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Bates, A., Baldwin, D. S., Pattison, N., Moyses, H., Huneke, N. T., Cortese, S., Grocott, M. P., & Cusack, R. (2024). Eye movement desensitisation and reprocessing for survivors of life-threatening medical events. Cochrane Database Syst Rev, 7(7), CD015640. https://doi.org/10.1002/14651858.CD015640

Open Access: https://pubmed.ncbi.nlm.nih.gov/39041417


Andrew Bates, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. E-mail: a.bates@soton.ac.uk.

Abstract

OBJECTIVES: This is a protocol for a Cochrane Review (intervention).
The objectives are as follows: To assess the effects of eye movement desensitisation and reprocessing (EMDR), a psychological intervention programme, on symptoms related to traumatic stress in survivors of life-threatening medical events.
SECONDARY OBJECTIVES: to evaluate whether the effects of EMDR differ according to the nature of the medical event (associated diagnosis or setting), measured outcome (post-traumatic stress disorder (PTSD), anxiety, depression, or quality of life), or intervention (online, face-to-face, group or individual sessions).

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Burback, L., Forner, C., Winkler, O. K., Al-Shamali, H. F., Ayoub, Y., Paquet, J., & Verghese, M. (2024). Survival, Attachment, and Healing: An Evolutionary Lens on Interventions for Trauma-Related Dissociation. Psychol Res Behav Manag, 17, 2403-2431. https://doi.org/10.2147/PRBM.S402456

Open Access: https://pubmed.ncbi.nlm.nih.gov/38912158

Lisa Burback, Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada. E:mail: burback@ualberta.ca

Abstract

PURPOSE: Dissociation is a necessary part of our threat response system, common to all animal species, normally temporarily activated under conditions of extreme or inescapable threat. Pathological dissociation, however, continues to occur after the initial threat has passed, in response to reminders or inaccessibility of safety and security. Present across the spectrum of psychiatric diagnoses, recurrent dissociative symptoms are linked to severe trauma exposure, insecure attachment, treatment non-response, and maladaptive coping behaviors such as substance use, suicidality, and self-harm. However, empirical studies testing treatments specific to dissociative processes remain scarce. This narrative review summarizes existing studies and provides theoretical, neurobiological, and evolutionary perspectives on dissociative processes and treatments for pathological dissociation.
METHODS: A systematic search of five databases (MEDLINE, EMBASE, APA PsycINFO, CINAHL plus, Scopus) was conducted on April 13, 2023. Peer-reviewed clinical studies with adult participants, assessing intervention effects on dissociative symptoms, were included. Results were thematically analyzed and summarized.
RESULTS: Sixty-nine studies were identified, mainly focused on posttraumatic stress disorder, trauma-exposed populations, and borderline personality disorder. Psychotherapy was studied in 72.5% of studies; other interventions included medications and neurostimulation. The majority reported positive outcomes, despite the heterogeneous spectrum of interventions. However, treatment of dissociative symptoms was the primary objective in only a minority.
CONCLUSION: Pathological dissociation is a complex phenomenon involving brain and body systems designed for perceiving and responding to severe threats, requiring an individualized approach. A literature is emerging regarding potentially evidence-based treatments to help those impacted by recurrent dissociative symptoms. When contextualized within a neurobiological and evolutionary perspective, these treatments can be understood as facilitating an internal and/or relational sense of safety, resulting in symptom reduction. Further studies are needed to explore effective treatments for dissociative symptoms.

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Colbert, S. (2024). The Impact On Eye Movement And Desensitization Reprocessing Of Incomplete Memory In A Drug-Facilitated Rape: A Single Case Study. J Trauma Dissociation, 25(2), 218-231. https://doi.org/10.1080/15299732.2023.2289193

URL: https://pubmed.ncbi.nlm.nih.gov/38031432

Susannah Colbert, Salomons Institute for Applied Psychology, Lucy Fildes Building, 1 Meadow Road, Tunbridge Wells, Kent TN1 2YG, UK of Great Britain and Northern Ireland. E-mail: susannah.colbert@canterbury.ac.uk

Abstract

In a drug-facilitated sexual assault (DFSA), the person's level of intoxication may result in incomplete memory. This paper describes eye movement and desensitization reprocessing (EMDR) with client-centered adaptations to address an incomplete trauma memory in a 26-year-old woman. The client was experiencing PTSD, characterized by nightmares and derealization. Therapy followed standard EMDR procedures with three minor modifications to help the client maintain current awareness. Although the memory remained incomplete, the client-centered adaptations promoted working through of the clients' trauma responses (e.g. disorientation, physical sensations) and a sense of competence and self-confidence were restored. At the end of reprocessing, and at follow-up, the client was no longer experiencing nightmares or derealization and her wellbeing had improved.

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Danese, A., Martsenkovskyi, D., Remberk, B., Khalil, M. Y., Diggins, E., Keiller, E., Masood, S., Awah, I., Barbui, C., & Beer, R. (2024). Scoping Review: Digital mental health interventions for children and adolescents affected by war. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1001/jamapsychiatry

Open Access: https://doi.org/10.1016/j.jaac.2024.02.017


Andrea Danese, MD, PhD, Professor of Child & Adolescent Psychiatry Child & Adolescent Psychiatry, 16 DeCrespigny Park, London, Greater London SE5 8AF; E-mail: andrea.danese@kcl.ac.uk

Abstract

Objective: More than 200 million children and adolescents live in countries affected by violent conflict, are likely to have complex mental health needs, and struggle to access traditional mental health services. Digital mental health interventions have the potential to overcome some of the barriers in accessing mental health support. We performed a scoping review to map existing digital mental health interventions relevant for children and adolescents affected by war, to examine the strength of the evidence base, and to inform the development of future interventions.
Method: Based on a pre-registered strategy, we systematically searched MEDLINE, Embase, Global Health, APA PsychInfo, and Google Scholar from the creation of each database to September 30, 2022, identifying k 1⁄4 6,843 studies. Our systematic search was complemented by extensive consultation with experts from the GROW Network.
Results: The systematic search identified 6 relevant studies: 1 study evaluating digital mental health interventions for children and adolescents affected by war, and 5 studies for those affected by disasters. Experts identified 35 interventions of possible relevance. The interventions spanned from universal prevention to specialist-guided treatment. Most interventions directly targeted young people and parents or carers/caregivers and were self-guided. A quarter of the interventions were tested through randomized controlled trials. Because most interventions were not culturally or linguistically adapted to relevant contexts, their implementation potential was unclear.
Conclusion: There is very limited evidence for the use of digital mental health interventions for children and adolescents affected by war at present. The review provides a framework to inform the development of new interventions.

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Daniels, J. K., & Fereidooni, F. (2024). Is a Personal Trauma History a Risk Factor for the Development of Secondary Traumatization in EMDR Therapists? Journal of EMDR Practice and Research, 18(2), 46-55. https://doi.org/10.1891/emdr-2023-0044

URL: https://doi.org/10.1891/emdr-2023-0044

Judith K. Daniels, Department of Clinical Psychol- ogy and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2, 9712 TS Groningen, The Netherlands. E-mail: j.k.daniels@rug.nl

Abstract

Symptoms severe enough to constitute a secondary traumatization (ST) can arise from providing eye movement desensitization and reprocessing (EMDR) treatment. However, little is known about specific risk factors such as a personal trauma history. EMDR therapists (n= 115) filled out a questionnaire battery to test whether the personal trauma history predicts symptom levels over and beyond vicarious exposure and whether vicarious exposure mediates the relationship between primary trauma history and current ST severity. Current exposure predicts ST symptom severity, while lifetime exposure is negatively associated. The number of primary traumata and the total severity of primary traumata do not explain additional variance in ST symptom severity. The mediation model suggests that primary trauma exposure instead is associated with treating more traumatized clients. The current results suggest that ST is a relevant topic to address in EMDR training, but the personal trauma history does not seem to constitute a relevant risk factor per se. It might, however, be associated with preferences for clientele composition, which in turn might act as a risk factor.

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Driessen, H. P. A., Morsink, S., Busschbach, J. J. V., Hoogendijk, W. J. G., & Kranenburg, L. W. (2024). Eye Movement Desensitization and Reprocessing (EMDR) treatment in the medical setting: a systematic review. Eur J Psychotraumatol, 15(1), 2341577. https://doi.org/10.1080/20008066.2024.2341577

Open Access: https://pubmed.ncbi.nlm.nih.gov/38747113


Helen P.A. Driessen, Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. E-mail: h.driessen@erasmusmc.nl

Abstract

Background: Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.
Objective: This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.
Methods: We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).
Results: Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.
Conclusions: Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed. First overview on the use of EMDR for adult patients treated in the medical setting. EMDR seems beneficial in improving psychological and physical symptoms. Given the heterogeneity of studies and high risk of bias, further controlled studies are needed in this field.

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Esteban-Serna, C., Loewenberger, A., Pick, S., & Cope, S. R. (2024). Psychological Therapy for Functional Neurological Disorder: Examining Impact on Dissociation, Psychological Distress and General Functioning. J Trauma Dissociation, 25(4), 516-532. https://doi.org/10.1080/15299732.2024.2356591

URL: https://doi.org/10.1080/15299732.2024.2356591

Celia Esteban-Serna, South West London & St George’s Mental Health NHS Trust Neuropsychiatry Service, St George’s Hospital, 2nd Floor Grosvenor Wing, Blackshaw Road, Tooting, London SW17 0QT, UK. E-mail: sarah.cope@swlstg.nhs.uk

Abstract

Functional neurological disorder (FND) represents a broad group of motor and sensory clinical symptoms which cannot be explained by other neurological diagnoses. Dissociation is considered a key mechanism in their development and maintenance. Despite psychological therapy being the recommended choice of treatment for FND, evidence for its effectiveness is in its infancy. This study explored the dissociative profile of forty-seven patients with FND and evaluated whether individual psychological therapy improved dissociative symptoms, psychological distress and general functioning among twenty-five adults with FND. Patients completed the Multiscale Dissociation Inventory, the EuroQol five-dimensional descriptive system, the General Anxiety Disorder-7 scale and the Patient Health Questionnaire-9. Our sample showed high levels of disengagement, depersonalization and memory disturbance at baseline. Treatment was associated with significant improvements in general functioning, and symptoms of dissociation and anxiety. Improvements in dissociative experiences were found to be possibly due to reduction in anxiety. Improvements in depression were the strongest predictor of improvements in general functioning. Limitations and areas for further research are discussed.

