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Baas, M. A. M., Stramrood, C. A. I., Dijksman, L. M., Vanhommerig, J. W., de Jongh, A., & van Pampus, M. G. (2023). How safe is the treatment of pregnant women with fear of childbirth using eye movement desensitization and reprocessing therapy? Obstetric outcomes of a multi-center randomized controlled trial. Acta Obstet Gynecol Scand. https://doi.org/10.1111/aogs.14628

Open Access: https://doi.org/10.1111/aogs.14628

Mariëlle G. van Pampus, Department of Obstetrics and Gynecology, OLVG, PO Box 95500, 1090 HM Amsterdam, the Netherlands. E-mail: m.g.vanpampus@olvg.nl

Abstract

INTRODUCTION: Pregnant women with fear of childbirth display an elevated risk of a negative delivery experience, birth-related post-traumatic stress disorder, and adverse perinatal outcomes such as preterm birth, low birthweight, and postpartum depression. One of the therapies used to treat fear of childbirth is eye movement desensitization and reprocessing (EMDR) therapy. The purpose of the present study was to determine the obstetric safety and effectiveness of EMDR therapy applied to pregnant women with fear of childbirth.
MATERIAL AND METHODS: A randomized controlled trial (the OptiMUM-study) was conducted in two teaching hospitals and five community midwifery practices in the Netherlands (www.trialregister.nl, NTR5122). Pregnant women (n = 141) with a gestational age between 8 and 20 weeks and suffering from fear of childbirth (i.e. sum score on the Wijma Delivery Expectations Questionnaire ≥85) were randomly allocated to either EMDR therapy (n = 70) or care-as-usual (CAU) (n = 71). Outcomes were maternal and neonatal outcomes and patient satisfaction with pregnancy and childbirth.
RESULTS: A high percentage of cesarean sections (37.2%) were performed, which did not differ between groups. However, women in the EMDR therapy group proved seven times less likely to request an induction of labor without medical indication than women in the CAU group. There were no other significant differences between the groups in maternal or neonatal outcomes, satisfaction, or childbirth experience.
CONCLUSIONS: EMDR therapy during pregnancy does not adversely affect pregnancy or the fetus. Therefore, therapists should not be reluctant to treat pregnant women with fear of childbirth using EMDR therapy.

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Bouman, S., Müller, F., Onghena, P., & Knoop, H. (2023). Eye Movement Desensitization and Reprocessing Therapy in Chronic Fatigue Syndrome: A Single-Case Experiment Testing the Effect on Persistent Negative Evaluation of Fatigue. Journal of EMDR Practice and Research, 17(3), 106-118. https://doi.org/10.1891/emdr-2022-0060

URL: https://doi.org/10.1891/emdr-2022-0060

Hans Knoop, Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. E-mail: hans.knoop@amsterdamumc.nl

Abstract

Background: While cognitive behavioral therapy (CBT) for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) can lead to the normalization of fatigue levels and resumption of activities, a subgroup of patients still evaluates fatigue negatively.
Objective: The objective was to investigate whether eye movement desensitization and reprocessing (EMDR) therapy leads to a less negative evaluation of fatigue.
Method: This was a randomized single-case experimental study. Five CFS/ME patients (all female, mean age of 35 years), who had completed CBT but still evaluated fatigue negatively, received EMDR therapy. The primary outcome, that is, negative evaluation of fatigue, was assessed daily (three items, e.g., “My fatigue is frustrating”). During EMDR therapy sessions, distress in response to a selected image was measured. Clinical assessments were performed before, directly after, and one month after EMDR therapy.
Results: During EMDR therapy sessions, all patients reported high distress related to memories of having CFS/ME. EMDR therapy led to a reduction in this distress. Daily measured negative evaluations of fatigue declined in three patients, albeit not significantly. Three of five patients showed clinically relevant improvement in evaluations of fatigue on clinical pre-/post measures.
Conclusion: EMDR therapy can reduce emotional distress associated with fatigue, but it is unclear whether it can change its negative evaluation.

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Burr, C., Schnackenberg, J. K., & Weidner, F. (2022). Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review. Front Psychiatry, 13, 983999. https://doi.org/10.3389/fpsyt.2022.983999

Open Access: https://doi.org/10.3389/fpsyt.2022.983999

Christian Burr, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland. E-mail: christian.burr@bfh.ch

Abstract

BACKGROUND: The positive effects of both antipsychotic medication and cognitive behavioral therapy in psychosis (CBTp) for people who are distressed by their experience of hearing voices remain limited. As a result, there has been a recent surge in talk-based individual approaches. Many of these continue not to be very well known nor implemented in practice. Some of the approaches may focus more on understanding and dealing constructively with voices, an element that has been identified as potentially helpful by voice hearers. Existing barriers to a wider implementation include both the widespread pathologization of hearing voices and a lack of mental health professionals who have been trained and trusted to carry out these new interventions.
METHODS: This scoping review aimed to identify and describe a current synthesis of talk-based individual approaches for people who hear voices, including studies independently of method of study or approach, diagnosis of voice hearers nor of the professional background of interventionists.
RESULTS: Nine different talk-based approaches were identified. These included: (1) Cognitive Behavioral Therapy for Psychosis (CBTp); (2) AVATAR therapy; (3) Making Sense of Voices (MsV) aka Experience Focused Counselling (EFC); (4) Relating Therapy; (5) Acceptance and Commitment Therapy; (6) Smartphone-based Coping-focused Intervention; (7) Prolonged and Virtual Reality Exposure Therapy; (8) Eye Movement Desensitization and Reprocessing, and (9) Individual Mindfulness-based Program for Voice Hearing. The different approaches differed greatly in relation to the number of sessions, length of time offered and the scientific evidence on efficacy. Psychologists represented the main professional group of interventionists. CBTp and the MsV/EFC approach also included health professionals, like nurses, as implementers. Most of the approaches showed positive outcomes in relation to voice related distress levels. None identified overall or voice specific deteriorations.
CONCLUSION: There appears to be a strong case for the implementation of a broader heterogeneity of approaches in practice. This would also be in line with recommendations for recovery focused services and requirements of voice hearers. A greater emphasis on whole systems implementation and thus the involvement of frontline staff, like nurses, in the delivery of these approaches would likely reduce the research-practice implementation gap.

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Carretero, K. P., Delgadillo, A., Villarreal, A. M., Roque, J. P., Poiré, A., Mainthow, N., Givaudan, M., & Jarero, I. (2023). Randomized Controlled Trial on the ASSYST Treatment Intervention with Female Children Polytraumatized by Adverse Childhood Experiences, Neglect, and Maltreatment. Academic Journal of Pediatrics & Neonatology, 12(5). https://doi.org/10.19080/ajpn.2023.12.555901

Open Access: https://doi.org/10.19080/ajpn.2023.12.555901

Kirsha Patricia Carretero, Email: byda.carretero@gmail.com

Abstract

The aim of this randomized controlled trial with an intention-to-treat analysis was to evaluate the effectiveness, efficacy, and safety of the Acute Stress Syndrome Stabilization Individual (ASSYST-I) treatment intervention in reducing posttraumatic stress disorder (PTSD) symptoms in female children polytraumatized by adverse childhood experiences, neglect, and maltreatment. A total of 40 female children met the inclusion criteria and participated in the study. Participants’ ages ranged from 8 to 17 years old (M =14.67 years). A two-arm randomized controlled trial (RCT) design was applied. PTSD symptoms were measured in three-time points for all participants in the study. Results showed that the intervention had a significant effect for time on PTSD symptoms (F (2,76) = 36.92 p <.000, η² = .493). A significant effect for group was also found (F (1, 38 = 32.7, p<.005, η² = .896) with a large effect, and a significant interaction between time and group, (F (2, 76) = 56.00, p <.000, η² = .600). Means comparison using t test between groups showed significant differences between the Treatment Group (TG) and the Control Group (CG) in the three-time points comparisons showing a large effect on Time 2 (Post-treatment assessment) which was maintained on Time 3 (Follow-up assessment). Results on the Reliable Change Index (RCI) and the Clinically Significant Change (CSC) Margin showed that the ASSYST-I treatment intervention exhibited reliable change on PTSD symptom reduction and clinically significant change, indicating that the treatment group participants are more likely to belong to the non-PTSD population after the intervention. Conversely, the control group participants are more likely to belong to the PTSD population. No adverse effects or events were reported by the participants during the treatment procedure administration or at follow-up. None of the participants showed clinically significant worsening/exacerbation of symptoms after treatment. Participants in the control group received the intervention treatment after the follow-up assessment, fulfilling our ethical criteria.

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Flatot-Blin, D., Rey, A., Derynck, F., Fossard, O., & Khalfa, S. (2023). Clinical Efficiency and Acceptability of EMDR and MOSAIC Therapy for PTSD. Healthcare (Basel), 11(15), 2226. https://doi.org/10.3390/healthcare11152226

Open Access: https://doi.org/10.3390/healthcare11152226

Deborah Flatot-Blin, Laboratoire de Psychologie Cognitive, CNRS, Aix Marseille University, 13003 Marseille, France. E-mail: deborah.flatot-blin@univ-amu.fr

Abstract

Eye movement desensitization and reprocessing (EMDR) therapy is one of the therapies recommended by the World Health Organization (2013) to treat posttraumatic stress disorder (PTSD). Although efficient, repeated exposure to the traumatic memory may reduce its acceptability to patients. The therapy (MOSAIC in French) was developed to improve acceptability and reduce pain by drawing on the patient's internal resources. MOSAIC therapy focuses on the body sensations that the patient wants to experience and avoids having to relive the traumatic memories. This observational study aimed to compare the clinical efficiency of EMDR and MOSAIC therapy for PTSD and to measure the well-being generated by both therapies. Twenty-six PTSD patients (17 females and 9 males, mean age 37.01 years, SD = 13.06) received treatment by psychiatrists and/or psychologists trained with EMDR or MOSAIC therapy. Both patient groups achieved a significant decrease in PTSD symptoms as measured with the PCL-5. However, fewer sessions were required with the MOSAIC therapy than with EMDR therapy. As expected, the level of well-being experienced by the patient during the therapy, assessed using the Lickert scale, was higher with MOSAIC than with EMDR therapy from the first session. These findings provide the first evidence of the efficacy of MOSAIC therapy treatment, which now needs to be corroborated in a larger randomized clinical trial.

