Choose any combination of the search options below. If you do not wish to include an option in your search, leave the box blank, or select "Any."
Your Results - you searched for the keyword Psychometric Scales 86 Results
1. Tsuchimochi, S. (2010, July). The possibility of EMDR use with juvenile delinquents. Poster presented at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
Objective: The purpose of this study was to examine the effects of EMDR use with juvenile delinquents, such as improvements
of physical and mental mal-adjustment, emotion control, self-recognition and attitudes toward others. It also examined under which conditions in the judicial proceedings, it is possible to apply the EMDR therapy to juveniles. Methods: Three
delinquents whose cases were in the Family Court process, were selected as participants in view of effectiveness, safety
and validity. The measurement scales are as follows: (a)IES-R, (b)the Life Gram ( a wavy line drawn by the participant to
describe one’s own life from the birth to present in the range of +10 and -10.), (c)SUDs, VOC, (d)self-reported impression by
the participant, and (e)observation by the writer. Self-tapping on knees under the instruction by the writer was used as the
bilateral stimulation. Each participant was interviewed four or five times during 4 weeks. Baseline measurements were done
on 1st or 2nd interview, while post measurements were done on 4th or 5th interview after the EMDR session was held on
3rd or 4th time. Results: Results showed clear improvements by one EMDR intervention in two cases out of three. Insufficient
care could be the reason for the absence of improvement with one participant. Conclusion: The results of this study suggest
that the EMDR is effective for the improvements of the various symptoms and problems of the juvenile delinquents, if being
properly applied on the certain guidelines set for them.
Keywords: Juvenile Delinquents Poster
Accuracy Verified: Yes
2. 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
3. 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
4. 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
5. Sautai, G. (2007, Juin). Approche des patient poly-traumatisés par immersion EMDR [Approach of poly traumatised patients with EMDR immersion]. Présentation à la réunion annuelle de l'Association EMDR Europe, Paris, France.
Language: French
Format: Conference
Abstract:
Certains patients présentent "traumatisme poly» ou «empoisonnement psychique» tel que décrit par Jacques Roques dans «Guérir Avec l" EMDR. "Souvent, il s'agit d'un environnement socio culturel a commencé pendant l'enfance. Sur la base de l'hypothèse formulée par Francine Shapiro que le traumatisme peut engendrer des «bloqué les réseaux neuronaux," nous supposons une mise en forme "pourrait se produire au cours de la petite période d'apprentissage.
Exposés à un traumatisme insidieux et répétitifs, un jeune cerveau Virgin Stores réseaux neuronaux liés à la vulnérabilité des enfants en tant que mécanisme de défense. Cela pourrait être obstrué par des perturbations répétitives créer une souffrance psychologique. En tant qu'adulte, ce réseau neuronal inhibiteur, stimulée par déclenchement d'exprimer des comportements excessifs et une forte émotion que nous avons appelé le «non adapté en forme» (NAF).
Nous savons combien il est difficile de prendre ce type d'intoxication »en charge des séances de thérapie EMDR traditionnels en raison de l'interférence des composants multimodal. Habituellement, ils participent émotions mixtes liés à la sécurité, l'estime de soi et le libre choix. Par conséquent, nous avons développé une modalité particulière: EMDR immersion qui est un cours intensif de 10 jours consécutifs de traitement par le patient. «L'objectif clinique est de traiter les dimensions de la croissance personnelle et le développement ainsi que l'élimination de plus de la souffrance» (Francine Shapiro).
Notre expérience comprend 24 patients avec un niveau élevé de troubles psychologiques liés à la NAF. Seuls les patients avec expérience dissociative échelle score inférieur à 25 ont été considérés.
Nous utilisons l'approche thérapie EMDR suivant les 8 étapes du protocole standard.
Nous recevons toute l'histoire chronologique du patient, «de la naissance à aujourd'hui», permet nous permet d'identifier une moyenne de sept objectifs principaux.
Pour être capable de transmuer la NAF à une résolution d'adaptation, nous introduisons un des noms de ressources notamment l '«archaïsme», définie comme «la partie de l'être humain en charge de Live principe de préservation."
Nous l'accès au réseau d'information dysfunctionally stockée par le biais des objectifs.
Nous stimulons le système de traitement de l'information et de la maintenir en forme dynamique avec tactiles et autres additifs stimulations bilatérales. Nous passons l'information par le suivi du processus de libre-association et de lancement des procédures pour s'assurer que la cible transmue à une résolution adaptative.
Comme mesure psychométrique et méthode d'évaluation, nous utilisons l'échelle PCL-S sur les traumatismes exprimé par le patient au début de MED immersion. Le score moyen est de 70 degrés avant l'immersion elle à 28 deux mois plus tard et à 26 six mois plus tard.
En ce qui concerne les résultats encourageants, nous décidons de partager l'expérience afin de mettre à jour.
Some patients present with “poly traumatism” or “psychic poisoning” as described by Jacques Roques in “guérir avec l”EMDR.” Often it is a socio cultural environment started during childhood. Based on the hypothesis formulated by Francine Shapiro that trauma could engender “blocked neuronal networks,” we assume a “formatting” could occur during the childhood learning period.
Exposed to insidious and repetitive trauma, a virgin young brain stores neuronal networks related to the child vulnerability as defense mechanism. That could get blocked by repetitive disturbances creating psychological pain. As an adult, this blocker neuronal network, stimulated by trigger express excessive behaviors and strong emotion we called the “Non Adapted Formatting” (NAF).
We know how difficult it is to take this “poisoning” in charge with traditional EMDR sessions because of the multimodal components interfering. Usually, they involved mixed emotions related to security, self esteem and free choice. Therefore, we developed a particular modality: EMDR Immersion that is an intensive, 10 consecutive days of therapy with the patient. “The clinical goal is to address the dimensions of personal growth and development along with the elimination of over suffering” (Francine Shapiro).
Our experience includes 24 patients with a high level of psychological disturbance related to the NAF. Only patients with Dissociative Experience Scale score less than 25 were considered.
We use EMDR therapy approach following the 8 phases of the standard protocol.
We receive the complete chronological story of the patient, “from birth to now,” allows allows us to identify an average of seven main targets.
To be able to transmute the NAF to an adaptive resolution, we introduce a particular resource names “Archaism” defined as “Part of the human being in charge of Live Principle Preservation.”
We access the dysfunctionally stored information network through the targets.
We stimulate the information-processing system and maintain it in dynamic form with tactile and additive alternative bilateral stimulations. We move the information by monitoring the free-association process and initiating procedures to make sure that the target transmutes to an adaptive resolution.
As psychometric measurement and method evaluation, we use PCL-S Scale on the traumatisms expressed by the patient at the beginning of MED Immersion. The average score is at 70 before Immersion it degrees to 28 two months later and to 26 six months later.
Regarding the encouraging results, we decide to share the experiment in order to upgrade it.
Keywords: EMDR Immersion
Accuracy Verified: Yes
6. Viechtbauer, W. (2007, March). Approximate confidence intervals for standardized effect sizes in the two-independent and two-dependent samples design. Journal of Educational and Behavioral Statistics, 32(1), 39-60. doi:10.3102/1076998606298034.
Language: English
Format: Journal
Abstract:
Standardized effect sizes and confidence intervals thereof are extremely useful
devices for comparing results across different studies using scales with incommensurable
units. However, exact confidence intervals for standardized effect
sizes can usually be obtained only via iterative estimation procedures. The present
article summarizes several closed-form approximations to the exact confidence
interval bounds in the two-independent and two-dependent samples
design. Monte Carlo simulations were conducted to determine the accuracy
of the various approximations under a wide variety of conditions. All methods
except one provided accurate results for moderately large sample sizes and converged
to the exact confidence interval bounds as sample size increased.
Keywords: Confidence Intervals Effect Size Standardized Mean Difference Two-Independent Samples Design
Accuracy Verified: Yes
7. MacCulloch, M., & Barrowcliff, A. (2001, May). Are EMDR effects caused by de-arousal?. Presentation at the EMDR Europe Association annual meeting, London, UK .
Language: English
Format: Conference
Abstract:
Eye Movement Desensitisation and Reprocessing (EMDR) is increasingly being recognised
as a coherent therapeutic procedure in the treatment of Post Traumatic Stress Disorder
(PTSD) and other anxiety disorders, yet we still do not fully understand by which process or
mechanisms it might work. We consider a number of models implicating orienting or
investigatory reflexes as a significant contributor to the success of EMDR as a treatment
method. A series of experiments were designed to test the predictions derived from these
models, examining the physiological effects of eye-movements following auditory challenge
compared to an eyes-stationary condition. A significant physiological de-arousal effect is
observed in conditions requiring eye-movements similar to those used in the EMDR protocol.
We go on to consider the implications for this de-arousal effect in the treatment of PTSD and
present preliminary data from a case series designed to examine the unique contribution of
EMDR when used with treatment resistant clients. A range of psychometric and
psychophysiological process and outcome measures were utilised in this study, providing a
detailed evaluation of change over the course of the treatment design. Specialised software
was developed for use in this study, in addition to a computerised test and software is
provided, along with data obtained from this test.
Keywords: De-Arousal
Accuracy Verified: Yes
8. O’Rawe, B. (2005, June). Assessing dissociation in the visually impaired. Poster presented at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
This case discussion focuses on a traumatically blinded man. Treatment
involved stabilisation using ego-state work with bilateral stimulation, followed
by trauma processing work using EMDR. The aim of this paper is to assess his
response to this approach, and to review the suitability of standard
diagnostic tools used in screening: in porticular the applicability of
Dissociation Scales -The Dissociative Experience Scale (DES) and The
Dissociative Disorders Interview Schedule (DDIS], in people suffering from
blindness
Keywords: Dissociation Poster Visual Impairment
Accuracy Verified: Yes
9. O'Rawe, B. (2005, June). Assessing dissociation in the visually impaired. Presentation at the annual meeting of the EMDR Europe Association, Brussels, Belgium.
Language: English
Format: Conference
Abstract:
This case discussion focuses on a traumatically blinded man. Treatment involved stabilisation using ego-state work with bilateral stimulation, followed by trauma precessing using EMDR. The aim of this paper is to assess his response to this approach, and to review the stability of standard diagnostic tools used in screening; in particluar the applicability of Dissociation Scales - The Dissociative Experience Scale (DES) and the Dissociative Disorders Interview Schedule (DDIS), in people suffering from blindness.
Keywords: Dissociation Visually Impaired
Accuracy Verified: Yes
10. 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
11. Lobenstine, F., & Courtney, D. (2013). A case study: The integration of intensive EMDR and ego state therapy to treat comorbid posttraumatic stress disorder, depression, and anxiety. Journal of EMDR Practice and Research, 7(2), 65-80. doi:10.1891/1933-3196.7.2.65.
Language: English
Format: Journal
Abstract:
This study used a quantitative, single-case study design to examine the effectiveness of the integration of intensive eye movement desensitization and reprocessing (EMDR) and ego state therapy for the treatment of an individual diagnosed with comorbid posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The participant received 25.5 hr of treatment in a 3-week period, followed with 12 hr of primarily supportive therapy over the next 6-week period. Clinical symptoms decreased as evidenced by reduction in scores from baseline to 6-week follow-up on the following scales: Beck Depression Inventory (BDI) from 46 (severe depression) to 15 (mild mood disorder), Beck Anxiety Inventory (BAI) from 37 (severe anxiety) to 25 (moderate anxiety), and Impact of Events Scale from 50 (severe PTSD symptoms) to 12 (below PTSD cutoff). Scores showed further reductions at 6-month follow-up. Results show the apparent effectiveness of the integration of intensive EMDR and ego state work.
Keywords: Anxiety Depression Ego State Therapy Evidence-Based Practice Posttraumatic Stress Disorder PTSD
Accuracy Verified: No
12. Frustaci, A., Lanza, G. A., Fernandez, F., di Giannantonio, M., & Pozzi, G. (2010). Changes in psychological symptoms and heart rate variability during EMDR treatment: A case series of subthreshold PTSD. Journal of EMDR Practice and Research, 4(1), 3-11. doi:10.1891/1933-3196.4.1.3.
Language: English
Format: Journal
Abstract:
Elevated psychophysiological parameters and heightened physiological reactivity to trauma-related cues
are acquired changes following trauma exposure. Measuring improvement in these variables is an appropriate
evaluation of outcome in treatment studies. Heart Rate Variability (HRV) is a computerized measure
of physiological responsivity derived from Holter ECG recording. Four female outpatients with persistent
post-traumatic symptoms and personal impairment following “small t” trauma exposure underwent a
course of EMDR treatment and were assessed at baseline, end of treatment, day 30 and day 90 of followup,
using self-report symptom scales and 90-min Holter ECG recordings. Symptom scores decreased
between baseline and end of treatment, with improvement maintained at follow-up. Several HRV measures
changed favorably in different recording intervals. HRV is a feasible and sensitive method to measure
physiological changes in the treatment of individuals distressed by “small t” trauma. Further investigation
is advisable to expand these preliminary data.
Keywords: Case Series Heart Rate Variability HRV IES Small T Trauma
Accuracy Verified: Yes
13. Oh, D., & Choi, J. (2004). Changes in the regional cerebral perfusion after EMDR: A SPECT study of two cases. Journal of the Korean Society of Biological Psychiatry, 11(2), 173-180.
Language: Korean
Format: Journal
Abstract:
Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR.Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99 . In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex.These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample. [Author Abstract]
Keywords: Brain Imagining Adults Females Koreans Motor Vehicle Accidents Neurophysiology Posttraumatic Stress Disorder Psychiatric Inpatients PTSD: Rape SPECT Survivors Treatment Effectiveness
Accuracy Verified: Yes
14. Cusack, K. J., & Spates, C. R. (1999, January-April). The cognitive dismantling of eye movement desensitization and reprocessing (EMDR) treatment of posttraumatic stress disorder (PTSD): A case report. Journal of Anxiety Disorders, 13(1-2), 87-99. doi:10.1016/S0887-6185(98)00041-3 .
Language: English
Format: Journal
Abstract:
Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables (ScienceDirect).
Keywords: Adults Americans Empirical Study Longitudinal Study Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Stressors Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
15. 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
16. Negadi, F., Jouvent, R., & Pelissolo, A. (2007, July). Contribution of EMDR's cognitive approach: A case of driving phobia. Journal International de Victimologie, 5(3), 146-152.
Language: English
Format: Journal
Abstract:
Most studies evaluating the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) therapy for various problems have focused on the importance of eye movements and largely ignored the fact that EMDR is an integrative therapeutic approach in which the cognitive approach plays a large part. The case study presented here includes an evaluation of the efficacy of EMDR, on various standardised evaluation scales, for a patient with driving phobia due to a traumatic event. The treatment of this patient was largely based on a cognitive approach (cognitive interweave) and the reprocessing of dysfunctional information according to the EMDR thérapy. The outcome one month after treatment was favourable, with the absence of phobic avoidance and a marked improvement in the patient's mood.
Keywords: Cognitive Interweave Driving Phobia Dysfunctional Belief
Accuracy Verified: Yes
17. Rothbaum, B. O. (1997, Summer). A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims. Bulletin of the Menninger Clinic, 61(3), 317-334.
Language: English
Format: Newsletter
Abstract:
Eye movement desensitization and reprocessing (EMDR) is a new method developed to treat PTSD. This study evaluated the efficacy of EMDR compared to a no-treatment wait-list control in the treatment of PTSD in adult female sexual assault victims. 21 subjects were entered and 18 completed. Treatment was delivered in 4 weekly individual sessions. Assessments were conducted pre- and posttreatment and 3 months following treatment termination by an independent assessor kept blind to treatment condition. Measures included standard clinician- and self-administered PTSD and related psychopathology scales. Results indicated that subjects treated with EMDR improved significantly more on PTSD and depression from pre- to posttreatment than control subjects, leading to the conclusion that EMDR was effective in alleviating PTSD in this study. [Author Abstract]
Keywords: Adults Americans Empirical Study Females Posttraumatic Stress Disorder PTSD Random Clinical Trial Rape RCT Survivors Treatment Effectiveness
Accuracy Verified: Yes
18. Gomez, A. M. (2006, September). Creative approaches to motivate, prepare, and guide children to use EMDR. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
This workshop is intended to teach specific ways to use storytelling, metaphors and play therapy
techniques within the context of the EMDR protocol. Participants will learn play therapy techniques to use during the target identification phase. Techniques such as the "mixed up box", "My yucky bags" among others, will provide a playful approach
to assist children in identifying EMDR targets as
well as to provide an opportunity for containment.
Safe place, as well as other types of resource
development, will be addressed using alternative ways to cue the child, such as olfactory stimulation. Participants will learn metaphors and stories to help children understand what happens in the mind and body when trauma occurs. These metaphors are intended to motivate children that are reluctant to embrace the memories associated to the trauma. By
using stones and metaphors, children can also
maintain emotional distance from their own
struggles. One of the main goals of this workshop
is to help clinicians learn to communicate more
effectively with children by using metaphors, stones and play. How to talk to children about EMDR and
how to prepare children for the outcome of EMDR
will be addressed. By making the process more
predictable, the likelihood of children stopping the
process when they experience the difficult feelings
associated with the trauma might be minimized.
Participants will also learn to use creative, fun and
playful ways to assist children in understanding and using the measure scales of the EMDR protocol
(SUDS and VOC).
Keywords: Children Metaphors Play Therapy Storytelling Targets
Accuracy Verified: Yes
19. Zucker, M., Spinazzola, J., Blaustein, M., & van der Kolk, B. A. (2006). Dissociative symptomatology in posttraumatic stress disorder and disorders of extreme stress. Journal of Trauma and Dissociation, 7(1), 19-32. doi:10.1300/J229v07n01_03.
Language: English
Format: Journal
Abstract:
The present study was designed to assess differences in
dissociative symptoms in adults with Posttraumatic Stress Disorder
(PTSD) vs. PTSD plus Disorders of Extreme Stress Not Otherwise Specified
(DESNOS). This study was done for two reasons: (1) to better understand
the clinical profile of DESNOS clients in order to inform more
effective treatment, and (2) to further empirical research on the validity
of the DESNOS construct. To assess severity of dissociative symptoms,
the authors administered the Dissociative Experiences Scale (DES) to
155 participants with PTSD. Using the Structured Interview for Disorders
of Extreme Stress (SIDES), participants were divided into two
groups: those who also met criteria for DESNOS and those who did not.
DES means are provided for the two groups. Participants with PTSD
plus DESNOS scored higher than participants with only PTSD on the
measure of dissociative symptomatology, particularly on the DES scales that tap absorption/fantasy and depersonalization/derealization. The two
groups did not differ on the amnesia subscale of the DES. Findings support
the construct validity of the DESNOS concept and further delineate
the clinical profiles of community-based PTSD with and without DESNOS,
thus contributing to the knowledge base on the assessment of complex
adaptations to trauma. [Article copies available for a fee from The Haworth Document
Delivery Service: 1-800-HAWORTH. E-mail address:
Keywords: DES DESNOS Dissociation Dissociative Experiences Scale Posttraumatic Stress Disorder PTSD Trauma
Accuracy Verified: Yes
20. Becich, H. A. (1995). The effect of varying the rate of the eye movements in eye movement desensitization reprocessing (EMDR) with battered women. California School of Professional Psychology, Los Angeles, CA. AAT 9531596.
Language: English
Format: Dissertation/Thesis
Abstract:
The rapid saccades used in eye movement desensitization reprocessing (EMDR) have been reputed to be critical to its efficacy. To evaluate this hypothesis, the rate of the eye movements was varied in this study. Subjects included 27 battered women who were rated PTSD-positive by a modified version of the Symptom Checklist (MSC). Participants were randomly assigned to one of three groups: EMDR Fast, EMDR Slow or Control.Prior to treatment, subjects completed the Revised Impact of Events Scale (IES). Treatment involved one experimental session lasting up to 90 minutes. Dependent variables included the Subjective Units of Distress (SUDs) (derived from the Subjective Units of Disturbance Scale), the Validity of Cognition (VOC) and the Vividness of Traumatic Image (VTI) Scales as well as the Intrusion subscales of the MSC and the IES. At post-treatment one week later, subjects again provided responses to the five dependent variables and, for ethical reasons, were provided another session of treatment at the EMDR Fast rate if their SUDs were 2 or greater. Results of the mixed, two factor analyses indicated no differences between the groups. Hence, the outcomes showed that the rapid eye movements did not provide a differential treatment effect as hypothesized. All groups experienced improvement on the SUDs and VTI Scales and the MSC Intrusion subscale, supporting occurrence of an exposure effect. This investigation was the first controlled EMDR study conducted with battered women, as well as the first experiment on this procedure using a clinical population in which the rate of the eye movements was varied. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 56(5-B), Nov 1995, pp. 2854
Keywords: Adults Americans Battery Empirical Study Follow-up Study Females Posttraumatic Stress DIsorder PTSD Spouse Abuse Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
21. Goodwin, D., Banner, L., & Hayward, R. (1995, June). Effects of EMDR in treating erectile dysfunction measured by magnetic resonance imaging. Symposium conducted at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The experimenters seek to determine whether the reported anxiety-relieving effects of (EMDR) can be effectively applied to patients reporting erectile dysfunction and whether the expected changes in levels of anxiety can be measured as a function of changes in brain function observed through MRI tracings. The MRI is well suited to reflect hypothesized changes in the lowering of sympathetic arousal and the increasing of parasympathetic arousal as a response to EMDR procedures. This investigation, using the MRI brain scanning procedures was followed in stages of (1) establishing criteria for the radiological determination of characteristics of brain function measured with the MRI that descriminate between levels of experimentally induced anxiety and (2) conducting an experimental investigation of the application of EMDR while patients are undergoing the MRI scanning protocol. Psychological measures include the Personality Assessment Inventory(PAI) to screen for psychotherapy of subjects, the Impact of Events Scale(IOE), and the State-Trait Anxiety Inventory(STAI). Correlations between these scales and ratings of physiological changes are reported.
Keywords: Erectile Dysfunction MRI Scanning Protocol Symposium
Accuracy Verified: Yes
22. Hampel, J. C. (1997, November). The effects of eye movement desensitization and reprocessing (EMDR) on self-reported test anxiety in college students. Western Michigan University, Kalamazoo, MI. AAT 9732881.
Language: English
Format: Dissertation/Thesis
Abstract:
Test anxiety is a common problem among students in western culture due to the importance of academic achievement and the consequences for failure. Many consider test anxiety to be primarily an issue of poor study habits and test readiness. However, some students who appear to possess excellent study habits also appear to experience severe anxiety during tests. A recent meta-analysis of test anxiety research substantiated these claims, finding that test anxiety appeared to be an emotionally-based as opposed to a cognitively-based problem. Despite these findings, the etiologies for test anxiety remain unknown. Similar to nearly all DSM-IV diagnostic categories, test anxiety is a syndrome with no known pathognomonic sign(s) which singularly diagnose the condition. Hence, treatments for test anxiety, as for nearly all other DSM-IV mental disorders are symptomatic as opposed to strategic. Unfortunately, there are few symptomatic treatments for test anxiety that are both efficient and effective.Eye movement desensitization and reprocessing (EMDR), which was developed for the symptomatic treatment of PTSD, was chosen to treat the symptoms of test anxiety for the following essential reasons: (a) the reported efficacy of EMDR with PTSD; (b) the similarities between test anxiety and PTSD that include intrusive thoughts, inability to concentrate, behavioral avoidance, and emotional symptomatology; and (c) the need for a brief, effective symptomatic treatment for test anxiety. Using a waiting control group against which to compare the treatment group and subsequently replicate treatment effects, the results found that EMDR was highly effective for the symptomatic reduction of self-reported test anxiety as measured by all test anxiety scales. Moreover, these results also suggest that measures of study habits and attitudes are also sensitive to enhancement as a result of treatment with EMD/R. Although the current results did not suggest specific mechanism(s) by which EMDR was effective, the pattern of highly effective results across widely different types of test anxiety presentations suggests the actions of an active placebo treatment. It is suggested that future research contrast EMD/R with known active placebo protocols. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 58(5-B), Nov 1997, pp. 2676.
Keywords: Anxiety Disorders College Students Empirical Study Life Experiences Posttraumatic Stress Disorder PTSD Survivors Treatment Effectiveness
Accuracy Verified: Yes
23. Bumke, P. J., & Sodemann, U. (2010, July). The efficacy of EMDR in a new context: Some findings from the ACEH survey. Symposium (Carolyn L. Neunuebel, Chair) conducted at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
Context: As a response to the Tsunami in 2004 the Aceh Project organized by TraumaAid and sponsored byTDH and the BMZ
from 2007 to 2009 treated more than 3200 clients for psychic disorders related to traumatic experiences .The treatment was
given by Indonesian therapists who against the background of a lack of local therapists trained in psychotraumatology had to
be trained within the project under the auspices of TraumaAid. This combination of EMDR-Training and EMDR-Therapy in an
extremely challenging context also offered an unique opportunity for a parallel and wide ranging monitoring and evaluation
of the social and diagnostic parameters involved. Methodology: To guide the therapeutic process and to check on its long
term efficacy 1200 adults and 1000 children were at the outset of their therapies asked to contribute detailed diagnostic
data. While for adults the Hopkins Anxiety and Depression scales along with a 42-item Harvard Trauma Questionnaire was
administered, children and adolescents up to age of 17 were given an adapted version of the CBCL. At the conclusion of their
therapies 20 % of all respondents were rechecked with the same diagnostic scales, another group of 5 % again after 6 months.
Results: The diagnostic data indicate a dramatic improvement after therapies that involved a range of therapeutic techniques
including stabilising and EMDR protocols. The relation between diagnostic dimensions (intrusions, somatic reactions, social
relations, expression of feelings and attention problems) and social factors (gender, age) was further explored.
Keywords: ACEH Survey
Accuracy Verified: Yes
24. Sellers, J. L. (1997, October). Efficacy of the eye movement desensitization procedure as compared to accelerated massed desensitization in the treatment of test anxiety. California School of Professional Psychology, San Diego, CA. ATT 9729659.
Language: English
Format: Dissertation/Thesis
Abstract:
The Eye Movement Desensitization and Reprocessing (EMDR) procedure had been widely promoted as an effective anxiety reducing treatment, yet the methodology of many studies has not been adequate to clearly investigate the procedure (Lohr, Kleinknecht, Conley, Dal Cerro, Schmidt, & Sonntag, 1992) and comparison treatments have been inappropriately applied (Lohr, Kleinknecht, Tolin & Barrett, 1995). This study compared EMDR and Accelerated Massed Desensitization (AMD), which has been empirically supported as a short term intervention in the treatment of test anxiety. All participants were screened for participation and 38 were determined test anxious, according to the Test Anxiety Inventory (TAI; Spielberger, 1980). No subjects were involved in any form of relaxation training or taking any medications to reduce anxiety at the time of their participation. All participants were recruited from college and university classes in the Orange and San Bernardino counties and were paid $10 for their participation. Six therapists and the primary investigator conducted therapy sessions for both treatments. All therapists completed the EMDR training, completed relevant reading materials for the AMD procedure, and followed protocols for both procedures throughout the therapy sessions. Participants were randomly assigned to either the EMDR or AMD treatment condition and a therapist. Participants completed the state portion of the State-Trait Anxiety Inventory (STAI; Spielberger, 1983) and the Subjective Units of Distress scale (SUD; Wolpe, 1982) measures at pre and post treatment and at pre and post in-class exam. Participants received two sessions of treatment for each of the conditions. This study hypothesized that the EMDR treatment would significantly reduce anxiety as measured by the STAI and the SUD as compared to the AMD treatment. This study also hypothesized that EMDR would significantly reduce anxiety in both treatment and in vivo settings. Supplementary hypotheses predicted that the AMD treatment would reduce anxiety in both the treatment and in vivo settings. Results indicated that students in the AMD condition experienced more anxiety reduction than students in the EMDR condition. However, both treatments were effective in reducing anxiety in both the treatment and in vivo setting, as measured by the STAI and SUD scales. These results suggest that both treatments may be effective for reducing anxiety. However, the AMD treatment led to greater reductions in anxiety, as compared to the EMDR treatment. It is suggested that further research of the EMDR procedure include suitable comparison groups in order to assess its effectiveness and allow clinicians to choose appropriate treatments based on empirical support. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 58(4-B), Oct 1997, pp. 2139.
Keywords: College or University Students Identified As Test Anxious Efficacy of Eye Movement vs Accelerated Massed Desensitization for Treating Test Anxiety Psychotherapeutic Techniques Sellers Test Anxiety
Accuracy Verified: Yes
25. Holmshaw, M. (2008, June). EMDR & CBT work equally well for psychological trauma – Why?. Presentation at the annual meeting of the EMDR Europe Association, London, UK.
Language: English
Format: Conference
Abstract:
The use of EMDR, CBT or a combination of the two, in managing psychological ill health following road Traffic
Accidents (RTA): The Results and analysis of 1100 consecutive referrals. This paper determines the role of
trauma-focused psychological treatment in the management of psychological ill health following road traffic
accidents in the UK. RTA’s are the biggest cause of PTSD in this country. All consecutively referred patients with
possible psychological ill-health following a RTA were offered a comprehensive psychological assessment by an
established provider of trauma services in the UK. Those with significant psychological ill health were offered
trauma-focused psychological treatment, EMDR and/or CBT, in line with NICE (National Institute for Health and
Clinical Excellence) guidelines. During the psychological assessment a clinical diagnosis was made and a number
of psychometric scores were used. These comprised
1 DSM IV criteria for PTSD and illness severity,
2 General Health Questionnaire,
3 Impact of Event Scale,
4 Hospital Anxiety and Depression Scale.
Similar subjective and objective measurements were made after every fourth session of therapy and on
discharge. The results offer a breakdown of diagnoses, the number of patients who proceeded to treatment and
the type of treatment and outcome of such treatment. Of the 658 patients who proceeded to Trauma-focused
psychological treatment, patients had either EMDR by itself (31%), CBT by itself (36%) or a Combination of EMDR
and CBT (33%). Subjectively and objectively three out of four patients were completely relieved of their
symptoms or were much better. There was no significant difference between CBT and EMDR in terms of
treatment results. Closer analysis of the three subgroups revealed a number of variables which seemed to be
associated with failure of EMDR treatment and failure of CBT treatment. These variables will be discussed against
the background of the trauma focused CBT model of Clarke, D and Ehlers A, 2002. Recommendations will be made of ways to improve the outcome of EMDR Therapy and improving EMDR training.
Keywords: CBT Cognitive Behaviorial Therapy Trauma
Accuracy Verified: Yes
26. Lindsay, J. (1995, June). EMDR and the treatment of rape survivors. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The study employed single case experimental design to test the efficacy of EMDR in the treatment of rape survivors. EMDR was
introduced sequentially to five subjects by five licensed psychotherapists with Level II EMDR training. Each subject received from
4 to 6 sessions depending upon her position in the sequence. Each met criteria for PTSD prior to treatment.
The study emphasized clinical significance, and with minor exceptions, all scores meet criteria for both clinical and statistical
significance.
Independent variables were the Beck Depression Inventory (BDI), the Brief Symptom Inventory (BSI), the Dissociative Experience
Scale (DES), the State-Traft Anxiety Inventory (STAI) and the PTSD Symptom Scale, Self-Report (PSC-SR). Pre- post- and followup
scores demonstrated dramatic changes (<.O1,DES<.05).
Subjects monitored PTSD symptomotology throughout the baseline, treatment and follow-up phases. The visual analog scales
which display these graphed data provide some interesting information regarding individual response to treatment and inter- and
intra- subject variability. These quantitative data were also analyzed with respect to qualitative data from pre- and post and followup
interviews and from clinical reports.
Keywords: Rape
Accuracy Verified: Yes
27. Adler-Tapia, R., & Settle, C. (2008, February). EMDR butterfly hug/group protocol: Fidelity research manual. Hamden, CT : EMDR Humanitarian Assistance Programs.
Language: English
Format: Book
Abstract:
This manual is based on EMDR theory created by Dr. Francine Shapiro and documented in Dr. Shapiro's books (1995, 2001); and, the EMDR Group Protocol created by Dr. Ignacio Jarero and Dr. Lucina Artigas documented in Artigas,L., Jarero,I., Mauer,M., López Cano,T., & Alcalá,N.(2000); Jarero, Artigas, López Cano, Maure, & Alcalá, (1999). This manual also references the fidelity manual created by Korn, D.L. & Spinazzola, J. (January, 2001); and the fidelity scales created by Korn, D.L., Zangwill, W., Lipke, H. & Smyth, N. (January, 2001).
In addition, we have included information provided by Dr. Robert Tinker and Dr. Sandra Wilson regarding additional directions for the group protocol with children.
This protocol references the book and treatment manual, EMDR and the Art of Psychotherapy with Children (2008) by Dr. Adler-Tapia and Ms. Settle.
This is a fidelity manual created for use in research. The protocol will need to be adjusted for the environment, culture and unique needs of the participants. All resources are documented in the reference section of this manual.
This manual was donated to the EMDR Humanitarian Assistance Program in order to sustain and advance the EMDR HAPKIDS Project which supports programs providing EMDR for children by training therapists, conducting research, and most importantly, providing treatment for those children who are most in need.
Keywords: Butterfly Hug Group Protocol
Accuracy Verified: Yes
28. Adler-Tapia, R., & Settle, C. (2006). EMDR fidelity treatment manual: Children’s protocol. Hamden, CT : EMDR Humanitarian Assistance Programs.
Language: English
Format: Book
Abstract:
This manual is based on EMDR theory created by Dr. Francine Shapiro and documented in Dr. Shapiro’s Books (1995, 2001), the fidelity manual created by Korn, D.L. & Spinazzola, J. (January, 2001), and the fidelity scales created by Korn, D.L., Zangwill, W., Lipke, H. & Smyth, N. (January, 2001). All resources are documented in the reference section of this manual. [EMDR-HAP]
Final version for pilot study, November 15, 2005
Accuracy Verified: Yes
29. Farrell, D., Tareen, S., & Keenan, P. (2008, November). EMDR HAP training in Pakistan in the aftermath of the 2005 earthquake and the ‘War on terror’. Presentation at the 24th Annual Meeting of the International Society for Traumatic Stress Studies .
Language: English
Format: Conference
Abstract:
On Saturday 8th October 2005, a devastating earthquake
measuring 7.6 on the Richter scale struck northern Pakistan. The
magnitude of the earthquake wiped out entire villages and
communities, destroyed 400,000 houses and created over 73,000
fatalities and 135,000 people injured.