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Gkintoni, E., Kourkoutas, E., Yotsidi, V., Stavrou, P. D., & Prinianaki, D. (2024). Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. Children (Basel), 11(5), 579. https://doi.org/10.3390/children11050579

Open Access: https://pubmed.ncbi.nlm.nih.gov/38790574

Evgenia Gkintoni, Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece. E-mail: evigintoni@upatras.gr

Abstract

Background: This systematic review aggregates research on psychotherapeutic interventions for Post-Traumatic Stress Disorder (PTSD) in children and adolescents. PTSD in this demographic presents differently from adults, necessitating tailored therapeutic approaches. In children and adolescents, PTSD arises from exposure to severe danger, interpersonal violence, or abuse, leading to significant behavioral and emotional disturbances that jeopardize long-term development. The review focuses on describing PTSD within two age groups, children (6 to 12 years) and adolescents (12 to 18 years), while evaluating the effectiveness of various clinical interventions aimed at this condition.
Methods: Utilizing the PRISMA guidelines, this review systematically examines studies that assess clinical interventions for PTSD in the younger population.
Results: Key symptoms of PTSD in children and adolescents include avoidance, overstimulation, flashbacks, depression, and anxiety. The review identifies several effective treatments, including Cognitive Behavioral Therapy (CBT), Trauma-Focused CBT (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy. Particularly, TF-CBT is highlighted as the most effective and commonly used method in treating childhood and adolescent PTSD, as supported by most of the studies reviewed.
Conclusions: A significant outcome of this study is the short-term effectiveness of CBT in reducing PTSD symptoms in children and adolescents. The findings underline the importance of psychotherapeutic interventions and mark a substantial advancement in understanding PTSD in young populations. It is crucial for practitioners to integrate various psychotherapeutic strategies into their practice to improve patient outcomes and treatment efficacy.

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Haddad, R. H., Alhusamiah, B. K., Haddad, R. H., Hamdan-Mansour, A. M., Abuhashish, Y. H., & Alshraideh, J. A. (2024). The effectiveness of using eye movement desensitization and reprocessing therapy on reducing the severity of symptoms among individuals diagnosed with post-traumatic stress disorder: a systematic review of literature to highlight the standardized therapy-based interventional protocol. Mental Health and Social Inclusion, 0. https://doi.org/10.1108/mhsi-04-2024-0057

URL: https://doi.org/10.1108/mhsi-04-2024-0057

Rabia H. Haddad, Department of Community Health Nursing, School of Nursing, The University of Jordan, Amman, Jordan. E-mail: rabiahaddad200@yahoo.com

Abstract

Purpose This systematic review (SR) aims to evaluate and summarize the effectiveness of using eye movement desensitization and reprocessing (EMDR) intervention among individuals diagnosed with post-traumatic stress disorder (PTSD), as well as to highlight the standardized EMDR-based interventional protocol.
Design/methodology/approach This SR is guided according to preferred reporting items for SRs and meta-analyses standards. Several online databases were used in searching for eligible studies in peer-reviewed journals relevant to the study keywords. The included studies were SRs and clinical trials that used EMDR interventions among patients experiencing PTSD symptoms, older than 18 years and were published in English language from 2015 to 2022. Three researchers independently contributed to study selections, data extraction and study evaluations from different aspects, including quality assessment, risk of bias and study synthesis.
Findings A total of eight published studies met the inclusion criteria and were included in this SR; four articles were randomized controlled trials and four were SR and meta-analysis studies. In all included studies, the EMDR was used as a primary psychotherapy intervention for PTSD symptoms. The results of this extensive and comprehensive review showed that EMDR is an effective psychotherapeutic intervention to reduce and control the severity of symptoms among individuals with PTSD. Research limitations/implications It is important to acknowledge several limitations inherent in this study. First and foremost, it is noteworthy to mention that only studies conducted in the English language were included in this review, potentially restricting the overall scope and diversity of the findings. Furthermore, the number of studies incorporated into this review was limited, which may have implications for the comprehensiveness and generalizability of the results. Finally, it is worth noting that certain studies within this review had a relatively small sample size, which could potentially limit the statistical power and precision of the conclusions drawn.
Practical implications This paper, a review of the literature, gives an overview of EMDR effectiveness, provides baseline information and plays a significant role in decreasing the gap in Jordanian literature regarding using EMDR as the strongest evident psychotherapy approach for PTSD treatment to help psychiatrists, psychologists and psychiatric nurses in the health-care sectors to design comprehensive strategies to enhance and improve the quality of health care and patients’ status. Social implications

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Haktanir, A., & Kurnaz, M. F. (2024). Systematic review of psychotherapies and meta-analysis of cognitive behavior therapy and narrative exposure therapy for treating earthquake-related posttraumatic stress disorder. Psychol Trauma. https://doi.org/10.1037/tra0001743

URL: https://pubmed.ncbi.nlm.nih.gov/38934933

Abdulkadir Haktanir, Department of Counselor Education, Kean University, 1000 Morris Avenue, Union, NJ 07083, United States. E-mail: ahaktani@kean.edu

Abstract

OBJECTIVE: Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods, employed psychotherapy approaches, and differences across studies warrant a systematic review and meta-analysis.
METHOD: In this study, first, a systematic review of experimental studies aiming to reduce the symptoms of PTSD in the aftermath of an earthquake was carried out. Second, a meta-analysis of cognitive behavior therapy (CBT) and narrative exposure therapy (NET) was conducted.
RESULTS: Several psychological treatments were used for treating earthquake-related PTSD. However, only CBT and NET were tested in multiple studies. Meta-analysis results suggested that CBT and NET significantly reduce earthquake-related PTSD symptoms compared to control groups.
CONCLUSIONS: Results suggest that CBT and NET are promising psychological treatment options. Further research on NET and other major PTSD interventions (e.g., prolonged exposure, eye movement desensitization and reprocessing, cognitive processing therapy) is needed.

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Hamid, A., Williams, A. C. C., Albakri, M., Scior, K., Morgan, S., Kayal, H., Wilcockson, M., Drouish Alkaja, R., Alsayed, S., Logie, R., Farrand, S., & Abdul-Hamid, W. (2024). Mental health and conflict: a pilot of an online eye movement desensitisation and reprocessing (EMDR) intervention for forcibly displaced Syrian women. Front Public Health, 12, 1295033. https://doi.org/10.3389/fpubh.2024.1295033

Open Access: https://doi.org/10.3389/fpubh.2024.1295033

Aseel Hamid, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom. E-mail: aseel.hamid@ucl.ac.uk

Abstract

BACKGROUND: The Syrian conflict has been ongoing since 2011. Practical and scalable solutions are urgently needed to meet an increase in need for specialised psychological support for post-traumatic stress disorder given limited availability of clinicians. Training forcibly displaced Syrians with a mental health background to remotely deliver specialised interventions increases the availability of evidence based psychological support. Little is known about the effectiveness of online therapy for forcibly displaced Syrian women provided by forcibly displaced Syrian women therapists.
PURPOSE: To pilot an evidence-based trauma therapy, Eye Movement Desensitisation and Reprocessing (EMDR), carried out online by trained forcibly displaced Syrian women therapists for forcibly displaced Syrian women who require treatment for post-traumatic stress disorder (PTSD). METHODS: 83 forcibly displaced Syrian women, living in Türkiye or inside Syria, with diagnosable PTSD, were offered up to 12 sessions of online EMDR over a period of 3 months. This was delivered by forcibly displaced Syrian women therapists who were trained in EMDR. Data were gathered, using Arabic versions, on PTSD symptoms using the Impact of Events Scale Revised, depression symptoms using the Patient Health Questionnaire-9 and anxiety symptoms using the Generalised Anxiety Disorder Assessment-7 at baseline, mid-point, and end of therapy.
RESULTS: PTSD scores, depression scores and anxiety scores all significantly reduced over the course of treatment, with lower scores at midpoint than baseline and lower scores at end of treatment than at midpoint. Only one participant (1%) exceeded the cutoff point for PTSD, and 13 (16%) exceeded the cutoff points for anxiety and depression at the end of treatment.
CONCLUSION: In this pilot study up to 12 sessions of online EMDR were associated with reductions in PTSD, anxiety and depression symptoms in Syrian women affected by the Syrian conflict. The training of forcibly displaced Syrian mental health professionals to deliver online therapy is a relatively low cost, scalable, sustainable solution to ensure that those who are affected by the conflict can access specialised support. Further research is needed using a control group to confirm that the observed effects are due to EMDR treatment, as is research with post-treatment follow-up to ascertain that benefits are maintained.

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Peng, K. S., Nolan, D., Shaheen, A., & Rudnick, A. (2024). Current Research on Matching Trauma-Focused Therapies to Veterans: A Scoping Review. Mil Med, 189(7-8), e1479-e1487. https://doi.org/10.1093/milmed/usae229

URL: https://doi.org/10.1093/milmed/usae229

Dougal Nolan, Mental Health and Addictions, Nova Scotia Health Authority, Dartmouth, NS B3B 1Y6, Canada. E-mail: Dougal.nolan@nshealth.ca

Abstract

INTRODUCTION: Trauma-focused (psycho)therapies (TFTs) are often used to treat post-traumatic stress disorder (PTSD) of (military) veterans, including prolonged exposure (PE), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing. However, research thus far has not conclusively determined predictors of TFTs' success in this population. This scoping review's objectives are 1) to explore whether it is possible, based on currently available evidence, to match TFTs to veterans to maximize their outcomes, (2) to identify possible contraindications and adaptations of TFTs for this population, and (3) to identify gaps in the literature to guide future research.
MATERIALS AND METHODS: Standard scoping review methodology was used. "White" and "gray" literature searches resulted in 4963 unique items identified. Following title and abstract screening and full-text analysis, 187 sources were included in the review. After data extraction, a narrative summary was used to identify common themes, discrepancies between sources, and knowledge gaps.
RESULTS: Included publications most often studied CPT and PE rather than eye movement desensitization and reprocessing. These TFTs were at least partly effective with mostly moderate effect sizes. Attrition rates were slightly higher for PE versus CPT. There was variance in the methodological quality of the included studies.
CONCLUSION: The current literature on TFTs to treat PTSD in veterans contains several knowledge gaps, including regarding treatment matching. Future research should examine effectiveness of these treatments using multiple sources of outcomes, longer time periods, combination with other treatment, outcomes outside of PTSD symptoms (such as functioning), and resilience.

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Hoge, C. W., Chard, K. M., & Yehuda, R. (2024). US Veterans Affairs and Department of Defense 2023 Clinical Guideline for PTSD-Devolving Not Evolving. JAMA Psychiatry, 81(3), 223-224. https://doi.org/10.1001/jamapsychiatry.2023.4920

URL: https://doi.org/10.1001/jamapsychiatry.2023.4920

Charles W. Hoge, MD, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20910. E-mail: charles.w.hoge.civ@ health.mil

Abstract

This Viewpoint discusses the updated 2023 clinical practice guidelines issued by the US Department of Veterans Affairs and the US Department of Defense regarding treatment approaches for posttraumatic stress disorder.

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Hooyer, K., Hamblen, J., Kehle-Forbes, S. M., & Larsen, S. E. (2024). “Pitching” posttraumatic stress disorder treatment: A qualitative study of how providers discuss evidence-based psychotherapies with patients. J Trauma Stress. https://doi.org/10.1002/jts.23058

Open Access: https://doi.org/10.1002/jts.23058

Katinka Hooyer, Department of Family and Community Medicine, Medical College of Wisconsin, 8701 West Watertown Plank Rd, Milwaukee, WI 53226, USA.
E-mail: khooyer@mcw.edu

Abstract

The two widely available evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) are cognitive processing therapy and prolonged exposure. Although the U.S. Department of Veterans Affairs (VA) has invested in intensive clinical training to provide these first-line treatments, most military veterans do not receive these therapies. Prior research indicates that patient interest and motivation depend on how patients are educated, and differences in how information is presented shape their decision-making. To our knowledge, no studies have addressed how clinicians "pitch" EBPs for PTSD and examined whether certain approaches are more effective than others. We recorded and thematically analyzed 25 treatment planning sessions across 10 VA sites in the United States to better understand how providers talk to patients about treatment options. Five themes were identified: using rich description, integrating various forms of questioning to engage the patient, sharing prior patient success stories, using inviting and direct language, and tailoring therapy talk to fit patient needs. Providers learning to offer EBPs can use these strategies to serve as a "menu" of options that will allow them to present EBPs in a way that appeals to a particular patient.

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Hoppen, T. H., Meiser-Stedman, R., Kip, A., Birkeland, M. S., & Morina, N. (2024). The efficacy of psychological interventions for adult post-traumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomised controlled trials. The Lancet Psychiatry, 11(2), 112-122. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00373-5/fulltext

URL: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00373-5/fulltext

Thole H Hoppen, Institute of Psychology, University of Münster, 48149 Münster, Germany. E-mail: thoppen@uni-muenster.de

Abstract

Background
Previous meta-analyses of psychological interventions for adult post-traumatic stress disorder (PTSD) did not investigate whether efficacy is diminished in individuals with PTSD related to multiple (vs single) traumatic events. We aimed to assess whether treatment efficacy would be lower in randomised controlled trials involving multiple-event-related PTSD versus single-event-related PTSD.
Methods
For this meta-analysis, we searched PsycINFO, MEDLINE, Web of Science, and PTSDpubs from database inception to April 18, 2023. Randomised controlled trials involving adult clinical samples (≥70% meeting full PTSD criteria) with adequate size (≥10 participants per arm) were included. We extracted data on trial characteristics, demographics, and outcome data. Random-effects meta-analyses were run to summarise standardised mean differences (Hedges' g). Trials involving 100% of participants with single-event-related PTSD versus at least 50% of participants with multiple-event-related PTSD (ie, associated with ≥two traumatic events) were categorised. Quality of evidence was assessed using the Cochrane criteria. The review protocol was registered in PROSPERO (CRD42023407754).
Findings
Overall, 137 (85%) of 161 randomised controlled trials were included in the quantitative synthesis, comprising 10 684 participants with baseline data and 9477 with post-treatment data. Of those randomly assigned, 5772 (54%) of 10 692 participants identified as female, 4917 (46%) as male, and three (<1%) as transgender or other. 34 (25%) of 137 trials exclusively involved women, 15 (11%) trials exclusively involved men, and the remainder were mixed samples. Mean age across the trials was 40·2 years (SD 9·0) ranging from 18·0 years to 65·4 years. 23 (17%) of 137 trials involved participants from low-income and middle-income countries (23 [17%] of 137). Data on ethnicity were not extracted. At treatment endpoint, psychological interventions were highly effective for PTSD when compared with passive control conditions in both samples with single-event-related PTSD (Hedges' g 1·04 [95% CI 0·77–1·31]; n=11; I2=43%) and multiple-event-related PTSD (Hedges’ g 1·13 [0·90–1·35]; n=55, I2=87%), with no efficacy difference between these categories (p=0·48). Heterogeneity between studies was substantial but outlier-corrected analysis yielded similar results. Moderate-sized effects were found compared with active control conditions with no significant difference between single-trauma and multiple-trauma trials. Results were robust in various sensitivity analyses (eg, 90% cutoff for multiple-trauma trials) and analyses of follow-up data. The quality of evidence was moderate to high.
Interpretation
Contrary to our hypothesis, we found strong evidence that psychological interventions are highly effective treatments for PTSD in patients with a history of multiple traumatic events. Results are encouraging for clinical practice and could counteract common misconceptions regarding treatment and treatment barriers.

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Hoppen, T. H., Wessarges, L., Jehn, M., Mutz, J., Kip, A., Schlechter, P., Meiser-Stedman, R., & Morina, N. (2024). The efficacy of psychological interventions for child and adolescent PTSD: a network meta-analysis. medRxiv, 0. https://doi.org/10.1101/2024.04.09.24305537

URL: https://doi.org/10.1101/2024.04.09.24305537


Thole H. Hoppen, Institute of Psychology University of Münster Fliednerstr. 21 48149 Münster, Germany. E-mail: thoppen@uni-muenster.de

Abstract

Pediatric post-traumatic stress disorder (PTSD) is a common and debilitating mental disorder and its effective treatment constitutes a health priority. Numerous randomized controlled trials (RCTs) have examined the efficacy of psychological interventions for pediatric PTSD. Yet, a comprehensive network meta-analysis (NMA) is lacking. The present work addresses this gap. A total of 67 RCTs met the inclusion criteria comprising 5,297 children and adolescents with full or sub-threshold PTSD. Five families of intervention were evaluated: trauma-focused cognitive behavior therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), other trauma-focused interventions, non-trauma-focused (non-TF) interventions, and multi-disciplinary treatments (MDTs). Most RCTs (73%) examined TF-CBT followed by EMDR. Other trauma-focused interventions had too few trials for analysis. At treatment endpoint, TF-CBT, EMDR, MDTs, and non-TF interventions were all effective in treating pediatric PTSD when compared to passive control conditions in random-effect NMA with large pooled effects (all Hedges’gs≥ 0.84, allps< .001). TF-CBT, EMDR, and MDTs also yielded significant short-term treatment effects compared to active control conditions. In a sensitivity analysis including only high-quality trials, only TF-CBT and EMDR outperformed active control conditions. And in a sensitivity analysis including only trials with ≥ 50% of participants reporting multiple-event-related PTSD, only TF-CBT yielded significant short-term effects. Results for mid-term (up to 5 months posttreatment) and long-term efficacy (beyond 5 months posttreatment) were very similar. TF-CBT consistently yielded the highest treatment effects except being second to EMDR at mid-term. The present NMA is the most comprehensive NMA of psychological interventions for pediatric PTSD to date. Results confirm that TF-CBT can effectively treat PTSD in children and adolescents both in the short and long-term and also for multiple-event-related PTSD. More long-term data and multiple-event-related PTSD data are needed for EMDR, MDTs, and non-TF interventions to draw firmer conclusions regarding their efficacy. Results for TF-CBT are encouraging for clinical practice and may help to reduce common treatment barriers.

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Knibbe, W., de Jongh, A., Acar‐Ceylan, K., Al Hamami, Z., Visscher, C. M., & Lobbezoo, F. (2024). The effects of trauma‐focused treatment on painful temporomandibular disorders, awake bruxism and sleep bruxism in patients with severe post‐traumatic stress disorder. Journal of Oral Rehabilitation, 0. https://doi.org/10.1111/joor.13785

Open Access: https://doi.org/10.1111/joor.13785

Wendy Knibbe, Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. E-mail: w.knibbe@acta.nl

Abstract

Background
Chronic painful temporomandibular disorders (TMD), awake bruxism and sleep bruxism are often comorbid with post‐traumatic stress disorder (PTSD), but the implications for treatment are unknown.
Objective(s)
To explore the effects of PTSD treatment on these conditions. We hypothesized that chronic painful TMD, pain intensity, pain interference, awake bruxism and sleep bruxism would decrease after evidence‐based trauma‐focused treatment and that this decrease would be maintained at the 6‐month follow‐up.
Methods
Individuals referred for PTSD treatment were assessed for chronic painful TMD (temporomandibular disorder pain screener), pain intensity, pain interference (Graded Chronic Pain Scale 2.0), awake bruxism and sleep bruxism (oral behaviours checklist) pre‐, post‐treatment and at the 6‐month follow‐up. Hypotheses were tested using the Friedman test, followed by a post hoc Wilcoxon signed‐rank test. Effect sizes (Cohen's r) are reported. Barely any pain interference was reported, therefore these outcomes were not analysed.
Results
In individuals with chronic painful TMD (n = 98), pain intensity, awake bruxism and sleep bruxism decreased across the three time points. Post hoc tests showed that chronic painful TMD (r = 0.59), pain intensity (r = 0.28), awake bruxism (r = 0.51) and sleep bruxism (r = 0.35) decreased between pre‐ and post‐treatment. Between pre‐treatment and the 6‐month follow‐up, chronic painful TMD (r = 0.58), awake bruxism (r = 0.30) and sleep bruxism (r = 0.39) decreased as well.
Conclusion
The results provide preliminary support for a trauma‐sensitive approach for patients with chronic painful TMD and PTSD and suggest that trauma‐focused treatment may be beneficial for chronic painful TMD, awake bruxism and sleep bruxism in patients with PTSD and chronic painful TMD.

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Knipschild, R., Klip, H., van Leeuwaarden, D., van Onna, M. J. R., Lindauer, R. J. L., Staal, W. G., Bicanic, I. A. E., & de Jongh, A. (2023). Treatment of multiple traumatized adolescents by enhancing regulation skills and reducing trauma related symptoms: rationale, study design, and methods of randomized controlled trial (the Mars-study). BMC Psychiatry, 23(1), 644. https://doi.org/10.1186/s12888-023-05073-4

Open Access: https://doi.org/10.1186/s12888-023-05073-4

Rik Knipschild, Child and Adolescent Psychiatry, Nijmegen, The Netherlands. 2Levvel Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands. E-mail: r.knipschild@karakter.com

Abstract

BACKGROUND: There is ongoing debate regarding the treatment of severe and multiple traumatized children and adolescents with post-traumatic stress disorder (PTSD). Many clinicians favor a phase-based treatment approach (i.e., a stabilization phase prior to trauma-focused therapy) over immediate trauma-focused psychological treatment, despite the lack of scientific evidence. Research on the effects of different treatment approaches is needed for children and adolescents with (symptoms of complex) PTSD resulting from repeated sexual and/or physical abuse during childhood.
OBJECTIVE: This paper describes the rationale, study design, and methods of the MARS-study, a two-arm randomized controlled trial (RCT) that aims to compare the results of phase-based treatment with those of immediate trauma-focused treatment and determine whether immediate trauma-focused treatment is not worse than phase-based treatment in reducing PTSD symptoms.
METHODS: Participants are individuals between 12 and 18 years who meet the diagnostic criteria for PTSD due to repeated sexual abuse, physical abuse, or domestic violence during childhood. Participants will be blindly allocated to either the phase-based or immediate trauma-focused treatment condition. In the phase-based treatment condition, participants receive 12 sessions of the Dutch version of Skill Training in Affective and Interpersonal Regulation (STAIR-A), followed by 12 sessions of EMDR therapy. In the immediate trauma-focused condition, the participants receive 12 sessions of EMDR therapy. The two groups are compared for several outcome variables before treatment, mid-treatment (only in the phase-based treatment condition), after 12 trauma-focused treatment sessions (post-treatment), and six months post-treatment (follow-up). The main parameter is the presence and severity of PTSD symptoms (Clinician-Administered PTSD Scale for Children and Adolescents, CAPS-CA). The secondary outcome variables are the severity of complex PTSD symptoms (Interpersonal Problems as measured by the Experiences in Close Relationship-Revised, ECR-RC; Emotion Regulation as measured by the Difficulties in Emotion Regulation Scale, DERS; Self Esteem as measured by the Rosenberg Self Esteem Scale, RSES), changes in anxiety and mood symptoms (Revised Anxiety and Depression Scale; RCADS), changes in posttraumatic cognitions (Child Posttraumatic Cognitions Inventory, CPTCI), changes in general psychopathology symptoms (Child Behavior Checklist, CBCL), and Quality of Life (Youth Outcome Questionnaire, Y-OQ-30). Furthermore, parental stress (Opvoedingsvragenlijst, OBVL) and patient-therapist relationship (Feedback Informed Treatment, FIT) will be measured, whereas PTSD symptoms will be monitored in each session during both treatment conditions (Children's Revised Impact of Event Scale, CRIES-13).
DISCUSSION: Treating (symptoms of complex) PTSD in children and adolescents with a history of repeated sexual and/or physical abuse during childhood is of great importance. However, there is a lack of consensus among trauma experts regarding the optimal treatment approach. The results of the current study may have important implications for selecting effective treatment options for clinicians working with children and adolescents who experience the effects of exposure to multiple interpersonal traumatic events during childhood.
TRIAL REGISTRATIONS: The study was registered on the "National Trial Register (NTR)" with the number NTR7024. This registry was obtained from the International Clinical Trial Registry Platform (ICTRP) and can be accessed through the ICTRP Search Portal ( https://trialsearch.who.int/ ).

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Lemkes, A. C., Struijs, S. Y., Littel, M., Ekkers, W. D. J., & van den Berg, J. F. (2024). The Effect of Eye Movements on Craving in Alcohol-Dependent Inpatients: A Randomized Controlled Experiment. Journal of EMDR Practice and Research, 18(2), 56-67. https://doi.org/10.1891/emdr-2024-0002

URL: https://doi.org/10.1891/emdr-2024-0002

Julia F. van den Berg, Parnassia Group Academy, Parnassia Group, Mangostraat 1, 2552 KS, The Hague, The Netherlands. E-mails: j.vandenberg@parnassia.nl; j.f.van.den.berg@fsw.leidenuniv.nl

Abstract

In this study, we explored whether making Eye Movements (EM) during the recall of intrusive images related to alcohol craving reduced the vividness and emotionality of these images and their ability to elicit craving. In a randomized controlled experiment in a treatment facility for substance use disorders in the Netherlands, 50 inpatients with alcohol use disorder were asked to recall mental images related to alcohol craving while simultaneously making EM (n= 29) or keeping a steady gaze (n= 21). Vividness and emotionality of the mental images and craving were measured. Making EM had no significant effect on the vividness and emotionality of images related to alcohol craving, nor on their ability to elicit craving. Our findings do not support the notion that EM reduce alcohol craving.

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Martínez-Fernández, D. E., Garzón-Partida, A. P., Aguilar-García, I. G., García-Estrada, J., Luquin, S., & Fernández-Quezada, D. (2024). The Effect of Eye Movement Desensitization and Reprocessing (EMDR) Therapy on Reducing Craving in Populations with Substance Use Disorder: A Meta-analysis. Research Square, 0. https://doi.org/10.21203/rs.3.rs-4391211/v1

Open Access: https://doi.org/10.21203/rs.3.rs-4391211/v1

David Fernández-Quezada, Universidad de Guadalajara. E-mail: David.Fernandez@academicos.udg.mx

Abstract

Substance use disorder (SUD) has a significant negative impact on individuals and communities worldwide. It is estimated that approximately 5.5% of the global population aged 15 to 64 has used drugs in the last year, without any proven cure. In the 1980s, the Eye Movement Desensitization and Reprocessing method (EMDR) was developed to treat Post-Traumatic Stress Disorder (PTSD). However, its effectiveness in reducing desire during withdrawal has not been demonstrated so far. Thus, a systematic review and meta-analysis were conducted to gain more insight into the therapeutic benefits of EMDR therapy. The search was performed on PubMed and Web of Science, and studies that used EMDR were selected, following the preferential information guidelines for systematic reviews and meta-analyses (PRISMA). The results indicated that EMDR therapy significantly reduced the desire to consume drugs. Using the fixed effects model, the standard median differential (SMD) was -0.7243, with a 95% confidence interval ranging from -0.9960 to -0.4527 (z = -5.23, p < 0.0001). The random effects model revealed a more significant effect (SMD = -0.7985), with a 95% confidence interval ranging from -1.2314 to -0.3656 (z = -3.62, p = 0. 0003). Based on these findings, it can be concluded that EMDR therapy is effective in inhibiting the desire to consume drugs.

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Meinke, C., Lueken, U., Walter, H., & Hilbert, K. (2024). Predicting treatment outcome based on resting-state functional connectivity in internalizing mental disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev, 160, 105640. https://doi.org/10.1016/j.neubiorev.2024.105640

Open Access: https://doi.org/10.1016/j.neubiorev.2024.105640

Charlotte Meinke, Humboldt-Universit at zu Berlin, Faculty of Life Sciences, Department of Psychology, Unter der Linden 6, Berlin 10099, Germany. E-mail: charlotte.meinke@hu-berlin.de

Abstract

Predicting treatment outcome in internalizing mental disorders prior to treatment initiation is pivotal for precision mental healthcare. In this regard, resting-state functional connectivity (rs-FC) and machine learning have often shown promising prediction accuracies. This systematic review and meta-analysis evaluates these studies, considering their risk of bias through the Prediction Model Study Risk of Bias Assessment Tool (PROBAST). We examined the predictive performance of features derived from rs-FC, identified features with the highest predictive value, and assessed the employed machine learning pipelines. We searched the electronic databases Scopus, PubMed and PsycINFO on the 12th of December 2022, which resulted in 13 included studies. The mean balanced accuracy for predicting treatment outcome was 77% (95% CI: [72%- 83%]). rs-FC of the dorsolateral prefrontal cortex had high predictive value in most studies. However, a high risk of bias was identified in all studies, compromising interpretability. Methodological recommendations are provided based on a comprehensive exploration of the studies' machine learning pipelines, and potential fruitful developments are discussed.

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Melani, M. S., Paiva, J. M., Mendlowicz, M. V., Vilete, L., Luz, M. P., Ventura, P. R., Passos, R. B. F., & Berger, W. (2024). Are There Differences Among Evidence-Based Psychotherapies for Treating Different DSM-5 PTSD Symptom Clusters? A Systematic Review and Meta-analysis of Controlled Clinical Trials. J Nerv Ment Dis, 212(6), 332-343. https://doi.org/10.1097/NMD.0000000000001769

URL: https://doi.org/10.1097/NMD.0000000000001769

Marina S. Melani, MSc, Department of Psychiatry and Legal Medicine, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB- UFRJ), 71 Venceslau Brás Av., Rio de Janeiro, RJ 22290-140, Brazil. E‐mail: marina.melani21@gmail.com.

Abstract

Posttraumatic stress disorder (PTSD) is a heterogeneous disease defined by four Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) symptom clusters: reexperiencing, avoidance, negative alterations in cognitions and mood, and hyperarousal. There are effective evidence-based psychotherapies (EBPs) for PTSD. However, given the variety of PTSD clinical presentations, we conducted the first meta-analysis investigating whether DSM-5 PTSD symptom clusters show different responses to EBPs. We systematically reviewed the literature for controlled clinical trials in five databases, performed a meta-analysis, and evaluated the methodological quality of the studies. We screened 633 studies and included seven. Three showed high risk, two showed some concerns, and one showed a low risk of bias. The symptom clusters do not seem to respond differently to EBPs (SMD cluster B: -0.40; 95% confidence interval [CI], -0.87 to 0.08; cluster C: -0.49; 95% CI, -0.90 to -0.08; cluster D: -0.44; 95% CI, -0.94 to 0.05; cluster E: -0.54; 95% CI, -1.07 to -0.0), even when analyzed by the therapeutic focuses. The findings dovetail nicely with the network theory of PTSD symptom, as although it is a heterogeneous disorder, the EBPs seem to promote a kind of cascade of symptom improvement.