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Grifoni, J., Pagani, M., Persichilli, G., Bertoli, M., Bevacqua, M. G., L’Abbate, T., Flamini, I., Brancucci, A., Cerniglia, L., Paulon, L., & Tecchio, F. (2023). Auditory Personalization of EMDR Treatment to Relieve Trauma Effects: A Feasibility Study [EMDR+]. Brain Sci, 13(7), 1050. https://doi.org/10.3390/brainsci13071050

Open Access: https://doi.org/10.3390/brainsci13071050


Franca Tecchio, LET’S and LABSS, Institute of Cognitive Sciences and Technologies ISTC, Consiglio Nazionale delle Ricerche CNR, 00185 Rome, Italy. E-mail: franca.tecchio@cnr.it

Abstract

According to the WHO (World Health Organization), Eye Movement Desensitization and Reprocessing (EMDR) is an elective therapy to treat people with post-traumatic stress disorders (PTSD). In line with the personalization of therapeutic strategies, through this pilot study, we assessed in people suffering from the effects of trauma the feasibility, safety, acceptance, and efficacy of EMDR enriched with sound stimulation (by administering neutral sounds synchronized with the guided bilateral alternating stimulation of the gaze) and musical reward (musical listening based on the patients' predisposition and personal tastes). Feasibility, quantified by the number of patients who completed the treatment, was excellent as this was the case in 12 out of the 12 enrolled people with psychological trauma. Safety and acceptance, assessed by self-compiled questionnaires, were excellent, with an absence of side effects and high satisfaction. Efficacy, quantified by the number of EMDR treatment sessions required to reach the optimal scores on the Subjective Units of Disturbance (SUD) and Validity of Cognition (VOC) scales typical of EMDR protocols, revealed an average duration of 8.5 (SD 1.2) sessions, which is well below the 12 sessions considered a standard EMDR treatment duration. EMDR+ appears to be a relevant personalization of EMDR, particularly in music-sensitive people, consolidating the therapeutic alliance through a multisensory communicative bond for trauma treatment.

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Hogg, B., Radua, J., Gardoki-Souto, I., Fontana-McNally, M., Lupo, W., Reinares, M., Jiménez, E., Madre, M., Blanco-Presas, L., & Cortizo, R. (2023). EMDR therapy vs. Supportive Therapy as adjunctive treatment in trauma-exposed bipolar patients: a randomized controlled trial. https://psyarxiv.com/s5hrf/download?format=pdf

Open Access: https://psyarxiv.com/s5hrf/download?format=pdf

Dr. Alicia Valiente-Gómez, Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, Spain. E-mail: avalientego@gmail.com

Abstract

Background. Patients with Bipolar Disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.
Methods. This multicentre RCT included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post- treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrollment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines.
Results. There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalization. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms.
Conclusions. Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR led to the reduction of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Importantly, focusing on traumatic events did increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.

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Kopmeiners, E. H. M., Hollander, M. H., van Voorst, N., & Stramrood, C. A. I. (2023). Effect of early postpartum EMDR on reducing psychological complaints in women with a traumatic childbirth experience. J Psychosom Obstet Gynaecol, 44(1), 2229010. https://doi.org/10.1080/0167482X.2023.2229010

Open Access: https://doi.org/10.1080/0167482X.2023.2229010


Emma H. M. Kopmeiners, Radboud University Medical Center, Nijmegen, The Netherlands. E-mail: emmakopmeiners@hotmail.nl

Abstract

This pilot study investigated the feasibility of postpartum Eye Movement Desensitization and Reprocessing (EMDR) for improving posttraumatic stress disorder (PTSD) symptoms, and its association with work absence, relationship difficulties, and development of psychiatric disorders in women with a traumatic childbirth experience who do not meet all criteria for PTSD. A randomized controlled study was conducted among 20 women (EMDR (N=11) vs. care as usual (CAU) (N=9)) who reported a traumatic birth. Outcomes were measured by questionnaires and a semi-structured interview. The results showed improvement of trauma-related psychological complaints for all women. EMDR appears to be more effective in reducing PTSD symptoms than CAU. Moreover, EMDR showed a small positive effect on work absence due to factors related to the traumatic childbirth experience. Results from the questionnaires were substantiated by interviews. However, due to the small size of the study, no statistically significant differences were found. In addition, no differences were found for relationship difficulties and development of psychiatric disorders. In conclusion, women with a traumatic birth experience may benefit from EMDR, even if they do not qualify for a diagnosis of PTSD. This study could be a starting point for future research aimed at early treatment that reduces trauma-related psychological complaints in postpartum women.

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Kratzer, L., Heinz, P., Knefel, M., Weindl, D., Tschöke, S., Biedermann, S. V., Schröder, J., & Karatzias, T. (2023). How Important Is Reprocessing in Personalized Multicomponent Therapy? Analyzing Longitudinal Data of Inpatients With Severe PTSD. J Nerv Ment Dis, 211(8), 592-600. https://doi.org/10.1097/NMD.0000000000001671

URL: https://doi.org/10.1097/NMD.0000000000001671


Leonhard Kratzer, PhD, Department of Psychotraumatology, Clinic St Irmingard, Osternacher Strasse 103, Prien am Chiemsee, Bavaria, 83209, Germany. E-mail: l.kratzer@st-irmingard.de

Abstract

Treatment guidelines for complex presentations of posttraumatic stress disorder (PTSD) are often cautious about the reprocessing of traumatic memories and recommend multicomponent treatments that are widely used in clinical practice. Yet, the role of reprocessing in these multicomponent treatments remains unknown. Using naturalistic data of 97 patients treated for PTSD, we used a linear mixed model to investigate the role of reprocessing for the outcome at discharge and at 6-month follow-up. Treatment effects were significant and large (g = 0.91-1.05). The final model showed good fit and explained 51% of the variance. There was a significant main effect of time (B = -8.1 [-11.5; -4.8], p < 0.001), as well as a reprocessing by time interaction (B = -17.2 [-30.5; -3.8], p = 0.012), indicating better outcomes with higher levels of reprocessing. Hence, maximizing the amount of reprocessing used in multicomponent treatments for PTSD may significantly enhance outcomes.

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Leeds, A. M. (2023). Foundations of the Positive Affect Tolerance Protocol: The Central Role of Interpersonal Positive Affect in Attachment and Self-Regulation. Journal of EMDR Practice and Research, 17(3). https://doi.org/10.1891/emdr-2023-0006

URL: https://doi.org/10.1891/emdr-2023-0006

Andrew M. Leeds, 1049 Fourth St., Suite G, Santa Rosa, California, USA. E-mail: andrewmleeds@gmail.com

Abstract

Research has highlighted the negative effects of early neglect and abuse on the development of emotional self-regulation and attachment. Attention has focused more on negative affect states related to past adverse and traumatic experiences than on the deactivating effects of the absence of early shared positive affect states from parent-infant play, warmth, and affection. Treatment strategies for survivors of early neglect and abuse have focused on methods to metabolize memories of traumatic events. Skills development models have emphasized the benefits of distress tolerance, acceptance, and mindfulness training for patients with persistent negative affect states. Research on the benefits of therapeutic interventions intended to increase positive affect indicates they promote prosocial behaviors and creativity, broaden the scope of attention, reduce emotional symptoms and behavioral problems, and improve physical health. Within the field of eye movement desensitization and reprocessing (EMDR) therapy, procedures to increase positive affect have generally focused on resource development and installation procedures intended to increase access to positive affect-related memories and images. A neglected clinical issue is the inability of survivors of early neglect to tolerate and integrate actual positive interpersonal experience into positive emotional states, interpersonal scripts, or self-concepts. These deficiencies, characteristic of those with dismissing insecure attachment, help produce and maintain profound psychological, medical, and social problems that limit the ability of patients with these histories from progressing in psychotherapy. This article explores research supporting the potential benefits of an EMDR-related procedure, the positive affect tolerance (PAT) and integration protocol, along with possible mechanisms by which the PAT protocol in general, and its bilateral stimulation procedures, might produce clinical benefits for survivors of early neglect. Case vignettes illustrate the potential challenges of implementing and the potential impact of the PAT protocol. Research designs and assessment tools are described that could clarify the potential benefits of the PAT protocol compared to other treatments designed to increase positive affect.

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Liou, H., Lane, C., Huang, C., Mookadam, M., Joseph, M., & Hecker DuVal, J. (2022). Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods. Telemed J E Health, 28(9), 1359-1366. https://doi.org/10.1089/tmj.2021.0454

Open Access: https://doi.org/10.1089/tmj.2021.0454

Jennifer Hecker DuVal, MSW, LCSW, DBH, Department of Family Medicine, Mayo Clinic, Phoenix, AZ 85054, USA. E-mail: heckyeswellness@gmail.com

Abstract

Introduction: Eye movement desensitization and reprocessing (EMDR) is an evidence-based psychotherapy method designed to treat distress associated with traumatic memories. The COVID-19 pandemic has challenged providers to shift EMDR to telehealth platforms. Objectives: This research had to aims. (1) To compare EMDR in conjunction with cognitive behavioral therapy (CBT) with CBT alone for treatment of a patient population with prevalent anxiety and (2) to compare the efficacy of virtual EMDR with that of in-person EMDR in the primary care setting.
Methods: Retrospective chart review of all adult patients seen by a single therapist at a primary care center was conducted from January 2018 to December 2020. Charts were reviewed for demographics, psychiatric diagnoses, number of visits, number and type of EMDR treatments, and patient health questionnaire (PHQ)-9 and general anxiety disorder (GAD-7) scores pre- and post-treatment.
Results: Patients who underwent EMDR with CBT demonstrated greater decreases in PHQ-9 and GAD-7 scores than patients who had only CBT (2.4, 2.5 vs. 0.9, 1.1). However, after adjusting for total number of sessions, post-traumatic stress disorder, grief, and pain, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent EMDR with CBT and CBT-exclusive patients were not statistically significant. Similarly, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent virtual EMDR and those who had in-person EMDR were not statistically significant.
Conclusions: To our knowledge, this is the first study describing the use of virtual EMDR in a primary care setting. Although our data did not provide evidence for the superiority of EMDR with CBT over CBT alone, we demonstrate that both in-person and virtual EMDR led to significantly improved GAD-7 scores.

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Mamtani, H., Mamtani, N., & Chaturvedi, S. K. (2023). The curious case of psycho-ophthalmology: A narrative review of ophthalmological aspects of psychiatric disorders. Psychiatr Danub, 35(2), 163-173. https://doi.org/10.24869/psyd.2023.163

Open Access: https://doi.org/10.24869/psyd.2023.163

Postdoctoral Fellow in Neuropsychiatry, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India- 560029. E-mail: harkishanmamtani@gmail.com

Abstract

Consultation Liaison Psychiatry (CLP) deals with the interface shared between psychiatry and various other disciplines of medicine. The interface shared by psychiatry and ophthalmology is among the lesser discussed ones in the field of CLP, despite the fact that it holds clinical relevance in the evaluation, management and outcomes of both psychiatric and ophthalmological disorders. This narrative review focusses on the ophthalmological aspects of psychiatric disorders, with respect to their manifestations, assessment, and management. Psychiatric disorders, including schizophrenia, affective disorders, 'functional' disorders, and substance use disorders, have numerous ophthalmic manifestations, which can have clinical implications for the patients. Even the psychotropic drugs given for psychiatric disorders can lead to side effects affecting the eye, but these are among the lesser-discussed side effects. Some psychiatric disorders can be investigated using various ophthalmic functions, the assessments ranging from simple physical examination to the use of instruments like a fundoscope, which can be useful for a psychiatrist in their routine practice. Lastly, eye functions can also be used in the treatment of psychiatric conditions, as is seen in eye movement desensitization and reprocessing. This review reiterates the fact that more attention needs to be given to the field of 'psycho-ophthalmology', which holds great promise in the coming days.

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Phaf, R. H. (2023). Merging and modifying hypotheses on the emotional and cognitive effects of eye movements: The dopaminergic regulation hypothesis. New Ideas in Psychology, 70, 101026. https://doi.org/10.1016/j.newideapsych.2023.101026

Open Access: https://doi.org/10.1016/j.newideapsych.2023.101026

R. Hans Phaf, Amsterdam Brain and Cognition Center, Universiteit van Amsterdam, PO Box 15915, 1001, NK Amsterdam, the Netherlands. E-mail address: r.h.phaf@contact.uva.nl.

Abstract

The integration of hypotheses from Eye-Movement Desensitization and Reprocessing (EMDR) and Saccade Induced Retrieval Enhancement (SIRE), both of which have been met with considerable skepticism, may lead to significant gains in both domains. Cognitive accounts of EMDR, the orienting response (OR) and working memory (WM) hypotheses, and of SIRE, the interhemispheric interaction (IHI) and the top-down attentional control (TDAC) hypotheses, are discussed. The accounts show several blind spots and frictions, for instance, on re-imagining during EMs, on hemispheric lateralization, and on emotional influences of eye movements. The failure to consider these factors across and within domains may well explain the many disparate findings. This perspective aims to remove the artificial separation and seeks a theoretical integration of the domains. It combines elements of OR and TDAC into a new dopaminergic regulation hypothesis while replacing affective (i.e., positive vs. negative) by motivational mechanisms (i.e., fostering approach and recoding). EMs are posited to result in a short-latency, targeted release of dopamine, which is the central neuromodulator in approach tendencies. According to this hypothesis, the largest effects are obtained in individuals with collateralized eye dominance and dopamine dominance. Concrete suggestions are made to improve research conditions and therapeutic efficacy.

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Rolli, N. J. (2023). Integrating EMDR Standard Treatment Protocol into Child Psychotherapy at a Primary School with a 5‐year‐old Boy Who Suffered Complex Trauma: A Single Case Study. British Journal of Psychotherapy. https://doi.org/10.1111/bjp.12861

URL: https://doi.org/10.1111/bjp.12861

Nadja Julia Rolli. E-mail: nadja.rolli@passt.co.uk

Abstract

Schools are making an important contribution to providing access to professional counselling for young people and their families. The population of children who access school counselling includes young people who have experienced severe and complex trauma in their early life, which presents itself as post‐traumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) therapy is a recommended method of intervention for PTSD, with effective results in a short time. However, school counsellors are rarely specifically trained to work with complex trauma or PTSD. This article presents a case study exploring the integration of the EMDR eight‐phase protocol into child psychotherapy in an English primary school setting with a 5‐year‐old boy who suffered complex trauma. Following treatment, the Strengths and Difficulties Questionnaire (SDQ) score and Generalized Anxiety Disorder Assessment (GAD‐7) score—filled in by the child's parent and schoolteacher because of the child's age—decreased to non‐clinical levels. The six‐month follow‐up assessment confirmed the improvement in the emotional well‐being of the client. The promising results suggest the value of having adequately qualified child psychotherapists linked to primary schools to support emotionally vulnerable pupils.

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Scimeca, G. (2023). Fear of premonition: A case report of cognitive therapy integrated with eye movement desensitization and reprocessing. Psychology of Consciousness: Theory, Research, and Practice. https://doi.org/10.1037/cns0000369

Open Access: https://doi.org/10.1037/cns0000369

Giuseppe Scimeca, Complex Operative Unit (U.O.C.) Psychology Service of Trapani, Provincial Health Authority (ASP) n. 9 of Trapani, Viale Europa n. 60, I-91011 Alcamo (TP), Italy. E-mail: giuseppescimeca@me.com

Abstract

The aim of this work is to describe the application of a cognitive approach to a patient who became distressed by an anomalous experience. The patient was already in treatment with a cognitive psychotherapy combined with an eye movement desensitization and reprocessing (EMDR) technique. The main focus is to analyze the effects of the memory of an apparent precognitive dream in eliciting negative automatic thoughts that turned out to be typical of the maladaptive personality pattern already diagnosed. It is discussed how a clinical approach to anomalous experiences might favor the development of healthy traits of the personality. The effectiveness of the combined cognitive and EMDR treatment is also discussed by considering the results of a multimethod assessment procedure using both explicit and implicit measures of personality and psychopathology.

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Simkin, D. R. (2023). Post-Traumatic Stress Disorder/Developmental Trauma Disorder/Complex Post-Traumatic Stress Disorder and Complementary and Integrative Medicine/Functional Medicine. Child Adolesc Psychiatr Clin N Am, 32(2), 317-365. https://doi.org/10.1016/j.chc.2022.08.011

URL: https://doi.org/10.1016/j.chc.2022.08.011

Deborah R. Simkin, MD. Department of Psychiatry, Emory University School of Medicine, 8955 Highway 98 West, Suite 204, Miramar Beach, FL 32550, USA. E-mail: Deb62288@aol.com

Abstract

Response to PTSD treatments differ based on the age the abuse occurred, the type of abuse, and the chronicity of the abuse. Even when modifications to treatment are made based on the developmental age when the abuse occurred, therapies may be insufficient. In addition, when diagnostic criteria are modified to identify more children, some children continue to escape detection. Developmental Trauma Disorder, (akin to the RDoC), may be more suitable to identify epigenetic and inflammatory effects of early abuse that may be responsible for the nonresponsive to treatment. Complementary and Integrative Medicine interventions (meditation, EFT, EMDR, PUFAs, etc.) may reverse these effects.

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Silva, R. C., Dattilo, V., Perusi, G., Mazzelli, M., Maffioletti, E., Bazzanella, R., Bortolomasi, M., Cattaneo, A., Gennarelli, M., & Minelli, A. (2023). Transcriptional Modulation of Stress-Related Genes in Association with Early Life Stress Exposure and Trauma-Focused Psychotherapy in Treatment-Resistant Depression Patients. Journal of EMDR Practice and Research, 17(3), 119-138. https://doi.org/10.1891/emdr-2023-0019

URL: https://doi.org/10.1891/emdr-2023-0019

Alessandra Minelli, Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia Viale, Europa 11 25123, Brescia, Italy. E-mail: alessandra.minelli@unibs.it

Abstract

Early life stress (ELS) is associated with treatment-resistant depression (TRD), and trauma-focused psychotherapy benefits TRD patients exposed to ELS. We explored peripheral modulations of stress-response genes (nuclear receptor subfamily 3 group C member 1[NR3C1], FK506-binding protein 5[FKBP5], and serum/glucocorticoid-regulated kinase 1 [SGK1]) in relation to ELS and symptom changes during psychotherapy. Forty-one TRD patients participated and 21 patients underwent trauma-focused psychotherapy, comprising eye movement desensitization and reprocessing or trauma-focused cognitive behavioral therapy. We used the Montgomery-Åsberg Depression Rating Scale, the Beck Depression Inventory-II and the Beck Anxiety Inventory for symptom evaluation, the Childhood Experience of Care and Abuse Questionnaire for ELS assessment, and the quantitative reverse transcription polymerase chain reaction (RT-qPCR) for transcript analysis. We found higherNR3C1andFKBP5baseline mRNA levels in patients with maternal neglect. Trauma-focused psychotherapy induced modifications in transcripts’ levels and symptom amelioration along psychotherapy correlated with genes’ modulations. Transcript levels for all genes were higher in patients relapsing after 24 weeks.

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Sorel, O., Saint-Jammes, J. T., Meillerais, S., & Bouchard, J. P. (2022). [Psychological impact of the COVID-19 pandemic on children and adolescents and treatments]. Ann Med Psychol (Paris), 180(10), 1115-1120. https://doi.org/10.1016/j.amp.2022.10.016

Open Access: https://doi.org/10.1016/j.amp.2022.10.016

Abstract

Children and adolescents were particularly affected by the psychological consequences of the COVID-19 health crisis. They were faced with multiple stressors such as repeated confinements, the use of masks, the disruption of daily routines, the lack of social interactions following the closure of schools and the cessation of extra-curricular activities. These adversities dramatically weakened their coping strategies and their resources. In this interview with Jean-Pierre Bouchard, Olivier Sorel, Juliane Tortes Saint-Jammes et Sandie Meillerais discuss the changes that have been implemented in their clinical practice for children in the context of the COVID-19 pandemic. Then, they will also identify, by using clinical examples, the procedures specifically used to develop, reinforce or reactivate the resources of children and adolescents during the therapy. Finally, they address the very notion of clinical support, with an emphasis on EMDR therapy and a family-centered approach.

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Udo, I., Javinsky, T.-R., & McDaniel, C. (2023). Eye movement desensitisation and reprocessing: part 3 – applications in physical health conditions. BJPsych Advances, 1-9. https://doi.org/10.1192/bja.2023.32

Open Access: https://doi.org/10.1192/bja.2023.32

Dr Itoro Udo. City Clinic & Wellness Center, London, Ontario, Canada. E-mail: dr_itoro@yahoo.com

Abstract

Eye movement desensitisation and reprocessing (EMDR) is a psychological therapy that addresses trauma, stress and emotional distress. It has been successfully used in the management of various psychiatric disorders. This article shows that it may also be safely used to manage the psychological distress arising from a variety of physical health conditions and in so doing, reduce the illness burden from conditions such as various cancers, traumatic childbirth, tokophobia, pre-eclampsia, myocardial infarction, haemodialysis in end-stage renal disease, and acute postoperative pain. It can be a stand-alone treatment for hyperemesis gravidarum and tinnitus. The article examines the rationale and evidence for its use in these conditions and suggests areas where more research is needed. Adding EMDR therapy to the range of available interventions in general hospitals has the potential to improve the health and well-being of patients in these settings.

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VA/DoD Clinical Practice Guideline. (2023). Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group. Washington, DC, U.S. Government Printing Office. https://www.healthquality.va.gov/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Provider-Summary.pdf

VA/DoD Clinical Practice Guideline. (2023). Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group: Provider Summary. Washington, DC, U.S. Government Printing Office. https://www.healthquality.va.gov/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Provider-Summary.pdf


VA/DoD Clinical Practice Guideline. (2023). Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group: Quick Reference Guide. Washington, DC, U.S. Government Printing Office. https://www.healthquality.va.gov/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Quick-Reference-Guide.pdf

Abstract

These Clinical Practice Guidelines provides an evidence-based framework for evaluating and managing care for individuals with posttraumatic stress disorder (PTSD) or acute stress disorder (ASD) toward improving clinical outcomes.

7. We recommend individual psychotherapies, listed in Recommendation 8, over pharmacologic interventions for the treatment of PTSD. [Strong for]

8. We recommend the individual, manualized trauma-focused psychotherapies for the treatment of PTSD: Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing, or Prolonged Exposure. [Strong for]

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van der Hoeven, M. L., Plukaard, S. C., Schlattmann, N. E. F., Lindauer, R. J. L., & Hein, I. M. (2023). An integrative treatment model of EMDR and family therapy for children with severe symptomatology after child abuse and neglect: A SCED study. Children and Youth Services Review, 152, 107064. https://doi.org/10.1016/j.childyouth.2023.107064

Open Access: https://doi.org/10.1016/j.childyouth.2023.107064

Mara L. van der Hoeven, University of Amsterdam, Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands. E-mail: m.l.vanderhoeven@amsterdamumc.nl

Abstract

Background: Children who endured child abuse and neglect (CAN) may develop a spectrum of symptoms that goes beyond the development of posttraumatic stress symptoms (PTSS) alone. This can pose unique challenges within the treatment context that may hamper the application of direct trauma-focused treatments. A new treatment model, which focuses on more than PTSS alone, has been developed. Through preparatory work, it aims to engage children in trauma processing.
Objective: This study aimed to examine if this integrative treatment model can diminish attachment problems, PTSS, behavior difficulties, and emotional control difficulties in children with a history of CAN who currently reside in permanent placement.
Participants & Settings: We included 15 children between the ages of four and twelve who experienced CAN in the past and who were referred to specialized youth mental health care and their caregivers.
Methods: We conducted a non-concurrent multiple baseline single-case experimental design study with weekly measurements on attachment problems, PTSS, behavior difficulties, and emotional control difficulties through questionnaires.
Results: Eight cases were fit to analyze of which all but one participant showed improvement on one or more of the four outcome measures. On group level, we found evidence for functional relationships between the intervention and change in attachment problems, behavioral difficulties, and emotional control difficulties.
Conclusions: This integrative treatment model appears to be a suitable treatment for children with a complex combination of psychiatric problems after CAN and therefore provides promising results for a complex population for whom limited treatment options are available.

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Wakusawa, K., Sugiyama, T., Hotta, H., Wada, K., Suzuki, F., Morimoto, T., Shiino, T., & Tomoda, A. (2023). Triadic Therapy Based on Somatic Eye Movement Desensitization and Reprocessing for Complex Posttraumatic Stress Disorder: A Pilot Randomized Controlled Study. Journal of EMDR Practice and Research, 17(3), 159-170. https://doi.org/10.1891/emdr-2023-0014

URL: https://doi.org/10.1891/emdr-2023-0014

Keisuke Wakusawa, Department of Developmen- tal Neuropsychiatry, Miyagi Children’s Hospital, 4-3-17, Ochiai, Aobaku, Sendai, Miyagi, 989-3126, Japan. E-mail: k-wakusawa@nifty.com

Abstract

The triadic therapy based on somatic eye movement desensitization and reprocessing (EMDR) for complex posttraumatic stress disorder (TSP) is a combination therapy, which comprises simplified EMDR, a triplet of micro-dose medicines, and a pair of Chinese medicines. The EMDR procedure is a tactile bilateral stimulation on the body surface with minimum verbal intervention within 15 minutes every two weeks in a period of 2–3 months. In this study, 22 adult patients were treated with TSP. The Impact of Event Scale—Revised, Beck Depression Inventory (second edition), and Global Assessment of Functioning scores of the patients were significantly improved. Moreover, TSP is a safe treatment procedure in terms of titration, cost-effectiveness, and time-effectiveness. It could also treat multiple difficulties in patients with cPTSD from medical problems to socioeconomic problems.

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van Woudenberg, C., Voorendonk, E. M., Tunissen, B., van Beek, V. H. F., Rozendael, L., Van Minnen, A., & De Jongh, A. (2023). The impact of intensive trauma-focused treatment on sexual functioning in individuals with PTSD. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1191916

Open Access: https://doi.org/10.3389/fpsyg.2023.1191916

Clair van Woudenberg E-mail: c.vanwoudenberg@psytrec.nl

Abstract

Background: Individuals with posttraumatic stress disorder (PTSD) often experience sexual disturbances.
Objective: To determine whether intensive trauma-focused treatment is associated with an improvement in sexual functioning (i.e., sexual satisfaction and sexual desire) in individuals with PTSD.
Method: In total, 227 patients with PTSD (68.7% women, mean age = 40.97) participated in an intensive eight-day trauma-focused treatment program consisting of prolonged exposure, eye movement and desensitization and reprocessing (EMDR) therapy, physical activity, and psychoeducation. Patients were assessed (i.e., Clinician Administered PTSD Scale and Sexual Functioning Questionnaire) pre- and post-treatment and at 6-months follow-up.
Results: Sexual satisfaction and sexual desire increased significantly associated with trauma-focused treatment from pre-treatment to 6-months follow-up, albeit the effect sizes were small (Cohen’s d = 0.39 and 0.17, respectively). Although men reported greater overall sexual desire than women, sexual functioning improved after treatment in both men and women. Furthermore, those with remission of PTSD reported greater sexual functioning post-treatment and at 6-months follow-up, than those without remission. However, changes in PTSD symptoms associated with treatment were not predictive of the level of sexual satisfaction or sexual desire 6 months after treatment.
Conclusion: The results of this uncontrolled study suggest that intensive treatment for PTSD can have beneficial effects on sexual satisfaction and desire in both men and women; however, this may not necessarily be due to a decrease in PTSD symptoms.

