Francine Shapiro Library

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1. Villa, M., & Sangiovanni, L. (2008, Novembre). Applicazione dell’EMDR ad una nuova popolazione: I pazienti posturali con dolore cronico e con deficit percettivi [Applying EMDR to a new population: Patients postural with chronic pain and perceptual deficits]. Presentazione al Applicazioni Cliniche dell'EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Lo studio riguarda l’applicazione dell’EMDR ai Pazienti affetti da “Sindrome da deficit posturale” (Da Cuña). Il problema coinvolge il 10% della popolazione, di cui il 15% è sintomatico. È di difficile inquadramento, dato che i sintomi somatici che presenta coinvolgono tutti e tre i versanti delle regolazioni automatiche: dolori muscolo-scheletrici migranti, derivanti da disordini posturali; pseudovertigini, da deficit di localizzazione spaziale; disturbi cognitivi (fino alla dislessia), da alterata integrazione percettiva. Le modalità compensatorie a tali deficit possono investire la sfera psicologica (senso profondo di inadeguatezza, ansia, depressione...), sviluppare atteggiamenti strategici di evitamento (agorafobia da deficit di orientamento spaziale), spingere a interpretare reazioni fisiche come se fossero psicologiche (attacchi di panico, enuresi notturna…). Proprio il sottile intreccio tra aspetti somatici e psicologici rende complessa la diagnosi; può capitare infatti che un paziente con problemi di questa natura si rivolga a un terapista somatico (posturologo, osteopata…), che non coglie il problema. Abbiamo così messo a punto un sistema diagnostico che riconosca se l’aspetto psichico sia conseguenza di un vero disturbo somatico o se invece sostenga una serie di somatizzazioni tendenzialmente derivanti da traumi. Nell’uno o nell’altro caso, l’utilizzo dell’EMDR può essere risolutivo: evidentemente sul versante traumatico, ma pure per la desensibilizzazione delle convinzioni negative derivate dalle strategie psicologiche reattive al deficit somatico. Metodi. La valutazione diagnostica e le variazioni sintomatologiche sono state effettuate con DSMIV, SWAP-200, SCL90-R, TAS 20, VAS, anamnesi posturologica, kinesiologia, posturodinamica, riflessi primitivi e sensoriali, valutazione osteopatica, Maddox, stabilometria basale e con challenges). Risultati. Gli interventi su misura hanno ridotto la sintomatologia, come è rappresentato dalle rilevazioni effettuate e dai feedback dei pazienti. La conoscenza integrata, sia che il primo approccio sia psicologico o posturale, consente una diagnosi accurata e dunque una strategia terapeutica sinergica efficace che permette di sbloccare terapie cronicizzate.

The study concerns the application of EMDR in patients with "postural deficiency syndrome" (Da Cuna). The problem affects 10% of the population, of which 15% are symptomatic. It is classification difficult, because the somatic symptoms presenting involving all three sides automatic adjustments: musculoskeletal pain migrants from postural disorders; pseudovertigini, spatial localization deficit, cognitive problems (up to dyslexia), from altered perceptual integration. The methods compensatory these deficits can invest the ball psychological (deep sense of inadequacy, anxiety, depression ...), develop attitudes strategic avoidance (agoraphobia deficit spatial orientation), push to interpret physical reactions as if they were psychological (panic attacks, nocturnal enuresis ...). Just the subtle interplay between somatic and psychological aspects makes it difficult to diagnose and can in fact happen that a patient with problems of this nature, please ask a somatic therapy (Posture, osteopath ...), who misses the problem. We have thus developed a diagnostic system that recognize if the appearance is the result of a true mental disorder or whether it supports somatic a series of somatization tendency resulting from trauma. In either case, use EMDR can be resolutely on the side obviously traumatic, but also for desensitization of the negative beliefs derived from psychological strategies responsive to deficit somatic. Methods. The diagnostic evaluation and symptom changes are were made with DSMIV, SWAP-200, SCL90-R, TAS 20, VAS, history Posture, kinesiology, posturodinamica, primitive reflexes and sensory evaluation osteopathic, Maddox, stabilometry baseline and challenges). Results. Tailored interventions have reduced symptomatology, as represented by the surveys conducted and feedback from patients. The integrated knowledge, whether the first approach is psychological or postural, allows a diagnosis accurate and therefore a therapeutic strategy that allows you to unlock synergistic effective therapies chronic.

Keywords: Chronic Pain  Perceptual Deficits  

Accuracy Verified: Yes

2. van der Kolk, B. A. (2009, December). Frontiers of trauma treatment. Presentation at the 6th Evolution of Psychotherapy Conference, Anaheim, CA.

Language: English

Format: Journal

Abstract:
The study of psychological trauma has been accompanied by an explosion of knowledge about how experience shapes the central nervous system and the formation of the self. We have learned that most experience is automatically processed on a subcortical level, i.e. by “unconscious” interpretations that take place outside of awareness. Insight and understanding have only a limited influence on the operation of theses subcortical processes. When addressing the problems of traumatized people who, in a myriad of ways, continue to react to current experience as a replay of the past, there is a need for therapeutic methods that do not depend exclusively on understanding and cognition. This workshop surveys current research on how people’s brains, minds and bodies respond to traumatic experiences, and will specifically address the use of affect modulation techniques, EMDR, yoga, theater, and neurofeedback in overcoming various aspects of the destabilization and disintegration caused by trauma. Educational Objectives 1) To describe three new approaches in the treatment of trauma. 2) To describe the differences between how ordinary memories are stored contrasted with the memory processing of traumatic experiences.

Keywords: Trauma Treatment  

Accuracy Verified: Yes

3. Forgash, C. A., & Copeley, M. (2008). Healing the heart of trauma and dissociation with EMDR and ego state therapy. New York, NY: Springer Publishing Co.

Language: English

Format: Book

Abstract:
"This book pioneers the integration of EMDR with ego state techniques and opens new and exciting vistas for the practitioners of each." --From the foreword by John G. Watkins, PhD, founder of ego state therapy "This is a book about polypsychism and trauma. It offers a number of creative syntheses of EMDR with several models of polypsychism. It also surveys and includes many other models of contemporary trauma theory and treatment techniques. The reader will appreciate its enrichment with case examples and very generous bibliographic material. If you are a therapist who works with patients who have been traumatized, you will want this book in your library." --Claire Frederick, MD, Distinguished Consulting Faculty, Saybrook Graduate School and Research Center "Training in EMDR seems to have spread rapidly among therapists in recent years. In the process, awareness is growing that basic EMDR training may not be adequate to prepare clinicians to effectively treat the many cases of complex trauma and dissociation that are likely to be encountered in general practice. By integrating it with ego state therapy, this book may just serve as a crucial turning point in the development of EMDR by providing a model for productively applying it to the treatment of this important and sizeable clinical population." --Steven N. Gold, PhD, President Elect, APA Division of Trauma The powerful benefits of EMDR in treating PTSD have been solidly validated. In this groundbreaking new work nine master clinicians show how complex PTSD involving dissociation and other challenging diagnoses can be treated safely and effectively. They stress the careful preparation of clients for EMDR and the inclusion of ego state therapy to target the dissociated ego states that arise in response to severe and prolonged trauma. [Springer]

Keywords: Dissociation  Ego State Therapy  

Accuracy Verified: Yes

4. Andonucci, H. (2004). The modifications of the EMDR protocol for sexually abused children. Alliant International University, San Francisco Bay. AAT 3133439.

Language: English

Format: Dissertation/Thesis

Abstract:
There is an increasing interest in using the procedures of EMDR with sexually abused children because of its effectiveness in treating PTSD and trauma in adults and children. Within the literature clinicians have reported modifications of the standard adult protocol originally developed by Shapiro in order to facilitate the therapy with children. To date, no study has investigated the actual modifications clinicians use when treating sexually abused children. A study was designed to elicit information about the actual use of such modifications from appropriately trained clinicians who work with sexually abused children 12 years and younger. A questionnaire was developed to obtain demographic information from therapists about their background and experience with abused children. An EMDR protocol modification survey was also created to elicit information about whether and how clinicians alter the standard EMDR protocol for use with abused children. Eight completed surveys were returned and the results of data analysis showed that clinicians do indeed modify the protocol as described and discussed. In particular, the results indicated the importance of modifications in the EMDR procedure for children and suggested important changes in the questionnaire that could be used for future data collection. [Author Abstract] Dissertation Abstracts International: Section B: The Sciences and Engineering. 65(5-B), 2004, pp. 2611.

Keywords: Child Abuse  Empirical Study  Psychotherapeutic Processes  Qualitative Study  Rape  School Age Children  Survivors  

Accuracy Verified: Yes

5. Isaacs, J. S. (2004, March). Numerical distraction therapy:  Initial assessment of a treatment for posttraumatic stress disorder. Traumatology, 10(1), 39-54. doi:10.1177/153476560401000104 .

Language: English

Format: Journal

Abstract:
The efficacy of a new therapy, numerical distraction therapy (NDT), in treating symptoms of PTSD was investigated. It was hypothesized that the therapy would change the traumatic visual memories of PTSD patients and reduce the intensity of negative feelings associated with them. Both hypotheses were supported: 92% of patients reported post-treatment (positive) changes in their visual memories, and these same patients reported diminished levels of fear, shame, anxiety, and other negative feelings. A subsample of patients reported stable treatment effects in follow-up surveys conducted two to four months later. The author also discusses possible mechanisms of NDT and suggests that NDT, eye movement desensitization and reprocessing (EMDR), and some forms of thought field therapy (TFT) might have "dual attention" as a common underlying mechanism. [Author Abstract]

Keywords: Adults  Americans  Behavior Therapy  Empirical Study  PTSD  Quantitative Study  Stressors  Survivors  Treatment Effectiveness  Treatment Outcome/Clinical Trial  

Accuracy Verified: Yes

6. Cusack, K. J. (2001). Refugee experiences of trauma and PTSD: Effects on psychological, physical, and financial well-being. Western Michigan University. AAT 3028752.

Language: English

Format: Dissertation/Thesis

Abstract:
This study examined the traumatic experiences and psychological symptoms of 60 refugees who were recently resettled in the United States. Subjects were from Cuba, Iraq, Haiti, Sudan, and Bosnia. Data was collected for each subject on traumatic experiences occurring prior to their arrival. In addition, anxiety and depression were assessed using the Hopkins Symptom Checklist (HSC-25). Quality of life and coping skills were assessed using the WHO Quality of Life-BREF and the Coping Styles Questionnaire, respectively. Trained, bi-lingual interviewers assessed for PTSD using the Clinician-Administered PTSD Scale. All instruments were translated into the appropriate language for subjects who did not speak English. Measures were back-translated to assure accuracy of translations. Three months following their arrival, information was collected regarding employment and public assistance. Predictors of PTSD, quality of life, and refugee self-sufficiency were analyzed using multiple regression and logistic regression analyses. Trauma-related variables were predictive of PTSD, which in turn had a negative impact on quality of life and self-sufficiency. Implications for the resettlement programs of government and non-governmental organizations are discussed.

Keywords: Hopkins Symptom Checklist (HSC-25)  Posttraumatic Stress Disorder  PTSD  PTSD Scale  Surveys  

Accuracy Verified: Yes

7. Pagani, M. (2008, Novembre). Sub-strato neurobiologico della sindrome da stress post-traumatico e relativo impatto funzionale e strutturale della terapia con EMDR [Neurobiological substrate of post-traumatic stress syndrome and impact on functional and structural therapy with EMDR]. Presentazione le Applicazioni Cliniche del EMDR Congresso Nazionale, Milano, Italia.

Language: Italian

Format: Conference

Abstract:
Recenti studi hanno dimostrato come la sindrome da stress post-traumatico (PTSD) possa causare nel cervello cambiamenti sia strutturali che funzionali. Studi di imaging funzionale tramite tomografia ad emissione di fotone singolo (SPECT) e ad emissione di positrone (PET) hanno evidenziato significative variazioni del flusso cerebrale in pazienti con PTSD durante la rivisitazione del trauma. A questo proposito sono stati riportati aumenti e diminuzioni di flusso nell’ippocampo, nell’amigdala, nella corteccia prefrontale mediale, nel cingolo anteriore e posteriore e nella corteccia temporale. Il modello prevalente collega i sintomi del PTSD ad una mancata inibizione dell’ amigdala, iperattivata dalla sensazione di incombente minaccia, da parte della corteccia prefrontale. E’ stato anche proposto che i cambiamenti strutturali dell’ippocampo e del cingolo anteriore rivelati dalla risonanza magnetica strutturale (RM) siano causati dalla risposta neuronale allo stress. L’obiettivo delle nostre ricerche e’ stato quello di analizzare la risposta funzionale e le variazioni strutturali in due gruppi di soggetti esposti a trauma occupazionale che hanno sviluppato (S=sintomatici, n=20) o no (NS=non sintomatici, n=27) il PTSD. Una parte dei S (n=16) è stata trattata con EMDR. La diagnosi di PTSD prima e dopo la terapia è stata basata sia sui criteri del DSM-IV sia su vari test neuropsicologici mirati. La SPECT (n=47) e la RM (n=33) sono state eseguite da 3 mesi a sei anni dal trauma e la prima è stata ripetuta dopo EMDR. I sintomi sono stati provocati da uno script individualizzato che ha riportato alla memoria il trauma e durante il quale è stato iniettato il tracciante di flusso cerebrale. Le analisi eseguite hanno mostrato differenze significative tra S e NS nella risposta del flusso cerebrale allo script. Nei 33 soggetti in cui sono state eseguite sia la SPECT che la RM sono state trovate differenze significative sia funzionali che strutturali nella corteccia temporo-parietale sinistra e nell’ippocampo, regioni nelle quali gli score dei test neuropsicologici correlano significativamente con il flusso cerebrale. Nei soggetti con remissione sintomatologica dopo EMDR (R; n=11) sono state trovate rispetto ai soggetti che non hanno risposto alla terapia (NR; n=5) significative differenze di flusso in 4 aree corticali che processano funzioni deteriorate in corso di PTSD. Diminuzioni di flusso dopo la terapia sono state registrate nei R rispetto ai NR nell’ippocampo, nel giro fusiforme (corteccia parieto-occipitale) e nella corteccia visiva primaria. L’ippocampo è sede della memoria episodica ed autobiografica; il giro fusiforme processa il riconoscimento di volti, dei corpi e delle parole; la corteccia visiva primaria custodisce la memoria visiva degli eventi. La mancata inibizione e/o l’iperattività di queste regioni nel PTSD sono responsabili della rivisitazione patologica figurata e somatica dell’evento traumatico e della presenza di flashback ed immagini allucinatorie. Viceversa la corteccia frontale dorsolaterale ha mostrato un aumento di flusso nei R. Questa regione oltre ad essere deputata ad inibire nel sistema limbico la risposta patologica a stimoli che ricordano l’evento traumatico è essenziale per i processi di attenzione e del “senso di sé”, diminuiti in corso di PTSD e recuperati in seguito alla remissione della malattia. In questi soggetti la RM ha inoltre messo in evidenza il valore predittivo delle dimensioni dell’ippocampo rispetto all’efficacia della terapia con EMDR. I nostri risultati confermano il coinvolgimento della corteccia temporo-parieto-occipitale nel PTSD e sottolineano il valore delle neuroimmagini sia nello svelare gli effetti neurobiologici dell’EMDR che determinare il valore delle indagini strutturali nel predirne l’efficacia.

Recent studies have shown that the post-traumatic stress syndrome (PTSD) may result in both structural and functional brain changes. Imaging studies using functional Single photon emission tomography (SPECT) and positron emission tomography (PET) shown significant changes in cerebral blood flow in patients with PTSD during revisiting the trauma. In this regard have been reported increases and decreases in flow hippocampus, amygdala, medial prefrontal cortex, the anterior cingulate and posterior and temporal cortex. The dominant model linking the symptoms of PTSD to a no inhibition of 'amygdala hyperactivity disorder by the sense of impending threat by the prefrontal cortex. E 'was also proposed that the structural changes of the hippocampus and anterior cingulate revealed by structural magnetic resonance imaging (MRI) are caused by the response neuronal stress. The aim of our research and 'was to analyze the response functional and structural variations in two groups of subjects exposed to occupational trauma that have developed (S = symptomatic, n = 20) or not (NS = non-symptomatic, n = 27) PTSD. Part of S (n = 16) was treated with EMDR. The diagnosis of PTSD before and after the therapy was based on both DSM-IV has on several neuropsychological tests targeting. SPECT (n = 47) and MRI (n = 33) are were performed from 3 months to six years from the trauma and the first was repeated after EMDR. Symptoms were caused by a script individual who reported to the memory of the trauma and during which were injected with a tracer of cerebral blood flow. The analysis performed showed significant differences between S and NS in the response of flow brain to the script. In the 33 subjects in which they were performed both SPECT and MRI were found significant differences in both functional and structural temporo-parietal cortex left hippocampus, regions in which the scores of neuropsychological tests correlate significantly with the flow in the brain. In subjects with symptomatic remission after EMDR (R; n = 11) were found compared with subjects who did not respond to therapy (NR, n = 5) significant differences in flow in 4 cortical areas that process functions deteriorated in the course of PTSD. Decreases in flow after treatment were recorded in R than NR hippocampus, within fusiform (parieto-occipital cortex) and in the primary visual cortex. The hippocampus is the seat of episodic memory and autobiographical, and the processes around the fusiform recognition of faces, bodies and words, the primary visual cortex preserves the memory visual events. The non-inhibition and / or 'hyperactivity of these regions in PTSD are responsible for pathological figured revisiting the traumatic event and physical and presence of flashbacks and hallucinatory images. Contrast, the dorsolateral frontal cortex has showed an increase of flow in R. This region in addition to being deputies to inhibit the system limbic response to pathological stimuli that recall the traumatic event is essential for processes of attention and the "sense of self, decreased in the course of PTSD and recovered following remission. In these subjects, MRI has also highlighted the predictive value the size of the hippocampus compared the efficacy of EMDR therapy. Our results confirm the involvement of the temporo-parietal-occipital cortex in PTSD and emphasize the value of neuroimaging in revealing both the neurobiological effects of EMDR that determine the value of the structural surveys in predicting effectiveness.

Keywords: Neurobiology  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes