Francine Shapiro Library - EMDR Bibliography Links
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Your Results - you searched for the keyword Selective Mutism 36 Results
1. Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117-132. doi:10.1891/1933-3196.3.3.117.
Language: English
Format: Journal
Abstract:
This article provides an overview of selective issues relating to adult posttraumatic stress disorder (PTSD) and its treatment with eye movement desensitization and reprocessing (EMDR). The article begins by providing a historical overview of PTSD, and debates about the etiology and definition of PTSD are discussed. The most predominant theories of PTSD are summarized by highlighting how they have evolved from traditional behavioral accounts based on the assumption that PTSD is an anxiety disorder to theories that now incorporate information-processing models. This article then examines the development of EMDR and the corresponding body of research that clearly demonstrates its efficacy for the treatment for adult PTSD. The underlying mechanisms of EMDR are discussed, with a focus on the importance of the eye movement component and how the therapeutic processes in EMDR differ from those of traditional exposure therapy. Finally, the adaptive information-processing (AIP) model that underlies EMDR is outlined, and evidence for the model is summarized. The article concludes by suggesting future research based on questions raised about PTSD and its treatment with EMDR when the AIP model is compared to other information-based theories of PTSD.
Keywords: Adult Mechanism of Action Review Posttraumatic Stress Disorder PTSD Theory
Accuracy Verified: Yes
2. Becker, C. B., Darius, E., & Schaumberg, K. (2007, December). An analog study of patient preferences for exposure versus alternative treatments for posttraumatic stress disorder. Behaviour Research and Therapy, 45(12), 2861-2873. doi:10.1016/j.brat.2007.05.006.
Language: English
Format: Journal
Abstract:
Although several efficacious treatments for PTSD exist, these treatments are currently underutilized in clinical practice. To address this issue, research must better identify barriers to dissemination of these treatments. This study investigated patient preferences for PTSD treatment given a wide range of treatment options in an analog sample. 160 individuals, with varying degrees of trauma history, were asked to imagine themselves undergoing a trauma, developing PTSD, and seeking treatment. Participants evaluated 7 different treatment descriptions, which depicted treatment options that they might encounter in a clinical setting. Participants rated their most and least preferred treatments along with their personal reactions to and the perceived credibility of each treatment. Participants also completed a critical thinking skills questionnaire. Participants predominantly chose exposure or another variant of cognitive-behavioral therapy as their most preferred therapy, and those who chose exclusively empirically supported treatments evidenced higher critical thinking skills. The present study contributes to a growing literature indicating that patients may be more interested in these therapies than indicated by utilization rates. The problem of underutilization of empirically supported treatments for PTSD in clinical practice may be due to therapist factors. [Author Abstract]
Keywords: Adults Americans Cognitive Processes Cognitive Therapy College Students Evidence Based Treatment Exposure Empirically Supported Treatment Patient Preference Posttraumatic Stress Disorder Posttraumatic Stress Disorder Psychoanalytic Psychotherapy Psychotherapeutic Processes PTSD Selective Serotonin Reuptake Inhibitors Stressors Survivors TFT Thought Field Therapy
Accuracy Verified: Yes
3. Saint Paul, N. V. (2002, May). Aus der fülle ... Ressourcen- und Korperorientierung in der traumatherapeutischen arbeit [Out of the abundance ... Resource and body orientation in trauma therapy]. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.
Language: German
Format: Conference
Abstract:
This paper describes how trauma therapy including body awareness
can reduce the impact of the traumatic memory and can efficiently
prevent retraumatization. The goal is to achieve the ability to self-regulate
activation of the autonomic nervous system and hence, to attain access to
states in which patients can maximize their resources. This procedure is
based on neurobiological findings and exemplified with case studies. The
approach complements other trauma therapeutic interventions, regardless of
the theoretical orientation, and can be combined with techniques like, for instance,
EMDR.
Keywords: Neurobiology Psychotherapy Psycho Trauma Resource Orientation Selective Mutism
Accuracy Verified: Yes
4. Saint Paul, N. V. (2008). Aus der fülle ... Ressourcen- und körperorientierung in der traumatherapeutischen arbeit [Out of the abundance ... Resource and body orientation in trauma therapy]. Interdisziplinär, 16(3), 166-175 .
Language: German
Format: Magazine
Abstract:
In diesem Beitrag wird beschrieben, wie Traumatherapie unter Einbeziehung der Körperwahrnehmung schonend gestaltet und so einer Retraumatisierungsgefahr wirksam begegnet wird. Ziel ist das Erlangen der Fähigkeit, den Aktivierungszustand des autonomen Nervensystems zu regulieren und auf diese Weise Zugang zu ressourcenvollen Ich-Zuständen zu erlangen. Das Vorgehen wird durch neurobiologische Erkenntnisse begründet und anhand von Fallbeispielen veranschaulicht. Der Ansatz wird als Ergänzung zu anderen traumatherapeutischen Verfahren, gleich welcher Schule, verstanden und lässt sich gut mit speziellen Methoden, wie beispielsweise EMDR, verbinden.
Summary: This paper describes how trauma therapy including bodyawareness can reduce the impact of the traumatic memory and can efficiently prevent retraumatization. The goal is to achive the ability to self-regulate activation of the atuonomic nervous system and hence, to attain access in states in which patients can maximize their resources. This proceedure is based on neurobiological findings and exemplified with case studies. The approach compliments other trauma therapeutic interventions, regardless of the theoretical orentation, and can be combined with techniques like, for instance, EMDR.
Keywords: Neurobiology Psychotherapy Psycho Trauma Resource Orientation Selective Mutism
Accuracy Verified: Yes
5. Forbes, D., Creamer, M., Phelps, A., Bryant, R., McFarlane, A., Devilly, G. J., Lynda Matthews, L., Raphael, B., Doran, C., Merlin, T., & Skye N. (2007, August). Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Australian & New Zealand Journal of Psychiatry, 41(8), 637-648. doi:10.1080/00048670701449161.
Language: English
Format: Journal
Abstract:
Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis. [InformaWorld]
Keywords: ASD Guidelines Posttraumatic Stress Disorder PTSD Trauma Treatment
Accuracy Verified: Yes
6. Australian Centre for Posttraumatic Mental Health (2007, February). Australian Guidelines for the treatment of Adults with Acute Stress disorder and posttraumatic stress disorder. Melbourne, Victoria: ACPMH.
Language: English
Format: Other
Abstract:
The Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis. [InformaWorld]
Keywords: Treatment Guidelines
Accuracy Verified: Yes
7. Mevissen, L., & Lievegoed, R. (2011, April). Behandeling van tandartsfobie bij een niet sprekend kind met pre-verbaal medisch trauma [Treatment of dental phobia in a non-speaking child with pre-verbal trauma medical]. Presentatie op de 5e Jaarlijkse Conferentie van EMDR Vereniging Nederland, Nijmegen, Nederland.
Language: Dutch
Format: Conference
Abstract:
In deze workshop staat de behandeling van een 5-jarig jongetje met extreme tandartsangst centraal. Er is sprake van een genetisch bepaalde overgevoeligheid van het mondgebied. Het patientje krijgt zijn dagelijkse voeding voornamelijk via een sonde. De oorsprong van de angst wordt toegeschreven aan pré-verbaal medisch trauma. Aan de hand van videobeelden worden zowel casusconceptualisatie, verloop van de behandeling als de effecten in de tandartskamer geïllustreerd. De complexe gehechtheidsrelatie is in de problematiek verweven; de behandeling daarvan wordt eveneens belicht.
In this workshop the treatment of a 5-year-old boy with extreme dental fear central. There is a genetically determined hypersensitivity of the mouth area. The young patient gets his daily diet primarily through a tube. The origin of fear is attributed to pre-verbal medical trauma. Using both video conceptualization, course of treatment if the effects illustrated in the dental room. The complex is in the attachment relationship issues intertwined their treatment is also highlighted.
Keywords: Dental Phobia Mutism Pre-Verbal Trauma
Accuracy Verified: Yes
8. Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003, April). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17(2), 221-229. doi:10.3758/PBR.15.3.515.
Language: English
Format: Journal
Abstract:
Two experiments examining effects of eye movements on episodic memory retrieval are reported. Thirty seconds of horizontal saccadic eye movements (but not smooth pursuit or vertical eye movements) preceding testing resulted in selective enhancement of episodic memory retrieval for laboratory (Experiment 1) and everyday (Experiment 2) events. Eye movements had no effects on implicit memory. Eye movements were also associated with more conservative response biases relative to a no eye movement condition. Episodic memory improvement induced by bilateral eye movements is hypothesized to reflect enhanced interhemispheric interaction, which is associated with superior episodic memory (S. D. Christman & R. E. Propper. 2001). Implications for neuropsychological mechanisms underlying eye movement desensitization and reprocessing (F. Shapiro, 1989, 2001), a therapeutic technique for posttraumatic stress disorder, are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved)
Keywords: Bilateral Eye Movements Episodic Memory Retrieval Saccadic Eye Movements
Accuracy Verified: Yes
9. Morris-Smith, J. (2002, May). Breaking the silence - EMDR for children suffering from selective mutism. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.
Language: English
Format: Conference
Keywords: Children Selective Mutism
Accuracy Verified: Yes
10. Rossello-Mir, J., Revert-Vidal, X., Obrador, P., & Cardell, E. (2007, June). Brief EMDR protocol versus bilateral stimulation in the treatment of spider phobia. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.
Language: English
Format: Conference
Abstract:
EMDR, that includes bilateral stimulation, causes the desensitization and reprocessing of traumatic memories, thus reducing anxiety, distress, fear, and other symptoms related with several anxiety disorders. Previous results show it is effective in reducing symptoms of PTSD, panic disorder, public speaking anxiety, etc. Relying on some previous results we think that a brief EMDR protocol could be applied to relieve symptoms of specific phobias.
To investigate this issue, we study the efficacy of a new brief EMDR protocol in the treatment of spider phobia. Furthermore, our design tries to clarify the controversy about which components of the EMDR procedure are relevant for patient’s improvement. More specifically, we compare the effectiveness of our brief procedures with that of simple bilateral stimulation that is, without eye movements, which necessity to obtain therapeutic outcome has been questioned.
We randomly assign twenty volunteers, female university students with spider phobia to one of three groups. We applied the brief EMDR protocol to the first one and bilateral stimulation to the second one, being the third group the control one. To assess the effectiveness of both treatments, in addition to apply traditional questionnaires, we designed a specific emotional Stroop task in order to make use of this tool to evaluate, before and after each treatment, the selective attentional biases, that seem to play an important role in the etiology and maintenance of anxiety disorders. We discuss the differences found in our results in reference to the controversy aforementioned and how they can help to understand the EMDR mechanism of action.
Keywords: Bilateral Stimulation BLS Brief EMDR Spider Phobia
Accuracy Verified: Yes
11. Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009). Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science. PLoS ONE, 4(1): e4153. doi:10.1371/journal.pone.0004153 .
Language: English
Format: Journal
Abstract:
Background.
Flashbacks are the hallmark symptom of Posttraumatic Stress Disorder (PTSD). Although we have successful treatments for full-blown PTSD, early interventions are lacking. We propose the utility of developing a ‘cognitive vaccine’ to prevent PTSD flashback development following exposure to trauma. Our theory is based on two key findings: 1) Cognitive science suggests that the brain has selective resources with limited capacity; 2) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation. The rationale for a ‘cognitive vaccine’ approach is as follows: Trauma flashbacks are sensory-perceptual, visuospatial mental images. Visuospatial cognitive tasks selectively compete for resources required to generate mental images. Thus, a visuospatial computer game (e.g. “Tetris”) will interfere with flashbacks. Visuospatial tasks post-trauma, performed within the time window for memory consolidation, will reduce subsequent flashbacks. We predicted that playing “Tetris” half an hour after viewing trauma would reduce flashback frequency over 1-week.
Methodology/Principal Findings.
The Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress. All participants viewed a traumatic film consisting of scenes of real injury and death followed by a 30-min structured break. Participants were then randomly allocated to either a no-task or visuospatial (“Tetris”) condition which they undertook for 10-min. Flashbacks were monitored for 1-week. Results indicated that compared to the no-task condition, the “Tetris” condition produced a significant reduction in flashback frequency over 1-week. Convergent results were found on a clinical measure of PTSD symptomatology at 1-week. Recognition memory between groups did not differ significantly. Conclusions/Significance.
Playing “Tetris” after viewing traumatic material reduces unwanted, involuntary memory flashbacks to that traumatic film, leaving deliberate memory recall of the event intact. Pathological aspects of human memory in the aftermath of trauma may be malleable using non-invasive, cognitive interventions. This has implications for a novel avenue of preventative treatment development, much-needed as a crisis intervention for the aftermath of traumatic events.
Keywords: Flashbacks Tetris
Accuracy Verified: Yes
12. Greenwald, R. (1999, June). Child trauma measures for research and practice. Poster presented at the annual meeting of the EMDR International Association, Las Vegas, NV.
Language: English
Format: Conference
Abstract:
This is a practical guide to objectively scored measures of child/adolescent post-traumatic stress
symptoms. It is geared to the field-based researcher and the practicing clinician, who must balance
scientific value with the limitations inherent in clinical practice settings. This is not a
comprehensive review, but rather a selective sampling of those instruments most likely to be
usefbl in the above contexts. Additional information on child trauma assessment is available at
www.childtrauma.com or by contacting the author.
Keywords: Children Poster Practice Research
Accuracy Verified: Yes
13. van Etten, M. L., & Taylor, S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy, 5(3), 126-144. doi:10.1002/(SICI)1099-0879(199809).
Language: English
Format: Journal
Abstract:
A meta-analysis was conducted on 61 treatment outcome trials for PTSD. Conditions included drug therapies (TCAs, carbamazepine, MAOIs, SSRIs, and BDZs), psychological therapies (behaviour therapy, Eye-Movement Desensitization and Reprocessing (EMDR), relaxation training, hypnotherapy, and dynamic therapy), and control conditions (pill placebo, wait-list controls, supportive psychotherapies, and non-saccade EMDR control). Psychological therapies had significantly lower drop-out rates than pharmacotherapies (14% versus 32%), with attrition being uniformly low across all psychological therapies. In terms of symptom reduction, psychological therapies were more effective than drug therapies, and both were more effective than controls. Among the drug therapies, the SSRIs and carbamazepine had the greatest effect sizes, although the latter was based upon a single trial. Among the psychological therapies, behaviour therapy and EMDR were most effective, and generally equally so. The most effective psychological therapies and drug therapies were generally equally effective. Differences across treatment conditions were generally evident across symptom domains, with little matching of symptom domain to treatment type. However, SSRIs had some advantage over psychological therapies in treating depression. Follow-up results were not available for most treatments, but available data indicates that treatment effects for behaviour therapy and EMDR are maintained at 15-week follow-up. [Author Abstract]
Keywords: Antimanic Drugs Benzodiazepine Derivatives Hypnotherapy Meta Analysis Monoamine Oxidase Inhibitors Posttraumatic Stress Disorder Psychoanalytic Psychotherapy PTSD Relaxation Therapy Selective Serotonin Reuptake Inhibitors Treatment Effectiveness Tricyclic Derivatives
Accuracy Verified: Yes
14. Perkins, B., & Rouanzoin, C. (2002, January). A critical evaluation of current views regarding eye movement desensitization and reprocessing (EMDR): Clarifying points of confusion. Journal of Clinical Psychology, 58(1), 77-97. doi:10.1002/jclp.1130.
Language: English
Format: Journal
Abstract:
EMDR is an active psychological treatment for PTSD that has received widely divergent reactions from the scientific and professional community. This article examines points of confusion in the published literature on EMDR, including the theoretical, empirical, and historical issues around EMDR and placebo effects, exposure procedures, the eye movement component, treatment fidelity issues, and outcome studies. It also examines historical information relevant to the scientific process and charges of "pseudoscience" regarding EMDR. We conclude that the confusion in the literature is due to (a) the lack of an empirically validated model capable of convincingly explaining the effects of the EMDR method, (b) inaccurate and selective reporting of research, (c) some poorly designed empirical studies, (d) inadequate treatment fidelity in some outcome research, and (e) multiple biased or inaccurate reviews by a relatively small group of authors. Reading the original research articles frequently helps to reduce the confusion arising from the research review literature. [Author Abstract]
Keywords: Literature Review Methodology Posttraumatic Stress Disorder Professional Criticism PTSD Treatment Effectiveness
Accuracy Verified: Yes
15. van Eijk, M. & ter Braak, A. (2008, Maart). De noodkreet van het lijf: Het lichaam spreekt [The cry of the body: The body speaks]. Presentatie aan de derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.
Language: Dutch
Format: Conference
Abstract:
De gevolgen van psychotrauma manifesteren zich in de meeste gevallen in de vorm van herbelevingen, vermijding, emotionele ontregeling, concentratiestoornissen en dergelijke.
Lichamelijke klachten worden inmiddels ook steeds vaker herkend als een van de gevolgen van PTSS.
In deze workshop wordt naast aandacht voor de theoretische achtergrond van psychofysiologische reacties, ingegaan op wat men als EMDR- therapeut in de praktijk kan tegenkomen: dit kan variëren van selectief mutisme tot stigmata en van verlammingsverschijnselen tot visus uitval. Een en ander wordt geïllustreerd aan de hand van voorbeelden en videomateriaal.
The effects of psychotrauma manifest themselves in most cases in the form of reexperiencing, avoidance, emotional disturbance, impaired concentration and the like.
Physical symptoms are also now increasingly being recognized as one of the effects of PTSD.
This workshop will next focus on the theoretical background of psycho-physiological responses, discuss what they like EMDR therapist in practice may encounter: this may range from selective mutism to stigmata and paralysis to vision loss. This is illustrated by examples and video material.
Keywords: Body Psychophysiological Responses Somatic
Accuracy Verified: Yes
16. Capezzani, L. (2012, June). EMDR and cancer patients: Effetcts on PTSD and their illness coping strategies [EMDR y pacientes con cáncer: Efectos sobre el TEPT y sus estrategias de afrontamiento de la enfermedad]. Presentation at the Annual Meeting of the EMDR Europe Association, Madrid Spain.
Language: English
Format: Conference
Abstract:
The
nature
of
this
study
is
both
observational
and
clinical.
On
the
one
hand
it’s
aimed
to
see
how
the
criteria
of
PTSD
(DSM-‐IV,
2000)
are
represented
in
traumatized
cancer
patients
in
between
two
different
illness
stages
-‐
medical
treatments
and
medical
follow-‐up
stages,
-‐
and
to
see
witch
coping
strategies
are
used
by
these
patients
with
PTSD
in
each
stage.
On
the
other
hand
it’s
aimed
to
know:
a)
whether
CBT
integrated
with
EMDR
produces
different
effects
on
PTSD
in
between
the
two
illness
stages
and
their
specific
coping
strategies;
b)
whether
CBT
with
EMDR
and
CBT
without
EMDR
produce
different
effects
on
PTSD
and
on
the
coping
strategies
within
the
only
medical
follow-‐up
stage.
All
31
subjects
were
recruited
randomly,
10
for
treatment
stage,
11
for
follow-‐up
stage,
both
receiving
CBT
and
EMDR,
and
10
for
a
follow-‐up
stage
treaty
with
CBT
and
no
EMDR.
CAPS
and
COPE
were
used
to
assess
PTSD
and
coping
strategies
respectively.
Results
show
similar
changes
in
between
the
two
illness
stages
after
CBT
with
EMDR,
and
different
ones
within
the
follow-‐up
stage
depending
on
whether
CBT
with
EMDR
or
without
EMDR
was
used.
This
may
suggest
considering
PTSD
such
a
disorder
that
removes
specific
stage
demands/threats
of
cancer
illness,
just
described
in
literature,
as
well
as
the
more
functional
coping
for
each
of
them.
You
may
instead
claim
that
only
CBT
with
EMDR
allows
cancer
patients
to
overcome
the
PTSD
and
consequently
retrieve
selective
specificity
in
coping
strategies
for
each
stage.
La
naturaleza
de
este
estudio
es
tanto
observacional
como
clínica.
Por
un
lado,
pretende
ver
como
se
representan
los
criterios
del
TEPT
(DSM-‐IV,
2000)
en
pacientes
con
cáncer
traumatizados
entre
dos
fases
diferentes
de
la
enfermedad
–
fases
de
tratamientos
médicos
y
seguimientos
médicos
-‐
,
y
ver
qué
estrategias
de
afrontamiento
son
usadas
por
estos
pacientes
con
TEPT
en
cada
una
de
estas
fases.
Por
otro
lado,
pretende
saber:
a)
si
la
TCC
integrada
con
EMDR
produce
efectos
diferentes
sobre
el
TEPT
entre
las
dos
fases
de
la
enfermedad
y
sus
estrategias
de
afrontamiento
específicas;
b)
si
la
TCC
con
EMDR
y
la
TCC
sin
EMDR
producen
efectos
diferentes
sobre
el
TEPT
y
sobre
las
estrategias
de
afrontamiento
tan
sólo
dentro
de
la
fase
de
seguimiento.
Cada
uno
de
los
31
sujetos
fueron
seleccionados
aleatoriamente,
10
para
la
fase
de
tratamiento,
11
para
la
fase
de
seguimiento,
ambos
grupos
recibiendo
TCC
y
EMDR,
y
10
para
la
fase
de
seguimiento
con
TCC
y
sin
EMDR.
Se
utilizaron
CAPS
y
COPE
para
evaluar
el
TEPT
y
las
estrategias
de
afrontamiento
respectivamente.
Los
resultados
muestran
cambios
similares
entre
las
dos
fases
de
la
enfermedad
después
de
la
TCC
con
EMDR,
y
cambios
diferentes
en
la
fase
de
seguimiento
en
función
de
si
se
utilizaba
la
TCC
con
o
sin
EMDR.
Esto
puede
sugerir
que
se
ha
de
considerar
al
TEPT
como
un
trastorno
que
quita
específicas
demandas/amenazas
de
cada
una
de
las
fases
de
la
enfermedad
del
cáncer,
tal
y
como
se
describe
en
la
literatura,
así
como
el
afrontamiento
más
funcional
para
cada
una
de
ellas.
En
vez
de
eso,
se
puede
afirmar
que
tan
sólo
la
TCC
con
EMDR
permite
a
los
clientes
superar
el
TEPT
y
consecuentemente
recuperar
especificidad
selectiva
en
estrategias
de
afrontamiento
para
cada
fase.
Keywords: Cancer Coping Strategies Illness
Accuracy Verified: Yes
17. Browning, C. (2000, March). EMDR in the inner city: Paterson, New Jersey. EMDRIA Newsletter, 5(1), 26.
Language: English
Format: Newsletter
Abstract:
During my Level I training, I couldn’t
help thinking about a family I’d treated
several years earlier while working in
Paterson, New Jersey, a
socioeconomically impoverished inner
city. The family was a grandmother and
four young grandchildren who had
recently been placed in her custody.
Their mother and little sister had been
brutally slaughtered with a knife by their
father while they were home. The four
surviving children were suffering from
nightmares about the incident, grief and
loss issues, and fears that their father
would get out of jail and come after them.
One of the children, a five-year-old girl,
had developed elective mutism. She had
narrowly escaped the same fate as her
mother and sister. The little girl had been
an eyewitness to the murders and as she
fled from her father, she slipped on her
mother’s blood and was nearly caught
by him. As I listened and learned at Level
I, I wished that I’d known EMDR when
I was working in Paterson.
Keywords: Family Violence: HAP Training
Accuracy Verified: Yes
18. van Rood,Y., & de Roos, C. (2010, June). EMDR in the treatment of body dysmorphic disorder. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
Body dysmorphic disorder (BDD) is defined in the Diagnostic
and Statistical Manual IV-TR (DSM-IV-TR) as a disorder characterised by a preoccupation with an imagined defect
in one's appearance (American Psychiatric Association (APA),
1994). BDD can be treated effectively with selective serotonin reuptake inhibitors (SSRls) or cognitive behaviour therapy (CBT)
(Williams et al.. 2006). CBT interventions which are most often
described in the literature are exposure and response prevention
(ERP) and cognitive techniques. These interventions successfully
weaken the catastrophic expectations of the patients.
However, they do not affect the negative valence of patients'
appearance. This negative meaning is not inborn but acquired
during life through association with distressful or even traumatic
events. Patients with BDD often report stressful events as the
starting point of their complaints (Buhlmann et al., 2007) as
well as PTSS like symptoms. i.e. intrusions (Osman et al.. 2004).
Processing of these unprocessed memories might free the way
to the development of a more positive meaning of their appearance.
Indeed, case series have been described in which EMDR
has been successfully applied in the treatment of BDD (Brown
et al , 1997). In the first part of this workshop background information
will be presented which might help identifying BDD
patients who might profit from EMDR and planning subsequent
EMDR treatment. In the second part of the workshop we share
our experiences treating BDD patients with EMDR. Clinical issues
will be analysed using videotaped cases of patients for illustration.
The goal of this workshop is to increase knowledge and
understanding of the use of EMDR in the treatment for BDD.
American Psychiatric Association (APA) (1994). Diagnostic and
statistical manual of mental disorders. (4th ed.) Washington
DC. American Psychiatric Association.
Brown, K. W., McGoldrick, T., & Buchanan, R. (1997). Body
dysmorphic disorder: Seven cases treated with eye movement
desensitization and reprocessing. Behavioural and Cognitive
Psychotherapy. 25(2), 203-207
Buhlmann, U., Cook, L. M., Fama, 1. M., & Wilhelm, 5. (2007).