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Yaşar, A. B., Kavakçı, Ö., Çiftçi, Z. Z., Tunca, G. A., Uygun, E., Gündoğmuş, İ., Kubilay, D., Aksöz, Y., Deveci, H., & Konuk, E. (2023). The Effectiveness of Online EMDR 2.0 Group Protocol on Posttraumatic Stress Disorder Symptoms, Depression, Anxiety, and Stress in Individuals Who Have Experienced a Traffic Accident: A Preliminary Study. Journal of EMDR Practice and Research, 17(3), 171-184. https://doi.org/10.1891/emdr-2023-0003

URL: https://doi.org/10.1891/emdr-2023-0003

İbrahim Gündoğmuş, Department of Psychia- try, Ankara Etlik City Hospital, Ankara, Turkey. E-mail: dribrahim06@gmail.com

Abstract

Introduction: As an innovative procedure, eye movement desensitization and reprocessing (EMDR) 2.0, which is based on standard EMDR, draws attention with its promising results. The adaptation of EMDR 2.0 to groups will be a significant contribution to the psychology literature. Considering the effectiveness of EMDR 2.0 on individual applications, this is a preliminary study that aims to explore the role of EMDR 2.0 on groups by developing the EMDR 2.0 group protocol (EMDR 2.0 GP).
Methods: In this pilot study, EMDR 2.0 GP is applied to a group of seven participants who had been exposed to a traffic incident. The role of EMDR 2.0 GP (three sessions; 3.5 hours in total) on posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and stress was measured. The Impact of Event Scale—Revised and the Depression-Anxiety-Stress Scale-21 (DASS-21) were used to assess these symptoms at pretreatment, one-week posttreatment, and one-month posttreatment.
Results: The participants (mean age = 47.14 ± 9.65) with a traffic accident experience (mean of the time elapsed = 88.57 ± 38.24 months) received EMDR 2.0 GP. Results showed that the EMDR 2.0 group had significantly lower depression (χ² [2,n= 7] = 9.364,p= .009, Kendall’sW= .668) and stress (χ² [2,n= 7] = 8.667,p= .013, Kendall’sW= .619) on the subscales of DASS-21 and lower intrusions (χ² [2,n= 7] = 6.333,p= .042, Kendall’sW= .452), avoidance (χ² [2,n= 7] = 7.280,p= .026, Kendall’sW= .520), and hyperarousal (χ² [2,n= 7]) = 10.800,p= .005, Kendall’sW= .771) at posttreatment.
Conclusion: The pilot study of EMDR 2.0 GP indicated that this newly developed protocol that was first applied to the group may be effective in reducing depression, stress, and PTSD symptoms among a nonclinical sample. This pilot study supports future randomized controlled EMDR GP applications.

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Yurtsever, A., Bakalim, O., Karaman, Ş., Kaya, S., & Konuk, E. (2022). The effect of the online eye movement desensitization and reprocessing early intervention protocol (EMDR R-TEP) for the risk groups with post-traumatic stress symptoms during the COVID-19 pandemic. Front Psychol, 13, 935782. https://doi.org/10.3389/fpsyg.2022.935782

Open Access: https://doi.org/10.3389/fpsyg.2022.935782

Asena Yurtsever, Institute AY, Istanbul, Turkey. E-mail: asenayurt@hotmail.com

Abstract

The aim of the research is to investigate the effect of eye movement desensitization and reprocessing (EMDR) therapy on post-traumatic stress disorder (PTSD) levels of individuals who can be defined as high-risk groups during the pandemic. Therefore, the online EMDR R-TEP Protocol was applied to a total of 154 individuals working with coronavirus patients, frontline professionals (Doctors, Nurses, Paramedics, Polices, Red Crescent), relatives of coronavirus patients, coronavirus patients, and relatives of someone who died from coronavirus and the PTSD symptom level before, after, and 1 month after therapy was measured and examined. A personal information form and impact of events scale were used to collect data. Analyses showed that EMDR therapy was effective in reducing the PTSD level in all groups. The PTSD levels of frontline professionals continued to decrease until the follow-up test but remained the same in the other groups.

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Yıldırım, N. G., & Bahayi, K. (2023). Examination of the Effect of EMDR Therapy in Adolescents with Specific Phobia and Test Anxiety. Üsküdar Üniversitesi Sosyal Bilimler Dergisi, 9(16), 171-189. https://doi.org/10.32739/uskudarsbd.9.16.124

Open Access: https://doi.org/10.32739/uskudarsbd.9.16.124

Nazmiye Gökçe Yildirim E-mail: gokceesas@hotmail.com

Abstract

This research is about the investigation of the Effect of EMDR Therapy on Adolescents between 15-17 years of age with Specific Phobia and Test Anxiety. The first hypothesis of the study is that “Adolescents who are treated with EMDR therapy will significantly decrease their fear scores of the phobia object (delusion, affective and total).” The second hypothesis is that the data on this research, collected by using Demographic Information Form, Test anxiety Inventory, DSM-5 Specific Phobia Scale for 11-17 Year-Old Children; through 31 adolescents living in Antalya (Turkey) and visiting the counselling centre for treatment between February 2022 and July 2022. Data were obtained and analysed in SPSS 25.0 package program. In the study, test anxiety sub-scale and total scores of adolescents who is receiving EMDR therapy with test anxiety, also total specific phobia scores of adolescents with specific phobia were compared as pre-test and post-test. As a result of the 5-session EMDR therapy, it was concluded that test anxiety sub-scale scores and total scores as well as specific phobia total scores decreased significantly in post-test measurement. Based on the research findings, it was considered that EMDR therapy gives positive results on adolescents with specific phobia and test anxiety.

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