Desensitization and Reprocessing (EMDR), relaxation training, hypnotherapy, and dynamic therapy), and control conditions (pill placebo, wait-list controls, supportive psychotherapies, and non-saccade EMDR control). Psychological therapies had significantly lower drop-out rates than pharmacotherapies (14% versus 32%), with attrition being uniformly low across all psychological therapies. In terms of symptom reduction, psychological therapies were more effective than drug therapies, and both were more effective than controls. Among the drug therapies, the SSRIs and carbamazepine had the greatest effect sizes, although the latter was based upon a single trial. Among the psychological therapies, behaviour therapy and EMDR were most effective, and generally equally so. The most effective psychological therapies and drug therapies were generally equally effective. Differences across treatment conditions were generally evident across symptom domains, with little matching of symptom domain to treatment type. However, SSRIs had some advantage over psychological therapies in treating depression. Follow-up results were not available for most treatments, but available data indicates that treatment effects for behaviour therapy and EMDR are maintained at 15-week follow-up. [Author Abstract]
Keywords: Antimanic Drugs Benzodiazepine Derivatives Hypnotherapy Meta Analysis Monoamine Oxidase Inhibitors Posttraumatic Stress Disorder Psychoanalytic Psychotherapy PTSD Relaxation Therapy Selective Serotonin Reuptake Inhibitors Treatment Effectiveness Tricyclic Derivatives
Accuracy Verified: Yes
10. Taylor, S., Thordarson, D., Maxfield, L., Fedoroff, I., Lovell, K., & Ogrodniczuk, J. (2003, April). Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training. Journal of Consulting & Clinical Psychology, 71(2), 330-338. doi:10.1037/0022-006X.71.2.330.
Language: English
Format: Journal
Abstract:
The authors examined the efficacy, speed, and incidence of symptom worsening for 3 treatments of PTSD: prolonged exposure, relaxation training, or eye movement desensitization and reprocessing (EMDR; N = 60). Treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms. Compared with EMDR and relaxation training, exposure therapy (a) produced significantly larger reductions in avoidance and reexperiencing symptoms, (b) tended to be faster at reducing avoidance, and (c) tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment. EMDR and relaxation did not differ from one another in speed or efficacy (Pilots).
Keywords: Adults Empirical Study Exposure Therapy Negative Therapeutic Reaction Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Relaxation Therapy Stressors Survivors Treatment Effectiveness Witnesses
Accuracy Verified: Yes
11. Williams, K. (2006, August). A comparative experimental treatment outcome study: Female survivors of sexual assault suffering from posttraumatic stress disorder, depression, and trauma-related guilt – self-report and psychophysiological measures. Trinity Western University, Langley, British Columbia, CAN.
Language: English
Format: Dissertation/Thesis
Abstract:
Diverse psychotherapeutic approaches for treating trauma-related sequelae have emerged over the last several decades in response to the widespread prevalence of sexual assault and resultant posttraumatic stress disorder among women (PTSD). In a recent formal study (Grace, 2003), a newer treatment called one eye integration (OEI) has been shown to be effective for traumatized individuals. The purpose of this study was to build upon those findings by comparing the effectiveness of two treatments for reducing PTSD symptoms with a breathing, relaxation, autogenics, imagery, and grounding (BRAIN) control condition. Twenty-seven female rape or sexual assault survivors who met the criteria for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders-Text-Revision, (DSM-IV-TR; APA, 2000) were randomly assigned to three groups: (a) a neurologically-based therapy called OEI, (b) an information processing model referred to as cognitive processing therapy-revised (CPT-R), or (c) a control condition (BRAIN), PTSD, depression, and trauma-related guilt symptoms were assessed pretreatment, posttreatment and at 3-month follow up, and qualitative electroencephalography (qEEG) brainwave patterns of two regions of the scalp (frontal and parietal) were measured pre and posttreatment. The following dependent measures were used: Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory II (BDI-II), and t he Trauma-Related Guilt Inventory (TRGI). Though there were no significant differences in PTSD symptoms between groups from pretreatment to post treatment assessments, a significant difference occurred between pretreatment and 3-month follow up, with OEI manifesting greater reductions than CPT-R or BRAIN. There were no significant differences between groups in depression, but there was a reduction in BDI-II scores over time. Reduction in guilt-related symptoms occurred on several scales and subscales for all three groups over time from pretreatment of posttreatment assessments, though not significantly by group. A significant difference was found for the Global Guilt subscale at 3-month follow up, with greater improvement for the OEI group. Preliminary results from cortical brain activity assessments indicate typical qEEG asymmetry patterns for PTSD and depression, though there were no significant group differences apart from minor post hoc analyses. Implications of these findings for clinical work and directions for future research were discussed.
Keywords: Depression Female Guilt Posttraumatic Stress Disorder PTSD Sexual Assault Survivors
Accuracy Verified: Yes
12. Oncley, P. R. (1992). A comparison of eye movement desensitization and implosion-like therapy with adult victims of sexual abuse. Fuller Theological Seminary, Pasadena, CA. AAT 9302718.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye movement desensitization and reprocessing is a recently developed technique that has been reported in the literature to be effective in treating many of the symptoms associated with PTSD. This study investigated the role of saccadic eye movements in this technique by utilizing a multiple-baseline, across subjects design with 4 adult victims of childhood sexual abuse.Eye movement desensitization conditions (EMD) were compared to non saccadic eye movement conditions (NM) utilizing a Latin square design over one treatment session. The Structured Clinical Interview for DSM-III-R (SCID-R) and the PTSD module of the Structured Clinical Interview for DSM-III (SCID) were used for initial diagnosis and screening. Treatment effectiveness between the intervention phase and 1 week follow-up was assessed using the Impact of Event Scale (IES) and the PTSD Symptom Checklist. Skin conductance response (SCR), heart rate, and subjective units of distress (SUDS) were assessed during pretreatment, treatment, posttreatment, and follow-up phases. Results showed no significant differences across subjects among SCR, heart rate, and SUDS between the EMD and NM conditions. IES and PTSD Symptom Checklist follow-up data showed symptom improvement for 3 of the 4 subjects. One subject's intrusive symptoms worsened. All subjects displayed less physiological reactivity to the traumatic imagery at follow-up. Mechanisms that contribute to the effectiveness of EMD and recommendations for future study were discussed. [Author Abstract]
Keywords: Adults Arousal Child Abuse Exposure Therapy Posttraumatic Stress Disorder PTSD Rape Survivors Treatment Effectiveness
Accuracy Verified: Yes
13. Nazari, H., Momeni, N., Jariani, M., & Tarrahi, M. J. (2011, November). Comparison of eye movement desensitization and reprocessing with citalopram in treatment of obsessive-compulsive disorder. International Journal of Psychiatry in Clinical Practice, 15(4), 270-274. doi:10.3109/13651501.2011.590210.
Language: English
Format: Journal
Abstract:
Objective. Obsessive-compulsive disorder (OCD) is one of the chronic anxiety disorders that interfere with routine individual life, occupational and social functions. There is controversy about the first choice of treatment for OCD between medication and psychotherapy. Aim. the aim was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) compared with medication by citalopram in treatment of OCD. Methods. This randomized controlled trial was carried out on 90 OCD patients that randomly were assigned into two groups. They either received therapeutic sessions of EMDR or citalopram during 12 weeks. Both groups blindly were evaluated by the Yale-Brown scale before and after the trial period. Results. Pretreatment average Yale-Brown score of citalopram group was about 25.26 as well as 24.83 in EMDR group. The after treatment scores were 19.06 and 13.6, respectively. There was significant difference between the mean Yale-Brown scores of the two groups after treatment and EMDR was more effective than citalopram in improvement of OCD signs. Conclusion. It is concluded that although both therapeutic methods (EMDR and Citalopram) had significant effect in improving obsessive signs but it seems that in short term EMRD has better effect in improvement of final outcome of OCD.
Keywords: Obsessive Compulsive Disorder OCD
Accuracy Verified: Yes
14. Marcus, S., Marquis, P., & Sakai, C. (1997, Fall). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34(3), 307-315. doi:10.1037/h0087791.
Language: English
Format: Journal
Abstract:
67 individuals diagnosed with PTSD were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) treatment or Standard Care (SC) treatment. Participants were assessed pretreatment, after 3 sessions, and at the completion of treatment using the Symptom Checklist-90, Beck Depression Inventory, Impact of Events Scale, Modified PTSD Scale, Spielberger State-Trait Anxiety Inventory, and Subjective Units of Disturbance. In addition, an independent evaluator assessed participants using DSM-III-R criteria for PTSD including Global Assessment of Functioning at the 3 data points. The individuals in the EMDR treatment group showed significantly greater improvement with greater rapidity than those in the SC treatment group on measures of PTSD, depression, anxiety, and general symptoms. Participants who received EMDR treatment used fewer medication appointments for their psychological symptoms and needed fewer psychotherapy appointments. [Author Abstract]
Keywords: Adults Americans Empirical Study Managed Care Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
15. Resick, P., Monson, C., Griffin, M., Rothbaum, B., Rasmusson, A., & Shalev, A. (2006, November). Cortisol pre and posttreatment with EMDR or prolonged imaginal exposure in PTSD assault survivors. In Psychobiology and Treatment of PTSD. Symposium conducted at the 22nd annual meeting of the International Society for Traumatic Stress Studies Fall Conference, Hollywood, CA.
Language: English
Format: Conference
Abstract:
Psychobiological treatment of PTSD: This symposium will examine four CBT treatment studies with
regard to biological markers. The questions here are whether pretreatment
psychobiology or physiological responding can be used to
predict treatment outcome, or whether they themselves change as a
result of effective treatment.
Cortisol pre and posttreatment with EMDR or
prolonged imaginal exposure in PTSD assault
survivors: Many studies have noted increased cortisol production in trauma
survivors with PTSD, but it is not clear whether effective treatment
alters these responses. As part of a larger study, 60 female sexual
assault survivors with PTSD began one of two types of cognitivebehavioral
treatment (Prolonged Exposure (PE) or EMDR). Each
treatment consisted of nine sessions. Sessions 1 and 2 included
information gathering, trauma education, and therapy preparation.
Sessions 3 through 9 consisted of processing traumatic memories
and emotions via either imaginal exposure or EMDR.To examine
potential cortisol changes over the course of treatment, salivary cortisol
samples were collected at three time points during treatment. A
baseline sample was taken at session 1, a second sample was taken at
the start of the treatment portion of therapy (session 3), and a third
sample was taken at the end of treatment (session 9). Of the original
sample of 60 participants, 50 women completed treatment, and ten
dropped out. Cortisol responses will be examined in treatment
responders and non-responders as well as in treatment completers
vs. treatment dropouts.
Keywords: Cortisol Posttraumatic Stress Disorder Prolonged Imaginal Exposure Assault PSTD Survivors Symposium
Accuracy Verified: Yes
16. Zhang, J. (2010, July). The effect of EMDR for children with PTSD/PTSS after the Sichaun earthquake. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
A devastating earthquake suddenly struck over Sichuan Province of China at May 12, 2008. Two weeks after the quake, over
five hundreds children who lost either parents or one parent were moved to RiZhao, ShanDong province. After a through
screening with MiNi, Kiddie-Sads and the diagnosed assessment with Clinician-Administered PTSD Scale for Children and
Adolescents (CAPS-CA), about 8 percent was diagnosed with PTSD or PTSS. 511 children were selected. The final diagnosis
was made with DSM-IV. We treated these PTSD/PTSS children with Eye Movement Desensitization and Reprocessing (EMDR),
which is taken as one of the most effective treatments for PTSD. 26 children with PTSD consented to receive EMDR treatment
and 26 completed the treatment. They were randomized into pretreatment group and waiting group. Children enrolled in
treatment completed a number of self-report measures and CAPS-CA; pre-, mid- and post-treatment and at follow-up. All
children received three 45-90minute sessions of EMDR, one session a week. The total score, subscale scores and ration of
decreased score were calculated for CAPS-CA. Comparing the ratio of decreased score, the rations after the three sessions’
treatment were significantly higher than that of waiting group and naturally decreased with time. The results indicate that
some children with PTSD after the SiChuan earthquake were getting well after short term EMDR.
Keywords: Children Earthquake Posttraumatic Stress Disorder PTSD: PTSS Sichaun
Accuracy Verified: Yes
17. Graham, L. B., & Robinson, E. M. (2007, Spring). Effect of EMDR on anxiety and swim times. Journal of Swimming Research, 17, 1-9.
Language: English
Format: Journal
Abstract:
This study investigated the effect of Eye Movement Desensitization and Reprocessing (EMDR) on swimmers who had experienced a traumatic swimming event. Measures of performance, anxiety, and self-perception in (N = 65) competitive college and high school swimmers were collected Swimmers were randomly assigned to one of three conditions; EMDR, imagery or no treatment. All participants took the State-Trait Anxiety Scale and performed a 100 yd freestyle swim pretreatment and posttreatment. The EMDR and imagery group had two additional anxiety measures: [heart rate and Subjective Units of Distress, (SUDS)] and one cognition scale the Validity of Cognition Scale. These two groups had three sessions of either EMDR or imagery. Trait anxiety scores did not differ among groups as expected but the EMDR group's state anxiety decreased compared to the no treatment group p = .002. Heart rate and SUDS decreased as a consequence of group, with EMDR showing a drop in rate p < .001. Swim times were not different for all the groups, but EMDR improved compared to the no treatment p = .043. The EMDR group endorsed greater coping beliefs than the imagery group p < .01. EMDR may provide coaches with an alternative to imagery to help the athlete who has a "mental block" (negative thoughts indicating inability to cope with the swimming event) secondary to a traumatic sport
Accuracy Verified: Yes
18. Schubert, S. (2010, July). The efficacy and psychobiological correlates of dual-attention task. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
The study being presented aimed to investigate the psycho physiological correlates and the effectiveness of different dualattention
tasks used during eye movement desensitisation and reprocessing (EMDR). Sixty-two non-clinical participants
with negative autobiographical memories received a single EMDR session that involved fixed or varied rate eye movements,
or exposure without eye movements. Subjective units of distress and vividness of the memory were recorded at pretreatment,
post-treatment, and 1 week follow-up. EMDR-with eye movements led to greater reduction in distress (SUDs)
than EMDR-without eye movements. Psycho physiological measures were continuously recorded throughout each session.
Heart rate decreased significantly when eye movements began; skin conductance decreased during eye movement sets;
heart rate variability and respiration rate increased significantly as eye movements continued; and orienting responses were
more frequent in the eye movement than no-eye movement condition at the start of exposure. These findings indicate that
eye movements in EMDR are beneficial, and are coupled with distinct psycho physiological changes that may aid in the
processing of negative memories. Implications for clinical practice, directions for future research, and the importance of
building bridges between East & West whilst conducting EMDR research will also be discussed.
Keywords: Dual Attention Psychophysiological Correlates
Accuracy Verified: Yes
19. Abbasnejad, M., Mahani, K. N., & Zamyad, A. (2007, Winter). Efficacy of "eye movement desensitization and reprocessing" in reducing anxiety and unpleasant feelings due to earthquake experience. Psychological Research, 9(3-4), 104-117.
Language: English
Format: Journal
Abstract: Keywords: Anxiety Earthquake Experience Empirical Study Eye Movements Follow-up Study Natural Disasters Quantitative Study Randomized Controlled Study Unpleasant Feelings Accuracy Verified: Yes 20. de jongh, A., & van de Oord, H. J. M. (2002). Efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of specific phobias: Four single-case studies in dental phobia. Presentation at the 80th General Session of the International Association for Dental Research, San Diego, CA. Language: English Format: Conference Abstract: Keywords: Specific Phobias Accuracy Verified: Yes 21. de Jongh, A., van den Oord, H., & ten Broeke, E. (2002, December). Efficacy of eye movement desensitization and reprocessing in the treatment of specific phobias: Four single-case studies on dental phobia. Journal of Clinical Psychology, 58(12), 1489-1503. doi:10.1002/jclp.10100. Language: English Format: Journal Abstract: Keywords: Adults Case Report Dental Procedures Females Follow-up Study Males Phobia Posttraumatic Stress Disorder PTSD Survivors Treatment Effectiveness Young Adults Accuracy Verified: Yes 22. Enright, M. B. (1995, August). The efficacy of eye movement desensitization and reprocessing in the treatment of test anxiety. University of Northern Colorado, Greeley, CO. AAT 9617465. Language: English Format: Dissertation/Thesis Abstract: Keywords: Anxiety Management College Students Empirical Study Test Anxiety Treatment of Test Anxiety Treatment Outcome/Clinical Trial Accuracy Verified: Yes 23. Arabia, E., Manca, M. L., & Solomon, R. M. (2011). EMDR for survivors of life-threatening cardiac events: Results of a pilot study. Journal of EMDR Practice and Research, 5(1), 2-13. doi:10.1891/1933-3196.5.1.2. Language: English Format: Journal Abstract: Keywords: Anxiety Cardiovascular Disease Depression Posttraumatic Stress Disorder PTSD Rehabilitation Accuracy Verified: Yes 24. Mazzola, A., Calcagno, M. L., Goicochea, M. T., Pueyrredòn, H., Leston, J., & Salvat, F. (2009). EMDR in the treatment of chronic pain. Journal of EMDR Practice and Research, 3(2), 66-79. doi:10.1891/1933-3196.3.2.66. Language: English Format: Journal Abstract: Keywords: Chronic Pain Neuroplastic Processes Pain Modulation Accuracy Verified: Yes 25. Hase, M., Schallmayer, S., & Sack, M. (2008). EMDR reprocessing of the addiction memory: Pretreatment, posttreatment, and 1-month follow-up. Journal of EMDR Practice and Research, 2(3), 170-179. doi:10.1891/1933-3196.2.3.170. Language: English Format: Journal Abstract: Keywords: Adaptive Information Processing Addiction Memory Craving Treatment TAU Treatment As Usual Accuracy Verified: Yes 26. Marr, J. (2012). EMDR treatment of obsessive-compulsive disorder:
Preliminary research. Journal of EMDR Practice and Research, 6(1), 2-15. doi:10.1891/1933-3196.6.1.2. Language: English Format: Journal Abstract: Keywords: Adapted EMDR Phobia Protocol Adapted EMDR Phobia Protocol with Video Playback OCD Obsessive-Compulsive Disorder Treatment Outcome Research Accuracy Verified: Yes 27. ter Heide, F. J. J., Mooren, T. M., Kleijn, W., de Jongh, A., & Kleber, R. J.
(2011, August). EMDR versus stabilisation in traumatised asylum seekers and refugees: Results of a pilot study. European Journal of Psychotraumatology, 2, 5881. doi:10.3402/ejpt.v2i0.5881. Language: English Format: Journal Abstract: Keywords: Asylum Seekers Refugees Posttraumatic Stress Disoder PTSD TF-CBT Trauma-Focused Cognitive-Behavioural Therapy Accuracy Verified: Yes 28. Hensel, T. (2009). EMDR with children and adolescents after single-incident trauma: An intervention study. Journal of EMDR Practice and Research, 3(1), 2-9. doi:10.1891/1933-3196.3.1.2. Language: English Format: Journal Abstract: Keywords: Adolescents Children Trauma Treatment Outcome Accuracy Verified: Yes 29. Capps, F., Andrade, H., & Cade, R. (2005). EMDR: An approach to healing betrayal wounds in couples counseling. In G. R. Walz & R. K. Yep (Eds.), VISTAS: Compelling Perspectives on Counseling (pp. 107-110). Alexandria, VA: American Counseling Association. Language: English Format: Book Section Abstract: Keywords: Betrayal Wounds Couples Counselling Couples Therapy Accuracy Verified: Yes 30. Taylor, S. (2003, October-November). Exposure therapy, EMDR and relaxation. In M. Creamer (Chair), PTSD treatment outcome predictors. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL . Language: English Format: Conference Abstract: Keywords: Exposure Therapy PSTD Outcome Predictors Relaxation Symposium Accuracy Verified: Yes 31. Ali, M. W., & Rana, M. H. (2008, June). Eye movement desensitization and reprocessing (EMDR) in patients of PTSD following
earthquake 2005, Pakistan. Presentation at the annual meeting of the EMDR Europe Association, London, England. Language: English Format: Conference Abstract: Keywords: Earthquake Pakistan Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 32. Lindsay, J. K. (1994). Eye movement desensitization and reprocessing (EMDR) in the treatment of rape survivors. University of Oregon. AAT 9519676. Language: English Format: Dissertation/Thesis Abstract: Keywords: Adults Empirical Study Females Postttraumatic Stress Disorder PTSD Rape Survivors Treatment Effectiveness Accuracy Verified: Yes 33. Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N.L., & Muraoka, M. Y. (1998, January). Eye movement desensitization and reprocessing (EMDR) treatment for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 3-24. doi:10.1023/A:1024448814268. Language: English Format: Journal Abstract: Keywords: Adults Americans Arousal Biofeedback Training Males Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Relaxation Therapy Treatment Effectiveness Veterans War Accuracy Verified: Yes 34. Rodenburg, R., Benjamin, A., Meijer, A. M., & Jongeneel, R. (2009, September). Eye movement desensitization and reprocessing in an adolescent with epilepsy and mild intellectual disability. Epilepsy & Behavior, 16(1), 175-180. doi:10.1016/j.yebeh.2009.07.015. Language: English Format: Journal Abstract: Keywords: Case Report Children Epilepsy Intellectual Disability Reliable Change Index Trauma Symptoms Accuracy Verified: Yes 35. Macklin, M. L., Metzger, L. J., Lasko, N. B., Berry, N. J., Orr, S.P., & Pitman, R. K. (2000, January-February). Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related posttraumatic stress disorder. Comprehensive Psychiatry, 41(1), 24-27. doi:10.1016/S0010-440X(00)90127-5. Language: English Format: Journal Abstract: Keywords: Adults Americans Empirical Study Follow-up Study Males Posttraumatic Stress Disorder PTSD Treatment Effectiveness Treatment Outcome/Clinical Trial Veterans Vietnam War Accuracy Verified: Yes 36. Marcus, S. (2006, September). Integrated EMDR headache treatment. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA. Language: English Format: Conference Abstract: Keywords: Headache Accuracy Verified: Yes 37. Wesson, M., & Gould, M. (2009). Intervening early with EMDR on military operations: A case study. Journal of EMDR Practice and Research, 3(2), 91-97. doi:10.1891/1933-3196.3.2.91. Language: English Format: Journal Abstract: Keywords: Early Interventions Military Trauma Accuracy Verified: Yes 38. Taylor, S. (2003, Summer). Outcome predictors for three PTSD treatments: Exposure therapy, EMDR, and relaxation training. Journal of Cognitive Psychotherapy, 17(2), 149-162. doi:10.1891/jcop.17.2.149.57432. Language: English Format: Journal Abstract: Keywords: Adults Brief Psychotherapy Clinical Trial Disability Evaluation Empirical Study Exposure Therapy Follow-up Study Insurance Legal Processes Manual-Based Treatments Quantitative Study Relaxation Therapy Posttraumatic Stress Disorder PTSD Random Clinical Trial Reexperiencing RCT Social Security Stressors Survivors Treatment Dropouts Treatment Effectiveness Treatment Outcome Accuracy Verified: Yes 39. Marcus, S. V. (2008). Phase 1 of integrated EMDR: An abortive treatment for migraine headaches. Journal of EMDR Practice and Research, 2(1), 15-25. doi:10.1891/1933-3196.2.1.15. Language: English Format: Journal Abstract: Keywords: Headache Treatment Medication Migraine Headache Accuracy Verified: Yes 40. Alley, A., Spinazzola, J., Blaustein, M., &
van der Kolk, B. A. (2005, November). Pretreatment attrition in a PTSD comparative
treatment outcome study. Poster presented at the 21st annual meeting of the International Society for Traumatic Stress Studies, Toronto, ON. Language: English Format: Conference Abstract: Keywords: Comparative Treatment Outcome Study Poster Pretreatment Attrition Posttraumatic Stress Disorder PTSD Accuracy Verified: Yes 41. Pagani, M., Di Lorenzo, G., Monaco, L., Niolu, C., Siracusano, A., Verardo, A. R., Lauretti, G., Fernandez, I., Nicolais, G., Cogolo, P., & Ammaniti, M. (2011). Pretreatment, intratreatment, and posttreatment EEG imaging of EMDR: Methodology and preliminary results from a single case. Journal of EMDR Practice and Research, 5(2), 42-56. doi:10.1891/1933-3196.5.2.42. Language: English Format: Journal Abstract: Keywords: Bilateral Ocular Stimulation Cortical Activation EEG Accuracy Verified: Yes 42. Gillies, D., Taylor, F., Gray, C., O’Brien, L., & D’Abrew, N. (2012). Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review). Cochrane Database of Systematic Reviews (Online), 12, CD006726. doi:10.1002/14651858.CD006726.pub2. Language: English Format: Journal Abstract: Keywords: Adolescents Children Posttraumatic Stress Disorder PTSD Review Accuracy Verified: Yes 43. Chang, S. H. (2007, September). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. Presentation at the annual meeting of the EMDR International Association Conference, Dallas, Texas. (NSC
93-2413-H-002-002-). Language: English Format: Conference Abstract: Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Semantic Association Accuracy Verified: Yes 44. Chang, S. H. (2009). Role of EM and stimulus valence presentation order in the return of fear: Possible implications for the therapeutic mechanism. National Taiwan University, Taipei, Taiwan. Language: English Format: Dissertation/Thesis Abstract: Keywords: Adaptive Information Processing Model REM-Sleep Dependent Memory Reprocessing Model Saccadic Eye Movement Sematic Association Accuracy Verified: Yes 45. Cohen, L. (2005, June). Rorschach assessment of treatment with EMDR, a multiple case study. In Research issues. Symposium conducted at the annual meeting of the EMDR Europe Association, Brussels, Belgium. Language: English Format: Conference Abstract: Keywords: Multiple Case Study Research Rorschach Assessment Symposium Accuracy Verified: Yes 46. Leitch, M. L. (2007, September). Somatic experiencing treatment with tsunami survivors in Thailand: Broadening the scope of early intervention. Traumatology, 13(3), 11-20. doi:10.1177/1534765607305439. Language: English Format: Journal Abstract: Keywords: Cross-Cultural Research Brief Treatment Disaster Integrative Treatment Mind–Body Psychotherapy Somatic Experiencing Trauma First Aide Tsunami Accuracy Verified: Yes 47. Marr, J. (2013). Traitement EMDR du trouble obsessionnel compulsif: Etude préliminaire [EMDR treatment of obsessive-compulsive disorder: Preliminary research]. Journal of EMDR Practice and Research, 7(2), 29E-43E. doi:10.1891/1933-3196.7.2.E29. Language: French Format: Journal Abstract: Keywords: Adapted EMDR Phobia Protocol Adapted EMDR Phobia Protocol with Video Playback OCD Obsessive-Compulsive Disorder Treatment Outcome Research Accuracy Verified: No 48. Ricci, R. J. (2006, June). Trauma resolution using eye movement desensitization and reprocessing with an incestuous sex offender: An instrumental case study. Clinical Case Studies, 5(3), 248-265. doi:10.1177/1534650104265276. Language: English Format: Journal Abstract: Keywords: Childhood Trauma Clinical Case Study Emotional Trauma Eye Movements Incest Incestuous Sex Offender Sex Offenders Sex Offenses Trauma Resolution Treatment Accuracy Verified: Yes 49. Midboe, A., Benight, C., Harding, A., Iwaishi, S., & Johnson, L. (2002, November). A trauma-based treatment intervention for