EMDR UK & Ireland, EMDR Europe, the British/ Pakistani
Psychiatric Association & the University of Birmingham supported
an eighteen month Humanitarian Assistance Programme to help
train forty-nine mental health workers, mainly psychiatrists and
psychologists from the earthquake affected areas, in the theory
and practice of EMDR in the management of psychological trauma.
This programme was one of the first University based HAP
trainings in EMDR ever to be undertaken.
This paper will provide an insight into the development and
progression of the trainings in light of the ongoing political
problems in Pakistan both in terms of post earthquake
reconstruction and the continued threat of terrorist attacks
throughout Pakistan. It will also consider cultural perspectives of
trauma and how this related to both EMDR and the conceptual
framework of PTSD. The paper will also highlight some of the
psychometric data acquired from survivors from the earthquake
areas and demonstrate the ways in which EMDR is being utilised
as a psychological treatment intervention in Northern Pakistan.
Keywords: Earthquake HAP Pakistan
Accuracy Verified: Yes
30. Farrell, D. (2008, November). EMDR HAP training in Pakistan in the aftermath of the 2005 earthquake and the ‘war on terror’. Symposium conducted at the 24th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
On Saturday 8th October 2005, a devastating earthquake
measuring 7.6 on the Richter scale struck northern Pakistan. The
magnitude of the earthquake wiped out entire villages and
communities, destroyed 400,000 houses and created over 73,000
fatalities and 135,000 people injured.
EMDR UK & Ireland, EMDR Europe, the British/ Pakistani
Psychiatric Association & the University of Birmingham supported
an eighteen month Humanitarian Assistance Programme to help
train forty-nine mental health workers, mainly psychiatrists and
psychologists from the earthquake affected areas, in the theory
and practice of EMDR in the management of psychological trauma.
This programme was one of the first University based HAP
trainings in EMDR ever to be undertaken.
This paper will provide an insight into the development and
progression of the trainings in light of the ongoing political
problems in Pakistan both in terms of post earthquake
reconstruction and the continued threat of terrorist attacks
throughout Pakistan. It will also consider cultural perspectives of
trauma and how this related to both EMDR and the conceptual
framework of PTSD. The paper will also highlight some of the
psychometric data acquired from survivors from the earthquake
areas and demonstrate the ways in which EMDR is being utilised
as a psychological treatment intervention in Northern Pakistan.
Keywords: Earthquake HAP Pakistan Symposium Terror
Accuracy Verified: Yes
31. Carlson, J. G., Chemtob, C. M., Rusnak, K., Hedlund, N. L., & Muroaka, M. Y. (1995, June). EMDR in combat-related PTSD: A controlled study. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
In view of potential, but largely undocumented benefits of eye movement desensitization and reprocessing (EMDR) as an intervention for PTSD in combat veterans, in our laboratory a study of EMDR treatment included (1) randomized patient assignment, (2) clinically appropriate comparison (treatment and control) groups, (3) a 12-session EMDR protocol administered by experienced, EMDR trained clinicians, and (4) extensive clinical assessment, including physiological evaluation at pre-treatment, post-treatment, and 3-month follow-up. Thirty-five veterans who met DSM-IV criteria for PTSD completed an extensive multimodal assessment protocol. Assessment instruments included: The Mississippi Scale for Combat-Related PTSD, the Impact of Events Scale (IES), the Clinician Administered PTSD Scale (CAPS), a self-rating of overall severity of "PTSD symptoms," the Beck Depression Inventory, and the Spielberger State and Trait Anxiety Inventories (STAI). In addition, each subject completed a Stressful Scene Construction Questionnaire (SSCQ) in which scripts of specific traumatic combat incidents were prepared for presentation during psychophysiological assessment. Following pre-assessment, a subset of the subjects constituted a waiting list control (CON, N = 12). Routine clinical care for these subjects was available at the VA Medical Center. Seven of these subjects also participated in group sessions for discussion of PTSD designed as an attentional control. There were no differences between the two control subgroups and their data was combined for all subsequent analyses. For the treatment groups, subjects assigned to the EMDR (EMD, N = 10) and relaxation (RXT, N = 13) groups were seated in a semi-reclined chair and continuous measures were taken of muscle tension levels (four sites), hand temperature, skin conductance levels, heart rate, and blood pressure. For all subjects, there were 20 minutes in each of the baseline sessions with no additional stimuli presented. At the end of session 2 of baseline, the patients remained in the experimental room and were assessed for an additional 20 minutes (pre-treatment) during which the SSCQ scripts also were presented. There were two sessions per week with a minimum of one day between sessions. Each subsequent treatment session for the EMD and RXT subjects was approximately 60 minutes in duration, allowing for set-up time and briefing. In the EMD group, a standard protocol for the EMDR interventions was administered, including periodic SUDS ratings and VoC scaling of combat and related images and cognitions (cf Shapiro, 1995). In the RXT group, home relaxation tapes and biofeedback on four sites (face, neck, arm, and back) to assist lowered muscle tension were provided. Following 12 treatment sessions (post-treatment), and again after three months (follow-up) the psychometric instruments and psychophysiological assessment were readministered using the format outlined above. Relative to the other conditions, the EMDR treatment produced substantially more positive clinical effects at post-treatment and follow-up. Comparing the EMD group to the CON group, significant effects (p<.05 or better) were obtained on measures of PTSD including the Mississippi and PTSD symptoms self-rating, and on the Beck and STAI-Trait. Comparing the EMD group to the RXT subjects, significant differences were found on the Mississippi, the IES-Intrusion scale, the CAPS, PTSD symptoms ratings, and the STAI-Trait scale. No differences were obtained on any of the physiological measures. Therefore, the present results support the effectiveness of EMDR with combat veterans with chronic PTSD. The data strongly suggest that some previous negative results obtained when EMDR was applied to chronic and severe combat PTSD may have resulted from methodological artifacts, such as inadequate amount of treatment and therapist inexperience. While the failure to find physiological effects is consistent with results of other controlled treatment exposure trials in PTSD, this finding raises clinical and conceptual questions with respect to the arousal component of the disorder.
Keywords: Combat Controlled Study
Accuracy Verified: Yes
32. Terreri, L. (2008, ). EMDR nei pazienti con tossicodipendenza: integrazione tra protocollo standard e protocolli modificati [EMDR in drug dependent subjects: integration between standard and modified protocols]. Bollettino Sulle Dipendenze, 31(4), 215-224.
Language: Italian
Format: Newsletter
Abstract:
Riassunto, Alcuni autori (Shapiro F., Omaha J., Popky A.J., Hase M.), ipotizzano che il metodo EMDR (Eye Movement Desensitization and Reprocessing) possa essere utile ai pazienti tossicodipendenti sia per avere una migliore adattabilità e funzionalità del comportamento sia per allontanare il tempo delle ricadute.
Tuttavia gli studi con l’EMDR applicato alle tossicodipendenze sono rari e in Italia pressoché
assenti. L’autore, con l’intento di offrire un input per stimolare future ricerche, riassume il protocollo standard dell’EMDR, il protocollo DSRC sulla desensibilizzazione degli stimoli e la rielaborazione della compulsione e il protocollo DRDA sulla desensibilizzazione e rielaborazione del ricordo del disturbo d’astinenza. Nei soggetti che hanno effettuato i vari protocolli EMDR è stato possibile rilevare un risultato
positivo a breve termine tramite i punteggi delle scale SUD (Subjective Units of Disturbance), VOC
(Validity of Cognition), LOU (Level of Urge) e anche attraverso la valutazione di disegni effettuati prima e dopo la seduta EMDR.///
Shapiro F., Omaha J., Popky A. J., Hase M. et al. have speculated that Eye Movement Desensitization and Reprocessing (EMDR) could be useful in the treatment of drug addicted subjects, to reach better adjustment and behavioural functioning and/or to increase the time interval between relapses. Currently,
studies reporting the use of EMDR with drug addicted patients are scarce and, in Italy, absent. The article, in order to offer an input to stimulate further research and increase its application, summarizes the
EMDR method and considers the possibility for the use of the “Standard EMDR protocol”, the
“Desensitization of Triggers and Urge Reprocessing” protocol and the “Withdrawal Disorder Memory Desensitization and Reprocessing” protocol within the Public Drug Abuse Departments. Subjects who underwent the various EMDR treatment protocols showed positive results in the short-term period, when tested with SUD (Subjective Units of Disturbance), VOC (Validity of Cognition) and LOU (Level of Urge)scales. Encouraging results were also obtained through the evaluation of drawings done by the subjects
before and after the EMDR treatments.[Author Abstract]
Keywords: Affect Bridge Compulsion Trauma Withdrawal
Accuracy Verified: Yes
33. Montes-Berges, B., Aranda, M., Castillo-Mayén, M. del R. (2011). EMDR Para el tratamiento de estrés postraumático en casos de violencia de género [EMDR for treatment of PTSD in cases of domestic violence]. Universidad de Jaén, Jaén, Spain.
Language: English
Format: Dissertation/Thesis
Abstract:
Introducción: La violencia de género es uno de los problemas sociales más graves de
nuestra sociedad tanto por su prevalencia (en el pasado año 2010 fueron asesinadas 74
mujeres, y se estima que alrededor del 11.1% de las mujeres andaluzas son maltratadas),
como por las consecuencias psicológicas que conlleva en las víctimas. Objetivos: En el
Gabinete de Psicología de la Universidad de Jaén, atendemos a las mujeres (alumnas, PAS
o PDI o familiares de éstos) que han sido o aún son víctimas de violencia de género, con el
objetivo prioritario de que superen las situaciones traumáticas y que estén preparadas
emocional y cognitivamente para llevar una vida plena con el desarrollo máximo de sus
capacidades. Durante la evaluación, entre otras escalas, las usuarias contestan al
cuestionario sobre Síndrome de Estrés Postraumático (Echeburúa, Corral, Amor,
Zubizarreta y Sarasúa, 1997), pues los episodios de violencia psicológica, sexual y física
extrema que la mayoría de ellas viven, ocasionan en el 100% de los casos este síndrome de
manera crónica y acusada. Metodología: Para tratar este síndrome se acomete el
entrenamiento en técnicas de respiración y relajación y posteriormente el tratamiento con
EMDR. Esta técnica consiste en el procesamiento de los sucesos que quedaron bloqueados
por el miedo sentido en el momento en que ocurrieron, mediante la movilización de los
ojos de manera simultánea a la escucha del episodio, tratando nuevamente de revivirlo.
Aplicamos esta técnica con 5 pacientes. Resultados: En todos los casos las usuarias
superaban la situación en 4 o 5 sesiones de 5 minutos cada una, de manera que
posteriormente, informaron de que la situación ya no les producía tristeza ni dolor, y que la
habían aceptado. Discusión: Estos resultados sugieren que esta técnica es eficaz y rápida
en la intervención de sucesos traumáticos de violencia de género, por lo que resulta
altamente recomendable para estos casos.
Introduction: Gender violence is one of the most serious social problems
our society because of its prevalence (in the past year 2010 were killed 74
women, and it is estimated that about 11.1% of women are battered Andalusian),
as for the psychological consequences on the victims involved. Objectives: In the
Cabinet of Psychology, University of Jaén, we look at women (students, PAS
or PDI or their relatives) who have been or still are victims of domestic violence, with
priority objective of exceeding trauma and who are prepared
emotionally and cognitively to lead a full life with the maximum development of their
capabilities. During the assessment, including scales, users answer the
questionnaire on PTSD (Echeburúa, Corral, Love,
Zubizarreta and Sarasua, 1997), because episodes of psychological, physical and sexual
extreme than most living, result in 100% of cases this syndrome
chronically and charged. Methodology: To treat this syndrome is undertaken the
training in breathing and relaxation techniques and subsequent treatment with
EMDR. This technique consists in processing events that were blocked
sense of fear at the time they occurred, by mobilizing the
eyes simultaneously listening to the episode, trying to revive him again.
We apply this technique in 5 patients. Results: In all cases the user
exceeded the 4 or 5 position in 5-minute sessions each, so that
subsequently reported that the situation no longer produce sadness or pain, and that the
had accepted. Discussion: These results suggest that this technique is effective and fast
intervention in the traumatic events of violence, so it is
highly recommended for these cases.
Keywords: Domestic Violence Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
34. Jarero, I., & Uribe, S. (2011). The EMDR Protocol for recent critical incidents: Brief report of an application in a human massacre situation. Journal of EMDR Practice and Research, 5(4), 156-165. doi:10.1891/1933-3196.5.4.156.
Language: English
Format: Journal
Abstract:
This ongoing field study was conducted subsequent to the discovery of clandestine graves with 218 bodies recovered in the Mexican state of Durango in April 2011. A preliminary psychometric assessment was conducted with the 60 State Attorney General employees who were working with the corpses to establish a triage criterion and provide baseline measures. The Impact of Event Scale (IES) and the short posttraumatic stress disorder (PTSD) rating interview were administered, and the 32 individuals whose scores indicated moderate-to-severe posttraumatic stress and PTSD symptoms were treated with the eye movement desensitization and reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI). Participants were assigned to two groups: immediate treatment (severe scores) and waitlist/delayed treatment (moderate scores). Each individual client session lasted between 90 and 120 minutes. Results showed that one session of EMDR-PRECI produced significant improvement on self-report measures of posttraumatic stress and PTSD symptoms for both the immediate treatment and waitlist/delayed treatment groups. This study provides preliminary evidence in support of the protocol's efficacy in a natural setting of a human massacre situation to a group of traumatized adults working under extreme stressors. More controlled research is recommended to evaluate further the protocol's efficacy.
Keywords: Human Massacre PRECI Posttraumatic Stress Disorder Protocol for Recent Critical Incidents PTSD Recent Events
Accuracy Verified: Yes
35. Silver, S. M., Rogers, S., Knipe, J., & Colelli, G. (2005, February). EMDR therapy following the 9/11 terrorist attacks: A community-based intervention project in New York City. International Journal of Stress Management, 12(1), 29-42. doi:10.1037/1072-5245.12.1.29.
Language: English
Format: Journal
Abstract:
This article presents the results of a time-limited psychological relief effort using eye movement desensitization and reprocessing (EMDR) following the attacks on the World Trade Center on September 11, 2001. Clients made highly significant positive gains on a range of outcome variables, including validated psychometrics and self-report scales. Analyses of the data suggest 2 broad conclusions: EMDR is a useful treatment intervention both in the immediate aftermath of disaster as well as later; the longer treatment is delayed, the greater the level of disturbance experienced by clients. Also discussed are problems in conducting research during mass disaster response situations. A demonstration of an analog to a wait-list control group is provided. [Author Abstract]
Keywords: 9/11 Americans Crisis Intervention Empirical Study Quantitative Study September 11 Survivors Terrorism Terrorist Attacks Treatment Effectiveness
Accuracy Verified: Yes
36. Couto, M., Farate, C., Ramos, S., & Fleming, M. (2012, June). EMDR, setting and therapeutic relationship: A comparative study with CBT and psychoanalytic therapists. Poster presented at the annual meeting of EMDR Europe, Madrid, Spain.
Language: English
Format: Conference
Abstract: The therapeutic efficacy of EMDR is increasingly documented in process and outcome studies. However there is an ongoing debate on whether this effectiveness is mainly due to EMDR therapeutic techniques or to other variables. Since EMDR technical procedures are also related to the way the therapist manages both the space and the therapeutic relationship with the patient there is a growing trend towards the study of the influence of contextual and therapist variables on treatment outcome. This study aims to compare the management of both setting and therapeutic relationship among experienced EMDR, CBT and psychoanalytic therapists. The data and sample correspond to a preliminary phase of a broader research project whose aim is the construction of a psychometric instrument of trans-theoretical nature (Management of the Setting Scale-MSS) aimed at the assessment of setting on therapeutic outcome.
Keywords: CBT Cogntive Behavior Therapy, Poster Psychoanalysis
Accuracy Verified: Yes
37. Lamprecht, F., Kohnke, C., Lempa, W., Sack, M., Matzke, M., & Munte, T. F. (2004, June). Event-related potentials and EMDR treatment of post-traumatic stress disorder. Neuroscience Research, 49(2), 267-272. doi:10.1016/j.neures.2004.02.013.
Language: English
Format: Journal
Abstract:
10 patients suffering from PTSD following a severe traumatic event, were assessed with event-related brain potentials (ERPs) in a modified oddball paradigm containing auditory standard, target, and novel tones. ERPs were assessed before and after a treatment session using the eye movement desensitization and reprocessing method. Compared to a control group that underwent sham treatment, ERPs of the patients showed a reduction of the P3a component in the post-treatment recording, suggesting a reduced orienting to novel stimuli and reduced arousal level after the treatment. Moreover, psychometric assessment revealed a marked improvement of the PTSD symptoms after treatment. [Author Abstract]
Keywords: Brain Imaging Adults Cognitive Processes Empirical Study Germans Longitudinal Study Posttraumatic Stress Disorder Psychophysiology PTSD Quantitative Study Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
38. Fannin, J. L. (1998, February). Eye movement desensitization and reprocessing (EMDR) in the treatment of anxiety as it pertains to work-related issues. Walden University, Minneapolis, MN. AAT 9804439.
Language: English
Format: Dissertation/Thesis
Abstract:
The purpose of this study was to determine the effect Eye Movement Densitization and Reprocessing (EMDR) has as a treatment protocol on work-related stressors. Today's faster pace, the growing perception of job insecurity, greater demands on the job, and inability to juggle family and work responsibilities has left millions of Americans to experience the debilitating effects of anxiety and stress. Many people lack the knowledge, resources, and strategies to effectively deal with such problems. The issue of stressors in work-related situations is costly and negatively impacts many individuals, organizations, and families. EMDR was found to be both effective and efficient in removing or substantially decreasing anxiety associated with work-related stressors and increase the association to positive cognitions. The data indicated both statistical and clinical improvement in all four areas of measure: subjective units of disturbance (SUD), verification of cognition (VOC), emotional state, and trait anxiety, after EMDR had been administered to members of the experimental group. This study found no statistical significance with these measures as they pertain to the control group. The three null hypotheses were rejected. Several different measures were employed to evaluate the statistical significance of the data produced by this study. Process measures of the verification of cognition (VOC) and subjective units of disturbance (SUD) scales were evaluated through paired sample t-tests. Analysis of variance (ANOVA) was used to evaluate the state and trait anxiety measures. Interactional analysis tested the hypotheses for interaction using repeated measures ANOVA with method and time. Pearson's product moment correlation tested for the association between two variables. Further study is recommended in both the conceptual and theoretical foundations of the EMDR protocol. Such research could lead to more effective and cost-efficient therapy for a wide range of problems affecting the individual, family, and the organization. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 58(8-B), Feb 1998, pp. 4512.
Keywords: Anxiety Empirical Study Eye Movement Desensitization Therapy Occupational Stress Stress Management Treatment Outcome/Clinical Trial Workplace Stress
Accuracy Verified: Yes
39. Finley, P. A. (2002, April). Eye movement desensitization and reprocessing (EMDR) in the treatment of sex offenders. Walden University, Minneapolis, MN. AAT 3068413.
Language: English
Format: Dissertation/Thesis
Abstract:
Most sex offenders in treatment in the United States understand and adapt well to the predominantly cognitive/behavioral/relapse prevention (RP) aspects of their treatment. "No more victims" is the fundamental goal of sex offender treatment, and due to this focus on relapse prevention, most sex offenders do not adequately address their own emotional wounding from early trauma and victimization. This author believes these unresolved affective issues lead to the cognitive distortions and justifications that allow sex offenders to give themselves permission to offend in the first place. Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic intervention that assists in rapidly resolving troubling thoughts, feelings, and physical sensations. Incorporating EMDR into the current cognitive/behavioral/relapse prevention (RP) treatment model for sex offender treatment opens the possibility of reducing the reoffense rate in society. In this study, affective issues of adult male sex offenders (n = 27) were addressed, employing EMDR; this comprised the experimental treatment group. The experimental group received a pretest, three EMDR sessions, and a posttest over an average time of 3.8 months. The Multiphasic Sex Inventory (MSI) was the measure used for this research. The three scales on that test designed to measure for thinking errors were: the Cognitive Distortion and Immaturity (CDI Scale; the Justification (Ju) Scale; and the Treatment Attitudes (TA) Scale. Archived pretest/posttest scores of randomly selected and anonymous adult male sex offenders comprised the control group (n = 27). This group was tested on the MSI and MSI 2 before entering Module 4 and after finishing Module 5, representing 22.5 months of treatment pretest/posttest. All control and experimental group subjects took part in a mandated cognitive/behavioral/relapse prevention (RP) program. The independent two-sample t test was used to compare two means utilizing the rate of change between the experimental and control group. The results of the study indicate a statistically significant reduction in justifications for offender behavior in the experimental group on the Ju scale (p-value = 0.008). On the CDI and TA scale, the null hypotheses were supported. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 63(10-B), Apr 2003, pp. 4899.
Keywords: Empirical Study Male Sex Offenders Relapse Prevention Sex Offenders Sex Offenses Sex Offender Treatment Therapeutic Intervention
Accuracy Verified: Yes
40. 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:
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]
Keywords: Adults Americans Arousal Biofeedback Training Males Posttraumatic Stress Disorder PTSD Random Clinical Trial RCT Relaxation Therapy Treatment Effectiveness Veterans War
Accuracy Verified: Yes
41. Kim, D., & Choi, J. (2004, November). Eye movement desensitization and reprocessing for disorder of extreme stress: A case report. Journal of the Korean Neuropsychiatric Association, 43(6), 760-763.
Language: Korean
Format: Journal
Abstract:
A chronic psychological disorder is often encountered in adult survivors of severe and repeated child abuse. We report a case of successful Eye Movement Desensitization and Reprocessing (EMDR) treatment in a multiply traumatized survivor whose previous treatments with psychotropic medication and supportive psychotherapy were unsuccessful. A series of consecutive six weekly sessions of EMDR were given. The patient completed Symptom Checklist-90-Revised. Dissociative Experiences Scale. State and Trait Anxiety Inventory, Beck Depression Inventory and Impact of Event Scale-Revised at four points; at two months and a week before EMDR, a week and six months after EMDR. After EMDR, the patient improved on all the measures of scales. These gains were maintained at six months after the termination of treatment. This case suggests a possible application of EMDR with for chronic difficult-to-treat post traumatic conditions.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
42. Tye, J. A. (2001, August). Eye movement desensitization and reprocessing treatment for posttraumatic stress disorder and other psychological traumas: A decade of research in review. United States International University, San Diego, CA. AAT 3006172.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new complex treatment method that incorporates salient aspects of many of the major therapeutic modalities as a treatment for PTSD and other psychological trauma in a civilian population. One of the basic underlying principles is elucidated in the Accelerated Processing Model which posits the ability to access and process dysfunctional perceptions that were stored at the time of the traumatic event. These state-dependent perceptions are considered the primary cause of posttraumatic stress symptomatology.The purpose of this review was to investigate whether the EMDR method is an efficacious treatment for individuals diagnosed with PTSD, as reflected in a critical review of the literature from the initial study conducted in 1989 through 2000. The review included the history and background, development, and research to date of EMDR as a method of treatment for PTSD. A description was provided of the psychometric instruments utilized in the assessment; diagnosis; and measurement of the presence, absence, and level of severity of PTSD symptomatology, as described in the research literature of EMDR. Of special concern was the discrepancy between the diagnostic criteria and the presence, absence, and level of severity of PTSD symptomology as described in the treatment outcomes presented in the literature. Included were criteria for assessment instrument comparison, as well as the current limitations in assessment conformity and methodology which restrict the generalizability and assumptions about the way in which traumatic experiences manifest and influence treatment outcomes. [Author Abstract]
Keywords: Empirical Study Literature Review Posttraumatic Stress Disorder PTSD Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
43. Eckley, T. L. (2002, August). Eye movement desensitization and reprocessing: Efficacy with residential latency-age children. Alliant International University, Fresno, CA. AAT 3042989.
Language: English
Format: Dissertation/Thesis
Abstract:
This archival study examined the efficacy of EMDR with residential latency-age children. Participants in the study were the records of 5 children who completed a 10-week EMDR treatment protocol, and 4 children who were in a control group. Treatment included art therapy, play therapy, drama therapy, and talk therapy. EMDR was included as a component of the overall treatment for the experimental group. Pre- and post-measures were assessed using the Behavior Assessment Scale for Children (BASC) and the Trauma Symptom Checklist for Children (TSCC). Three versions of the BASC were used in this study: the Parent Rating Scale (PRS), the Teacher Rating Scale (TRS), and the Self Report of Personality (SRP).Paired-sample t tests demonstrated significant differences on the BASC-SRP and the TSCC for the experimental group at pre- and post-measures. For the BASC-SRP, the children in the experimental group endorsed significantly fewer items for Atypicality, Locus of Control, Social Stress, and Anxiety at the conclusion of the study as compared to initial results. For the experimental group, three of the six scales on the TSCC were significantly lower at the end of the study than at the beginning of the study. The children endorsed significantly fewer symptoms of PTSD, Depression, and Dissociation at the end of treatment as compared to the beginning of treatment. Because of the numerous limitations of this study, generalizability is inevitably limited. However, the outcome of this research indicates that EMDR can be effective to reduce overall symptomology of severely traumatized children. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 63(2-B), Aug 2002, pp. 1021.
Keywords: Depressive Disorders Dissociative Symptoms Empirical Study Posttraumatic Stress Disorder PTSD School Age Children Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
44. Zeper, R. S. (1996). Eye movement desensitization and reprocessing: A multiple baseline study. The Union Institute, Cincinnati, OH. AAT 9701084.
Language: English
Format: Dissertation/Thesis
Abstract:
Eye Movement Desensitization and Reprocessing (EMDR) was developed in 1987 by Francine Shapiro, as a modality for relieving anxiety, traumatic memories, intrusive thoughts, and reprocessing negative self-beliefs to positive self-beliefs. One of the most common uses of EMDR in recent years has been the treatment of PTSD.This current study investigated the effects of EMDR across a sample of 3 sexually abused women diagnosed with PTSD using a multiple baseline design across subjects. The study specifically focused on whether or not intervention with EMDR effects traumatic memory and negative/irrational cognitions, decreases stress or changes levels of anxiety, depression and heart rate. The study intended to assess the efficacy of EMDR while simultaneously reduce human suffering and answer some of the more serious criticisms which have blurred confidence in EMDR outcome research. Specifically, the study controlled for a number of the criticisms in the literature predominantly through a confirmation of an accurate PTSD diagnosis and through the use of a multiple baseline design. The multiple baseline design was applied sequentially to the same problem across different but matched subjects sharing the same environmental conditions. Heart rate level and well-known psychometrics were used to obtain baseline, intervention and post-intervention measures. Psychometric scores reflecting levels of depression, anxiety, and subjective levels of the impact of distress regarding the trauma were assessed along with the levels of anxiety currently experienced about the trauma and subjective ratings regarding the acceptance of the preferred, self-generated positive cognition. The measures used in this study were an initial clinical interview, an Anxiety Disorders Interview Schedule for the DSM-IV, Beck Depression Inventory, Beck Anxiety Inventory, Wolpe's Subjective Unit of Disturbance Scale, Validity of Cognition, Impact of Event Scale and heart rate. The study reported descriptive statistics to analyze the multiple baseline study and to determine EMDR's clinical significance in treating PTSD. The effects of EMDR on the three PTSD subjects of this study demonstrated that meaningful changes occurred in several areas. Subjective disturbance and stress surrounding the traumatic memory decreased, positive self-cognitions increased, and both depression and anxiety levels decreased following EMDR treatment. No change in heart rate physiology occurred. All of the study's treatment measures were maintained at follow-up. The results of this study suggest that EMDR may be a powerful and effective intervention to reduce patient suffering in a relatively painless fashion. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 57(8-B), Feb 1997, pp. 5350.
Keywords: Adults Empirical Study Females Posttraumatic Stress Disorder PTSD Rape Survivors Treatment Effectiveness Treatment Outcome/Clinical Trial
Accuracy Verified: Yes
45. Wildwind, L. (1995, June). Facilitating live consultation. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The objectives of this presentation are to define ADHD in the various ways it presents adults, using EMDR cognitions and
observations of clients as clues; then, to clarify why and EMDR works differently before, during, and after diagnosis,
The presenter will provide background on the biological differences of those with the disorder, some thoughts on why this diagnosis
is becoming so frequent at this time, and why therapists who use EMDR may be more likely to have the disorder and to see it in their
clients.
During the workshop participants will explore their own attitudes toward ADHD and learn about how these attitudes influence their
ability to identify and assess ADHD symptoms in clients. Values, judgments and common myths about ADHD will be briefly
discussed.
Specific suggestions about modifying treatment when ADHD is suspected, suggested as a possible diagnosis to the client, and
treated will be given, including a list of modified positive cognitions. Treatment planning ideas for clients with a variety of
concurrent diagnoses will be offered, with special attention to the problems of resistance to the diagnosis, the medications use for
treatment, and the process of adapting patterns to solve specific problems, using a specific example a group treatment planning
exercise will be conducted. The actual treatment history of the case will be given clarifying how the treatment goals were reached.
There will he time for participants to formulate negative and positive cognitions regarding their attitudes toward ADHD clients and
the use of appropriate medications, and to assess the strength those attitudes, SUDS scales will be used.
Participants will have an opportunity to ask questions and will obtain a bibliography, a client questionnaire, a list of modified
cognitions, and a summary of resources for medical treatment, education and social support.
Keywords: Consultation
Accuracy Verified: Yes
46. 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:
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]
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
47. Pagani, M. (2010, June). Gray matter density is associated with EMDR outcome in PTSD patients. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder patients. Eye Movement Desensitization Reprocessing (EMDR) is currently used to treat PTSD but its neurobiological implications are still unknown. The aim of this study was to evaluate GM density in PTSD relation to trauma load, and to assess the GM differences between responders (R) and non-responders (NR) to EMDR therapy.
Structured clinical interviews for DSM-IV Axis I Disorders were carried out before and after EMDR treatment. Those who no longer fulfilled the DSM-IV criteria for PTSD were classified as R and those who still met the diagnostic criteria of PTSD after treatment were classified as NR. Two scales 0f self-related Trauma Antecedent Questionnaire (‘trauma and neglect’ TAQ-, and ‘resilience factors’ TAQ+), were administered to assess lifelong trauma load and resilience. Magnetic Resonance Imaging (MRI) scans 10 R and of 5 NR were compared before therapy by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM. For group analysis, a threshold of p<0.05 corrected for multiple comparisons at cluster level and an uncorrected threshold of p <0.001 at voxel-level were used.
NR subjects showed no significant differences nor in TAQ- scores neither in TAQ+ as compared to R(t=0.140, p+0.891). The contract R>NR exhibited a significant GM lower density in NR as compared to R in three different cluster: the first bilaterally located over posterior cingulate (Brodmann Areas, Bas 23 and 31); the second centered over the left precentral (BA 4), middle and medial frontal gyri (BA 6); the third including anterior insula (BA 13), and the complex anterior parahippocampal gyrus/amygdala, over the right hemisphere.
To our knowledge, this is the first study investigating GM alterations with a VBM approach in a sample of PTSD patients respond and non responding to EMDR therapy. Posterior cingulate, parahippocampal and insular lower GM concentrations have been found to relate to responsiveness to EMDR therapy suggesting a high vulnerability of these structures to the effects of stress and trauma. These regions are well known to be implicated in processes such as: integration, encoding and retrieval of autobiographical and episodic memories; emotional processing, interoceptive awareness and sefl-referential conscious experience. Thus, our study supports lower GM densities in limbic and paralimbic cortices as a potential structural basis for memory and dissociative dysfunction in PTSD. Using such methodological approach can contribute to better understand the neurostructural basis for traumatic responses and their treatment.
The goals for the audience are: 1. To understand the methodological research principles; 2. To be updated on neurobiological research in EMDR; 3. to be informed on the neural basis of EMDR.
Keywords: Gray Matter Posttraumatic Stress Disorder PTSD Research Symposium
Accuracy Verified: Yes
48. Connor, P. K. (2005). Guideline-based programs in the treatment of complex PTSD. Deakin University, Victoria, Australia.
Language: English
Format: Dissertation/Thesis
Abstract:
The term “post-traumatic stress disorder” (PTSD) is a relatively new diagnostic label, being formally recognized in 1980 in the Diagnostic Statistical Manual for Psychiatric Illness – Third Edition (DSM-III) of the American Psychiatric Association (APA, 1980). Complex Post-Traumatic Stress Disorder (CP) is a more recently discussed, and newly-classified, phenomenon, initially discussed in the early 1990s (Herman, 1992a). Thus, as research into effective treatments for CP is sparse, the treatment of CP is the topic of this study, in which a guideline-based treatment program developed by the researcher for the treatment of CP is implemented and evaluated. Ten individuals participated in this study, undertaking individualized, guideline-based treatment programs spanning a period of six months. In providing background information relevant to this study, an explanation is provided regarding the nature of CP, and the reasons for its consideration as a separate phenomenon to PTSD. The adequacy of the PTSD formulation in enabling effective assessment and treatment of CP is also explored, with endorsement of previous researchers’ conclusions that the CP construct is more useful than the PTSD construct for assessing and treating survivors of long-term and multiple forms of abuse. The PTSD classification is restrictive, and not necessarily appropriate for certain forms of trauma (such as prolonged trauma, or multiple forms of trauma), as such trauma experiences may lead to specific effects that lay outside those formerly associated with PTSD. Such effects include alterations in affect regulation, consciousness, self-perception, interpersonal relationships, and in systems of meaning. Following discussion regarding the PTSD/CP classification, an examination of treatment methods currently used in the treatment of PTSD, and a review of treatment outcome studies, takes place. The adequacy of primary treatment methods in treating CP symptoms is then examined, with the conclusion that a range of treatment methods could potentially be useful in the treatment of CP symptoms. Individuals with a diagnosis of CP may benefit from the adoption of an eclectic approach, drawing on different treatment options for different symptoms, and constantly evaluating client progress and re-evaluating interventions. This review of treatment approaches is followed by details of an initial study undertaken to obtain feedback from individuals who had suffered long-term/multiple trauma and who had received treatment. Participants in this initial study were asked open-ended questions regarding the treatment approach they had experienced, the most useful aspect of the treatment, the least useful aspect, and other strategies/treatment approaches that may have been useful – but which were not used. The feedback obtained from these individuals was used to inform the development of treatment guidelines for use in the main study, as were recommendations made by Chu (1998). The predominant focus of the treatment guidelines was “ego strengthening”, a term coined by Chu (1998) to describe the “initial (sometimes lengthy) period of developing fundamental skills in maintaining supportive relationships, developing self-care strategies, coping with symptomatology, improving functioning, and establishing a positive self identity” (p.75). Using a case study approach, data are then presented relating to each of the ten individuals involved in the treatment program: details of his/her trauma experience(s)and the impact of the trauma (as perceived by each individual); details of each individual’s treatment program (as planned, and as implemented); post-treatment evaluation of the positive and negative aspects of the treatment program (from the therapist’s perspective); and details of the symptoms reported by the individual post-treatment, via psychometric assessment and also during interview. Analysis and discussion of the data relating to the ten participants in the study are the focal point of this study. The evaluation of the effectiveness of each individual’s treatment has been based predominantly on qualitative data, obtained from an analysis of language (discourse analysis) used by participants to describe their symptoms pre- and post-treatment. Both blatant and subtle changes in the language used by participants to describe themselves, their behaviour, and their relationships pre- and post-treatment have provided an insight into the possible changes that occurred as a result of the treatment program. The language used by participants has been a rich source of data, one that has enabled the researcher to obtain information that could not be obtained using psychometric assessment methods. Most of the participants in this study portrayed notable changes in many of the CP symptoms, including being more stable and having improved capacity to explore their early abuse. Although no direct cause-effect relationship between the participants’ treatment program and the improvements described can be established from this study, the participants’ perception that the program assisted them with their symptoms, and reported many aspects of “ego strengthening”, is of major importance. Such self-perception of strength and empowerment is important if an individual is going to be able to deal with past trauma experiences. In fact, abreactive work may have a greater chance of succeeding if those who have experienced long-term or multiple trauma are feeling more empowered, and more stable, as were the participants in this study (post-intervention). In concluding this study, recommendations have been made in regard to the use of guideline-based treatment programs in the responsible treatment of CP. Strengths and limitations of this study have also been highlighted, and recommendations have been made regarding possibilities for future research related to CP treatment. On the whole, this study has supported strongly other research that highlights the importance of focusing on “ego strengthening” in assisting those who have suffered long-term/multiple trauma experiences. Thus, a guideline-based program focusing on assisting sufferers of long-term trauma with some, or all, of the symptoms of CP, is recommended as an important first stage of any treatment of individuals who have experienced long-term/multiple trauma, allowing them to develop the emotional and psychological strength required to deal with past traumatic events. Clinicians who are treating patients whose history depicts long-term or multiple trauma experiences (either from their childhood, or at some stage in their adult life) need, therefore, to be mindful of assessing individuals for symptoms of CP – so that they can treat these symptoms prior to engaging in any work associated directly with the past traumatic experiences. [Author abstract]
D.H.Sc.(Psych.) thesis, School of Psychology.
Keywords: Posttraumatic Stress Disorder Psychotherapy Treatment
Accuracy Verified: Yes
49. Adúriz, M. E., Bluthgen, C., & Knopfler, C. (2009, May). Helping child flood victims using group EMDR intervention in Argentina: Treatment outcome and gender differences. International Journal of Stress Management, 16(2), 138-153. doi:10.1037/a0014719.
Language: English
Format: Journal
Abstract:
A comprehensive group intervention with 124 children who experienced disaster-related trauma during a massive flood in Santa Fe, Argentina, in 2003 is illustrated, utilizing a one-session group eye movement desensitization and reprocessing (EMDR) protocol. A posttreatment session was done 3 months after the treatment intervention to evaluate results. Results of this one-session treatment procedure, utilizing the EMDR-Integrative Group Treatment Protocol, showed statistically significant reduction of symptoms immediately after the intervention. These statistically significant differences were sustained at posttreatment evaluation 3 months later, as measured by psychometric scales, and by clinical and behavioral observation. Data analysis also revealed significant gender differences. Despite methodological limitations, this study supports the efficacy of EMDR group treatment in the amelioration and prevention of posttraumatic stress disorder symptoms, providing an efficient, simple, and economic (in terms of time and resources) tool for disaster-related trauma. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Keywords: Argentina Floods Gender Difference Group Interventions Integrative Group Treatment Protocol Treatment Outcome Victims
Accuracy Verified: Yes
50. Giamp, J. S. (2003). Honoring their voice: Eye movement desensitization and reprocessing through the eyes of inmates with developmental disabilities. Walden University, Minneapolis, MN. AAT 3119790.
Language: English
Format: Dissertation/Thesis
Abstract:
This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) on inmates with developmental disabilities (DD) who were incarcerated in a special needs correctional facility in the southwestern United States. Cognitively, these inmates ranged from borderline intellectual functioning (BIF) to mild mental retardation (MMR), and all suffered from PTSD-like symptoms. A repeated measure pre- and postanalysis design with one sample group was utilized. The Emotional Problem Scales (EPS), Impact of Events Scales - 8 Items (IES-8), Validity of Cognition Scales (VOCS), and Subjective Units of Disturbance Scales (SUDS) were used to gather quantitative data on the 17 volunteer participants. Baseline and outcome data were collected by an independent assessor. The T-Test was incorporated to analyze the data and determine significance. Due to the small sample of convenience, the data were skewed, so the researcher also used the nonparametric Wilcoxon Signed Rank Test. Descriptive data on EMDR were collected and analyzed.As measured by the SUDS, IES-8, and VOCS, the statistical findings revealed self-reported reductions in levels of distress, avoidance, and intrusiveness of the traumatic memory, and an increase in self-esteem and the believability of positive cognitions about self and the event after the application of EMDR. However, the clinical scales from the Self-Report Inventory (SRI) of the EPS did not reveal any changes after the application of EMDR. Staff familiar with the study volunteers also reported a significant decrease in clinical pathology and an increase in prosocial behavior, as measured by the Behavior Rating Scale (BRS) of the EPS. Findings suggest that the utilization of EMDR with persons having developmental disabilities may have clinical utility. Thus, further research in this area is warranted. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(1-B), 2004, pp. 436.
Keywords: Americans Empirical Study Mentally Retarded Posttraumatic Stress Disorder Prison Inmates PTSD Quantitative Study Self Esteem Treatment Effectiveness
Accuracy Verified: Yes
51. Lamprecht, F., Sack, M., & Lempa, W. (2002, November). Improved regulatory capacities after successful treatment of PTSD. Poster presented at the 18th annual meeting of the International Society for Traumatic Stress, Baltimore, MD.
Language: English
Format: Conference
Abstract:
We assessed the effects of psychotherapeutic treatment on psychophysiological
hyperarousal and self-regulation during confrontation with a traumatic
reminder in 15 subjects with PTSD before, shortly after EMDR-treatment
and at 6-month follow-up.All subjects underwent a psychphysiological evaluation
with a modified traumascript paradigm including assessment of scriptprovoked
heart rate changes and heart rate variability. Respiratory sinus
arrhythmia (RSA) as the component of heart rate variability closely related
to vagal tone was derived from the time-series of inter-beat intervals via
polynomial band-pass filtering (Porges 1992). Psychometric instruments (IES,
PDS, SUD-Scale) were used to assess treatment outcome.We found a significant
overall reduction in psychometric measures of PTSD-symptomatology
as well as significantly decreased levels of script provoked HR-acceleration
after EMDR-treatment (11.3 ± 10.8 bpm vs. 5.1 ± 5.7 bpm, p < .03). As
expected, traumascript presentation suppressed RSA-levels reflecting the
effect of stress on vagal regulation. In comparison pre- vs. follow-up RSA
increased significantly during baseline (5.06 ± .98 vs. 5.86 ± 1.2, p < .004) as
well as during traumascript (4.55 ± 1.26 vs. 5.55 ± 1.23, p < .02). Our findings
of higher RSA-levels in combination with reduced HR reactions on a traumatic
reminder after successful psychotherapy can be interpreted as a therapy
mediated enhancement of biologically determined self regulation capacities.
Keywords: Poster Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
52. Frustaci, A., Pozzi, G., Aurigemma, C., La Rosa, C., Lanza, G., Fernandez, I., & Ruggeri, G. (2006, Febbraio). Indicatori di cambiamento in pazienti con disturbi da eventi stressanti: Impiego della heart rate variability [Indicators of change in patients with disorders of stressful events: Use of heart rate variability]. Poster presentato al XI Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia.
Language: Italian
Format: Conference
Abstract:
Introduzione: i pazienti traumatizzati presentano alterazioni sintomatiche quali intrusività, evitamento ed aumentato arousal, che ostacolerebbe la possibilità di elaborazione/integrazione
delle tracce mnesiche, oltre ad esprimersi a livello periferico. Tecniche specifiche di trattamento sembrano promuovere
l’elaborazione/integrazione delle memorie traumatiche, tra cui la Eye Movement Desensitization and Reprocessing
(EMDR). Nella ricerca valutativa è quindi necessario affiancare alle scale psicologiche un appropriato indicatore
biologico di attivazione neurovegetativa. La variabilità della frequenza cardiaca (Heart Rate Variability – HRV) esprime
l’integrità funzionale del sistema neurovegetativo in risposta
allo stress e può essere misurata nei domini di tempo o di frequenza. Lo studio della HRV è stato applicato in psichiatria ai disturbi
d’ansia (panico, DOC, PTSD) e dell’umore (depressione unipolare) in ricerche trasversali (confronto con controlli sani) e longitudinali di trattamento farmacologico (triciclici,
SSRIs) ma in pochi casi a trattamenti psicoterapici. Gli AA. valutano l’impiego della HRV come indicatore biologico nel trattamento psicoterapeutico di pazienti con Disturbo dell’adattamento erdurante da oltre un mese dopo l’esposizione ad eventi vitali stressanti (EVS). Metodi: sono stati reclutati 6 soggetti (M/F = 1/5, età 40,5 ± 11,0) esposti ad EVS ed avviati a ciclo di trattamento psicoterapico
breve (4-6 sedute a cadenza settimanale) di tipo
specifico (EMDR) o generico (colloqui supportivi). Costituivano criteri di esclusione: età < 18 o > 65 anni; comorbilità psichiatrica, neurologica e cardiologica; uso di farmaci interferenti. Le valutazioni psicopatologiche sono state eseguite al reclutamento
(TBASE: colloquio anamnestico, MINI, Brief
COPE), a inizio e fine ciclo di trattamento (TINI, TFINE: IES, SCL-90-R), a uno e tre mesi di follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Le registrazioni Holter sono state effettuate ad ogni intervallo valutativo coprendo: 60 min. attività libera, 10 min. tilt-test, 3-5 min. ascolto dell’evento traumatico, 30-45 min. seduta psicoterapica. Sono stati impiegati test statistici non parametrici per l’analisi
delle correlazioni (Spearman) e delle differenze
(Wilcoxon). Risultati preliminari: vengono valutate le correlazioni a TINI e le variazioni T90 vs. TINI. Sono significative le seguenti correlazioni: ansia fobica SCL e SDNN (dev. standard intervalli R-R) [r = + 0,9; p = ,037]; collera-ostilità
SCL e SDNN [r = -0,95; p =.014]; depressione SCL e
r-MSSD (radice media somma quadrati diff. R-R) [r = + 0,9; p = ,037]; sint. intrusivi IES e LF (basse frequenze) [r
= -0,9; p = ,037]. Sono risultate statisticamente significative le seguenti variazioni:
IES totale [Z = -1,99; p = ,046], sintomi intrusivi IES [Z = -2,21; p = ,027], sintomi di evitamento IES [Z = -1,99; p = ,046], ideazione paranoide SCL [Z = -2,21; p = ,027]; R-R, LF e LF/HF (rapporto basse/alte frequenze) durante ascolto evento [Z = -2,02; p = ,043].
Discussione: a livello basale gli indicatori HRV di distress vegetativo correlano positivamente con collera-ostilità e sintomi intrusivi, negativamente con ansia e depressione. Anche dopo tre mesi dalla fine del trattamento gli interventi psicoterapeutici tendono a ridurre i punteggi sintomatici, e migliorano il bilancio simpato-vagale durante il riascolto dell’evento traumatico.
Introduction: trauma patients have symptomatic changes such as intrusiveness, avoidance and increased arousal, which hampers the development / integration
of memory traces, as well as speak at the peripheral level. Specific techniques of treatment seem to promote
the formulation and integration of traumatic memories, including eye movement desensitization and reprocessing
(EMDR). In evaluation research is therefore necessary to combine psychological scales appropriate indicator
organic autonomic activation. The heart rate variability (Heart Rate Variability - HRV) expresses
functional integrity of the autonomic nervous system in response
stress and can be measured in time or frequency domains. The study of HRV has been applied in psychiatric disorders
anxiety (panic, DOC, PTSD) and mood (unipolar depression) in cross-disciplinary (compared with healthy controls) and longitudinal drug treatment (tricyclic
SSRIs), but in a few cases in psychotherapeutic treatment. The AA. evaluate the use of HRV as a biological indicator in the psychotherapeutic treatment of patients with adjustment disorder erdurante more than a month after exposure to stressful life events (EVS). Methods: 6 subjects were recruited (M / F = 1 / 5, age 40.5 ± 11.0) exposed to EVS and initiated treatment cycle psychotherapeutic
short (4-6 sessions weekly) type
specific (EMDR) or generic (hearing supported). Exclusion criteria were: age <18 or> 65 years, psychiatric comorbidity, neurological and cardiological, use of drugs interfering. Psychopathological assessments were performed at recruitment
(TBASE: anamnestic interview, MINI, Brief
COPE) at the beginning and end of treatment cycle (TINI, TFINE: IES, SCL-90-R) in a three-month follow-up (T30, T90: IES, SCL-90-R, Brief COPE). Holter recordings were made at each interval evaluation covering: 60 min. free activity, 10 min. tilt-test, 3-5 min. listening to the traumatic event, 30-45 minutes. psychotherapy session. Were used nonparametric statistical tests for analysis
correlations (Spearman) and differences
(Wilcoxon). Preliminary results: the correlations are evaluated and changes TINI vs. T90. TINI. Significant correlations are the following: SCL phobic anxiety and SDNN (standard dev. RR intervals) [r = + 0.9, p =, 037]; anger-hostility
SCL SDNN [r = -0.95, p =. 014]; SCL depression
r-mssd (root mean square sum diff. RR) [r = + 0.9, p =, 037]; sint. IES intrusive and LF (low frequency) [r
= -0.9, P =, 037]. Were statistically significant, the following changes:
IES total [Z = -1.99, p =, 046], IES intrusive symptoms [Z = -2.21, p =, 027], symptoms of avoidance IES [Z = -1.99, p =, 046] , SCL paranoid [Z = -2.21, p =, 027], RR, LF and LF / HF ratio (low / high frequencies) while listening event [Z = -2.02, p =, 043].
Discussion: At baseline HRV indicators of distress correlated positively with growing anger-hostility, and intrusive symptoms, negatively with anxiety and depression. Even after three months of the end of psychotherapeutic treatment interventions aimed at reducing symptom scores and enhance sympathetic vagal balance during the playback of the traumatic event.
Keywords: Heart Rate Variability Poster Stress Disorders
Accuracy Verified: Yes
53. Grand, D. (1996, June). Integrating EMDR into the psychodynamic treatment process. EMDRIA Newsletter, 1(1), 14-16.
Language: English
Format: Newsletter
Abstract:
EMDR was originally developed utilizing cognitive therapy theories and constructions (i.e., cognitive/behavior restructuring, information processing, rating scales) (Shapiro, 1995). Accordingly, the relevance and potential applications of psychodynamic concepts to EMDR went largely unnoticed. However, Dr. Shapiro formed the concept ‘syclectic’ (synthesis of the eclectic) as she recognized the analytic contributions to EMDR such as the significance of early childhood memories, the unconscious, free association, insight, catharsis, abreaction, and symbolism (Shapiro, 1995). In face, a psychodynamic therapist incorporating EMDR into his or her technique cannot help but learn and recognize the value of many cognitive ideas and practices. The same holds true for cognitive practitioners who can discover that the use of EMDR opens to them the shadowy word so familiar to the analyst. Accordingly, EMDR lies at the confluence of two great rivers of thought which is further evidence of its profound nature.
Keywords: Psychodynamic Syclectic
Accuracy Verified: Yes
54. Tarquinio, C., Schmitt, A., Tarquinio, P., Rydberg, J.-A., & Spitz, E. (2012, April-June). Intérêt de la psychothérapie « eye movement desensitization reprocessing » dans le cadre de la prise en charge de femmes victimes de viols conjugaux [Benefits of "eye movement desensitization and reprocessing" psychotherapy in the treatment of female victims of intimate partner rape]. Sexologies, 21(2), 92-99. doi:10.1016/j.sexol.2011.05.001.
Language: French
Format: Journal
Abstract:
L’objectif de cette étude est de mettre en évidence à partir du suivi de six femmes
victimes de viols par leur conjoint, les effets de la thérapie « eye movement desensitization
reprocessing », notamment en ce qui concerne la réduction des symptômes d’état de stress posttraumatique,
d’anxiété et de dépression. Toutes ces femmes ont, en outre, fait l’objet d’une
évaluation quantitative à partir d’échelles de mesure proposées avant la prise en charge ainsi
qu’à l’issue de chacune des séances. Les échelles utilisées sont l’Hospital Anxiety and Depression
scale, l’Impact Event Scale et un indicateur propre à la thérapie Eye Movement Desensitization
Reprocessing, le Subject Unit of Distress. Les victimes ont également participé à deux entretiens
plus qualitatifs avant et après la prise en charge, afin d’évaluer plus précisément la présence ou
non de symptômes d’état de stress post-traumatique sur la base des indications fournies par le
Manuel Diagnostic et Statistique des troubles mentaux (American Psychiatric Association [APA],
2004). Les résultats obtenus sont conformes à nos attentes et montrent une diminution significative
et progressive des scores aux différentes échelles au fur et à mesure des séances. Ainsi,
comme on le rencontre classiquement dans la littérature, une prise en charge par la thérapie
Eye Movement Desensitization Reprocessing conduit les sujets à s’auto-évaluer comme étant
de moins en moins perturbés au fur et à mesure que la psychothérapie progresse. Nous avons également pu observer une réduction importante des scores aux différentes échelles à l’issue
des deux premières séances. Enfin, la prise en charge psychologique réalisée à partir de la
thérapie « eye movement desensitization reprocessing » a conduit à une diminution notable du
nombre de symptômes liés au diagnostic d’état de stress post-traumatique. Cette diminution
s’est révélée homogène pour les trois critères pris en compte (critère B, C et D du American
Psychiatric Association [APA], 2004).
The objective of this study is to demonstrate through monitoring of six women
raped by their spouses, the effects of therapy "Eye Movement Desensitization
reprocessing, "including with regard to reducing symptoms of posttraumatic stress state,
anxiety and depression. All these women have also been a
quantitative assessment based on measurement scales proposed by the management and
at the end of each session. The scales used were the Hospital Anxiety and Depression
Scale, the Impact Event Scale and an indicator specific therapy Eye Movement Desensitization
Reprocessing, the Subject Unit of Distress. Victims have also participated in two interviews
more qualitative before and after treatment to assess more accurately the presence or
without symptoms of Posttraumatic Stress Disorder on the basis of information provided by the
Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association [APA],
2004). The results are consistent with our expectations and show a significant decrease
and progressive scores at different levels as and when the sessions. Thus,
as is typically found in the literature, supported by a therapy
Eye Movement Desensitization Reprocessing leads individuals to assess themselves as
less disturbed as and as psychotherapy progresses. We also observed a significant reduction in scores on different scales at the end
the first two sessions. Finally, the psychological care made from the
therapy "eye movement Desensitization Reprocessing" led to a significant reduction in the
number of symptoms to diagnosis of posttraumatic stress disorder. This decrease
has been consistent for the three criteria considered (criterion B, C and D of the American
Psychiatric Association [APA], 2004).
Keywords: Anxiety Depression Females Marital Rape Partner Rape Victims Women
Accuracy Verified: Yes
55. Maquieira, S., Aduriz, M. E., & Knopfler, C. (2008, Abril). La catastrofe y el trauma: Un model de abordaje con grupos acotados [Catastrophe and trauma: An approach with short terms]. Revista de Psicotrauma, 5(1), 28-39.
Language: Spanish
Format: Journal
Abstract:
Este documento se centra en un modelo de intervención para las catástrofes que utiliza grupo a corto plazo y el enfoque psicoterapéutico conocido como el método EMDR. Ayudar a una gran cantidad de personas es posible a través de este método de intervención terapéutica, que ha demostrado ser muy eficaz. Su objetivo es proporcionar ayuda emocional y para garantizar los eventos traumáticos son procesados correctamente, lo que impide el desarrollo de cualquier secuelas traumáticas. Requisitos para la planificación y excuting este tipo de intervención se describen. Conseptualisations metodológicos que subyacen a este enfoque, que tiene sus raíces en la salud mental en el modelo de desastres elaborado por Ignacio Jarero y Artigas Lucinca en México, se explicó. Algunos casos clínicos se presentan para ilustrar el nuevo tratamiento de experiencias perturbadoras y los resultados de la intervención. Esta intervención se consigue una reducción significativa de los síntomas, según lo confirmado por las mediciones con las escalas, así como las observaciones clínicas y de comportamiento. (Resumen del autor)
This paper focuses on an intervention model for catastrophes that uses short term groups and the psychotherapeutic approach known as EMDR. Assisting a large amount of people is possible through this therapeutic intervention method, which has proven to be highly effective. Its purpose is to provide emotional relief and to ensure traumatic events are correctly processed, thus preventing the development of any traumatic sequels. Requirements for planning and excuting this type of intervention are described. Methodological conseptualisations that underline this approach, which has its roots in mental health in disasters model developed by Ignacio Jarero and Lucinca Artigas in Mexico, are explained. Some clinical cases are presented to illustrate the reprocessing of disruptive experiences and the results of intervention. This intervention achieves significant symptom reduction, as confirmed by measurements with scales as well as clinical and behavior observations. (Author abstract)
Keywords: Crisis Intervention Trauma
Accuracy Verified: Yes
56. Hingorany, S. (2010, July). Long-term treatment effect for pain disorder and eating disorder by using EMDR: A case report. Symposium (Samin Karim, Chair) conducted at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
This case received an integrated approach treatment mainly composed of eye movement desensitization and reprocessing
(EMDR) and Resource Development. The patient did not respond to the previous treatment with psychotropic medications
and supportive psychotherapy.
Thirty sessions of EMDR treatment were done for the patient. Psychological assessments were conducted before starting
the treatment, after 5 months of treatment (mainly using EMDR ), the pain had disappeared completely. Binging Episodes
had reduced to nil. The antidepressant medication had been maintained through the treatment. After the treatment, the
patient improved on all the psychological scales and behavioural measures. This case suggests that the integrated approach
treatment using EMDR may be effective for complex Pain Disorders and Eating Disorders
Keywords: Case Report Eating Disorders Pain Disorders
Accuracy Verified: Yes
57. Kim , N. H. (2010, July). Long-term treatment effect of complex PTSD by using eye movement desensitization and reprocessing: A case report. Poster presented at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
People who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological
disturbances and many of them meet the criteria for proposed diagnosis of complex posttraumatic stress disorder (complex
PTSD). The author reports a case of the successful sequential integrative treatment mainly composed of eye movement
desensitization and reprocessing (EMDR) in a complex PTSD patient. The patient did not respond to the previous treatment
with psychotropic medications and supportive psychotherapy. Nineteen sessions of EMDR treatment were done for the
patient. Psychological assessments and behavioral measures were performed before starting the treatment, after 4 months of
treatment (mainly EMDR treatment), after 17 months of treatment (mainly supportive psychotherapy integrated with EMDR
treatment for 13 months) and after 32 months of treatment (supportive psychotherapy for 15 months). The antidepressant
medication had been maintained through the treatment. After the treatment, the patient improved on all the psychological
scales and behavioral measures. This case suggests that the sequential integrative treatment using EMDR may be effective
for complex PTSD patients.
Keywords: Case Report Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD Poster
Accuracy Verified: Yes
58. Pagani, M., Flumeri, F., Salmaso, D., Nardo, D., Sanchez-Crespo, A., Danielsson, A. M., Brolin, F., Jacobsson, H., Larsson, S. A., & Hogberg, G. (2008, October). Neurobiological changes in post traumatic stress disorder following treatment with eye movement desensitisation reprocessing. Presentation at the European Association of Nuclear Medicine Congress, Munich, Germany, European Journal of Nuclear Medical and Molecular Imaging, 35(Supp 2).
Language: English
Format: Conference
Abstract:
Background: Only few studies have reported functional or structural modifications in Post Traumatic Stress Disorder (PTSD) patients following pharmacological treatment or psychotherapy. Eye movement desensitization and reprocessing (EMDR) is a novel eclectic psychotherapy utilising, among other techniques, relaxation and safe place exercises, cognitive restructuring, future projections, and imaginal exposure of the trauma combined with sensory stimulation. The aim of the study was to analyse the differences in regional cerebral blood flow (rCBF) distribution and in brain volumetry before and after EMDR therapy.
Subjects and Methods: Fifteen subjects with chronic PTSD following occupational health hazards were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before and directly after treatment. SPECT, during administration of an individualised trauma script, was performed using 99mTc-HMPAO. After EMDR, the subjects were subdivided into responders (R, n=10) and non-responders (NS, n=5), based on the absence or presence, respectively, of full PTSD diagnosis. SPECT and volumetric data (MRI) analyses were carried out by Statistical Parametric Mapping (SPM2). SPECT and MRI data were covaried by age and by time elapsed from trauma to SPECT. SPECT data were further covaried by the amount of grey matter normalised by the total intracranial volume.
Results: Immediate significant post-treatment changes towards normality in all scales measuring psychological status were found in responders. As compared to NR, R showed a significantly decreased tracer uptake in parieto-occipital (Brodmann Area, BA, 37, fusiform gyrus) and in primary visual cortex (BA17) and in the hippocampus (p<0.001). The opposite comparison highlighted an increased tracer uptake in left frontal cortex (BA 44; p<0.05). Structural grey matter modifications were found in visual, posterior cingulate and parieto-temporal cortex, paralleling the functional changes.
Conclusion: The positive EMDR outcome corresponded to increased 99mTc-HMPAO uptake in the left dorsolateral frontal cortex, processing attention and self confidence and exerting an inhibitory effect on the amygdala whose firing is supposed to be responsible for PTSD. After successful treatment significant decreases were found in primary visual cortex, processing images of traumatic memories and flashbacks; in fusiform gyrus, processing the memories of faces, bodies and words and in the hippocampi, involved in episodic and autobiographical memories. Volumetric changes paralleled the ones in tracer uptake in all regions Taken as a whole these findings suggest that the positive clinical outcome following EMDR therapy causes functional and structural neurobiological changes towards normality.
Keywords: Brain Volumetry Neurobiological Changes Posttraumtic Stress Disorder PTSD rCBF Regional Cerebral Blood Flow
Accuracy Verified: Yes
59. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia.
Language: Italian
Format: Conference
Abstract:
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e
con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione
preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano
come lo stress causi atrofia ippocampale e inibizione della
neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore
neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un
lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di
atrofia ippocampale è dovuto ad un’alterazione dell’asse
Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa
increzione di glucocorticoidi che determina un aumento del
feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale.
Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale
indotta dallo stress nell’animale 5 e nell’uomo sono in grado
di ridurre i sintomi del PTSD, incrementare le dimensioni
dell’ippocampo e ridurre i deficit mnesici tipici della patologia
6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio
che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono:
– valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free);
– valutare l’effetto della terapia: farmacologica con SSRI e
psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico,
che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di
Siena affetti da PTSD e un gruppo di controllo di soggetti
sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi
i gruppi sono stati sottoposti ad uno studio morfovolumetrico
computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici
e scale psicometriche per approfondire il quadro
psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di
terapia psicofarmacologica sono stati ripetuti i test neuropsicologici,
le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM.
Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati
dopo 8 sedute (due mesi).
Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di
sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile
evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento
dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati
sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio
risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno
anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento
medio dei volumi ippocampali pari a 338,25 mm3 per
l’ippocampo DX e 357,93 mm3 per l’ippocampo SN.
Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%).
L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi;
è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR.
Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia
diretta alla struttura cerebrale.
Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
60. Hogberg, G., Pagani, M., Sundin, Ö., Soares, J., Aberg-Wistedt, A., Tarnell, B., & Hallstrom, T. (2007, February). On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers – A randomized controlled trial. Nordic Journal of Psychiatry, 61, 54-61. doi:10.1080/08039480601129408.
Language: English
Format: Journal
Abstract:
Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.
Keywords: Counter-Conditioning Empirical Study Occupational Health Posttraumatic Stress Disorder PTSD Quantitative Study Random Control Trial RCT
Accuracy Verified: Yes
61. Raynaud, P., Boxus, A., Renoir, V., & Sanchez, S. (2012, January). P-975 - From mind to brain: Event-related potentials and EMDR treatment of post-traumatic stress disorder. European Psychiatry, 27(Supplement 1), 1-1. doi:10.1016/S0924-9338(12)75142-8.
Language: English
Format: Journal
Abstract:
Introduction: Eye movement desensitization and reprocessing (EMDR) is a relevant technique to improve post-traumatic stress disorder (PTSD) symptoms. Objectives: To compare the electrophysiological profile of patients suffering post traumatic stress disorder before and after EMDR treatment. Aims: The authors are in search of a specific event-related brain potentials profile for post-traumatic stress disorder (PTSD). Methods: Eight patients suffering from post-traumatic stress disorder (PTSD) following a severe traumatic event, were assessed with event-related brain potentials (ERPs) in a modified oddball paradigm containing auditory standard, target, and novel tones. ERPs were assessed before and after a treatment session using the eye movement desensitization and reprocessing method. Results: Psychometric assessment revealed a marked improvement of the PTSD symptoms after treatment. Compared to a control group that underwent sham treatment, ERPs of the patients showed morphological changes in the post-treatment recording, suggesting a reduced orienting to novel stimuli and reduced arousal level after the treatment. Conclusions: EMDR therapy provides clinical improvement and event-related potentials changes that could be used in clinical practice as an interesting marker to assess diagnosis and successful treatment of PTSD.
Keywords: Event-Related Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
62. Greway, G. (2003). Personality change in trauma victims by the use of eye movement desensitization and reprocessing, resource development and installation, and emotional freedom techniques. Union Institute and Unversity, Cincinnati, OH. AAT 3088540.
Language: English
Format: Dissertation/Thesis
Abstract:
Personality change in victims of trauma has been demonstrated by key researchers in the field of trauma. This research explored this area further by studying if problem personality patterns can improve to healthier levels by processing trauma symptoms with new rapid trauma techniques. This research provides new information in trauma and personality, as well as offers links to possible new treatment methods. The hypothesis tested in this research was that significant change in problem personality patterns would occur in trauma subjects whose symptoms were processed through a multi-impact therapy that included Eye Movement Desensitization and Reprocessing (EMDR), building ego structure through Resource Installation and Development and reducing physiological stress through the use of Emotional Freedom Techniques, as compared to subjects in the control group who received talking therapy. A sample of ten female participants was selected that had traumatic backgrounds and posttraumatic symptoms. All subjects received the Millon Clinical Multiaxial Inventory III (MCMI III) as a pre and a post test, and the Personality Assessment Screener (PAS) throughout 14 weeks of treatment. The PAS provided a means to measure subjects through descriptive statistics and the MCMI III measured the three highest clinical personality scales and the changes that occurred after the treatment. Within the two groups, the results of the PAS showed that talking therapy may be extremely helpful for personality improvement for some individuals processing trauma issues, but not all. The MCMI III results showed that the multi-impact group appeared to be somewhat more stable, meaning that the multi-impact treatment appeared to aid improvement on all three personality scales. The talking treatment group showed improvement on the most problematic personality scale, minimal increase on the second highest personality scale, and the third highest personality scale became significantly worse as compared to the multi-impact treatment group. This confirmed the hypothesis that there would be significant change in clinical personality scores. This implies that the multi-impact treatment helped individuals in a more efficient manner, in that improvement on personality syndromes or disorders was global. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Dissertation Abstracts International: Section B: The Sciences and Engineering. 64(4-B), 2003, pp. 1902.
Keywords: Emotional Freedom Techniques Emotional Trauma Emotions Freedom Empirical Study Personality Change Resource Development Resource Installation Trauma Victims
Accuracy Verified: Yes
63. Kohnke, C. (2000). Pilotstudie zur evaluation der EMDR - Therapie mittels psychometrischer verfahren und EKP [A pilot study to evaluate the EMDR therapy using psychometric methods and EKP Medical School Thesis]. Hanover, Germany: Medizinesche Hochschuler.
Language: German
Format: Dissertation/Thesis
Keywords: Psychometric Methods
Accuracy Verified: Yes
64. Korn, D., & Leeds, A. (2002, December). Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex posttraumatic stress disorder. Journal of Clinical Psychology, 58(12), 1465-1487. doi:10.1002/jclp.10099.
Language: English
Format: Journal
Abstract:
This article reviews the complexity of adaptation and symptomatology in adult survivors of childhood neglect and abuse who meet criteria for the proposed diagnosis of Complex PTSD, also known as Disorders of Extreme Stress, Not Otherwise Specified (DESNOS). A specific EMDR protocol, Resource Development and Installation (RDI), is proposed as an effective intervention in the initial stabilization phase of treatment with Complex PTSD/DESNOS. Descriptive psychometric and behavioral outcome measures from two single case studies are presented which appear to support the use of RDI. Suggestions are offered for future treatment outcome research with this challenging population. [Author Abstract]
Keywords: Adults Child Abuse Clinical Case Study Complex Empirical Study Females Neglect Postt traumatic Stress Disorder Psychotherapeutic Processes PTSD Review Survivors Treatment Effectiveness
Accuracy Verified: Yes
65. Devilly, G. J., & Borkovec, T. D. (2000, June). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73-86. doi:10.1016/S0005-7916(00)00012-4.
Language: English
Format: Journal
Abstract:
The present research evaluated the psychometric properties of the credibility/expectancy questionnaire, a quick and easy-to-administer scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. The results suggested that this questionnaire derives the two predicted factors (cognitively based credibility and relatively more affectively based expectancy) and that these factors are stable across different populations. Furthermore, the questionnaire demonstrated high internal consistency within each factor and good test-retest reliability. The expectancy factor predicted outcome on some measures, whereas the credibility factor was unrelated to outcome. The questionnaire is appended to the paper, yet the authors stress care when utilizing the scale. During the administration of the questionnaire, the participant sees two sections -- one related to thinking and one related to feeling. However, the researcher needs to be aware that the 2 factors derived are not grouped into those questions. Instead credibility was found to be derived from the first three think questions and expectancy was derived from the fourth think question and the two feel questions. [Author Abstract]
Keywords: Adults Australians Cognitive Therapy Postttraumatic Stress Disorder PTSD Self Report Instruments Stressors Survivors
Accuracy Verified: Yes
66. Sack, M., Nickel, L., Lempa, W., & Lamprecht, F. (2003). Psychophysiologische regulation bei patienten mit PTSD: Veränderungen nach EMDR-behandlung [Psychophysiological regulation in patients with PTSD: Improvement after EMDR-treatment]. Zeitschrift für Psychotraumatologie und Psychologische Medizin (ZPPM), 1(3), 47-57.
Language: German
Format: Journal
Abstract:
Behandlung psychotraumatischer belastungsstörungen mit EMDR
Uns interessierte die Frage, ob die EMDR-Behandlung bei Patienten mit Posttraumatischer Belastungsstörung (PTSD) neben einer Symptomreduktion auch mit einer verbesserten psychophysiologischen Regulationsfähigkeit einhergeht. 15 Patienten (9 w, 6 m) mit PTSD nach Einzeltraumatisierung wurden vor und nach einer EMDR- Behandlung sowie in einer 6-Monate Katamnese per Fragebogen (PDS, IES, STAI, SCL-90-R) sowie mit psychophysiologischen Parameter (HR, HRV) während Konfrontation mit der individuellen traumatischen Erinnerung (Traumaskript) untersucht. Im Vergleich Prä-/Post, sowie Prä-/Katamnese kam es zu einer signifikanten Abnahme der Beschwerden in allen Symptombereichen. Gleichzeitig konnte nach Behandlung und in der Katamnese eine signifikante Verminderung des Anstiegs der Herzfrequenz während Konfrontation mit dem Traumaskript beobachtet werden. Der HF-Anteil der Herzratenvariabilität als Indikator für den Parasympathikotonus nahm im Vergleich Prä-/Katamnese unter Ruhebedingungen sowie während Traumaskript signifikant zu. Die EMDR-Behandlung erwies sich als wirksam hinsichtlich einer Reduktion der traumaassoziierten Symptomatik und einer Reduktion des psychophysiologischen Arousals bei Konfrontation mit der belastenden Erinnerung. Die Zunahme der HRV im Behandlungsverlauf im Sinne eines höheren Parasympathikotonus lässt auf eine Verbesserung der psychophysiologischen Regulationsfähigkeit schließen.
Our question was whether PTSD-patients would show a decrease of trauma associated symptoms as well as improved psychophysiological regulatory capacities after EMDR-treatment. 15 patients (9 female, 6 male) with PTSD after single traumatizations underwent psychometric assessment including questionnaires (PDS, IES, STAI, SCL-90-R) and psychophysiological variables (HR, HRV) during presentation of their individual trauma script before and after treatment and in a 6-month follow-up. Pre-/post as well as pre-/follow-up comparison showed significant decreases in all symptom measures. At the same time HR acceleration during trauma script decreased significantly after treatment. HF-HRV, an indicator for parasympathetic tone, increased significantly during baseline as well as during trauma script in pre-/post comparison. EMDR treatment led to an effective and lasting symptom reduction as well as to a reduction of the psychophysiological arousal associated with the traumatic memory. Enhancement of HRV after treatment in terms of a higher parasympathetic tone might be the result of improved psychophysiological regulatory capacities after successful EMDR treatment. [Author Summary]
Keywords: Adults Effects Posttraumatic Stress Disorder Psychophysiology PTSD Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
67. Kinowski, K. (2003). Put your best foot forward. Clinical practice manual. An EMDR-related protocol for empowerment using somatosensory and visual priming of resource experiences (2nd Ed.). Victoria, BC: Author.
Language: English
Format: Other
Abstract:
The theory and how-to of the protocol are contained in a 153 page manual, 8 ½" x 11". The second edition updates the database and includes a new chapter with case reports from other therapists. The manual's contents include:
the full text protocol
enough practical information so you can knowledgeably use it if you wish
a simplified record form for the client's file
two new ratings scales: Subjective Units of Body Safety( SUBS) and Rating of Confidence (RoC)
theoretical discussion of midbrain areas that I think are activated by the process
13 tables of descriptive statistics, n= 40, 67 administrations of the protocol
stills taken from video of therapy sessions (with client permission, faces obscured)
colored illustrations of client imagery, key midbrain areas, and body diagrams summarizing different results
a 3 page table summarizing each of the protocol's eight stages from four operational factors - therapist mode of activity, information processing, somatosensory processing, and conjectured neural activation
more than 15 cases are described in whole or in part, 8 from other therapists
Keywords: Empowerment Protocol
Accuracy Verified: Yes
68. Hogberg, G., Pagani, M., Salmaso, D., Stain, R., Soares, J., Aberg-Wisted, A., Jacobsson, H., Hallstrom, T., Larsson, S. A., & Sundin, Ö. (2005, June). A randomised study of public transportation workers suffering PTSD, being treated with EMDR and assessed by psychometric scales and physiological parameters during symptom provocation. Symposium conducted at the 9th European Conference on Traumatic Stress, Stockholm, Sweden.
Language: English
Format: Conference
Keywords: Posttraumatic Stress Disorder Psychometric Scales PTSD Public Transportation Symposium Symptom Provocation
Accuracy Verified: Yes
69. Hogberg, G., Pagani, M., Salmaso, D., Stain, R., Soares, J., Jacobsson, H., Hallström, T., Larsson, S. A., & Sundin, O. (2005, June). A randomised study of public transportation workers suffering PTSD, being treated with EMDR and assessed by psychometric scales and physiological parameters during symptom provocation. In J. Ford (Chair) Methods of Treatment of Today. Symposium presented at the 9th European Conference on Traumatic Stress (ECOTS), Stockholm, Sweden.
Language: English
Format: Conference
Keywords: Public Transportation Workers Randomized Study Posttraumatic Stress Disorder Psychometic Scales PTSD Symptom Provation
Accuracy Verified: Yes
70. Holmshaw, M., Hodder, K. I., & Carswell, J. W. (2009, April). The relative efficacy of trauma-focused cognitive behavioural therapy and EMDR in treating psychological trauma resulting from road traffic accidents. Presentation at the annual British Psychological Society Conference, Brighton, UK.
Language: English
Format: Conference
Abstract:
Objectives: Following road traffic accidents (RTAs) psychological problems are common and can cause long-term disability. Whilst both trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) have proved successful in treating such problems there is currently no clear evidence supporting one treatment over the other. Previous comparisons of these treatments have been based on small samples. The present research aimed to explore the relative efficacy of CBT and EMDR in treating psychological trauma resulting from RTAs in a large sample.
Design: Patients who had previously been involved in an RTA were referred to a psychological rehabilitation provider and received treatment with either CBT or EMDR by accredited therapists. The treatments were compared on drop-out rate number of sessions required for completion of treatment therapist rating of success and a number of widely used psychometric measures which were administered at assessment and again at the end of treatment.
Methods: A total of 1179 referrals were made of which 435 met the inclusion criteria and proceeded to treatment. These patients presented with a range of psychological trauma symptoms resulting from RTAs which had occurred an average of 21 months previously. Posttraumatic stress disorder (PTSD) was diagnosed in 51 per cent of patients with the remaining patients presenting with travel anxiety depression general anxiety and other psychological conditions. Outcomes were assessed in the whole sample and separately for those with a diagnosis of PTSD.
Results: No differences emerged between the treatments on any outcome measure both for patients diagnosed with PTSD and for those with other trauma-related symptoms. Both CBT and EMDR resulted in large improvements in self-rated symptoms as assessed using the psychometric measures and in both groups over 80 per cent of cases were rated by the therapist as successful or having made good progress by the end of treatment. The CBT group required an average of 9.1 sessions and the EMDR group required an average of 9.9 sessions. Reliable change indices showed that over 80 per cent of patients made clinically significant improvements in both treatment groups.
Conclusions: In conclusion both CBT and EMDR proved to be effective treatments for psychological trauma resulting from RTAs but no differences emerged between them in terms of efficacy patient compliance and number of sessions required. Psychological trauma following RTAs is eminently treatable in the community when treatment is offered by trained CBT or EMDR therapists.
Keywords: CBT Cognitive Behavior Therapy Road Traffic Accidents
Accuracy Verified: Yes
71. Iracane-Blanco, M. (2010, June). Research to evaluate the therapeutic effectiveness of an EMDR treatment versus debriefing for victims of workplace accidents. In Research. Symposium conducted at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
The objective of this study is to evaluate the therapeutic effectiveness of an EMDR treatment set-up (R-TEP protocol) within an early healthcare scheme for victims of workplace accidents, while taking into consideration such variables as institutional recognition and the availability of psychological debriefing services (inspired by Mitchell's model). The research procedure consists of first creating a program including referenced organisations (businesses, police force, hospitals...) from different French regions. Efforts will be made
to raise resource people's (management, occupational health staff) awareness of PTSD prevention and of the role played by institutional recognition in the psychological recovery process. A regional network of EMDR therapists trained in debriefing (will be set up to work in partnership with the healthcare network for first line interventions following workplace accidents involving one or several workers. Participants will be recruited within these organisations. They the will all have been confronted with a single critical incident at work (accidental bodily harm of physical origin, physical aggression...) and meet DSM-IV Acute Stress Disorder criteria at the time of the therapy session. The research program will test, evaluate, and compare the effectiveness of a single therapeutic intervention taking place between Day 0 and Day 8 after exposure to a workplace accident BS do for 2 groups of 20 workers (men and women) who present the clinical signs of acute stress disorder. G1: control group - no access or refusal of care to be. G2: group with a debriefing session. G3: group with an EMDR session. In order to evaluate treatment effects on health and adaptive behavior in workers, participants will complete standardized self-evaluation scales (IESR PCLS Hamilton) before and after treatment. Another questionnaire will be completed by the therapists. Expected results: Significant decrease of symptoms and improvement of scores on measures after a single EMDR session. Greater effectiveness of EMDR compared to psychological debriefing. Eye Learning objectives: Participants will learn the advantages of promoting early interventions for victims of workplace accidents with the adapted EMDR protocol in order to prevent incapacitating PTSD and to facilitate an early return to autonomy for the worker. EMDR therapists will have a raised awareness of public health prevention initiatives, combining training and information within social and professional networks and occupational health services.
Keywords: Debriefing Research, Symposium Workplace Accidents
Accuracy Verified: Yes
72. Tavanti, M., Bossini, L., Calossi, S., Lombardelli, A., Polizzotto, N., Vatti, G., Galli, R., Pieraccini F., & Castrogiovanni, P. (2008, Febbraio). Sertralina vs EMDR: Effetti sul volume ippocampale [Sertraline vs. EMDR: Effects on hippocampal volume]. Poster presentato al XII Congresso SOPSI (Società Italiana di Psicopatologia), Roma, Italia.
Language: Italian
Format: Conference
Abstract:
Molti dati sperimentali hanno mostrato che la terapia farmacologica
con SSRI può incrementare il volume dell’ippocampo,
invece il solo studio che ha investigato gli effetti di un tipo
di psicoterapia (TEB, Terapia Eclettica Breve) non ha evidenziato
alcuna efficacia sul volume ippocampale 1. Scopo
del nostro studio è valutare gli effetti del trattamento con EMDR
(Eye Movement Desensitization and Reprocessing) sul
volume ippocampale, sui sintomi e sulle performances mnesiche
di pazienti con Disturbo Post-Traumatico da Stress
(DPTS). La EMDR è una terapia la cui efficacia nel DPTS è
stata dimostrata in numerosi studi sperimentali.
Sono stati selezionati 12 soggetti drug-free con diagnosi di
DPTS alla SCID-P, senza comorbidità psichiatrica.
Ogni soggetto reclutato è stato sottoposto alla prima visita
(Tempo 0, Drug-Free) ad una indagine psicometrica (tramite
DTS), ad una indagine neuropsicologica (tramite una batteria
di test) e alla misurazione dei volumi cerebrali tramite
Risonanza Magnetica.
Successivamente, i 12 soggetti sono stati attribuiti in maniera
random a due diversi protocolli terapeutici. Sei soggetti
hanno effettuato 12 sedute di EMDR della durata di 1,5
ore, mentre sei soggetti sono stati trattati con 100 mg di sertralina.
Dopo il trattamento (Tempo 1, Post-Terapia) i soggetti sono
stati nuovamente sottoposti alle indagini effettuate al Tempo
0.
La seconda valutazione al Tempo 1 è stata effettuata dopo
tre mesi nei soggetti trattati con EMDR e dopo 6 mesi nei
soggetti trattati con la sertralina, in base ai tempi medi necessari
per la remissione cilinica del DPTS riportati in letteratura
per i due presidi terapeutici.
In questo studio verranno presentati i dati relativi alle differenze
volumetriche, ai miglioramenti clinici e alla performance
mnesica nei due gruppi di soggetti (soggetti sottoposti
ad EMDR e soggetti trattati con sertralina) e un dettagliato
confronto dei risultati ottenuti.
Many experimental data have shown that drug therapy
with SSRIs may increase the volume of the hippocampus,
Instead the only study that has investigated the effects of a type
psychotherapy (TEB, Brief Therapy Eclectic) showed no
no effect on hippocampal volume 1. Purpose
of our study was to evaluate the effects of treatment with EMDR
(Eye movement desensitization and reprocessing) on
hippocampal volume, symptoms and performance mnesic
of patients with Post-Traumatic Stress Disorder
(PTSD). The EMDR is a therapy whose efficacy in PTSD is
been demonstrated in numerous experimental studies.
Were selected 12 subjects with a diagnosis of drug-free
PTSD in the SCID-P, without psychiatric comorbidity.
Each recruited subject was submitted to the first visit
(Time 0, Drug-Free) at a psychometric investigation (by
DTS), a neuropsychological investigation (using a battery
test) and measurement of brain volume through
Magnetic Resonance Imaging.
Subsequently, 12 subjects have been allocated
random to two different treatment protocols. Six subjects
have carried out 12 sessions of EMDR duration of 1.5
hours, while six patients were treated with 100 mg of sertraline.
After treatment (Time 1, Post-Therapy) subjects are
were again subjected to the investigations made at the time
0.
The second evaluation at Time 1 was made after
three months in subjects treated with EMDR and after 6 months in
subjects treated with sertraline, based on the average time needed
cylinder for the remission of PTSD reported in the literature
for the two therapeutic aids.
In this study will be presented data on differences
displacement, the clinical improvements and performance
mnesic in the two groups of subjects (subjects
EMDR for patients treated with sertraline) and a detailed
comparison of results.
Listen
Read phonetically
Dictionary - View detailed dictionaryGoogle Translate for my:SearchesVideosEmailPhoneChatBusinessAbout Google TranslateTurn off instant translationPrivacyHelp
©2010Business ToolsTranslator ToolkitAbout Google TranslateBlogPrivacyHelp►
Keywords: Hippocampal Volume Poster Sertraline
Accuracy Verified: Yes
73. Sivan, A. (2008, June). Therapists’ views on the use of EMDR: The case of Hong Kong. Presentation at the annual meeting of the EMDR Europe Association, London, England.
Language: English
Format: Conference
Abstract:
Since the introduction of EMDR training courses in Hong Kong a few years ago, the method has been gaining an
enormously growing interest among professionals. One of the indications to the growing interest in EMDR is the
high rate of participation in the training courses. While there is a volume of studies on the efficacy of EMDR
among different populations, therapists’ viewpoints on its use has not been studied extensively. The purpose of
the paper is to examine the views of therapists who have undergone EMDR training in Hong Kong and have used
the method in their practice. Data were collected through an open-ended questionnaire and follow-up in depth
interviews with a group of therapists. The questionnaire sought information about their initial experience of
using EMDR, the types of patients they used it with, the contribution of the method to the therapy and the
difficulties they encountered. Follow-up interviews aimed to shed more light on issues raised by the respondents
and to provide a platform for their further elaboration. Participants’ responses indicated the positive effects
EMDR use on clients and its facilitation of the therapy process. The respondents indicated difficulties in following
the exact EDMR protocol especially in relation to the terminology such as: “completely false”, “completely true”,
“emotions” and “sensation”. Additional issues raised around the use of the scales and of different bilateral
stimulations. On the basis of these finding special consideration should be given to the adaptation of the EMDR
protocol to the Chinese language and way of thinking.
Keywords: Hong Kong
Accuracy Verified: Yes
74. Aduriz, M. E. (2007, Novembro). Trabajando creativamente con EMDR en niños y familia - Como motivar al niño a usar EMDR [Working creatively with EMDR children and family - How to motivate the child to use EMDR]. Presentación en el Primer Congreso Iberoamericano de EMDR, Brasilia, Brasil.
Language: Spanish
Format: Conference
Abstract:
Como aplicar las 8 fases a distintas edades en
relación a:
• Informar que es EMDR y que sucede en el
cerebro
• Acceder a la Estimulación Bilateral como una
experiencia segura
• Maneras de armar y amplificar la función del
Lugar Seguro
• Introducir el I C E S (Imagen- Creencia –
Emoción – Sensación Corporal).y las Escalas
del SUD y VOC
• Reconocimiento y tolerancia de las emociones• Fase de desensibilización. Su diferencia con
los adultos.
• Como detectar y superar: ab-reacciones -
bloqueos – riesgo de disociación
• Modos de instalar y amplificar la creencia
positiva.
• Como hacer cierre de sesión en las distantes
edades y situaciones
• Importancia del Seguimiento o reevaluación
con la ayuda de los padres.
How to apply the 8 stages at different ages in
relation to:
• Report is EMDR and what happens in the
brain
• Access to a Bilateral Stimulation
safe experience
• Ways to set up and amplify the role of
Safe Place
• Enter the I C E S (Picture-Belief -
Emotion - Feeling Body). And Scales
of SUD and VOC
• Recognition and tolerance of emotions • Phase desensitization. The difference with
adults.
• How to identify and overcome: ab-reactions -
blocks - the risk of dissociation
• Ways to set up and amplify the belief
positive.
• How to logout in the distant
ages and situations
• Importance of monitoring or reassessment
with the help of parents.
Accuracy Verified: Yes
75. Zampieri, A. J., Zampieri, M. J., & Godoy, M. F. (2012, Novembro). Trauma: Estudo comparativo de sessão única entre psicoterapia da fala e EMDR [Trauma: A comparative study between single-session psychotherapy and EMDR speech]. In comunicações de pesquisa. Apresentação no II Congresso Brasileiro de EMDR, Brasília, Brasil.
Language: Portuguese
Format: Conference
Abstract:
Introdução: Flashback, sono e autoestima perturbados, reatividade e agressividade, são efeitos de traumas. Prejudicam a vida pessoal e social. Dilatam a demanda em psicoterapia desafiando a rede publica de saúde. Novas saídas fazem-se urgentes, que antecipem e melhorem efeitos curativos. Desde 87 na Califórnia, Francine Shapiro criou a Eye Movement Desensitization and Reprocessing, ou simplesmente Psicoterapia por Reprocessamento de Informações, inspirada nos movimentos oculares típicos do sono REM. Método: Estudo comparativo entre efeitos de psicoterapia com ou sem recursos do EMDR, aplicando as escalas Beck para ansiedade, depressão e desesperança, e uma escala de impacto de eventos, antes e após uma sessão. Aos sujeitos do grupo experimental foi aplicado o protocolo padrão de EMDR e para os do grupo controle, o método da psicoterapia da fala. Resultados: A análise estatística demonstrou que, embora o estado inicial dos sujeitos de ambos os grupos fosse o mesmo, houve diferença significante nos resultados, na comparação pós-intervenção, para todos os itens pesquisados. O grupo de sujeitos atendidos em psicoterapia por EMDR apresentou pontuação final muito abaixo da inicial para ansiedade (p < 0,0001), depressão (p < 0,0001), desesperança (p = 0,0001) e impacto de eventos (p = 0,0083), em relação àqueles atendidos pela terapia da fala. Conclusão: A psicoterapia com EMDR é adequada para tratamento de situações traumáticas, e apresenta resultados expressivos desde a primeira sessão sobre o impacto do evento e sintomas de ansiedade, depressão, desesperança. Pelos resultados e agilidade deve ser cogitada para grandes demandas tais como na rede pública de saúde.
Introduction: Flashback, disturbed sleep and self-esteem, aggression and reactivity, are effects of trauma. Affect the personal and social life. Dilate demand in psychotherapy defying public health network. New outlets are made urgent that anticipate and improve curative effects. From 87 in California, Francine Shapiro created the Eye Movement Desensitization and Reprocessing, or simply Psychotherapy for Reprocessing Information, inspired by the eye movements typical of REM sleep. Methods: Comparative study of effects of psychotherapy with or without features of EMDR, applying Beck scales for anxiety, depression and hopelessness, and a scale of impact of events before and after a session. The subjects in the experimental group was administered the standard protocol for EMDR and the control group, the method of psychotherapy speech. Results: Statistical analysis showed that although the initial state of the subjects in both groups were the same, there was a significant difference in results when comparing post-intervention for all items surveyed. The group of subjects treated with EMDR in psychotherapy presented final score far below the initial anxiety (p <0.0001), depression (p <0.0001), hopelessness (p = 0.0001) and impact of events (p = 0.0083), compared to those treated by speech therapy. Conclusion: Psychotherapy with EMDR is suitable for treatment of traumatic situations, and presents significant results from the first session on the impact of the event and symptoms of anxiety, depression, hopelessness. The results and agility should be considered for large demands such as in public health.
Keywords: Beck Depression Inventory Comparative Study Psychotherapy Speech Single Session Trauma
Accuracy Verified: Yes
76. Kim, N. H., Lee, H. Y., & Kim, J. K. (2007, June). Treatment of complex PTSD by using eye movement desensitization and reprocessing: A case report. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract: P
eople who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological disturbances and many of them meet the criteria for proposed diagnosis of complex posttraumatic stress disorder (complex PTSD). The authors report a case of the successful sequential integrative treatment mainly composed of eye movement desensitization and reprocessing (EMDR) in a complex PTSD patient. The patient did not respond to the previous treatment with psychotropic medications and supportive psychotherapy.
Twelve sessions of EMDR and three sessions of supportive psychotherapy were done for the patient. Psychological assessments were performed before starting the treatment and a week after completing the treatment. After the treatment, the patient improved on all the psychological scales and behavior measures. The case suggests that the integrative treatment composed of EMDR may be [unfinished abstract as found in the Conference Program]
Keywords: Case Study Complex Posttraumatic Stress Disorder Complex PTSD C-PTSD
Accuracy Verified: Yes
77. Hogberg, G., Pagani, M., Sundin, Ö., Soares, J., Aberg-Wistedt, A., Tarnell, B., & Hallström, T. (2008, May). Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up. Psychiatry Research, 159(1-2), 101-108. doi:10.1016/j.psychres.2007.10.019.
Language: English
Format: Journal
Abstract:
PTSD is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). 20 subjects with chronic PTSD following occupational health hazards from "person under train" accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but 3 patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3 years of follow-up, 83% of the initial remitters had full working capacity. [Author Abstract]
Keywords: Accidents Adults Assault Conditioning Follow-up Study Longitudinal Study Occupational Health Posttraumatic Stress Disorder Psychotherapy PTSD Railroad Accidents Swedes Transport Workers Treatment Effectiveness
Accuracy Verified: Yes
78. Oras, R., de Ezpeleta, S. C., & Ahmad, A. (2004, June). Treatment of traumatized refugee children with eye movement desensitization and reprocessing in a psychodynamic context. Nordic Journal of Psychiatry, 58(3), 199-203. doi:10.1080/08039480410006232.
Language: English
Format: Journal
Abstract:
This study examines the effects of a psychodynamic approach of Eye Movement Desensitization and Reprocessing (EMDR) in treatment of traumatized refugee children. Among a child psychiatric outpatient refugee team, 13 children with post-traumatic stress disorder (PTSD), were treated by EMDR incorporated in a traditional psychodynamic therapeutic approach. The Posttraumatic Stress Symptom Scale for Children (PTSS-C) and the Global Assessment of Functioning (GAF) were administered before and after the treatment, to measure the effects. After treatment, a significant improvement was noticed in the functioning level and all PTSS-C scales, mostly in re-experiencing and least in the avoidance symptoms. The improvement in the functioning level was significantly correlated with the reduction of the PTSD-non-related and the depression, but not with that of the PTSD-related symptoms. Used in a psychodynamic context, EMDR is suggested to be effective treatment for traumatized refugee children. Our findings support the hypothesis of child-specific criteria for PTSD.
Keywords: Children Comorbidity Depressive Disorders Empirical Study Posttraumatic Stress Disorder PTSD Quantitative Study Refugees School Age Children Adolescents Stressors Survivors Trauma Treatment Effectiveness
Accuracy Verified: Yes
79. Abruzzese, M. (1995, June). Use of EMDR with disruptive behavior disorders. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
Disruptive behavior disorders such as Conduct Disorder, Oppositional Defiant Disorder, Tourette's Disorder, Intermittent Explosive
Disorder and, to a lesser extent, some children with Bipolar Disorder, are among the most difficult conditions for clinicians to treat.
The difliculty is two-fold: Clinicians must find the balance between developing a rapport and working with the disruptive child
while also addressing the concerns of the parents who may be beyond their level of tolerance and looking for prompt improvement
and frequently the child's very diagnostic condition - disruptiveness - may prevent the child from willingly participating in the
treatment, despite the good rapport that the child and clinician may have.
EMDR is, a technique which has shown great promise in helping children who are 'stuck' break through their own stubbornness and
disruption to help them achieve a sense of self-control, insight and self-confidence. It also provides parents with reason to hope that
a prompt improvement maybe possible.
The essential aspect of successful utilization of EMDR with disruptive disorders resides in the creativity of the clinician and the
modfication of the standard EMDR protocol. Using EMDR with children, especially with young children, requires a nonstandard
administration only loosely based on the standard protocol. Children often won't - or can't - verbalize cognition's or adequately
employ SUDS scales reliably. Disruptive children may have access to their cognitions, but may decline to cooperate with clinicians.
The key in using EMDR with Children - as with many other techniques employed in treating children - is to make -the technique
challenging or fun or maybe a bit mysterious, depending upon the presentation of the child and his or her ability to take some
responsibility for the treatment process. The key with disruptive children is knowing how to combine EMDR usage with
engagement of the difficult child.
This workshop explores the use of such nonstandard EMDR administrations as auditory cueing and hand tapping and will review
how EMDR has been used to engage very difficult children.
The presentation will include both successful and unsuccessful treatment outcome, focusing on the identification of hidden
handicaps which could prevent engagement of a diflicult child and techniques on how to overcome those handicaps to help the child
to help him or herself.
Keywords: Children Disruptive Behavior Disorder
Accuracy Verified: Yes
80. Friday, S. (2003). Using eye movement desensitization and reprocessing as an intervention for trauma and behavior symptom severity in attention deficit hyperactivity disorder. Capella University, Minneapolis, MN. AAT 3093820.
Language: English
Format: Dissertation/Thesis
Abstract:
This study investigated the intervention effects of Eye Movement Desensitization Reprocessing (EMDR) on the trauma and behavior symptom severity of 10 children, ages 8 to 11, diagnosed with Attention Deficit Hyperactive Disorder (ADHD). ADHD is a common childhood disorder with increasing prevalence rates that raise questions concerning overdiagnoses, misdiagnoses, and possible inadequate assessment of primary, comorbid, and differential diagnoses. Accurate assessments for ADHD and trauma-related attentional problems have important implications for diagnostic intervention and treatment planning. The purpose of this research was to investigate if a three-phased treatment intervention including EMDR, a therapy method proven effective in the reduction of PTSD, would show a reduction in the trauma and behavior symptom severity in children with ADHD and trauma symptoms. Evaluation of the efficacy of EMDR in the treatment of ADHD was examined using a multiple-component case study and a repeated measure design for evidence of trauma. Two of the three treatment phases were randomly adjusted from one to three sessions in length, with the intervention method, EMDR, remaining constant for a total of three sessions. Outcome measures were the Subjective Units of Disturbance Scale (SUDS), the Behavioral Assessment of Children Scales (BASC), (teacher and parent forms), and repeated assessments of trauma using the Lifetime Incidence of Traumatic Events Scales (LITE-P&S, parent and student forms), the Child and Parent Reports of Post-Traumatic Symptoms Scales (PROPS & CROPS), and the Problem Rating Scales (PRS). The results from quantitative analysis suggested that the intervention method incorporating EMDR affected a decrease in Externalizing and Internalizing behavior symptom severity and trauma symptom severity in the ADHD children that were studied. Qualitative data suggested that trauma and behavioral symptom severity decreased as a result of the intervention method incorporating EMDR. The results underscore the need for further research to distinguish between the symptom presentation of ADHD and comorbid trauma and behavioral symptoms. A continuous refining of the method of diagnosis and determination of the comorbid disorders is warranted. [Author Abstract]
Dissertation Abstracts International: Section B: The Sciences and Engineering. 64(6-B), 2003, pp. 2901
Keywords: Comorbidity Disruptive Behavior Disorders Elementary School Students Posttraumatic Stress Disorder PTSD Empirical Study Quantitative Study School Age Children Stressors Treatment Effectiveness
Accuracy Verified: Yes
81. Rivlin, E. (2009, March). The utility of psychometric assessment and monitoring within the Context of EMDR with refugee and asylum seeking Children/Adolescents. Symposium conducted at the 7th annual Conference of the EMDR UK & Ireland Association, Manchester, UK.
Language: English
Format: Conference
Abstract:
Accurate neuropsychological/psychological assessment and monitoring are
crucial to complex cases of refugee and asylum seeking children and adolescents. These are
examined in the context of relevant case vignettes. The limitations and relevance of
accurate and therapeutic assessment and monitoring are examined and the utility of
psychological instruments. Language and timing of interventions are also considered. The
use of a multimodal approach sensitive to individual and intellectual differences and
relevance of EMDR is discussed.
Keywords: Asylum Psychometric Assessment Refuges Symposium
Accuracy Verified: Yes
82. 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:
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]
Keywords: Adults Koreans Self Report Instruments Stressors Subjective Units of Disturbance SUDS Survivors Validity
Accuracy Verified: Yes
83. Kemp M., Drummond P., & McDermott B. (2010, January). A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents. Clinical Child Psychology and Psychiatry, 15(1), 5-25. doi:10.1177/1359104509339086.
Language: English
Format: Journal
Abstract:
The present study investigated the efficacy of four EMDR sessions in comparison to a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress - Reaction Index, clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of their child's PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison studies are required.
Keywords: Childhood Controlled Posttraumatic Stress Disorder PTSD Trauma
Accuracy Verified: Yes
84. Bender, S. S. (2006, September). Wash your hands: Healthy and practical EMDR practices. Presentation at the annual meeting of the EMDR International Association, Philadelphia, PA.
Language: English
Format: Conference
Abstract:
This workshop will focus on insider tips for
healthy and practical EMDR practice issues. An
effective strategy for introducing EMDR therapy
and how to make it part of your initial patient
interview will be described from the nitty-gritty
aspect of dealing with sanitizing your equipment
whether using your hands or plastic sensors to an
assortment of useful forms. Three forms will be
distributed and explained: Welcome to My
Practice form, Tracking EMDR Session form, and
Addendum to the Multimodal form. In addition,
a means of "previewing" with your patient the
safe place, the VOC and SUD scales and each of
the questions in the assessment phase will be
discussed. Emphasis will be placed on the
importance of each of these steps for de;eloping
a sound therapeutic relationship and gleaning
more information about the patient. Newcomers
to EMDR will have an opportunity to get the
answers to basic questions and the hands on
materials that will increase their comfort and
competence using and integrating EMDR into
their practices.
Accuracy Verified: Yes
85. Lazrove, S. (1997, January). When is 0 not equal to 0?. EMDRIA Newsletter, 2(3), 28-29.
Language: English
Format: Newsletter
Abstract:
EMDR protocols rely heavily on the SUDs and VoC as both process and outcome measures. It is my impression that these scales are much less global in assessing the patient’s mental state than generally assumed and that clinicians needs to be aware of the limitations of these ratings.
Keywords: Subjective Units of Distress SUD
Accuracy Verified: Yes
86. Wildwind, L. (1995, June). When something is wrong with me--EMDR and ADHD. Presentation at the EMDR Network Conference, Santa Monica, CA.
Language: English
Format: Conference
Abstract:
The objectives of this presentation are to define ADHD in the various ways it presents adults, using EMDR cognitions and
observations of clients as clues; then, to clarify why and EMDR works differently before, during, and after diagnosis,
The presenter will provide background on the biological differences of those with the disorder, some thoughts on why this diagnosis
is becoming so frequent at this time and why therapists who use EMDR may be more likely to have the disorder and to see it in their
clients.
During the workshop participants will explore their own attitudes toward ADHD and learn about how these attitudes influence their
ability to identify and assess ADHD symptoms in clients. Values, judgments and common myths about ADHD will be briefly
discussed.
Specific suggestions about modifying treatment when ADHD is suspected, suggested as a possible diagnosis to the client, and
treated will be given, including a list of modified positive cognitions. Treatment planning ideas for clients with a variety of
concurrent diagnoses will be offered, with special attention to the problems of resistance to the diagnosis, the medications use for
treatment, and the process of adapting patterns to solve specific problems, using a specific example a group treatment planning
exercise will be conducted. The actual treatment history of the case will be given clarifying how the treatment goals were reached.
There will he time for participants to formulate negative and positive cognitions regarding their attitudes toward ADHD clients and
the use of appropriate medications, and to assess the strength those attitudes, SUDS scales will be used.
Participants will have an opportunity to ask questions and will obtain a bibliography, a client questionnaire, a list of modified
cognitions, and a summary of resources for medical treatment, education and social support.
Keywords: ADHD Attention Deficit Hyperactive Disorder
Accuracy Verified: Yes