Perceived teasing experiences in body dysmorphic disorder.
Body Image. 4, 381-385.
Osman. S., Cooper, M., Hackmann, A,, & Veale, D. (2004).
Spontaneously occurring images and early memories in people
with body dysmorphic disorder Memory, 12, 428-436.
Williams, J., Hadjistavropoulos, T., & Sharpe, D. (2006). A meta-
analysis of psychological and pharmacological treatments for
Body Dysmorphic Disorder. Behaviour Research and Therapy.
44, 99-111.
Keywords: Body Dysmorphic Disorder
Accuracy Verified: Yes
19. Jacobs, S., Rackowitz, M., Strack, M., & de Jongh, A. (2009). EMDR und biofeedback in der behandlung der posttraumatischen belastungsstorung - Erweiterung der evaluation des neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the treatment of post traumatic stress disorder - extension of the evaluation of the neuropsychological treatment program]. In S. Jacobs, (Hrsg.), Neurowissenschaften und Traumatherapie. Grundlagen und Behandlungskonzepte [Neurosciences and Trauma Therapy, Bases and treatment approaches] (pp. 51-81). Göttingen: Universitätsverlag.
Language: German
Format: Book Section
Abstract: In the year (2007) the manual of the neuropsychotherapeutic intervention program EMDR and biofeedback in the therapy of posttraumatic stress disorder by Jacobs and de Jong was published. The therapeutic concept based on new neuroscienctific findings, which declare a dissociation of implicit and explicit traumamemory as one reason for emergence a PTSD. On this background the treatment program integrates selective modules. The allocation of information carried out by an educational movie for patients, specific cognitive-behavioural intervention techniques, which are supplemented by biofeedback-supported Eye Movement Desensitisation and Reprocessing (EMDR). During the treatment the skin conductance (electrodermal activity), which is a stress parameter, is mesured. This program was already evaluated in the pilot-study. The patient pool could be enlarged, so that 28 patients were available for the evaluation. Additionally the educational movie was examined on efficiency. The total feedback was positive. After therapy-end the PTSD-symptomatology decreased consistently (demp=2.48), as well as the psychological stress in another problem areas (demp=1.30). Moreover the EMDR-method achieved objective a significant decrease of the autonomic arousal (demp=.79) and subjective an explicit reduction of the felt stress (demp=2.40), while growth of the coherence of a worked out positive cognition (demp=2.52). Three- and 12-month follow-up analysis could demonstrate the stability and sustainability of the changes. The intervention program EMDR and biofeedback was also proved to be efficient ( 19 sessions) and effective (demp=1.39) in the enlarged sample, with high
Keywords: Biofeedback Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
20. D‘Hooghe, D. (2010, June). EMDR‘s application in the treatment of children with selective mutism. In Experimental use of EMDR. Symposium presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
This case concerns a 4,5 year old girl with Selective Mutism.
In this particular case. I considered Selective Mutism a symptom
of an attachment trauma. Since the trauma wasn't accessible seeing her age and the complexity of the trauma, I used the symptom
as a target. I applied EMDR within a phase model: the preparation
phase, confrontation phase and integration phase. During
these three phases I continuously worked with bilateral stimulation
It is my hypothesis that in this case the bilateral stimulation:
1. stimulated and strengthened positive links in the adaptive
network.
2 synchronized the activity of both cerebral hemispheres, resulting
in a connection between the primary emotions of traumatic
experiences and rational insights and language.
3. unblocked the traumatic information and reactivated the natural
healing process of the brain. I used several forms of bilateral
stimulation as visual stimulation, tactile stimulation and the butterfly
hug. Because of her lack of words, she wasn't able to tell me
anything. So through storytelling I offered her different themes to
which she could respond by making drawings, figures in clay, etc.
During the preparation phase, I focused on safety, ego strengthening
and affect management to reduce the fear to speak.
1. Working with safety : the eye movements were first accomplished
using a safe Image which brought up her own sense
of security. Then, after imagining this safe place, the child was
willing to play tapping games to strengthen feelings of safety.
2. Ego strengthening : to feel as strong as possible by installing
resources and positive cognitions, and guiding the child towards
acceptance and development of its unique being. Bilateral stimulation
was used to strengthen the positive experiences.
3. Affect management: in the process of strengthening affect
management, the child was given access to her anxiety by storytelling
linked to visualization, the use of images and bodywork.
Again, bilateral stimulation was used to strengthen the
positive experiences/skills. After a few sessions. I introduced
the use of language and stimulated her to make sounds, followed
by pronouncing places of words and finally the pronunciation
of complete words and sentences. Through this whole
process, 1 combined the specific exercises to learn how to speak
with bilateral stimulations. During the twelfth session, the child
started talking spontaneously Given the fact that there wasn't
any direct confrontation work during the sessions, we are left
to wonder whether there has or hasn't occurred any trauma
processing. The symptom came to a halt, together with the disappearance
of other symptoms that were Inked to the trauma.
The question is whether it is necessary to confront young children
with their trauma in order to heal. Nevertheless, it seems
like the combination of bilateral stimulation with storytelling,
art therapy, play therapy and visualization speeded up the elimination of the child's trauma symptoms considerably.
Keywords: Experimental Use Selective Mutism
Accuracy Verified: Yes
21. Greenwald, R. (2001, 1999). Eye movement desensitization and reprocessing (EMDR) in child and adolescent psychotherapy. Northvale, New Jersey: Jason Aronson.
Language: English
Format: Book
Abstract:
This book serves several functions. First, it provides an introduction to a trauma-based integrative approach to child and adolescent psychotherapy, incorporating the selective use of EMDR. It also provides a practical reference for clinicians seeking both theoretical and technical guidance on how to use EMDR with children and adolescents, and it serves as a documented standard of care for training and research purposes. [Text, p. xxvi] [Pilots]
Keywords: Adolescents Children Stressors Survivors
Accuracy Verified: Yes
22. Ohtani, T., & Matsuo, K. (2006). Functional abnormality of the prefrontal cortex in posttraumatic stress disorder: Psychophysiology and treatment studies assessed by near-infrared spectroscopy. In N. Kato; M. Kawata, & Pitman, R. K (Eds.), PTSD: Brain mechanisms and clinical implications (pp. 235-245). Tokyo: Springer-Verlag.
Language: English
Format: Book Section
Abstract:
A growing number of functional neuroimaging studies on PTSD have described the abnormal response of amygdala and prefrontal cortex to traumatic stimuli. Abnormal activation of some parts of the prefrontal cortex might possibly be involved in the pathophysiology of PTSD. [Adapted from Text, pp. 235-236]TOPICS TREATED: Near-infrared spectroscopy (NIRS); NIRS studies in PTSD; Neuroimaging studies of treatment in PTSD (Selective-serotonin reuptake inhibitor [SSRI] and Eye movement desensitization and reprocessing [EMDR].([Adapted from Text, pp. 235-236] [Pilots]
Keywords: Brain Imaging Neuroanatomy Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
23. Occhi, S., Albiol, L. M., & Cicognani, E. (2007). Il disturbo post-traumatico da stress: Una rassegna [Post-traumatic stress disorder: A review]. Psicoterapia Cognitiva e Comportamentale, 13(3), 323-344.
Language: Italian
Format: Journal
Abstract:
Questo articolo presenta una rassegna aggiornata teorico del Post-Traumatico da Stress Disorder (PTSD) concetto, un disturbo mentale che può comparire dopo essere stato esposto direttamente o indirettamente, ad un evento traumatico. L'articolo inizia con una descrizione della sintomatologia, suddivisi in: rivivere l'evento traumatico, evitamento, ottundimento reattività generale e ipervigilanza. Questo è seguito da una presentazione dei più recenti studi che indicano la presenza di disordine da stress post-traumatico nella popolazione, sia nella popolazione generale e nei soggetti direttamente coinvolti in un evento traumatico. Post-traumatico da stress sintomi del disturbo sono identificati mediante questionari specifici descritti nella sezione riferimento a strumenti di indagine. Lo studio delle basi biologiche per il PTSD è diventata particolarmente significativo negli ultimi anni, e abbiamo analizzato questo contesto in modo più approfondito per questo motivo, con particolare riferimento al ruolo dell'asse ipotalamo-ipofisi-surrene. Un impulso importante dello studio del PTSD è dovuto alla crescente importanza dato alla prevenzione, intesa come riduzione dell'impatto dei disturbi psichiatrici che concentrandosi su Eye Movement Desensibilizzazione e ritrattamento (EMDR), il trattamento psicologico, con il supporto di tecniche che riguarda la terapia cognitivo comportamentale e il trattamento farmacologico che prevede l'uso di inibitori della ricaptazione della serotonina selettiva, quali siano le forme più studiate. (PsycINFO record del database (c) 2008 APA, tutti i diritti riservati)
This article presents an updated theoretical review of the Post-Traumatic Stress Disorder (PTSD) concept, a mental disorder that can appear after being exposed directly or indirectly to a traumatic event. The article begins with a description of the symptomatology, divided in: re-living the traumatic event, avoidance, dulling general reactivity and hyperarousal. This is followed by a presentation of the most recent studies which indicate the presence of post-traumatic stress disorder in the population, both in the general population and in subjects directly involved in a traumatic event. Post-traumatic stress disorder symptoms are identified by using specific questionnaires described in the section referring to investigation instruments. The study of the biological bases for PTSD has become particularly significant in recent years, and we analysed this context in greater detail for this reason, with particular reference to the role of the hypothalamo-pituitary-adrenocortical axis. An important boost of the study of PTSD is due to the increasing importance placed on prevention, understood as a reduction of the impact of psychiatric disorders which focusing on Eye Movement Desensitisation and Reprocessing (EMDR), on psychological treatment, with the support of techniques that concerns cognitive behavioral therapy and pharmacological treatment that involves the use of serotonin selective reuptake inhibitors, which are the forms studied most. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Posttraumatic Stress Disorder PTSD Review
Accuracy Verified: No
24. Knipe, J. (1998). It was a golden time...: Treating narcissistic vulnerability. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 232-255), New York: Norton.
Language: English
Format: Book Section
Abstract:
This chapter focuses on EMDR-enhanced therapeutic protocols to treat individuals whose painful life experience is separated from consciousness by complex defensive structures, particularly those associated with narcissistic and avoidance defenses.In many of the clients I have worked with, the healing power of EMDR is prevented or impaired by unresolved positive feelings that block the client's full awareness of the negative experience associated with trauma. This can occur when the overall complex of posttraumatic images, self-defeating cognitions, unpleasant feelings and sensations (what Francine Shapiro calls the unprocessed "memory network") contains embedded strong positive affect that is highly valued by the client. In the case of a person with narcissistic defenses, the positive material may block awareness of negative memories, especially if the positive experience occurred in the larger context of trauma and neglect. In such instances the positive part of the experience is idealized through selective memory and strengthened in intensity, because it serves as a defense against the core PTSD. The negative part of the memory is partially or wholly dissociated and is thus less accessible to processing. [Adapted from Text, pp. 232, 233-234]
Keywords: Adults Americans Case Report Defense Mechanisms Life Experiences Males Posttraumatic Stress Disorder PTSD Self Concept Survivors Treatment Effectiveness
Accuracy Verified: Yes
25. Bryant, R. A., & Friedman, M. J. (2001, March). Medication and non-medication treatments of post-traumatic stress disorder. doi:10.1097/00001504-200103000-00004. Current Opinion in Psychiatry, 14(2), 119-123. doi:10.1097%2F00001504-200103000-00004.
Language: English
Format: Journal
Abstract:
Recent developments in the psychological and pharmacological management of post-traumatic stress disorder are reviewed. This review of controlled outcome studies indicates that: (i) cognitive behavior therapy is the psychological treatment of choice; (ii) different components of cognitive behavior therapy can be effective; (iii) eye movement desensitization and reprocessing is not as effective as cognitive behavior therapy; (iv) selective serotonin re-uptake inhibitors are the pharmacological treatment of choice; and (v) there is increasing support for nefazadone but not for cyproheptadine in reducing the symptoms of post-traumatic stress disorder. The need for increased treatment effectiveness and the integration of recent findings into clinical practice is discussed. [Author Abstract]
Keywords: Atypical Antidepressants Cognitive Therapy Drug Therapy Literature Review Posttraumatic Stress Disorder PTSD Selective Serotonin Reuptake Inhibitors Treatment Treatment Effectiveness
Accuracy Verified: Yes
26. 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
27. Creamer, M., & O'Donnell, M. (2002). Post-traumatic stress disorder. Current Opinion in Psychiatry, 15(2), 163-168. doi:10.1097/00001504-200203000-00007.
Language: English
Format: Journal
Abstract:
This paper provides an overview of recent developments in the literature on post-traumatic stress disorder. Epidemiological studies indicate that approximately 15-25% of individuals experiencing a significant trauma will go on to develop post-traumatic stress disorder, although approximately half will recover without formal intervention. Potential vulnerability factors for post-traumatic stress disorder have been identified, but the mechanisms and complexities require further exploration, with recent research suggesting that prevalence rates and risk factors may differ across populations. Studies of psychological treatment have demonstrated prolonged exposure and cognitive therapies to be equally beneficial, whereas eye movement desensitization and reprocessing may be useful but perhaps less effective in the long term. Pharmacological treatment studies indicate that selective serotonin reuptake inhibitors may be the first choice of drug treatments for post-traumatic stress disorder. Non-selective primary prevention strategies remain contentious, although secondary prevention, in the form of cognitive behavioural interventions for acutely symptomatic survivors, appears to reduce the subsequent development of post-traumatic stress disorder.
Keywords: Cognitive Therapies Drug Therapy Exposure Therapies Posttraumatic Stress Disorder Prevention Primary Prevention PTSD Risk Factors Secondary Prevention Susceptibility (Disorders) Treatment Vulnerability Factors
Accuracy Verified: Yes
28. Cahill, P. C., Pontoski, K., & D’Olio, C. M. (2005, September). Posttraumatic stress disorder and acute stress disorder II: Considerations for treatment and prevention. Psychiatry, 2(9), 34-46.
Language: English
Format: Journal
Abstract:
Posttraumatic stress disorder is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the second of two invited articles summarizing the nature and treatment of PTSD and the associated condition of acute stress disorder (ASD). The present article reviews evidence for the efficacy of psychological and pharmacological treatments for PTSD and ASD. In summary, cognitive behavior therapy (CBT) has been found efficacious in the treatment of chronic PTSD as well as the treatment of ASD/prevention of PTSD. The selective serotonin reuptake inhibitors, sertraline, paroxetine, and fluoxetine, have been found efficacious in the treatment of chronic PTSD, with sertraline and paroxetine receiving the FDA indication for this condition. There is less evidence for efficacious medications in the treatment of ASD/prevention of PTSD. At present, hydrocortisone and propranolol show the greatest promise. Limitations of these treatments, including dropout and a significant number of patients showing no or only partial response, are discussed as well as issues related to selecting among efficacious treatments.
Keywords: ASD Acute Stress Disorder Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
29. Davidson, J. R. T., Stein, D. J., Shalev, A.Y., & Yehuda, R. (2004, Spring). Posttraumatic stress disorder: Acquisition, recognition, course, and treatment. Journal of Neuropsychiatry and Clinical Neuroscience, 16(2), 135-147. doi:10.1176/appi.neuropsych.16.2.135.
Language: English
Format: Journal
Abstract:
Following exposure to trauma, a large number of survivors will develop acute symptoms of posttraumatic stress disorder (PTSD), which mostly dissipate within a short time. In a minority, however, these symptoms will evolve into chronic and persistent PTSD. A number of factors increase the likelihood of this occurring, including characteristic autonomic and hypothalamic-pituitary-adrenal axis responses. PTSD often presents with comorbid depression, or in the form of somatization, both of which significantly reduce the possibilities of a correct diagnosis and appropriate treatment. Mainstay treatments include exposure-based psychosocial therapy and selective serotonin reuptake inhibitors, such as paroxetine and sertraline, both of which have been found to be effective in PTSD. This paper looks at the course of PTSD, its disabling effect, its recognition and treatment, and considers possible new research directions.
Keywords: Comorbidity Posttraumatic Stress Disorder PTSD Recognition and Treatment SSRIs
Accuracy Verified: Yes
30. Greenwald, R. (1999, November-December). The power of suggestion - Comment on EMDR and mesmerism: A comparative historical analysis. Journal of Anxiety Disorders, 13(6), 611-615. doi:10.1016/S0887-6185(99)00019-5.
Language: English
Format: Journal
Abstract:
This response to McNally challenges the notion that scientific controversy should be waged with smear tactics. McNally's anti-EMDR conclusions are contested as premature and based on red herrings, selective neglect of the literature, and erroneous application of scientific principles. The importance of treatment fidelity is highlighted as a way of distinguishing between EMDR studies of widely varying quality (ScienceDirect).
Keywords: Franz Anton Hypnotherapy Mesmerism Professional Criticism
Accuracy Verified: Yes
31. van Loey, N. E. E., & van Son, M. J. M. (2003). Psychopathology and psychological problems in patients with burn scars: Epidemiology and management. American Journal of Clinical Dermatology, 4(4), 245-272. doi:10.2165/00128071-200304040-00004.
Language: English
Format: Journal
Abstract:
Burn injury is often a devastating event with long-term physical and psychosocial effects. Burn scars after deep dermal injury are cosmetically disfiguring and force the scarred person to deal with an alteration in body appearance. In addition, the traumatic nature of the burn accident and the painful treatment may induce psychopathological responses. Depression and PTSD, which are prevalent in 13-23% and 13-45% of cases, respectively, have been the most common areas of research in burn patients. Risk factors related to depression are pre-burn depression and female gender in combination with facial disfigurement. Risk factors related to PTSD are pre-burn depression, type and severity of baseline symptoms, anxiety related to pain, and visibility of burn injury. Neuropsychological problems are also described, mostly associated with electrical injuries. Social problems include difficulties in sexual life and social interactions. Quality of life initially seems to be lower in burn patients compared with the general population. Problems in the mental area are more troublesome than physical problems. Over a period of many years, quality of life was reported to be rather good. Mediating variables such as low social support, emotion and avoidant coping styles, and personality traits such as neuroticism and low extraversion, negatively affect adjustment after burn injury. Few studies of psychological treatments in burn patients are available. From general trauma literature, it is concluded that cognitive (behavioral) and pharmacological (selective serotonin reuptake inhibitors) interventions have a positive effect on depression. With respect to PTSD, exposure therapy and eye movement reprocessing and desensitization [EMDR] are successful. Psychological debriefing aiming to prevent chronic post-trauma reactions has not, thus far, shown a positive effect in burn patients. Treatment of problems in the social area includes cognitive-behavioral therapy, social skills training, and community interventions. Sexual health promotion and counseling may decrease problems in sexual life. In conclusion, psychopathology and psychological problems are identified in a significant minority of burn patients. Symptoms of mood and anxiety disorders (of which PTSD is one) should be the subject of screening in the post-burn phase and treated if indicated. A profile of the patient at risk, based on pre-injury factors such as pre-morbid psychiatric disorder and personality characteristics, peri-traumatic factors and post-burn factors, is presented. Finally, objective characteristics of disfigurement appear to play a minor role, although other factors, such as proneness to shame, body image problems, and lack of self-esteem, may be of significance. [Author Abstract]
Keywords: Burns Comorbidity Epidemiology Literature Review Posttraumatic Stress Disorder Predisposition PTSD Survivors Treatment
Accuracy Verified: Yes
32. van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007, January). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68(1), 37-46. doi:10.4088/JCP.v68n0105.
Language: English
Format: Journal
Abstract:
Objective: The relative short-term efficacy and long-term benefits of pharmacologic versus psychotherapeutic interventions have not been studied for PTSD. This study compared the efficacy of a selective serotonin reuptake inhibitor (SSRI), fluoxetine, with a psychotherapeutic treatment, eye movement desensitization and reprocessing (EMDR), and pill placebo and measured maintenance of treatment gains at 6-month follow-up. Method: 88 PTSD subjects diagnosed according to DSM-IV criteria were randomly assigned to EMDR, fluoxetine, or pill placebo. They received 8 weeks of treatment and were assessed by blind raters posttreatment and at 6-month follow-up. The primary outcome measure was the Clinician-Administered PTSD Scale, DSM-IV version, and the secondary outcome measure was the Beck Depression Inventory-II. The study ran from July 2000 through July 2003. Results: The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group. For most childhood-onset trauma patients, neither treatment produced complete symptom remission. Conclusions: This study supports the efficacy of brief EMDR treatment to produce substantial and sustained reduction of PTSD and depression in most victims of adult-onset trauma. It suggests a role for SSRIs as a reliable first-line intervention to achieve moderate symptom relief for adult victims of childhood-onset trauma. Future research should assess the impact of lengthier intervention, combination treatments, and treatment sequencing on the resolution of PTSD in adults with childhood-onset trauma. [Author Abstract]
Keywords: Adults Depressive Disorders Empirical Study Posttraumatic Stress Disorder PTSD Quantitative Study Random Clinical Trial RCT Selective Serotonin Reuptake Inhibitors Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
33. Weinberg, R. M., & Dye, J. (2002, June). Tina doesn’t talk at school – Utilizing EMDR to treat a child with selective mutism. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.
Language: English
Format: Conference
Abstract:
Selective mutism is a relatively rare disorder in which individuals who have the ability to speak and comprehend spoken language are unable to speak in specific social situations. This condition is typically resistant to intervention, becoming more intractable the longer it persists. Tina Doesn’t
Talk At School: Utilizing EMDR Within a Multi-Modal Intervention to
Treat a Child with Selective Mutism describes a qualitative research study
of a 4th grade student who went almost 5 years of no talking at school
despite multiple intervention attempts. Surprisingly rapid results ensued
shortly after initializing the EMDR technique, and the goal of speech in
the school environment was fully attained.
Keywords: Children Selective Mutism
Accuracy Verified: Yes
34. Forbes, D., Creamer, M. C., Phelps, A. J., Couineau, A. L., Cooper, J. A., Bryant, R. A., McFarlane, A. C., Devilly, G. J., Matthews, L. R., & Raphael, B. (2007, July). Treating adults with acute stress disorder and post-traumatic stress disorder in general practice: A clinical update. Medical Journal of Australia, 187(2), 120-123.
Language: English
Format: Journal
Abstract:
General practitioners have an important role to play in helping patients after exposure to severe psychological trauma. In the immediate aftermath of trauma, GPs should offer "psychological first aid", which includes monitoring of the patient's mental state, providing general emotional support and information, and encouraging the active use of social support networks, and self-care strategies. Drug treatments should be avoided as a preventive intervention after traumatic exposure; they may be used cautiously in cases of extreme distress that persists. Adults with acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) should be provided with trauma-focused cognitive behaviour therapy (CBT). Eye movement desensitisation and reprocessing (EMDR) in addition to in-vivo exposure (confronting avoided situations, people or places in a graded and systematic manner) may also be provided for PTSD. Drug treatments should not normally replace trauma-focused psychological therapy as a first-line treatment for adults with PTSD. If medication is considered for treating PTSD in adults, selective serotonin reuptake inhibitor antidepressants are the first choice. Other new generation antidepressants and older tricyclic antidepressants should be considered as second-line pharmacological options. Monoamine oxidase inhibitors may be considered by mental health specialists for use in people with treatment-resistant symptoms.
Keywords: Acute Stress Disorder Anti-Depressants ASD MAO Inhibitors Posttraumatic Stress Disorder PSTD SSRIs
Accuracy Verified: Yes
35. Fisher, N. (2010, April). Treatment options for combat veterans with PTSD. Poster presented at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.
Language: English
Format: Conference
Abstract:
In this review I explored the most effective treatment options available for military veterans with Post Traumatic Stress Disorder. Specifically, psychotherapy and pharmacotherapy was examined. Psychotherapy encompassed cognitive behavioral therapy, emotional desensitization and reprocessing and exposure therapy. Pharmacotherapy included selective serotonin reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, novel antidepressants and benzodiazepines. Meta analyses, literature reviews and research experiments formed the basis for the comparisons between treatments. The main findings include that the psychotherapies cognitive behavioral therapy and eye movement desensitization and reprocessing, and the pharmacotherapy selective serotonin reuptake inhibitors are the most superior treatments for veterans with PTSD.
Learning Outcomes
Delegates will learn about the variables which make treating combat veterans with PTSD different than other groups with PTSD. In terms of treatment, psychotherapeutic and psychopharmacologic options will be examined. Delegates will leave the presentation aware of what current research states on treatment efficacy of CBT, EMDR, Exposure Therapy, Antidepressants and Anxiolytics.
Keywords: Poster Posttraumatic Stress Disorder PSTD Veterans
Accuracy Verified: Yes
36. Cohena, J. A., Mannarino, A. P., & Rogal, S. (2001, January). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25(1), 123-135. doi:10.1016/S0145-2134(00)00226-X.
Language: English
Format: Journal
Abstract:
Objective: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. Method: An anonymous survey was mailed to 207 child psychiatrists ("medical") [members of the American Academy of Child and Adolescent Psychiatry] and 460 nonphysician ("non-medical") therapists [members of the International Society for Traumatic Stress Studies] inquiring about current interventions used to treat children with PTSD. Results: 247 responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. 95% of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. Conclusions: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR. [Author Abstract]
Keywords: Adolescents Arousal Avoidance Children Drug Therapy Mental Health Personnel Reexperiencing Posttraumatic Stress Disorder PTSD Treatment Effectiveness
Accuracy Verified: Yes