domestic violence victims. Poster presented at the 18th annual meeting of the International Society of Traumatic Stress Studies, Baltimore, MD. Language: English Format: Conference Abstract: Keywords: Domestic Violence Poster Accuracy Verified: Yes 50. Wells, A., & Colbear, J. S. (2012, April). Treating posttraumatic stress disorder with metacognitive therapy: A preliminary controlled trial. Journal of Clinical Psychology, 68(4), 373-381. doi:10.1002/jclp.20871. Language: English Format: Journal Abstract: Keywords: Cognitive Therapy Metacognition Metacognitive Therapy Posttraumatic Stress Disorder PTSD Stress Accuracy Verified: Yes 51. Matthieu, M., & Ivanoff, A. (2006). Treatment of human-caused trauma: Attrition in the adult outcomes research. Journal of Interpersonal Violence, 12(21), 1654-1664. doi:10.1177/0886260506294243. Language: English Format: Journal Abstract: Keywords: Attrition Dropout Posttraumatic Stress Disorder PTSD Treatment Outcome Accuracy Verified: Yes 52. Kim, E., Bae, H., & Park, Y. C. (2008). Validity of the subjective units of disturbance scale in EMDR. Journal of EMDR Practice and Research, 2(1), 57-62. doi:10.1891/1933-3196.2.1.57. Language: English Format: Journal Abstract: Keywords: Adults Koreans Self Report Instruments Stressors Subjective Units of Disturbance SUDS Survivors Validity Accuracy Verified: Yes 53. Levin, P., Lazrove, S., & van der Kolk, B. (1999, January-April). What psychological testing and neuroimaging tell us about the treatment of posttraumatic stress disorder by eye movement desensitization and reprocessing. Journal of Anxiety Disorders, 13(1-2), 159-172. doi:10.1016/S0887-6185(98)00045-0. Language: English Format: Journal Abstract: Keywords: Adults Americans Brain Imaging Empirical Study Posttraumatic Stress Disorder PTSD Treatment Effectiveness Accuracy Verified: Yes
Objectives: Several years ago a new treatment for anxiety related problems was introduced, named Eye Movement Desensitization and Reprocessing (EMDR). EMDR combines short exposure periods with an external distracting stimulus. The aim of this study was to examine the applicability of EMDR to trauma-based dental phobia. Methods: EMDR treatment outcome was tested with four dental phobic individuals by means of a single-subject experimental design. Pretreatment assessment included: severity of dental fear (DAS), trauma-related symptomatology (IES), occurrence and believability of negative cognitions (DCQ), and general psychopathology (SCL-90-R). A psychologist administered a clinical interview and a behavior test. Behavior tests were videotaped and rated for observed anxiety level (0-10) by a blind and independent observer. Results: Following two to three sessions of EMDR treatment three of the four patients demonstrated substantially reduced self-reported and observer-rated anxiety, reduced credibility of dysfunctional beliefs, and behavior changes. These gains were maintained at six weeks follow-up. In all four cases the clinical diagnosis present at pretreatment was not present at posttreatment at a clinical level. All patients actually underwent the dental treatment they feared most within three weeks following EMDR treatment. Conclusion: The findings support the notion that EMDR can be an effective treatment alternative for traumatically induced dental phobia.
A series of single-case experiments was used to evaluate the application of Eye Movement Desensitization and Reprocessing (EMDR) to traumatically induced dental phobia. Following two to three sessions of EMDR treatment, three of the four patients demonstrated substantially reduced self-reported and observer-rated anxiety, reduced credibility of dysfunctional beliefs concerning dental treatment, and significant behavior changes. These gains were maintained at six weeks follow-up. In all four cases, the clinical diagnosis present at pretreatment was not present at posttreatment at a clinical level. All patients actually underwent the dental treatment they feared most within three weeks following EMDR treatment. The findings support the notion that EMDR can be an effective treatment alternative for phobic conditions with a trauma-related etiology. [Author Abstract]
This study explores the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of test anxiety. Thirty-five college students who scored above the 50th percentile on test anxiety were randomly assigned to either a treatment or wait-list control group. Subjects received two 1 hour sessions of EMDR. After posttesting, the control group also received EMDR treatment. The treatment group had a significant reduction in Test Anxiety Inventory total score, emotionality scale score, worry scale score, and state anxiety as compared to the control group. After treatment, the control group matched the experimental group for significant reductions on all dependent measures. The subject group as a whole had significant reductions in subjective units of distress during treatment as well as a significant increase in the validity of positive self-statements. Reductions in anxiety measures were maintained at one month follow-up. The differential effect of EMDR on subjects based on gender and pretreatment level of trait anxiety was also examined. Subjects with high trait anxiety had a greater reduction in total test anxiety, emotionality, and worry on posttesting as compared to subjects with lower trait anxiety. Males and females were found to respond equally to the treatment. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(2-B), Aug 1996, pp. 1436
This pilot study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) in
treating posttraumatic stress disorder (PTSD) symptoms and concomitant depressive and anxiety symptoms
in survivors of life-threatening cardiac events. Forty-two patients undergoing cardiac rehabilitation
who (a) qualified for the PTSD criterion “A” in relation to a cardiac event and (b) presented clinically
significant PTSD symptoms were randomized to a 4-week treatment of EMDR or imaginal exposure
(IE). Data were gathered on PTSD, anxiety, and depressive symptoms at pretreatment, posttreatment,
and 6-month follow-up. EMDR was effective in reducing PTSD, depressive, and anxiety symptoms and
performed significantly better than IE for all variables. These findings provide preliminary support for
EMDR as an effective treatment for the symptoms of PTSD, depression, and anxiety that can follow a
life-threatening cardiac event.
Chronic pain can significantly diminish life quality, causing depression, anxiety, and sleep disturbances, and may lead to neuroplastic processes that influence pain modulation. The current study investigated eye movement desensitization and reprocessing (EMDR) treatment of 38 patients suffering from chronic pain with 12 weekly 90-minute sessions. A battery of self-reported questionnaires assessing quality of life, pain intensity, and depression level were administered pre- and posttreatment for objective outcome evaluation. The Structured Clinical Interview for DSM was administered at pretreatment to identify participants' personality traits that may influence pain perception. Patients showed statistically significant improvement relative to baseline after 12 weeks of EMDR treatment. Our findings suggest that EMDR is an effective tool in the psychological treatment of chronic pain, resulting in decrease pain sensations, pain-related negative affect, and anxiety and depression levels. We examine possible theories about the mechanisms by which EMDR achieves these effects. Results were consistent with the underlying EMDR premise that posits the important effect of emotions on pain perception.
This randomized controlled study investigated the effects of eye movement desensitization and reprocessing (EMDR) in the treatment of alcohol dependency. EMDR was applied to reprocess the addiction memory (AM) in chronically dependent patients. The AM includes memories of preparatory behavior, drug effects (drug use), and loss of control (Wolffgramm, 2002). It is understood to involve extensive brain circuitry, drive part of conscious and unconscious craving, change environmental response at an organic level, and modify circuits that link to feelings of satisfaction, future planning, and hope. Thirty-four patients with chronic alcohol dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus two sessions of EMDR (TAU+EMDR). The craving for alcohol was measured by the Obsessive-Compulsive Drinking Scale (OCDS) pre-, post-, and 1 month after treatment. The TAU+EMDR group showed a significant reduction in craving posttreatment and 1 month after treatment, whereas TAU did not. Results indicate that EMDR might be a useful approach for the treatment of addiction memory and associated symptoms of craving.
This article reports the results of two experiments, each investigating a different eye movement desensitization
and reprocessing (EMDR) protocol for obsessive-compulsive disorder (OCD) and each with two
young adult male participants with long-standing unremitting OCD. Two adaptations of Shapiro’s (2001)
phobia protocol were developed, based on the theoretical view that OCD is a self-perpetuating disorder,
with OCD compulsions and obsessions and current triggers reinforcing and maintaining the disorder.
Both adaptations begin by addressing current obsessions and compulsions, instead of working on past
memories; one strategy delays the cognitive installation phase; the other uses mental video playback in
the desensitization of triggers. The four participants received 14–16 one-hour sessions, with no assigned
homework. They were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), with scores
at pretreatment in the extreme range (mean 5 35.3). Symptom improvement was reported by participants
after 2 or 3 sessions. Scores at posttreatment were in the subclinical/mild range for all participants
(mean 5 8.5). Follow-up assessments were conducted at 4–6 months, indicating maintenance of treatment
effects (mean 5 7.5). Symptom reduction was 70.4% at posttreatment and 76.1% at follow-up
for the Adapted EMDR Phobia Protocol and 81.4% at posttreatment and at follow-up for the Adapted
EMDR Phobia Protocol with Video Playback. Theoretical implications are discussed, and future research
is recommended.
Background: Traumatised asylum seekers and refugees are clinically considered a complex population. Discussion exists on whether with this population treatment guidelines for post-traumatic stress disorder (PTSD) should be followed and Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) or Eye Movement Desensitisation and Reprocessing (EMDR) should be applied, or whether a phased model starting with stabilisation is preferable. Some clinicians fear that trauma-focused interventions may lead to unmanageable distress or may be ineffective. While cognitive-behavioural interventions have been found to be effective with traumatised refugees, no studies concerning the efficacy of EMDR with this population have been conducted as yet. Objective: In preparation for a randomised trial comparing EMDR and stabilisation with traumatised refugees, a pilot study with 20 participants was conducted. The objective was to examine feasibility of participation in a randomised trial for this complex population and to examine acceptability and preliminary efficacy of EMDR. Design: Participants were randomly allocated to 11 sessions of either EMDR or stabilisation. Symptoms of PTSD (SCID-I, HTQ), depression and anxiety (HSCL-25), and quality of life (WHOQOL-BREF) were assessed at pre- and post-treatment and 3-month follow-up. Results: Participation of traumatised refugees in the study was found feasible, although issues associated with complex traumatisation led to a high pre-treatment attrition and challenges in assessments. Acceptability of EMDR was found equal to that of stabilisation with a high drop-out for both conditions. No participants dropped out of the EMDR condition because of unmanageable distress. While improvement for EMDR participants was small, EMDR was found to be no less efficacious than stabilisation. Different symptom courses between the two conditions, with EMDR showing some improvement and stabilisation showing some deterioration between pre-treatment and post-treatment, justify the conduct of a full trial. Conclusion: With some adaptations in study design, inclusion of a greater sample is justifiable to determine which treatment is more suitable for this complex population.
This study used a naturalistic design to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) with children and adolescents who were exposed to single-incident trauma. Participants were 36 children and adolescents ranging in age from 1 year 9 months to 18 years 1 month who were referred consecutively to the author's private practice. Assessments were conducted at intake, post-waitlist/pretreatment, and at follow up. EMDR treatment resulted in significant improvement (Cohen's d = 1.87). Follow-ups after 6 months revealed stable, further slight improvement. It was shown that children younger than 4 years of age can be treated using EMDR and that the group of preschool children had the same benefit from the treatment as the school-age children.
Since its introduction by Francine Shapiro in
1989, eye movement desensitization and reprocessing
(EMDR) has gained wide acceptance as an efficacious
clinical treatment. It is particularly useful in the
treatment of posttraumatic stress disorder (PTSD) (Alto,
2001). Despite its relative novelty, EMDR has been used
to treat survivors, emergency workers, and disaster
relief counselors worldwide. EMDR therapists have
successfully employed EMDR in Oklahoma City,
Belfast, Zagreb, Rwanda, Dunblane, Sarajevo,
Columbine, and Londonderry. EMDR has also been
used in the treatment of PTSD for combat veterans from
World War II, the Korean War, Beirut, and the Vietnam
War (Silver & Rogers, 2002, p. xix). EMDR effects
exceed those of nonspecific effects shared by all
treatments and are independent of client expectations.
Moreover, EMDR effects are at least equal to effects
of cognitive behavioral therapy, and EMDR requires
less time than other models with less client attrition
(Silver & Rogers, p. 254). Importantly, the American
Psychological Association has listed EMDR as an
efficacious treatment for civilian PTSD (Alto, 2001).
Several psychosocial treatments appear to be effective in treating
posttraumatic stress disorder (PTSD). However, little is known about
the predictors of treatment outcome. It is possible that some variables
predict poor outcome for some treatments but not for others.
To investigate this issue, outcome predictors were examined for
three 8-session treatments: Exposure therapy (entailing prolonged
imaginal and in vivo exposure), relaxation training, and eye movement
desensitization and reprocessing (EMDR). Sixty people with
PTSD entered and 45 completed treatment. To our knowledge, ours
was the first EMDR study to meet all the Foa and Meadows Gold
Standards for methodologically sound outcome research.
Treatments did not differ in attrition or perceived credibility.
Predictors of treatment outcome in PTSD:
While psychological treatments for PTSD have developed considerably
in recent years, large variation in individual treatment response
is apparent. This symposium integrates research from the USA,
Canada, and Australia to examine the impact of personal characteristics,
childhood abuse history, and treatment setting as predictors
of response to cognitive behavioral interventions.
PTSD treatment outcome predictors: Exposure therapy, EMDR and relaxation: Exposure tended to be most effective, and EMDR and relaxation
did not differ in efficacy. Low patient ratings of treatment credibility
(assessed in session 2) predicted treatment dropout, regardless of
treatment type. Of the potential outcome predictors examined,
severe reexperiencing symptoms (assessed prior to treatment) predicted
poor outcome for relaxation training but not for the other
therapies. The best predictor of treatment outcome was whether or
not patients received exposure therapy.
Objective: The purpose of the study is to asses the usefulness of EMDR in patients of PTSD who survived the
October 2005 earthquake in Pakistan. Background: On October the 8th an earthquake of 7.6 on rector scale
struck Kashmir and Northwest of Pakistan leaving millions injured and more than 80,000 dead. A survey of the
affected areas has shown a high prevalence of PTSD amongst the survivors. A selected series of patients with the
diagnosis of PTSD from amongst the survivors is enrolled for EMDR at CTRPI. The study is based on their response
to this intervention. Design and Settings: The study involves an ongoing compilation of clinical data and the study
of therapeutic responses to various interventions including EMDR, at a tertiary mental health facility and Centre
for Trauma Research and Psychosocial Interventions (CTRPI), Rawalpindi /Islamabad, Pakistan. This mental health
facility is the tertiary care referral point for patients from metal health relief units located allover in earthquake
affected areas of Azad Kashmir and Northwest of Pakistan. Method: Earthquake survivors who develop
psychosocial sequelae referred to CTRPI from Kashmir, who go on to fulfill the criteria of Post-traumatic Stress
Disorder according to ICD-10 are registered for further studies and appropriate interventions. A select group who
give informed consent for EMDR are then included for detailed evaluation and follow up. Sessions are conducted
in eight phases from manuals by therapists who are trained till level 2 in the method. Pre- treatment assessment
is done by an independent assessor for scores on Impact of Event Scale and Global Assessment of Functioning
(GAF). The post treatment assessment is conducted 1 week after the treatment with the same procedures as at
pretreatment. In session Scoring of subjective unit of distress is also recorded serially. According to the degree of
improvement and severity of illness, sessions of EMDR are carried out with the duration of about 60 to 90
minutes each session and with a minimum of 6 sessions using the bilateral stimulation. The authors plan to
compile their work with ten patients who fulfill the prerequisites of the study in process. Results: The work has
been done so far on three clients which suggest that EMDR is effective in reducing the scores of IES back to
normal and there is marked difference in the GAF level after the said intervention. It has a dramatic effect on
29
within-session SUD levels .Furthermore, at a qualitative level it is observed that involvement of other family
members in the therapeutic process may improve treatment adherence. Conclusions: Ongoing results of this
study tend to suggest that the EMDR is an effective intervention for patients of PTSD following a natural disaster
like an earth quake. However, the results drawn cannot be generalized on account of their small count.
In the context of managed care, effective short-term treatment has become a priority for psychologists. This is particularly true for the recalcitrant symptoms of PTSD which are often associated with protracted treatment and disappointing outcome.This study investigated the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) as a short-term treatment for PTSD. The independent variable, EMDR, was introduced sequentially in a multiple baseline design across subjects. 5 survivors of rape who met DSM-III-R criteria for PTSD received 4 to 6 weekly sessions of EMDR provided by five licensed psychotherapists with Level 2 EMDR training. Treatment outcomes included (a) large reductions in symptomatology evident in self-monitored data and objective measures, (b) replication of treatment effect in 5 out of 5 subjects, (c) qualitative and behavior change data which corroborate treatment effect, and (d) analyses which demonstrate the clinical significance of the changes, as well as the statistical significance of the differences between pretreatment and follow-up scores (with a confidence level of .05 or beyond). The study suggests that EMDR is very effective for treating long-term, recalcitrant symptoms of PTSD which have not resolved with time or previous therapy. The study provides a methodological model for calibrating treatment and developing accountability for treatment efficacy which can be applied across treatments and settings. [Author Abstract]
Despite the clinical and social impact of PTSD, there are few controlled studies investigating its treatment. In this investigation, the effectiveness of two psychotherapeutic interventions for PTSD were compared using a randomized controlled outcome group design. 35 combat veterans diagnosed with combat-related PTSD were treated with either (a) 12 sessions of eye movement desensitization and reprocessing, EMDR (n = 10), (b) 12 sessions of biofeedback-assisted relaxation (n = 13), or (c) routine clinical care, serving as a control (n = 12). Compared with the other conditions, significant treatment effects in the EMDR condition were obtained at posttreatment on a number of self-report, psychometric, and standardized interview measures. Relative to the other treatment group, these effects were generally maintained at 3-month follow-up. Psychophysiological measures reflected an apparent habituation effect from pretreatment to posttreatment but were not differentially affected by treatment condition. [Author Summary]
Intellectual disability is a comorbid condition in epilepsy. People with epilepsy and intellectual disability are at high risk of developing behavioral problems. Among the many contributors to behavioral problems in people with epilepsy and intellectual disability are those of traumatic experiences. As such, behavioral problems can be seen as a reflection of these traumatic experiences. Among established trauma therapies, eye movement desensitization and reprocessing (EMDR) is an emerging treatment that is effective in adults and also seems to be effective in children. This article is a case report of EMDR in an adolescent with epilepsy and mild intellectual disability, in whom the EMDR children’s protocol was used. The aim was to assess whether clinical trauma status significantly diminished to nonclinical status posttreatment. Change in trauma symptoms was evaluated with the Reliable Change Index (RCI). Results showed a significant decrease in trauma symptoms toward nonclinical status from pretreatment to posttreatment. EMDR consequences for epilepsy and intellectual disability are discussed.[Elsevier 2009]
This study reports the results of a 5-year follow-up evaluation of 13 Vietnam combat veterans with chronic PTSD who participated in a study of eye movement desensitization and reprocessing (EMDR) therapy previously reported in this journal. Pretreatment and follow-up psychometric outcome measures were compared with those of a demographically matched control group of 14 combat veterans with chronic PTSD who did not receive EMDR. Analysis of variance showed that the modest to moderate therapeutic benefits that were manifest immediately following EMDR were lost at the 5-year follow-up evaluation, and there was an overall worsening of PTSD symptomatology over the 5-year period in both EMDR-treated and nontreated control subjects. [Author Abstract]
Forty-three individuals diagnosed with classic or
common migraine were randomly assigned to
either Integrated EMDR treatment or a medication
treatment. lntegrated EMDR combines
diaphragmatic breathing, cranial compression and
EMDR for abortive migraine treatment. Various
abortive medications were used in the comparison
group including Demerol, DHE, oral triptans,
Excedrin, Florinal, Percoset, Toradol and Vicodin.
Participants were treated during mid to late stage
acute migraine and assessed by an Independent
evaluator at pretreatment, post treatment, 24
hours, 48 hours and 7 days for migraine pain level. Both medication and Integrated EMDR treatment
groups demonstrated reduced migraine pain levels
at post treatment, 24 hours, 48 hours and 7 days.
Howevei lntegrated EMDR treatment showed
significantly greater improvement compared to
medication at post treatment. Also, lntegrated
EMDR reduced or eliminated migraine pain level
with greater rapdity than medications. This study
introduces lntegrated EMDR as a new abortive
behavioral treatment for acute migraine episodes.
The U.K. armed forces are currently involved in a number of military operations throughout the world. Offering structured psychological interventions such as eye movement desensitization and reprocessing (EMDR) in theater has a number of potential advantages. This single-case study describes how the EMDR recent event protocol (Shapiro, 1995) was used in theater with a 27-year-old active-duty U.K. soldier who was experiencing an acute stress reaction after treating a land mine casualty. The intervention took place 2 weeks posttrauma with four sessions conducted on consecutive days, resulting in a positive outcome, with the soldier able to return immediately to frontline duties. Treatment response was assessed with administration of four standardized measures at pretreatment, posttreatment, and 18-month follow-up. Treatment effects remained at 18-month follow-up. The challenges of conducting EMDR in operational theaters and clinical implications are explored.
Several psychosocial treatments appear to be effective in treating PTSD. However, little is known about the predictors of treatment outcome. It is possible that some variables predict poor outcome for some treatments but not for other treatments. To investigate this issue, outcome predictors were investigated for three 8-session treatments: exposure therapy (entailing prolonged imaginal and in vivo exposure), relaxation training, and eye movement desensitization and reprocessing (EMDR). 60 people with PTSD entered and 45 completed treatment. Treatments did not differ in attrition or perceived credibility. Exposure tended to be most effective, and EMDR and relaxation did not differ in efficacy. A number of clinical and cognitive variables were examined to identify predictors of treatment dropouts as well as predictors of the likelihood that patients would be remitted from PTSD after treatment. These analyses were conducted by controlling for treatment condition. Low patient ratings of treatment credibility (assessed in session 2) predicted treatment dropout, regardless of treatment type. Severe reexperiencing symptoms (assessed prior to treatment) predicted poor outcome for relaxation training but not for the other therapies. These findings suggest that treatment outcome could be improved by improving treatment credibility. The findings also support the use of exposure therapy and, to a lesser extent, the use of EMDR in treating PTSD. [Author Abstract]
Forty-three individuals diagnosed with classic or common migraine headache were randomly assigned
to either phase 1 of integrated eye movement desensitization reprocessing (EMDR) treatment or a
standard care medication treatment. Integrated EMDR combines diaphragmatic breathing, cranial
compression, and EMDR for abortive migraine treatment. The comparison standard care medication
group received various abortive medications, including Demerol, DHE, oral triptans, Excedrin, Fiorinal, Percocet, Toradol, and Vicodin. Participants were treated during mid- to late-stage acute migraine and assessed by an independent evaluator at pretreatment, posttreatment, 24 hours, 48 hours, and 7 days for migraine pain level. Both standard care medication and integrated EMDR treatment groups
demonstrated reduced migraine pain levels immediately at posttreatment, 24 hours, 48 hours, and 7 days. However, integrated EMDR treatment reduced or eliminated migraine pain with greater rapidity and showed signifi cantly greater improvement compared to standard care medication immediately posttreatment. [Author Abstract]
Treatment attrition represents a considerable problem for effective delivery
of care for PTSD. While treatment attrition during the course of treatment is
well researched, little is known about the factors that affect sample selection
before the beginning of a study. Previous research on other Axis I disorders
indicates that patients may refuse participation more often because of study
medication than because of psychosocial treatment. The present study
examines traits and predictors of pretreatment attrition from a study of PTSD
that compared treatment outcomes for fluoxetine versus EMDR. Potential
study participants were screened over the telephone for study eligibility.
During the telephone screen, a total of 394 people met study eligibility
requirements but declined participation (59% of total eligible participants).
While a variety of factors were cited for declining study participation, consistent
with previous research, refusal of study medication emerged as the pre-dominant reason for pretreatment attrition (49%). Results are discussed in
terms of how treatment preferences and other pretreatment attrition factors
may impact the external validity of comparative treatment outcome studies.
Clinical implications discussed include the potential for pretreatment attrition
factors to interfere with trauma survivors’ ability to seek and obtain effective
treatment
Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.
Background:
Post-traumatic stress disorder (PTSD) is highly prevalent in children and adolescents who have experienced trauma and has high
personal and health costs. Although a wide range of psychological therapies have been used in the treatment of PTSD there are no
systematic reviews of these therapies in children and adolescents.
Objectives:
To examine the effectiveness of psychological therapies in treating children and adolescents who have been diagnosed with PTSD.
Search methods:
We searched the Cochrane Depression, Anxiety and Neurosis Review Group’s Specialised Register (CCDANCTR) to December 2011.
The CCDANCTR includes relevant randomised controlled trials fromthe following bibliographic databases: CENTRAL (the Cochrane
Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also checked
reference lists of relevant studies and reviews. We applied no date or language restrictions.
Selection criteria:
All randomised controlled trials of psychological therapies compared to a control, pharmacological therapy or other treatments in
children or adolescents exposed to a traumatic event or diagnosed with PTSD.
Data collection and analysis:
Two members of the review group independently extracted data. If differences were identified, they were resolved by consensus, or
referral to the review team.
We calculated the odds ratio (OR) for binary outcomes, the standardised mean difference (SMD) for continuous outcomes, and 95%
confidence intervals (CI) for both, using a fixed-effect model. If heterogeneity was found we used a random-effects model. Main results
Fourteen studies including 758 participants were included in this review. The types of trauma participants had been exposed to included
sexual abuse, civil violence, natural disaster, domestic violence and motor vehicle accidents. Most participants were clients of a traumarelated
support service.
The psychological therapies used in these studies were cognitive behavioural therapy (CBT), exposure-based, psychodynamic, narrative,
supportive counselling, and eye movement desensitisation and reprocessing (EMDR). Most compared a psychological therapy to a
control group. No study compared psychological therapies to pharmacological therapies alone or as an adjunct to a psychological
therapy.
Across all psychological therapies, improvement was significantly better (three studies, n = 80, OR 4.21, 95% CI 1.12 to 15.85) and
symptoms of PTSD (seven studies, n = 271, SMD -0.90, 95% CI -1.24 to -0.42), anxiety (three studies, n = 91, SMD -0.57, 95% CI
-1.00 to -0.13) and depression (five studies, n = 156, SMD -0.74, 95% CI -1.11 to -0.36) were significantly lower within a month of
completing psychological therapy compared to a control group.
The psychological therapy for which there was the best evidence of effectiveness was CBT. Improvement was significantly better for
up to a year following treatment (up to one month: two studies, n = 49, OR 8.64, 95% CI 2.01 to 37.14; up to one year: one study,
n = 25, OR 8.00, 95% CI 1.21 to 52.69). PTSD symptom scores were also significantly lower for up to one year (up to one month:
three studies, n = 98, SMD -1.34, 95% CI -1.79 to -0.89; up to one year: one study, n = 36, SMD -0.73, 95% CI -1.44 to -0.01),
and depression scores were lower for up to a month (three studies, n = 98, SMD -0.80, 95% CI -1.47 to -0.13) in the CBT group
compared to a control. No adverse effects were identified.
No study was rated as a high risk for selection or detection bias but a minority were rated as a high risk for attrition, reporting and
other bias. Most included studies were rated as an unclear risk for selection, detection and attrition bias.
Authors’ conclusions:
There is evidence for the effectiveness of psychological therapies, particularly CBT, for treating PTSD in children and adolescents for
up to a month following treatment. At this stage, there is no clear evidence for the effectiveness of one psychological therapy compared
to others. There is also not enough evidence to conclude that children and adolescents with particular types of trauma are more or less
likely to respond to psychological therapies than others.
The findings of this review are limited by the potential for methodological biases, and the small number and generally small size
of identified studies. In addition, there was evidence of substantial heterogeneity in some analyses which could not be explained by
subgroup or sensitivity analyses.
More evidence is required for the effectiveness of all psychological therapiesmore than one month after treatment.Much more evidence
is needed to demonstrate the relative effectiveness of different psychological therapies or the effectiveness of psychological therapies
compared to other treatments. More details are required in future trials in regards to the types of trauma that preceded the diagnosis
of PTSD and whether the traumas are single event or ongoing. Future studies should also aim to identify the most valid and reliable
measures of PTSD symptoms and ensure that all scores, total and sub-scores, are consistently reported.
Research background & aims: This study examined possible therapeutic mechanisms of eye
movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989,
1995, 2001) in terms of exposure and information processing model. While exposure model
contended process of extinction and response habituation, Stickgold (2002) proposed that
sleep induced change in associative memory via activation of weak association during REM
state and EM functioned as REM sleep to integrate the episodic memory of trauma into
general semantic memory. In this study, the effect of EM compared to that of Exposure-Only
(non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along
with outcome measures were examined. Specifically, the degree of return of fear and response
habituation was explored.
Methods: Thirty-six college students with cockroach phobias were recruited as participants
and invited after informed consent for 4 1-week interval treatment sessions and a 1 month
follow-up session. The instruments for outcome measures included Cockroach Phobia
Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the
Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and
cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic
relationship rating, and physiological measures such as HR, HRV, EOG, served as process
measures. Due to space limitations, the results of cognitive task and physiological measures
were reported elsewhere. The participants were randomly assigned to one of the four groups:
EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme
presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2
(order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the
4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with
time serving as within Ss factor and the other two variables serving as between Ss factors.
There were 20 trials in each therapeutic session. The duration of each trial was 30s for both
the EM and Exposure-Only conditions.
Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) ×
2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of
time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of
valence presentation) × 9 (time) ANOVAs were performed for EM condition and
Exposure-Only condition, respectively. The results showed that for EM condition, only time
effect was significant (p < .006); while for Exposure-Only condition, there were a significant
time effect (p < .001) and an approaching significant valence presentation order effect (p
< .065), with the SUDs being higher in negative cognition presented first condition compared
to positive cognition presented first condition; whereas the effect was not significant for the
EM condition. Using trend analyses and inspection of time effect showed that significant
within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise
comparisons for the 9 time points indicated salient phenomena of return of fear among several
of the 5 sessions for this condition when comparing the pre-assessment of each session with
post-assessment of its previous session. Whereas for EM condition the return of fear between
sessions was small and the trend analysis showed a reduction with linear trend.
Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of
sufferings while participants encountering negative theme which in turn might facilitate
further processing of negative memory. In addition, EM might add something beyond the
mechanism of pure exposure. The less return of fear indicating that information processing in
addition to response inhibition might take place between sessions. The results echoed
Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent
memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative
memory systems by activating different strength of associations of negative semantic nodes
for different semantically related words. Given that previous research showed that EM
decreased emotionality and also generate greater amount of associations for negative stimuli,
the implications of the present results from theoretical and therapeutic point of views and
future research possibilities are discussed.
Research background & aims: This study examined possible therapeutic mechanisms of eye
movements in Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989,
1995, 2001) in terms of exposure and information processing model. While exposure model
contended process of extinction and response habituation, Stickgold (2002) proposed that
sleep induced change in associative memory via activation of weak association during REM
state and EM functioned as REM sleep to integrate the episodic memory of trauma into
general semantic memory. In this study, the effect of EM compared to that of Exposure-Only
(non-EM) on process measures of SUDs, ratings of cockroach phobia across sessions, along
with outcome measures were examined. Specifically, the degree of return of fear and response
habituation was explored.
Methods: Thirty-six college students with cockroach phobias were recruited as participants
and invited after informed consent for 4 1-week interval treatment sessions and a 1 month
follow-up session. The instruments for outcome measures included Cockroach Phobia
Questionnaire, fear ratings of cockroach slides, FSS, STAI-S, BDI, short form of SCL-90, the
Revised Thought-Action Fusion Questionnaire, White Bear Suppression Inventory, and
cognitive tasks for measuring strength of associations. The SUDs, credibility and therapeutic
relationship rating, and physiological measures such as HR, HRV, EOG, served as process
measures. Due to space limitations, the results of cognitive task and physiological measures
were reported elsewhere. The participants were randomly assigned to one of the four groups:
EM condition (EM vs. Non-EM exposure only) × block order of cockroach theme
presentation (negative cognition first vs. positive cognition first). A 2 (EM condition) × 2
(order of valence presentation) × 9 (time: pre-assessment and post-assessment for each of the
4 sessions plus 1 month follow-up assessment) mixed factorial design was performed, with
time serving as within Ss factor and the other two variables serving as between Ss factors.
There were 20 trials in each therapeutic session. The duration of each trial was 30s for both
the EM and Exposure-Only conditions.
Results: After preliminary analyses for group differences on pretreatment variables, credibility-relationship ratings, and outcome variables were explored, the 2 (EM condition) ×
2 (order of valence presentation) × 9 (time) ANOVA on SUDs showed that the main effects of
time and EM were both significant (p < .001 and p < .034). Subsequently, two 2 (order of
valence presentation) × 9 (time) ANOVAs were performed for EM condition and
Exposure-Only condition, respectively. The results showed that for EM condition, only time
effect was significant (p < .006); while for Exposure-Only condition, there were a significant
time effect (p < .001) and an approaching significant valence presentation order effect (p
< .065), with the SUDs being higher in negative cognition presented first condition compared
to positive cognition presented first condition; whereas the effect was not significant for the
EM condition. Using trend analyses and inspection of time effect showed that significant
within session SUDs reduction for Exposure-Only conditions. Notwithstanding, the pairwise
comparisons for the 9 time points indicated salient phenomena of return of fear among several
of the 5 sessions for this condition when comparing the pre-assessment of each session with
post-assessment of its previous session. Whereas for EM condition the return of fear between
sessions was small and the trend analysis showed a reduction with linear trend.
Conclusions & Discussion: Compared to Exposure-Only, EM resulted in less degree of
sufferings while participants encountering negative theme which in turn might facilitate
further processing of negative memory. In addition, EM might add something beyond the
mechanism of pure exposure. The less return of fear indicating that information processing in
addition to response inhibition might take place between sessions. The results echoed
Shapiro’s Adaptive Information Processing model and Stickgold’s REM-sleep dependent
memory reprocessing model, suggesting that EM in EMDR might reflect a shift in associative
memory systems by activating different strength of associations of negative semantic nodes
for different semantically related words. Given that previous research showed that EM
decreased emotionality and also generate greater amount of associations for negative stimuli,
the implications of the present results from theoretical and therapeutic point of views and
future research possibilities are discussed.
Rorschach protocols from patients whose treatment includes the use of
EMDR are analyzed. Rorschach protocols are obtained prior to a first EMDR
session and following treatment. The structural summary for the pretreatment
protocols are used to formulate ideas (hypotheses) concerning
the desired and/or expected effects of treatment. Post-treatment protocols
are compared with pre-treatment protocols. Effects reported by patients in
treatment is related to changes in Rorschach protocols. The study is
relevant for the analysis of perceptual changes occurring in treatment
involving EMDR.
This exploratory study examines the treatment effects
of brief (1 to 2 sessions) Somatic Experiencing with 53
adult and child survivors of the 2004 tsunami in
Thailand. Somatic Experiencing’s early-intervention
model, now called Trauma First Aide, was provided
1 month after the tsunami. Survivor assessments were
done pretreatment, immediately posttreatment, 3 to
5 days posttreatment, and at the 1-year follow-up.
Results indicate that immediately following treatment,
67% of participants had partial to complete improvement
in reported symptoms and 95% had complete or
partial improvement in observed symptoms. At the 1-year
follow-up, 90% of participants had complete or partial
improvement in reported symptoms, and 96% had
complete or partial improvement in initially observed
symptoms. Given the small sample size and lack of an
equivalent comparison group, results must be interpreted
with caution. Nonetheless, the results suggest
that integrative mind–body interventions have promise
in disaster treatment.
Cet article rapporte les résultats de deux expériences qui examinent chacune un protocole EMDR (désensibilisation
et retraitement par les mouvements oculaires) différent pour le trouble obsessionnel-compulsif
(TOC), chacune avec deux jeunes participants masculins adultes présentant un TOC sans rémission
de longue date. Deux adaptations du protocole pour la phobie de Shapiro (2001) ont été développées
à partir de la perspective théorique selon laquelle le TOC est un trouble qui s’autoperpétue, avec des
compulsions et des obsessions TOC ainsi que des déclencheurs présents qui renforcent et maintiennent
le trouble. Les deux adaptations commencent par viser les obsessions et compulsions actuelles, plutôt
que de travailler sur des souvenirs passés ; l’une des stratégies retarde la phase d’installation cognitive
tandis que l’autre utilise la lecture mentale d’une vidéo dans la désensibilisation des déclencheurs.
Les quatre participants ont bénéficié de 14–16 séances d’une heure, sans tâche à effectuer entre les
rendez-vous. Ils ont été évalués à l’aide de l’Echelle obsessionnelle compulsive de Yale-Brown (Yale-
Brown Obsessive Compulsive Scale [Y-BOCS]), avec des scores lors du prétraitement dans la gamme
extrême (moyenne 5 35,3). Une amélioration des symptômes était rapportée par les participants après
2 ou 3 séances. Les scores lors du post-traitement étaient dans la gamme infraclinique/légère pour tous
les participants (moyenne 5 8,5). Des évaluations de suivi ont été réalisées après 4–6 mois, indiquant
le maintien des effets thérapeutiques (moyenne 5 7,5). La diminution des symptômes était de 70,4%
lors du post-traitement et de 76,1% lors du suivi pour le protocole EMDR adapté pour les phobies et de
81,4% lors du post-traitement et du suivi pour le protocole EMDR adapté pour les phobies avec lecture
vidéo. Les implications théoriques sont examinées et des recherches futures sont recommandées.
This article reports the results of two experiments, each investigating a different eye movement desensitization and reprocessing (EMDR) protocol for obsessive-compulsive disorder (OCD) and each with two young adult male participants with long-standing unremitting OCD. Two adaptations of Shapiro’s (2001) phobia protocol were developed, based on the theoretical view that OCD is a self-perpetuating disorder, with OCD compulsions and obsessions and current triggers reinforcing and maintaining the disorder. Both adaptations begin by addressing current obsessions and compulsions, instead of working on past memories; one strategy delays the cognitive installation phase; the other uses mental video playback in the desensitization of triggers. The four participants received 14–16 one-hour sessions, with no assigned homework. They were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), with scores at pretreatment in the extreme range (mean 5 35.3). Symptom improvement was reported by participants after 2 or 3 sessions. Scores at posttreatment were in the subclinical/mild range for all participants (mean 5 8.5). Follow-up assessments were conducted at 4–6 months, indicating maintenance of treatment effects (mean 5 7.5). Symptom reduction was 70.4% at posttreatment and 76.1% at follow-up for the Adapted EMDR Phobia Protocol and 81.4% at posttreatment and at follow-up for the Adapted EMDR Phobia Protocol with Video Playback. Theoretical implications are discussed, and future research is recommended.
This case describes the use of eye movement desensitization and reprocessing (EMDR) to reduce reactivity to childhood trauma in an incestuous sex offender. It explores the relationship between desensitization and reprocessing of traumatic memory and how this may promote sex offender treatment progress as an enhancement of, not a replacement for, the cognitive-behavioral or relapse prevention treatment of sexual offenders. Pretreatment and posttreatment self-report and other-report instruments and semistructured interviews are employed to explore the results of this intervention. Implications and suggestions for this treatment protocol are suggested.
Twenty-four participants from a local domestic violence center were selfselected
into an individual therapy-plus-standard advocacy group (P/SA) or a
standard advocacy (SA) group. The center’s advocacy staffed administered
treatment for the SA group and the P/SA group. In addition to the SA treatment
received by individuals in the P/SA group, there were also six licensed
therapists who provided a manualized treatment incorporating CBT and
EMDR. Symptoms of PTSD, depression, CSE, self-esteem, and coping skills
were assessed.Additionally, saliva sample measurements were taken to examine
the effect of treatment on the regulation of salivary cortisol. Results indicate
that participants in the P/SA treatment condition experienced a
significantly greater reduction in intrusive symptomatology and overall level
of PTSD symptom severity, as well as a greater increase in CSE over time
than those individuals in the SA condition. Moreover, changes in CSE were
related to changes in psychological symptoms in individuals in the P/SA group
from pretreatment to posttreatment and at follow-up.Almost no linear relationship
between changes in CSE and other psychological variables in the SA
group emerged.A minimal impact of treatment on coping skills was observed.
There was a move towards a greater regulation of salivary cortisol at posttreatment
in the P/SA group.
Objectives: Exposure, trauma-focused cognitive therapy and eye-movement desensitisation and re-processing (EMDR) are effective treatments for posttraumatic stress disorder (PTSD) producing equivalent outcomes. How might the field advance? One way is to base new treatments on PTSD maintenance mechanisms. A treatment that does this, metacognitive therapy (MCT), underwent preliminary controlled evaluation in this study. Method: Twenty participants aged 18 to 65 years with chronic PTSD were randomly allocated to either a total of 8 sessions of MCT or a delayed treatment control. Measures of PTSD, emotional symptoms, and underlying metacognitive variables were obtained at pretreatment and posttreatment. Patients were followed-up at 3 and 6 months postintervention. Results Statistically significant reductions in PTSD symptoms, depression, and anxiety at posttreatment were observed in the MCT group but not in the control group. Changes were maintained over follow-up. The average number of sessions delivered was 6.4. Eighty percent of patients (intention to treat) met clinical significance criteria for recovery based on the IES. Treatment was well tolerated with only one (10%) dropout. Changes in thought control strategy hypothesized to be involved in the maintenance of PTSD were found. Conclusions: MCT appeared to be a brief treatment producing high recovery rates. The data add to existing uncontrolled evaluations and provide strong justification for future evaluation of this treatment against existing evidence-based interventions. [Abstract from author].
Attrition or dropout is the failure of a participant to complete, comply, or the prematurely discontinuation or discharge from treatment, resulting in lost data and affecting outcomes. This review of 10 years of adult posttraumatic stress disorder (PTSD) treatment outcome literature specific to Criterion A events of human origin examines how attrition is defined and addressed, methodologically and statistically. Of the 13 experimental or quasi-experimental studies, 11 report attrition information. Compared to treatment completers, attriters more often had elevated pretest scores on PTSD and other symptom measures. The characteristics of dropouts given the intentional nature of the traumatic events reviewed in this study are shared to inform clinical practice. Recommendations for consistent methods in examining, analyzing, and interpreting treatment outcome data are also discussed.
To test the psychometric properties of the Subjective Units of Disturbance Scale (SUDS), this study analyzed the data from 61 patients treated with EMDR. The pretreatment self-reported questionnaires, the in-session records of EMDR, and the Clinical Global Impression-Change (CGI-C) scale at the termination of EMDR were reviewed. The initial score of the SUDS at the first session was significantly correlated with the patient's level of depression, the state anxiety, and distress from the impact of events. The final score of the SUDS at the first session was significantly correlated with the CGI-C score at termination. Consequently, this study confirmed that the SUDS in EMDR sessions has good psychometric properties. [Author Abstract]
To better understand the pathophysiology and treatment of Posttraumatic Stress Disorder (PTSD), standard psychological testing, Rorschach Ink Blot testing, and neuroimaging using Single Photon Emission Computed Tomography (SPECT) were administered to subjects with PTSD prior to and following three sessions of Eye Movement Desensitization and Reprocessing (EMDR). Using this within-subject design, data from one of six subjects in our series is presented as a case report. Following EMDR, the subject experienced improvement in his level of distress, which correlated with decrements in PTSD and depressive symptomatology on psychological testing. Analysis of the Rorschach data corroborated these changes. Among other findings, the Hypervigilance Index went from positive to negative, indicating that the subject was spending less time scanning the environment for threats, and available ego resources also increased, as measured by the Experience Actual variable. Upon recall of the traumatic memory during SPECT scanning, two areas of the brain were hyperactive post-EMDR treatment relative to pretreatment: the anterior cingulate gyrus and the left frontal lobe. These changes were consistent with summed data from four out of six subjects in the ongoing study. An important implication of these findings is that successful treatment of PTSD does not reduce arousal at the limbic level, but instead, enhances the ability to differentiate real from imagined threat. The psychology and neurophysiology of PTSD are discussed in greater detail. (ScienceDirect)