Video of the month

This month I feature the video published October 18, 2012: an Interview with Professor Marcel Van den Hout on EMDR and Psychotherapy. Marcel Van den Hout is Chair of the Department of Clinical Psychology in experimental psychopathology at Utrecht University in the Netherlands. He is co-author of more than a dozen papers on EMDR. As he reveals in the interview, he was initially extremely skeptical about EMDR. In 2010, together with Professor Iris M. Engelhard, he was awarded the outstanding research award from the EMDR International Association.

Journal Articles

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Balibey, H., & Balikçi, A. (2013). Eye movement desensitization and reprocessing (EMDR) treatment at a patient diagnosed with post-traumatic stress disorder: Case report. Düşünen Adam: The Journal of Psychiatry and Neurological Sciences, 26(1), 96-101.

Hakan Balıbey, Ankara Mevki Asker Hastanesi Psikiyatri Klinigi Dıskapı, Ankara, Turkiye. E-mail: hbalibey@gmail.com

Abstract

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that is characterised with autonomic, dysphoric and cognitive signs together with affective numbing, distressed reexperiencing and avoidance from previous traumatic events at a person who has encountered, lived or heard an excessive traumatic event. EMDR is a psychological method which has proven to be effective and it brings together elements of well established approaches such as psychodynamic, cognitive, behavioral and client-centered approaches. In this paper treatment process with Eye Movement Desensitization and Reprocessing (EMDR) of a case who shows signs of post-traumatic stress disorder after a car accident and the need for using this method by clinicians more frequent and widespread at post-traumatic stress disorder patients will be discussed.

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George, A., Thilly, N., Rydberg, J. A., Luz, R., & Spitz, E. (2013). Effectiveness of EMDR treatment in PTSD after childbirth: A randomized controlled trial protocol. Acta Obstetricia Et Gynecologica Scandinavica. doi:10.1111/aogs.12132

Elisabeth Spitz, Health Psychology, University of Lorraine EA4360 APEMAC, Ile du Saulcy, Metz 57006, France. Email: elisabeth.spitz@univ-lorraine.fr

Abstract

A traumatic experience of childbirth is an important public health issue (1; 2). Approximately 1-2% of women suffer from post-traumatic stress disorder (PTSD) following childbirth (3). To date, no large research project has attempted to evaluate psychotherapeutic interventions for women suffering from PTSD after childbirth in a randomized controlled trial (4). Qualitative pilot studies and clinical expertise suggest that eye movement desensitization and reprocessing (EMDR) treatment is a highly successful psychotherapy for women suffering from traumatic birth.

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Landin-Romero, R., Novo, P., Vicens, V., McKenna, P. J., Santed, A., Pomarol-Clotet, E., . . . Amann, B. L. (2013). EMDR therapy modulates the default mode network in a subsyndromal, traumatized bipolar patient. Neuropsychobiology, 67(3), 181-4. doi:10.1159/000346654

FIDMAG Research Foundation Germanes Hospitalàries, Barcelona, Spain.

Abstract

Background: Some functional imaging abnormalities found in bipolar disorder are state related, whereas others persist into euthymia. It is uncertain to what extent these latter changes may reflect continuing subsyndromal affective fluctuations and whether those can be modulated by therapeutic interventions. Method: We report functional magnetic resonance imaging (fMRI) findings during performance of the n-back working memory task in a bipolar patient who showed a marked improvement in subsyndromal affective symptoms after receiving eye movement desensitization and reprocessing (EMDR) therapy in the context of a clinical trial. Results: The patient's clinical improvement was accompanied by marked changes in functional imaging, as compared to 30 healthy subjects. fMRI changes were noted particularly in deactivation, with failure of deactivation in the medial frontal cortex partially normalizing after treatment. Conclusions: This case supports the potential therapeutic overall benefit of EMDR in traumatized bipolar patients and suggests a possible neurobiological mechanism of action: normalization of default mode network dysfunction.

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Shapiro, F. (2013). The case: Treating Jared through Eye Movement Desensitization and Reprocessing therapy. Journal of Clinical Psychology. doi:10.1002/jclp.21986

Mental Research Institute, Palo Alto, CA

No abstract was available for this article.

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Spence, J., Titov, N., Johnston, L., Dear, B. F., Wootton, B., Terides, M., & Zou, J. (2013). Internet-delivered eye movement desensitization and reprocessing (iEMDR): An open trial. F1000Research, 2.

Full text available at: http://f1000research.com/articles/2-79


Jay Spence. Email:jay@jayspence.com.au

Abstract

Recent research indicates internet-delivered cognitive behavioural therapy (iCBT) can reduce symptoms of post traumatic stress disorder (PTSD). This study examined the efficacy of an internet-delivered treatment protocol that combined iCBT and internet-delivered eye movement desensitization and reprocessing (iEMDR), in an uncontrolled trial. Eleven of the 15 participants completed post-treatment questionnaires. Large effect sizes were found from pre-treatment to 3-month follow-up (d = 1.03 – 1.61) on clinician-assessed and self-reported measures of PTSD, anxiety and distress, with moderate effect sizes (d = 0.59 – 0.70) found on measures of depression and disability. At post-treatment, 55% of the participants no longer met criteria for PTSD and this was sustained at follow-up. Symptom worsening occurred in 3 of 15 (20%) of the sample from pre- to post-treatment; however, these participants reported overall symptom improvement by follow-up. Future research directions for iEMDR are discussed.

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Taghva, A., Oluigbo, C., Corrigan, J., & Rezai, R. (2013). Posttraumatic stress disorder: Neurocircuitry and implications for potential deep brain stimulation. Stereotactic and Functional Neurosurgery, 91(4), 207-219. doi:10.1159/000343148

Full text or PDF available at: http://www.karger.com/Article/Fulltext/343148#SA4

Alexander Taghva, 26732 Crown Valley Parkway, Suite 561, Mission Viejo, CA 92691. E-Mail alextaghva@gmail.com

Abstract

Posttraumatic stress disorder (PTSD) is a prevalent and highly disabling psychiatric disorder that is notoriously difficult to treat. At some point in their lifetimes, 5-8% of men, 10-14% of women, and up to a quarter of combat veterans carry this diagnosis. Despite pharmacological and behavioral therapies, up to 30% of patients are still symptomatic 10 years after initial diagnosis. Recent advances in imaging have implicated changes in the limbic and autonomic corticostriatopallidothalamocortical (CSPTC) circuitry in the pathogenesis of this disease. Deep brain stimulation modulates CSPTC circuits in movement and other neuropsychiatric disorders. In this review, we discuss the salient clinical features and neurocircuitry of PTSD and propose a neuromodulation strategy for the disorder.

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Zantvoord, J. B., Diehle, J., & Lindauer, R. J. (2013). Using neurobiological measures to predict and assess treatment outcome of psychotherapy in posttraumatic stress disorder: Systematic review. Psychotherapy and Psychosomatics, 82(3), 142-151. doi:10.1159/000343258

Department of Child and Adolescent Psychiatry, Academic Medical Centre, University of Amsterdam and the Bascule Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.

Abstract
Background: Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. Methods: Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. Results: We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. Conclusion: TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice.

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