EMDR Research News April 2012

Here are this month’s recently published, peer-reviewed journal articles related to EMDR. This month you will also find summaries for two forthcoming books on EMDR (by Uri Bergmann and Ana Gomez), and a new book chapter (by Robbie Adler-Tapia). With each reference below, you will find the citation, abstract and author contact information (when available). Prior quarterly summaries of journal articles can be found on the EMDRIA website and a comprehensive listing of all EMDR-related research is available at the Francine Shapiro Library. EMDRIA members can access recent Journal of EMDR Practice and Research articles in the member’s area on the EMDRIA website. Each month I also feature an EMDR video. This month we start with the trailer from EMDR - a documentary film from Michael Burns.

Be sure to scroll to the last of the alphabetically listed articles for the new study from van den Hout, et al. “Tones inferior to eye movements in the EMDR treatment of PTSD” and then join the EMDR International Association Members discussion on this topic on LinkedIn.

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This trailer for EMDR a documentary film from Michael Burns features interviews with Bessel van der Kolk, Steve Silver, Uri Bergmann, Laurel Parnell, Debbie Korn, and Francine Shapiro. More information on the documentary is available at http://emdrmovie.com/




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Forthcoming titles


Neurobiological Foundations for EMDR Practice
Bergmann, U. (2012). Neurobiological foundations for EMDR practice. New York, NY: Springer Pub. Co.

Pub. Date: 05/22/2012

This volume introduces the most current research about the neural underpinnings of consciousness and EMDR (eye movement desensitization and reprocessing) in regard to attachment, traumatic stress, and dissociation. It is the first book to comprehensively integrate new findings in information processing, consciousness, traumatic disorders of information processing, chronic trauma and autoimmune compromises, and the implications of these data on the Adaptive Information Processing (AIP) model and EMDR treatment

The text examines online/wakeful information processing, including sensation, perception, somatosensory integration, cognition, memory, language and motricity, and off-line/sleep information processing, such as slow wave sleep and cognitive memorial processing, as well as REM/dream sleep and its function in emotional memory processing. The volume also addresses disorders of consciousness, including coma, anesthesia, and other neurological disorders, particularly disorders of Type 1 PTSD, complex PTSD/dissociative disorders, and personality disorders. It delves into chronic trauma and autoimmune function, especially in regard to diseases of unknown origin, and examines them from the perspective of autoimmune compromises resulting from the unusual neuroendocrine profile of PTSD sufferers. The final section integrates all material to illustrate the tenets of the AIP model and the implication of this material with respect to current EMDR treatment, as well as techniques to render it more robust.

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EMDR Therapy and Adjunct Approaches with Children
Gomez, A. M. (2012). EMDR therapy and adjunct approaches with children. New York, NY: Springer Pub.

Pub. Date: 05/22/2012

This is the first book to provide a wide range of leading-edge, step-by-step strategies for clinicians using EMDR therapy and adjunct approaches with children with severe dysregulation of the affective system. Written by an author internationally known for her innovative work with children, the book offers developmentally appropriate and advanced tools for using EMDR therapy in treating children with complex trauma, attachment wounds, dissociative tendencies, and compromised social engagement. The book also presents the theoretical framework for case conceptualization in EMDR therapy and in the use of the Adaptive Information Processing (AIP) model with children.

Principles and concepts derived from the Polyvagal Theory, affective neuroscience, attachment theory, interpersonal neurobiology, developmental neuroscience and the neurosequential model of therapeutics, which can greatly support and expand our understanding of the AIP model and complex trauma, are presented. The text also offers an original and pioneering EMDR therapy-based model to working with parents with abdicated caregiving systems. The model is directed at assisting parents in developing the ability for mentalization, insightfulness, and reflective capacities linked to infant's development of attachment security.

A unique and innovative feature of this book is the masterful integration of strategies from other therapeutic approaches, such as Play therapy, Sandtray therapy, Sensorimotor psychotherapy, Theraplay and Internal Family Systems (IFS), into a comprehensive EMDR treatment maintaining appropriate adherence to the AIP model and EMDR therapy methodology.

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Available now

Clinician's Guide to Evidence-Based Practice
Adler-Tapia, R. (2012). EMDR for the treatment of children in the child welfare system who have been traumatized by abuse and neglect. In A. Rubin (Ed.), Clinician's Guide to Evidence-Based Practice: Programs and interventions for maltreated children and families at risk. (pp. 141-60). John Wiley & Sons Inc.

Abstract

Children who have experienced abuse and neglect can be challenging for even the seasoned child therapist. This chapter describes an empirically supported treatment approach for such children: Eye Movement Desensitization and Reprocessing (EMDR), based on the EMDR psychotherapy treatment methodology created by Shapiro (1989a, 1989b). EMDR provides a treatment protocol that allows the therapist to work with developing resources in the child with attachment trauma while also reprocessing traumatic events that can lead to chronic and severe mental health and physical symptoms. Within the EMDR protocol there is the opportunity to provide reparative work even without a healthy attachment figure and to provide the child with a clinical intervention to address current symptoms while also creating a positive template for the future. When using EMDR with children, the therapist is in a unique role of having the opportunity to intervene at a time when neurodevelopment is most rapid and malleable and treatment can have its greatest impact. This chapter provides a brief overview of EMDR applied to the specific issues of children in the child welfare system.

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Journal Articles


Hagenaars, M. A., & Arntz, A. (2012). Reduced intrusion development after post-trauma imagery rescripting; an experimental study.
Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 808-814. doi:10.1016/j.jbtep.2011.09.005

Muriel A. Hagenaars, Department of Clinical, Health and Neuropsychology, Leiden University, PO Box 9555, 2300 RB Leiden, The Netherlands. Email: mhagenaars@fsw.leidenuniv.nl

Abstract


BACKGROUND AND OBJECTIVES: Contemporary theories predict PTSD development after trauma if trauma information is not adequately processed or negatively appraised. Mental imagery and emotional processing seem to be strongly related and evidence-based treatment strategies such as imaginal exposure and EMDR indeed include imagery as a main component. Moreover, imagery rescripting of traumatic memories is an effective treatment for PTSD.
METHODS: The present study combined these lines of research and investigated the impact of early imagery rescripting on intrusion development after an aversive film. Seventy-six participants were randomly allocated to one of three conditions: imagery rescripting (IRS), imagery reexperiencing (IRE) and positive imagery (PI). All participants watched an aversive film, had a 30-min break and then received a 9-min intervention (IRS, IRE or PI). They indicated subjective distress during the intervention, recorded intrusive memories of the film for 1 week and completed the Posttraumatic Cognitions Inventory (PTCI) and a cued recall test one week later.
RESULTS: The IRS group developed fewer intrusive memories relative to the IRE and PI groups, and less negative cognitions than the IRE group, while cued recall was enhanced in IRS and IRE groups compared to the PI group. IRS and PI groups experienced less distress during the intervention than the IRE group.
LIMITATIONS: This is an analogue design and results should be replicated in clinical samples.
CONCLUSIONS: The results suggest that IRS might be an adequate technique to change memory consolidation at an early stage and therefore a powerful and non-distressing strategy to prevent PTSD symptoms.

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Kurth, R. A., H. Gerhardt, & I. Schäfer. (2012). Posttraumatische und psychotische symptome bei schwer traumatisierten patienten: Eine darstellung anhand von 3 fallvignetten. [Post-traumatic and psychotic symptoms in severely traumatised patients: Three case reports.]
Fortschritte Der Neurologie, Psychiatrie. doi:10.1055/s-0031-1281801

R. A. Kurth, Behandlungszentrum fur Folteropfer Ulm (BFU), Innere Wallstr. 6, Ulm, Germany, 89077, Email: r.kurth@reha-verein.de

Abstract


Background: Severely traumatised patients may show a variety of impairments, including psychotic symptoms. The therapist’s specific professional background (e. g., trauma-focussed psychotherapy or general psychiatry) may impede adequate diagnosis and treatment of these patients. Methods: Three case reports show the development and change of post-traumatic and psychotic symptoms over time and the influence of specific interventions. Conclusions: It is important not to jump to conclusions and interpret perceptual disturbances (flashbacks, dissociative or psychotic ones) too quickly in an one-sided way. Further scientific investigations are mandatory in order to understand and treat patients in an adequate way.

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Lamphear, M. H. (2012). Effectiveness of the post critical incident seminar in reducing critical incident stress among law enforcement officers.
Dissertation Abstracts International: Section B, 72(7b), 4297.

Abstract


Summative program evaluation was used to examine the effectiveness of the Post Critical Incident seminar (PCIS) in reducing traumatic stress symptoms of law enforcement officers (LEOs). Previous trauma theory research indicated when not addressed, the impact of such trauma leads to serious physical and mental health problems. The use of the PCIS with the study population had not been evaluated. This study was conducted, using archival data, to address this gap. The sample consisted of LEOs in the southeastern US. Officers participated in either PCIS-only or PCIS + EMDR (eye movement desensitization and reprocessing) groups and were also categorized according to time since the incident. The Impact of Events Scale-Revised (IES-R) was administered at the start of each PCIS and again at 6 months. Dependent t tests were used to demonstrate significant pre/post decreases in IES-R scores for both groups. Of clinical concern at pretest, the IES-R scores for the PCIS + EMDR group were reduced to below the scale’s threshold for clinical concern. Regression analyses were used to also document significant links connecting the time since the incident, type of incident, and gender with IES-R scores. These preliminary findings lend support for the PCIS, with implications for social change and further study: With continued research and recommendations, the PCIS can be enhanced to best help LEOs remain healthy and fit for duty, resulting in a safer society.

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van den Hout, M. A., Rijkeboer, M. M., Engelhard, I. M., Klugkist, I., Hornsveld, H., Toffolo, M. J., & Cath, D. C. (2012). Tones inferior to eye movements in the EMDR treatment of PTSD.
Behaviour Research and Therapy, 50(5), 275-279. doi:10.1016/j.brat.2012.02.001

Marcel A. van den Hout, Clinical and Health Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands. Email: m.vandenhout@uu.nl

Abstract


Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature.