Francine Shapiro Library: EMDR Bibliography
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1. Heber, R., Kellner, M., & Yehuda, R. (2002, December). Salivary cortisol levels and the cortisol response to dexamethasone before and after EMDR: A case report. Journal of Clinical Psychology, 58(12), 1521-1530. doi:10.1002/jclp.10102.
Trauma survivors with PTSD have been shown to have lower basal cortisol levels in the urine, plasma, and saliva than in trauma survivors without PTSD, nontraumatized mentally ill, or healthy subjects. We report on a case study in which we measured pre- and post-Eye Movement Desensitization and Reprocessing (EMDR) treatment salivary cortisol levels and salivary cortisol response to 0.50 mg of dexamethasone in a 41-year-old female with chronic PTSD symptoms. Our goal was to determine whether symptom improvement following trauma-focused treatment (EMDR) is associated with changes in basal salivary cortisol or in the cortisol response to dexamethasone administration. Our findings show moderate symptom improvement, an increase in basal cortisol levels, and a more attenuated cortisol hypersuppression in response to the dexamethasone suppression test following EMDR treatment. These results suggest the potential utility of including neuroendocrine measures in the assessment of treatment outcome in PTSD. [Author Abstract]
Keywords: Battery Biologic Markers Brief Psychotherapy Case Report Clinical Case Study Cortisol Dexamethasone Suppression Test Empirical Study Females Legal Procedures Middle Aged Multiple Traumatic Events Neuroendocrine Neuroendocrine Testing Neuroendocrinology Posttraumatic Stress Disorder PTSD Rape Survivors Treatment Effectiveness
2. Lytle, R. A. (1993). An investigation of the efficacy of eye-movement desensitization in the treatment of cognitive intrusions related to memories of a past stressful event. Pennsylvania State University. AAT 9334778.
A novel clinical technique, referred to as "eye-movement desensitization," has recently been reported to rapidly achieve significant reductions in the frequency and intensity of the two primary symptoms of PTSD; cognitive intrusions and the behavioral and emotional avoidance of trauma related fear cues. The current study was intended to provide an experimentally controlled replication of this procedure. The 45 students with the highest scores on a self-report questionnaire were selected for participation in the study and randomly assigned to one of three treatment conditions. These conditions included "eye-movement desensitization," "eye-fixation desensitization," and a non-directive control condition.Sessions One and Three consisted of pretest and posttest assessment respectively, administered by questionnaire and behavioral measures of cognitive intrusions relating to the reported trauma. Session Two, consisted of immediate pretest and posttest assessment of information regarding subjective discomfort, perceived validity of adaptive cognitions, and vividness of images related to the reported trauma. The results of this experiment indicated that treatment-related pretest to posttest change was limited to (a) a relative reduction in cognitive intrusions for the eye-fixation group compared to the other treatment conditions, and (b) initial superiority of both desensitization techniques in immediately reducing subject distress, vividness of the initial image (and for eye-fixation, improved validity of an adaptive cognition) in comparison to the non-directive condition. The latter condition, however, then achieved equivalent gains by one-week follow-up. It was concluded that: (a) the relative efficacy of the eye-movement desensitization technique, was not supported in this non-clinical population, (b) to the degree that the outcomes resulting from the two desensitization conditions were at variance from those of the more traditional non-directive technique, those differences appear to have been predominantly transient in character, and (c) the induction of saccadic eye-movements did not demonstrably function as an active component of treatment within this experimental context. It was additionally concluded that further research will be required to satisfactorily resolve the discrepant findings of experimentation and case reports regarding the efficacy of this technique. Specific suggestions for further research were presented. [Truncated Author Abstract] [Pilots]
3. Lytle, R. A., Hazlett-Stevens, H., & Borkovec, T. D. (2002). Efficacy of eye movement desensitization in the treatment of cognitive intrusions related to a past stressful event. Journal of Anxiety Disorders, 16(3), 273-288. doi:10.1016/S0887-6185(02)00099-3.
Much of the Eye Movement Desensitization and Reprocessing (EMDR) efficacy research has been widely criticized, limiting scientific understanding of its therapeutic components. The present investigation of Eye Movement Desensitization (EMD) effectiveness included undergraduate students reporting current intrusive cognitions concerning a traumatic event. Forty-five participants received a single treatment session of either: (a) EMD, as described by Shapiro [J. Behav. Ther. Exp. Psychiatry 20 (1989b) 211], (b) an identical procedure which employed eye fixation on a stationary target, or (c) non-directive counseling. Standardized self-report, subjective rating, Daily Diary, and intrusive thought sampling measures were collected before and after treatment. Results indicated that participants in the eye fixation group reported marginally (p<.052) fewer cognitive intrusions than the non-directive group 1 week following treatment. No significant differences between the EMD and non-directive conditions or between the EMD and eye fixation conditions on this measure were found. During the treatment session, both desensitization groups were superior to the non-directive group in reducing reported vividness of the mental image of the original event. However, the non-directive group improved to the level of the two other groups by the following week. Rapid saccadic eye movements were therefore unrelated to immediate treatment effects for this sub-clinical sample, and non-directive treatment largely yielded eventual outcomes equivalent to the two desensitization conditions (Pilots).