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Miccoli, M., & Poli, A. (2024). Randomized trial on the effects of an EMDR intervention on traumatic and obsessive symptoms during the COVID-19 quarantine: a psychometric study. Front Psychiatry, 15, 1369216. https://doi.org/10.3389/fpsyt.2024.1369216

Open Access: https://doi.org/10.3389/fpsyt.2024.1369216

Andrea Poli, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. E-mail: andrea.poli@med.unipi.it

Abstract

INTRODUCTION: It has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery.
METHODS: In order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention.
RESULTS: The EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms.
CONCLUSIONS: EMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined.
CLINICAL TRIAL REGISTRATION: https://www.clinicaltrials.gov, identifier NCT06110702.

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Molero-Zafra, M., Fernández-García, O., Mitjans-Lafont, M. T., Pérez-Marín, M., & Hernández-Jiménez, M. J. (2024). Psychological intervention in women victims of childhood sexual abuse: a randomized controlled clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy. Front Psychiatry, 15, 1360388. https://doi.org/10.3389/fpsyt.2024.1360388

Open Access: https://doi.org/10.3389/fpsyt.2024.1360388

Marıa Jesus Hernandez-Jimenez, Faculty of Psychology, University of Valencia, Valencia, Spain, 2Health Sciences Area, Valencian International University, Valencia, Spain. E-mail: mariajesus.hernandez@professor.universidadviu.com

Abstract

INTRODUCTION: Childhood sexual abuse persists as a painful societal reality, necessitating responses from institutions and healthcare professionals to prevent and address its severe long-term consequences in victims. This study implements an intervention comprising two psychotherapeutic approaches recommended by the WHO and international clinical guidelines for addressing short-, medium-, and long-term posttraumatic symptomatology: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Both approaches are adapted from group formats for implementation in small online groups via Zoom.
METHODS: The impact of both therapeutic approaches on trauma improvement was assessed in a sample of 19 women who were victims of childhood sexual abuse through a Randomized Clinical Trial comparing EMDR Psychotherapy and Trauma-Focused Cognitive Behavioral Therapy after a baseline period. Intra and inter comparison were made using statistics appropriate to the sample.
RESULTS: Both therapeutic approaches significantly reduced symptomatology across various evaluated variables, suggesting their efficacy in improving the quality of life for these individuals. Following CBT-FT treatment, patients exhibited enhanced emotional regulation, reduced reexperiencing, and avoidance. The EMDR group, utilizing the G-TEP group protocol, significantly improved dissociation, along with other crucial clinical variables and the perception of quality of life.
DISCUSSION: Although the limitations of this study must be taken into account due to the size of the sample and the lack of long-term follow-up, the results align with existing scientific literature, underscoring the benefits of trauma-focused psychological treatments. The online group format appears promising for enhancing the accessibility of psychological treatment for these women. Furthermore, the differential outcomes of each treatment support recent research advocating for the inclusion of both approaches for individuals with trauma-related symptomatology.
ETHICS AND DISSEMINATION: The study has been approved by the Ethics Committee of the Valencian International University (VIU) (Valencia, Spain) (Ref. CEID2021_07). The results will be submitted for publication in peer-reviewed journals and disseminated to the scientific community. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04813224, identifier NCT04813224.

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Murad, S. T., Hansen, A. L., Sim, L. A., & Murad, M. H. (2024). Heterogeneity in Treatment Effect in Posttraumatic Stress Syndrome Trials: A Meta-Regression Analysis. Mayo Clin Proc Innov Qual Outcomes, 8(3), 301-307. https://doi.org/10.1016/j.mayocpiqo.2024.04.003

Open Access: https://doi.org/10.1016/j.mayocpiqo.2024.04.003

M. Hassan Murad, MD, MPH, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905. E-mail: murad.mohammad@mayo.edu

Abstract

OBJECTIVE: To evaluate the heterogeneity in treatment effect in posttraumatic stress disorder (PTSD) trials.
PATIENTS AND METHODS: We downloaded data from a publicly available repository that captured PTSD trials published from January 1988 through February 2023. We applied restricted maximum-likelihood random-effect meta-analyses and meta-regression to explore potential moderators of treatment effect including methodologic study features (risk of bias domains and control group response rate), characteristics of the population, and intervention features following the theme, intensity, and platform framework.
RESULTS: We included 199 PTSD trials that reported the outcomes of diagnosis resolution (122 trials, 8437 patients) and clinically meaningful improvement (133 trials, 9895 patients). Multiple treatments demonstrated effectiveness but with significant heterogeneity. Statistically significant moderators included risk of bias domains of randomization sequence and outcome measurement, control group response rate reflecting severity of PTSD in the enrolled population, and whether the psychotherapeutic approach was trauma focused (P values <0.05). There was no statistically significant effect for the frequency of treatments per week, format of the intervention (eg, individual vs group), duration of the intervention, or delivery method (in person vs not), (P values <0.05). Characteristics of the population such as sex, age, and military status did not appear to significantly affect the treatment effect (P values <0.05).
CONCLUSION: Trauma focused psychotherapies should be considered the first-line intervention to induce remission. Several patient characteristics or treatment context did not modify the treatment effect, which allows tailoring care based on patient values, preferences and logistics.

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Pape, V., Sammer, G., Hanewald, B., Schäflein, E., Rauschenbach, F., & Stingl, M. (2024). Apples and oranges: PTSD patients and healthy individuals are not comparable in their subjective and physiological responding to emotion induction and bilateral stimulation. Front Psychol, 15, 1406180. https://doi.org/10.3389/fpsyg.2024.1406180

Open Access: https://doi.org/10.3389/fpsyg.2024.1406180

Markus Stingl, Center for Psychiatry and Psychotherapy Justus-Liebig-University Giessen, Giessen, Germany. E-mail: markus.stingl@psychiat.med.uni-giessen.de

Abstract

OBJECTIVES: Bilateral stimulation is a core element of Eye Movement Desensitization and Reprocessing Therapy, a psychotherapeutic intervention for the treatment of Posttraumatic Stress Disorder (PTSD). Promising previous findings showed measurable physiological effects of bilateral stimulation in healthy individuals, but studies that replicated these findings in PTSD patients are sparse.
METHODS: 23 patients with PTSD and 30 healthy controls were confronted with affective standard scripts (pleasant, neutral, unpleasant) while bilateral tactile stimulation was applied. Monolateral and no stimulation served as control conditions. Noise-induced startle reflex response (valence measure) and galvanic skin response (arousal measure) were used for physiological responses and the valence and arousal scale of the Self-Assessment-Manikin for subjective responses.
RESULTS: Both groups showed a subjective distress reduction for unpleasant scripts and a subjective attention increase for positive scripts under bilateral stimulation. In healthy individuals, this was also for physiological measures, and a general startle-reducing effect of bilateral stimulation in the absence of affective stimuli was found. In PTSD patients, however, the effects were restricted on the subjective level, and no concomitant physiological effects were observed.
CONCLUSIONS AND SIGNIFICANCE: The findings indicate, that generalizing the effects of BLS in healthy individuals to PTSD patients may be problematic. The herein-reported group differences can be explained by PTSD-specific peculiarities in emotion processing and cognitive processing style.

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Peng, Z., Liu, J., Liu, B., Zhou, J., Zhang, L., & Zhang, Y. (2024). Psychological interventions to pregnancy-related complications in patients with post-traumatic stress disorder: a scoping review. BMC Psychiatry, 24(1), 478. https://doi.org/10.1186/s12888-024-05926-6

Open Access: https://doi.org/10.1186/s12888-024-05926-6

Li Zhang, Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China. E-mail: 505260@csu.edu.cn

Abstract

OBJECTIVE: This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD. METHOD: Publications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of "Stress Disorders, Post-Traumatic", "Pregnant Women", and "psychotherapy". To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched.
RESULTS: Twenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population.
CONCLUSION: Fetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.

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Pouladi, H., Rajabi, S., Jamshidi, F., Pakizeh, A., & Talbot, D. (2024). Efficacy of EMDR in Body Dysmorphic Disorder and Associated Cognitive-Emotional Features. Journal of EMDR Practice and Research, 18(2), 82-99. https://doi.org/10.1891/emdr-2024-0013

URL: https://doi.org/10.1891/emdr-2024-0013

Soran Rajabi, Department of Psychology, Persian Gulf University, Bushehr, Iran. Email: sooranrajabi@pgu.ac.ir

Abstract

Body dysmorphic disorder (BDD) is a severe psychological disorder that significantly impacts functioning and quality of life. Eye movement desensitization and reprocessing (EMDR) presents as an emerging alternate psychological intervention. This study aimed to examine the efficacy of EMDR in BDD symptoms and associated cognitive-emotional features. These features include appearance-based rejection sensitivity, body shame, and self-compassion. Our study utilized a multiple-baseline across-subjects design, monitoring four randomly allocated female patients with BDD over a 10-session/90-minute EMDR treatment phase and two follow-up sessions at 1 and 3 months, respectively. Our results showed that EMDR significantly reduced BDD symptoms (recovery percentage [RP] = 60.54), appearance-based rejection sensitivity (RP = 36.56), and body shame (RP = 54.82) and increased self-compassion (RP = 51.79). Therefore, our study suggests that EMDR may be an effective treatment for BDD patients.

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Rojnic Kuzman, M., Padberg, F., Amann, B. L., Schouler-Ocak, M., Bajic, Z., Melartin, T., James, A., Beezhold, J., Artigue Gómez, J., Arango, C., Jendricko, T., Ismayilov, J., Flannery, W., Chumakov, E., Başar, K., Vahip, S., Dudek, D., Samochowiec, J., Mihajlovic, G., . . . Gorwood, P. (2024). Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries. Eur Psychiatry, 67(1), e24. https://doi.org/10.1192/j.eurpsy.2024.19

Open Access: https://doi.org/10.1192/j.eurpsy.2024.19

Martina Rojnic Kuzman, Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia. E-mail: mrojnic@gmail.com

Abstract

BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD).
METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).
RESULTS: About 82% would use antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.
CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

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Ruvalcaba-Delgadillo, Y., Martínez-Fernández, D. E., Luquin, S., Moreno-Alcázar, A., Redolar-Ripoll, D., Jauregui-Huerta, F., & Fernández-Quezada, D. (2024). Visual EMDR stimulation mitigates acute varied stress effects on morphology of hippocampal neurons in male Wistar rats. Front Psychiatry, 15, 1396550. https://doi.org/10.3389/fpsyt.2024.1396550

Open Access: https://doi.org/10.3389/fpsyt.2024.1396550

David Fernandez-Quezada, Neuroscience Department, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, Mexico. E-mail: david.fernandez@academicos.udg.mx

Abstract

INTRODUCTION: Stress is a pervasive health concern known to induce physiological changes, particularly impacting the vulnerable hippocampus and the morphological integrity of its main residing cells, the hippocampal neurons. Eye Movement Desensitization and Reprocessing (EMDR), initially developed to alleviate emotional distress, has emerged as a potential therapeutic/preventive intervention for other stress-related disorders. This study aimed to investigate the impact of Acute Variable Stress (AVS) on hippocampal neurons and the potential protective effects of EMDR. METHODS: Rats were exposed to diverse stressors for 7 days, followed by dendritic morphology assessment of hippocampal neurons using Golgi-Cox staining.
RESULTS: AVS resulted in significant dendritic atrophy, evidenced by reduced dendritic branches and length. In contrast, rats receiving EMDR treatment alongside stress exposure exhibited preserved dendritic morphology comparable to controls, suggesting EMDR's protective role against stress induced dendritic remodeling.
CONCLUSIONS: These findings highlight the potential of EMDR as a neuroprotective intervention in mitigating stress-related hippocampal alterations.

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Rydberg, J. A., Virgitti, L., & Tarquinio, C. (2024). Bolstering the adaptive information processing model: a narrative review. Front Psychiatry, 15, 1374274. https://doi.org/10.3389/fpsyt.2024.1374274

Open Access: https://doi.org/10.3389/fpsyt.2024.1374274

Jenny Ann Rydberg, University of Lorraine, Inserm, INSPIIRE, Nancy, France. E-mail: jenny.rydberg@univ-lorraine.fr

Abstract

In recent years, several theoretical models have been suggested as complementary to the adaptative information processing model of eye movement desensitization and reprocessing therapy. A narrative review of such models was conducted to assess the contributions of each, as well as their convergences, contradictions, and potential complementarity. Seven theoretical models were identified. All focus on the effects of EMDR therapy as a comprehensive psychotherapy approach with its principles, procedures, and protocols. Several refer to concepts related to propositional or predictive processing theories. Overall, the contribution of these proposals does appear to bolster Shapiro's original AIP model, potentially offering additional depth and breadth to case conceptualization and treatment planning in clinical practice, as well as a more precise theoretical understanding. The current exploratory comparative analysis may serve as a preliminary baseline to guide research into the relative merit of suggested theoretical proposals to enhance current standards for the clinical practice and teaching of EMDR therapy.

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Sanz, S., Valiente, C., Espinosa, R., & Trucharte, A. (2024). Psychological Group Interventions for Reducing Distress Symptoms in Healthcare Workers: A Systematic Review. Clin Psychol Psychother, 31(3), e2980. https://doi.org/10.1002/cpp.2980

Open Access: https://doi.org/10.1002/cpp.2980

Sandra Sanz, Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain. E-mail: sandsanz@ucm.es

Abstract

Healthcare workers exposed to emergencies and chronic stressors are at high risk of developing mental health problems. This review synthesized existing studies of group psychological therapy to reduce distress symptoms in healthcare workers (i.e., as complex and heterogeneous emotional states, characterized by the presence of symptoms associated with post-traumatic stress disorder, burnout, anxiety, depression and moral injury). Searches were conducted using PRISMA guidelines and databases such as PubMed, PsycINFO, Medline and Web of Science, along with manual searches of reference lists of relevant articles. The search returned a total of 1071 randomized trials, of which 23 met the inclusion criteria. Of the total studies, nine were mindfulness interventions, seven were cognitive behavioural programmes, one was a programme based on acceptance and commitment therapy, one was an EMDR protocol and two focused on systemic and art therapy. Most studies aimed to reduce burnout, anxiety and depression; only three focused on post-traumatic stress disorder, and no studies were found that addressed moral injury. The results suggested that group interventions could be an effective tool to improve the mental health of healthcare workers and reduce their symptoms of distress, although many of the studies have methodological deficiencies. Limitations and future directions are discussed.

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Schäflein, E., Mardin, C., Morawa, E., Rudolf, S., Erim, Y., & Rhein, C. (2024). Exacerbation of central serous chorioretinopathy during trauma-confronting psychotherapy- a case report. BMC Psychiatry, 24(1), 368. https://doi.org/10.1186/s12888-024-05756-6

Open Access: https://doi.org/10.1186/s12888-024-05756-6

Eva Schäflein, Department of Psychosomatic Medicine and Psychotherapy, University
Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg
(FAU), Erlangen, Germany. E-mail: eva.schaeflein@uk-erlangen.de

Abstract

BACKGROUND: Psychotherapy for post-traumatic stress disorder, in particular trauma-confronting psychotherapy, can be associated with increased stress. However, research on the somatic impact and psychosomatic interactions of these psychological stress reactions is lacking. We report on a 43-year old man whose central serous chorioretinopathy exacerbated upon trauma-confronting psychotherapy.
CASE PRESENTATION: We report on a man with pre-diagnosed, asymptomatic central serous chorioretinopathy who underwent inpatient psychosomatic therapy. He disclosed a history of sexual abuse by a family member and consequently showed intrusions, flashbacks, nightmares, avoidance behavior, and hyperarousal. Thus, we diagnosed post-traumatic stress disorder. After a stabilization phase, he underwent trauma-focused psychotherapy including trauma confrontation. In the course of this treatment, acute vision loss with blurred vision and image distortion of his right eye occurred. An ophthalmologic visit confirmed a relapse of a pre-diagnosed central serous chorioretinopathy. The analysis of stress biomarkers showed a decrease in testosterone levels and a noon peak in diurnal cortisol secretion, which is indicative of a stress reaction.
CONCLUSION: Central serous chorioretinopathy may exacerbate upon psychotherapeutic treatment. In this case, an exacerbation of chorioretinopathy was observed in direct relation to the therapeutic intervention. Psychotherapists and ophthalmologists should collaborate in the psychotherapeutic treatment of patients with chorioretinopathy. Our case demonstrates the need to consider the possible increased stress levels during psychotherapy and resulting physical side effects, such as exacerbation of an existing condition. It is advisable to adjust the level of generated stress particularly well in the presence of stress-inducible physical diseases. Our case is a good example of the interplay between psychological and physical stress.

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Schmidt, A., Grey, N., Strauss, C., & Gaysina, D. (2024). Predictors of treatment outcome of psychological therapies for common mental health problems (CMHP) in older adults: A systematic literature review. Clin Psychol Rev, 112, 102463. https://doi.org/10.1016/j.cpr.2024.102463

Open Access: https://doi.org/10.1016/j.cpr.2024.102463

Alexandra Schmidt, School of Psychology, University of Sussex, Pevensey 1, Brighton BN1 9GH, UK. E-mail: as2085@sussex.ac.uk

Abstract

Identifying factors that impact psychological treatment outcomes in older people with common mental health problems (CMHP) has important implications for supporting healthier and longer lives. The aim of the present study was to synthesise the evidence on predictors of psychological treatment outcomes in older people (aged 65+). PubMed, Scopus, Web of Science and PsycINFO were searched and 3929 articles were identified and screened, with 42 studies (N = 7978, M age = 68.9, SD age = 2.85) included: depression: k = 21, anxiety: k = 11, panic disorder: k = 3, mixed anxiety & depression: k = 3, PTSD: k = 2, various CMHP: k = 2, with CBT being the most common treatment (71%). The review identified 28 factors reported as significant predictors of treatment outcome in at least one study, across different domains: psychosocial (n = 9), clinical (n = 6), treatment-related (n = 6), socio-demographic (n = 4), neurobiological (n = 3). Homework completion was the most consistent predictor of positive treatment outcome. Baseline symptom severity was the most frequently studied significant predictor and across all conditions, with higher baseline symptom severity largely linked to worse treatment outcomes. No significant effects on treatment outcome were reported for gender, income and physical comorbidities. For a large majority of factors evidence was mixed or inconclusive. Further studies are required to identify factors affecting psychological treatment outcomes, which will be important for the development of personalised treatment approaches.

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Schnurr, P. P., Sall, J. A., & Riggs, D. (2024). VA/Department of Defense Clinical Practice Guideline for PTSD and ASD: A Tool to Optimize Patient Care for Trauma Survivors. JAMA Psychiatry, 81(8), 743-744. https://doi.org/10.1001/jamapsychiatry.2024.1238

URL: https://doi.org/10.1001/jamapsychiatry.2024.1238

Paula P. Schnurr, PhD, National Center for PTSD, VA Medical Center, 215 Main St, White River Junction, VT 05009. E-mail: paula.schnurr@ va.gov

Abstract

Clinical practice guidelines (CPGs) offer recommendations to enhance the quality of care provided to patients. Over time, the rigor of the guideline development process has increased to provide a transparent and replicable process1 and so that recommendations are increasingly based on evidence rather than expert consensus. Guidelines developed jointly by the Department of Veterans Affairs (VA) and Department of Defense (DoD) are based on an internationally recognized framework for guideline development.1 VA and DoD have embraced US Preventive Services Task Force criteria for evaluating individual studies and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evaluating the body of evidence from systematic evidence review.1
We therefore were concerned by the negative characterization by Hoge et al2 of the 2023 CPG for post- traumatic stress disorder (PTSD) and acute stress dis- order (ASD) developed by the VA and DoD.3 Given this characterization, we thought it would be helpful for readers to understand more about how VA/DoD guidelines are developed.

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Simons, A., Noordegraaf, M., & van Regenmortel, T. (2024). ‘We can be a family again, but different than before’. A single-case study on therapeutic interventions that initiated a recovery process in a family after the disclosure of sibling sexual behavior. Child Abuse Negl, 106920. https://doi.org/10.1016/j.chiabu.2024.106920

Open Access: https://doi.org/10.1016/j.chiabu.2024.106920

Aletta Simons, Tilburg School of Social and Behavioral Sciences, Tranzo, Tilburg, the Netherlands. E-mail: apsimons@che.nl, a.p.simons@tilburguniversity.edu

Abstract

Disclosures of sibling sexual behavior (SSB) usually affect all family members but there remains, however, a paucity in studies on therapeutical family interventions and how they can initiate changes in families. This study was designed to explore relational impacts of SSB disclosures, goals for therapy and interventions that helped a family initiate the recovery process after a SSB disclosure. A single case study design was used to analyze a family's long-term therapy process. Data on this N = 1 study comprised 18 interviews with involved therapists, five interviews with involved family members, therapy files, and notes on family sessions. Data was analyzed using a thematic approach. Relational traumas were experienced in broken relationships, relationships under pressure and damaged trust between family members. Therapy goals were to (1) recreate family's safety, (2) help the family process the SSB consequences and (3) restore trust and search for relationship healing. Appropriate interventions to target the goals included individual-centered psycho trauma treatment as well as interventions for the parents, the involved siblings, and the uninvolved siblings, followed by sessions between the involved siblings and with the whole family. Therapy outcomes were found in reduced individual trauma symptoms, a recreated sense of family safety, the start of relational trauma processing, and newfound forms of sibling/family relationships. This study provides a unique and comprehensive insight into a family's healing process after SSB disclosures from the perspectives of both professionals and family members. The effective interventions identified in this study may provide tools for therapists working with these families. This study may also offer greater insights into both the abusive and mutual types of SSB.

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Steenen, S. A., Linke, F., van Westrhenen, R., & de Jongh, A. (2024). Interventions to reduce adult state anxiety, dental trait anxiety, and dental phobia: A systematic review and meta-analyses of randomized controlled trials. J Anxiety Disord, 105, 102891. https://doi.org/10.1016/j.janxdis.2024.102891

Open Access: https://doi.org/10.1016/j.janxdis.2024.102891

Serge A. Steenen, Department of Oral and Maxillofacial Surgery, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands,
Amsterdam University Medical Centers, Meibergdreef 5, Room D2–240, 1105 AZ, Amsterdam, the Netherlands. E-mail addresses: serge.steenen@gmail.com, s.a.steenen@amsterdamumc.nl

Abstract

This review evaluates randomized controlled trials (RCTs) intervening on adult state anxiety (fear and emotional distress during dental treatment), chronic dental (trait) anxiety or dental phobia (disproportionately high trait anxiety; meeting diagnostic criteria for specific phobia). Seven online databases were systematically searched. 173 RCTs met inclusion criteria, of which 67 qualified for 14 pooled analyses. To alleviate state anxiety during oral surgery, moderate-certainty evidence supports employing hypnosis (SMD=-0.31, 95 %CI[-0.56,-0.05]), and low-certainty evidence supports prescribing benzodiazepines (SMD=-0.43, [-0.74,-0.12]). Evidence for reducing state anxiety is inconclusive regarding psychotherapy, and does not support virtual reality exposure therapy (VRET), virtual reality distraction, music, aromatherapy, video information and acupuncture. To reduce trait anxiety, moderate-certainty evidence supports using Cognitive Behavioral Therapy (CBT; SMD=-0.65, [-1.06, -0.24]). Regarding dental phobia, evidence with low-to-moderate certainty supports employing psychotherapy (SMD=-0.48, [-0.72,-0.24]), and CBT specifically (SMD=-0.43, [-0.68,-0.17]), but not VRET. These results show that dental anxieties are manageable and treatable. Clinicians should ensure that interventions match their purpose-managing acute emotions during treatment, or alleviating chronic anxiety and avoidance tendencies. Existing research gaps underscore the necessity for future trials to minimize bias and follow CONSORT reporting guidelines.

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Stingl, M., Hemmerde, M., Drutschmann, E., Pape, V., & Hanewald, B. (2024). The use of the “group traumatic episode protocol (G-TEP) “ in an outpatient randomized and hospital setting: Implementation and effects in heterogeneous patient samples. Psychol Trauma. https://doi.org/10.1037/tra0001711

URL: https://doi.org/10.1037/tra0001711

Markus Stingl, Center for Psychiatry and Psychotherapy, Justus-Liebig-University Giessen, 35385 Giessen, Germany. E-mail: Markus.Stingl@psychiat.med.uni-giessen.de

Abstract

OBJECTIVE: The resource-based eye movement desensitization and reprocessing group intervention group traumatic episode protocol G-TEP showed promising results in reducing posttraumatic stress disorder, depression, and anxiety. Using a high structured G-TEP worksheet, the patients conduct self-bilateral stimulation while (re)processing their targets. We examined the effectiveness on multiple symptoms and practicability of G-TEP in an outpatient setting and its feasibility in hospital treatment.
METHOD: Study A: Forty-four patients suffering from different symptoms and diagnoses received four ambulatory G-TEP sessions within three eye movement desensitization and reprocessing-G-TEP sessions in a randomized delayed waitlist control group design. We investigate the improvements in symptoms and advantages of G-TEP as an upstream treatment. Study B: The targeted changes in symptom burden in 23 patients and the implementation process of G-TEP as an additional treatment option in a psychiatric hospital were examined. The measures used were Impact of Event Scale-Revised, Beck Depression Inventory-II, Brief Symptom Check List, and the Questionnaire on Dissociative Symptoms at pre- and posttreatment and follow-up.
RESULTS: Both studies showed significant and long-lasting reductions in subjective distress and concomitant impairments. The distressing experiences became more "ego-syntonic," levels of avoidance decreased, abilities to manage negative emotions got strengthened, and they gained hope. All effects had a positive impact on subsequent treatment processes; some patients already went free of symptoms only with this short G-TEP treatment.
CONCLUSION: G-TEP effectively alleviates symptoms caused by stressful experiences. G-TEP can be used as a stand-alone intervention in outpatients and can easily be integrated into the offer of multimodal therapy in a psychiatric ward. It can prevent the exacerbation of symptoms and chronification of disease and should be implemented into the (German) health system.

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Tait, J., Kellett, S., Saxon, D., Deisenhofer, A. K., Lutz, W., Barkham, M., & Delgadillo, J. (2024). Individual treatment selection for patients with post-traumatic stress disorder: External validation of a personalised advantage index. Psychother Res, 1-14. https://doi.org/10.1080/10503307.2024.2360449

Open Access: https://doi.org/10.1080/10503307.2024.2360449

James Tait. School of Psychology, University of Sheffield, ICOSS Building, 219 Portobello, Sheffield, S1 4DP, United Kingdom. E-mail: jetait1@sheffield.ac.uk

Abstract

OBJECTIVE: To test the predictive accuracy and generalisability of a personalised advantage index (PAI) model designed to support treatment selection for Post-Traumatic Stress Disorder (PTSD).
METHOD: A PAI model developed by Deisenhofer et al. (2018) was used to predict treatment outcomes in a statistically independent dataset including archival records for N = 152 patients with PSTD who accessed either trauma-focussed cognitive behavioural therapy or eye movement desensitisation and reprocessing in routine care. Outcomes were compared between patients who received their PAI-indicated optimal treatment versus those who received their suboptimal treatment.
RESULTS: The model did not yield treatment specific predictions and patients who had received their PAI-indicated optimal treatment did not have better treatment outcomes in this external validation sample.
CONCLUSION: This PAI model did not generalise to an external validation sample.

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Thunnissen, M. R., de Jong, P. J., Rijkeboer, M. M., Voncken, M. J., & Nauta, M. H. (2024). Interventions Targeting Negative Mental Imagery in Social Anxiety: A Systematic Review and Meta-Analysis of Characteristics and Outcomes. Clin Psychol Psychother, 31(3), e2996. https://doi.org/10.1002/cpp.2996

Open Access: https://doi.org/10.1002/cpp.2996

Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands | 2Child Study Center, Accare, Groningen, The Netherlands. Marjolein R. Thunnissen (m.r.thunnissen@rug.nl)

Abstract

Psychological treatment for social anxiety disorder (SAD) has been found to be less effective than for other anxiety disorders. Targeting the vivid and distressing negative mental images typically experienced by individuals with social anxiety could possibly enhance treatment effectiveness. To provide both clinicians and researchers with an overview of current applications, this systematic review and meta-analysis aimed to evaluate the possibilities and effects of imagery-based interventions that explicitly target negative images in (sub)clinical social anxiety. Based on a prespecified literature search, we included 21 studies, of which 12 studies included individuals with a clinical diagnosis of SAD. Imagery interventions (k = 28 intervention groups; only in adults) generally lasted one or two sessions and mostly used imagery rescripting with negative memories. Others used eye movement desensitization and reprocessing and imagery exposure with diverse intrusive images. Noncontrolled effects on social anxiety, imagery distress and imagery vividness were mostly large or medium. Meta-analyses with studies with control groups resulted in significant medium controlled effects on social anxiety (d = -0.50, k = 10) and imagery distress (d = -0.64, k = 8) and a nonsignificant effect on imagery vividness. Significant controlled effects were most evident in individuals with clinically diagnosed versus subclinical social anxiety. Overall, findings suggest promising effects of sessions targeting negative mental images. Limitations of the included studies and the analyses need to be considered. Future research should examine the addition to current SAD treatments and determine the relevance of specific imagery interventions. Studies involving children and adolescents are warranted.

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Tijsseling, I., Noordende, A. T. V. ’., Zijlstra, B. J. H., Merbis, M., & Veen, S. C. V. (2024). The Effectiveness and Tolerability of an Intensive Outpatient Trauma Treatment Program for Adolescents With PTSD. Journal of EMDR Practice and Research, 18(2), 68-81. https://doi.org/10.1891/emdr-2023-0051

URL: https://doi.org/10.1891/emdr-2023-0051

Irene Tijsseling, iHub, Mozartlaan 150, 3055 KJ Rotterdam, The Netherlands. E-mails: Irene@opvoed- poli.nl; irene_tijsseling@hotmail.com

Abstract

Following the promising effects of an intensive trauma treatment for adults, the question arises whether adolescents suffering from posttraumatic stress disorder (PTSD) can also benefit from a similar treatment program. The objective of this study was to assess the effectiveness and tolerability of an intensive trauma treatment program combining two evidence-based, trauma-focused therapies—prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR)—with psychoeducation and physical activity for adolescents suffering from PTSD in an outpatient clinic. We used a multiple-baseline study design. Fifteen adolescents aged 12–18 years old with a Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnosis of PTSD were included. Participants were randomized to wait 2, 3, or 4 weeks between the start of baseline and the start of the intervention. In the 2-week intervention period, participants received daily PE, EMDR, and physical activity. The social network of adolescents was involved for support. PTSD symptoms and treatment tolerability were assessed daily. PTSD diagnosis was assessed at baseline and at 1 month and 3 months after completion of treatment. In addition, semi structured interviews were conducted after treatment to determine the tolerability. After treatment, we found a diagnostic PTSD remission of 58%–62% and a decrease in PTSD severity compared with baseline. The effects were maintained at 1-month and 3-month follow-ups. The dropout rate was 13%. Participants reported good treatment tolerability. This study provides initial evidence that an intensive outpatient trauma treatment including PE, EMDR therapy, psychoeducation, and physical activity is effective and tolerable for adolescents with PTSD and is associated with low dropout rates.

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Unwin, G., Stenfert‐Kroese, B., Rogers, G., Swain, S., Hiles, S., Clifford, C., Farrell, D., & Willner, P. (2023). Some observations on remote delivery of eye‐movement desensitisation and reprocessing to people with intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities, 20(2), 205-215. https://doi.org/10.1111/jppi.12452

Open Access: https://doi.org/10.1111/jppi.12452

Paul Willner, Department of Psychology, Swansea University, Swansea SA2 8PP, UK.
E-mail: p.willner@swansea.ac.uk

Abstract

It is increasingly recognised that many people with intellectual disabilities suffer from post‐traumatic stress disorder (PTSD). Eye‐movement desensitisation and reprocessing (EMDR) has been proposed as a potentially helpful intervention that is less reliant on verbal skills than other effective treatments for PTSD and therefore could be more effective than verbal interventions for people with intellectual disabilities. The Trauma‐AID project is a randomised clinical trial (RCT) evaluating the effectiveness of a bespoke EMDR protocol for adults with intellectual disability and PTSD, which incorporates a prolonged phase of Psycho‐Education and Stabilisation (PES) prior to the trauma confrontation phase of EMDR. The COVID‐19 pandemic struck during the feasibility phase of the Trauma‐AID project, necessitating a second feasibility study to evaluate the acceptability and feasibility of remote or hybrid delivery of the PES + EMDR protocol. To this end, we conducted two online surveys of therapists followed by interviews with clients, carers and senior therapists. The surveys were analysed descriptively. Content analysis was used for client and carer interviews, and framework analysis for therapist interviews. All stakeholders reported positive experiences of EMDR; however, some challenges were identified. The majority of clients, carers and therapists interviewed reported that the intervention, whether PES alone or the full PES‐EMDR package, had improved symptoms of PTSD and psychological well‐being, and carers also reported decreases in challenging behaviour. A full account of the data is provided in four Supplementary Digital files. PES‐EMDR therapy appears both feasible and acceptable for clients with intellectual disabilities and therapists, whether delivered face‐to‐face or in a remote or hybrid mode, though remote working appears easier for the PES phase than the EMDR phase of the intervention.

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Vaage-Kowalzik, V., Engeset, J., Jakobsen, M., Andreassen, W., & Evensen, J. H. (2024). Exhausting, but necessary: the lived experience of participants in an intensive inpatient trauma treatment program. Front Psychol, 15, 1341716. https://doi.org/10.3389/fpsyg.2024.1341716

Open Access: https://doi.org/10.3389/fpsyg.2024.1341716

Julie Horgen Evensen, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. E-mail: juliehevensen@gmail.com; uxevej@ous-hf.no

Abstract

BACKGROUND: Intensive inpatient treatment programs have shown robust results in the treatment of post-traumatic stress disorder (PTSD). How patients experience this treatment program and what changes they experience as a result of the treatment have, however, only scarcely been explored through qualitative studies.
OBJECTIVE: This study aimed to explore the lived experience of participants in an intensive inpatient trauma treatment program. Our research questions were as follows: how do patients experience intensive trauma-focused treatment? How do they experience possible changes related to participating in the treatment program?
METHODS: Six patients diagnosed with PTSD with significant comorbidities, who recently participated in an intensive 2-week (4 + 4 days) inpatient trauma treatment program with prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), and therapist rotation (TR), were interviewed with a semi-structured qualitative interview. Transcripts were analyzed using a thematic analysis approach.
RESULTS: Our analysis resulted in five main themes: (1) the need to feel safe; (2) the benefits of many and different therapeutic encounters; (3) variable experience with elements of treatment; (4) intensity; and (5) experienced change. Our results suggest that feeling safe within the framework of the treatment program facilitated the treatment process. Many and different therapeutic encounters, both through TR and with ward staff, contributed to experienced change. All participants described the intensity as facilitative to trauma processing. However, most participants also describe often feeling too overwhelmed to benefit from all elements of the treatment program.
CONCLUSIONS: Our findings suggest that participants experience the overall treatment program as beneficial and contributing to experienced change. Participants described the intensity of the program as exhausting, but necessary. Most did, however, report at times of being too overwhelmed to benefit from elements of the program. Consequently, our results prompt us to question the optimal level of intensity.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05342480. Date of registration: 2022-04-22.

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van der Heijden, A. C., van der Werf, Y. D., van den Heuvel, O. A., Talamini, L. M., & van Marle, H. J. F. (2024). Targeted memory reactivation to augment treatment in post-traumatic stress disorder. Curr Biol, S0960-9822(24)00922. https://doi.org/10.1016/j.cub.2024.07.019

Open Access: https://doi.org/10.1016/j.cub.2024.07.019

Hein J.F. van Marle. E-mail: h.j.vanmarle@amsterdamumc.nl

Abstract

Post-traumatic stress disorder (PTSD) is a psychiatric disorder with traumatic memories at its core. Post-treatment sleep may offer a unique time window to increase therapeutic efficacy through consolidation of therapeutically modified traumatic memories. Targeted memory reactivation (TMR) enhances memory consolidation by presenting reminder cues (e.g., sounds associated with a memory) during sleep. Here, we applied TMR in PTSD patients to strengthen therapeutic memories during sleep after one treatment session with eye movement desensitization and reprocessing (EMDR). PTSD patients received either slow oscillation (SO) phase-targeted TMR, using modeling-based closed-loop neurostimulation (M-CLNS) with EMDR clicks as a reactivation cue (n = 17), or sham stimulation (n = 16). Effects of TMR on sleep were assessed through high-density polysomnography. Effects on treatment outcome were assessed through subjective, autonomic, and fMRI responses to script-driven imagery (SDI) of the targeted traumatic memory and overall PTSD symptom level. Compared to sham stimulation, TMR led to stimulus-locked increases in SO and spindle dynamics, which correlated positively with PTSD symptom reduction in the TMR group. Given the role of SOs and spindles in memory consolidation, these findings suggest that TMR may have strengthened the consolidation of the EMDR-treatment memory. Clinically, TMR vs. sham stimulation resulted in a larger reduction of avoidance level during SDI. TMR did not disturb sleep or trigger nightmares. Together, these data provide first proof of principle that TMR may be a safe and viable future treatment augmentation strategy for PTSD. The required follow-up studies may implement multi-night TMR or TMR during REM sleep to further establish the clinical effect of TMR for traumatic memories.

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van Vliet, N. I., Stant, A. D., Huntjens, R., van Dijk, M. K., & de Jongh, A. (2024). Cost-effectiveness analysis of the treatment of posttraumatic stress disorder related to childhood abuse: comparison of phase-based treatment and direct trauma-focused treatment. Front Psychol, 15, 1310372. https://doi.org/10.3389/fpsyg.2024.1310372

Open Access: https://doi.org/10.3389/fpsyg.2024.1310372

Noortje I. van Vliet, Dimence Mental Health Group, Deventer, Netherlands, 2 Zovon, Enschede, Netherlands, 3 Department of Experimental Psychotherapy and Psychopathology, University of Groningen, Groningen, Netherlands. E-mail: n.vanvliet@dimence.nl

Abstract

BACKGROUND: Policymakers, health insurers, and health care providers are becoming increasingly interested in cost-effectiveness analyses (CEA's) when choosing between possible treatment alternatives, as costs for mental health care have been increasing in recent years.
OBJECTIVE: The current study compared the cost-effectiveness and cost-utility of a phased-based treatment approach that included a preparatory stabilization phase with direct trauma-focused treatment in patients with PTSD and a history of childhood abuse.
METHODS: A cost-effectiveness analysis was conducted based on data from a randomized controlled trial of 121 patients with PTSD due to childhood abuse. A phase-based treatment (Eye Movement Desensitization and Reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) was compared with a direct trauma-focused treatment (EMDR therapy only; n = 64). The primary outcome of cost-effectiveness was the proportion of patients with remitted PTSD. Quality-adjusted life years (QALY) were used as the primary outcome measure for cost-utility analysis.
RESULTS: Although the results of the cost-effectiveness analyses yielded no statistically significant differences between the two groups, the mean societal costs per patient differed significantly between the STAIR-EMDR and EMDR therapy groups (€19.599 vs. €13.501; M cost differences = €6.098, CI (95%) = [€117; €12.644]).
CONCLUSION: STAIR-EMDR is not cost-effective compared with EMDR-only therapy. Since trauma-focused treatment is less time-consuming, non-trauma-focused phase-based, treatment does not seem to be a viable alternative for the treatment of PTSD due to adverse childhood events.
Clinical trial registration: https://onderzoekmetmensen.nl/nl/trial/22074, identifier NL5836.

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Vereecken, S., & Corso, G. (2024). Revisiting Eye Movement Desensitization and Reprocessing Therapy for Post-traumatic Stress Disorder: A Systematic Review and Discussion of the American Psychological Association’s 2017 Recommendations. Cureus, 16(4), e58767. https://doi.org/10.7759/cureus.58767

Open Access: https://doi.org/10.7759/cureus.58767

Sasha Vereecken, Department of Medicine, Saint James School of Medicine, The Quarter, AIA. E-mail: svereecken@mail.sjsm.org

Abstract

This literature review evaluates the efficacy and clinical applications of eye movement desensitization and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD). The review highlights the effectiveness of EMDR in reducing PTSD symptoms and explores variations in treatment protocols, populations studied, and outcome measures. We conducted systematic searches of multiple databases, supplemented with manual searches and reference list exploration. The inclusion criteria focused on English-language studies published between January 2000 and June 2023, with a specific emphasis on adult psychiatric patients with PTSD receiving EMDR treatment. The review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for narrative literature reviews. Out of 867 identified studies, 16 met the eligibility criteria. Most studies found that EMDR was superior in relieving PTSD when compared to controls. Eleven of the 16 selected studies demonstrated improvement in PTSD symptoms. An additional three studies noted an improvement in PTSD symptoms when compared to their waitlist control counterparts. One study found EMDR superior in combating depressive symptoms when compared to rapid eye movement desensitization. EMDR therapy is an appropriate treatment for PTSD. Although some studies compared to waitlist controls, and others have a small number of participants, the data supports the use of EMDR for PTSD. Future studies are needed to continue to better understand the mechanism and application in different populations.

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Wang, S., He, Y., Hu, J., Xia, J., Fang, K., Yu, J., & Wang, Y. (2024). Eye movement intervention facilitates concurrent perception and memory processing. Cereb Cortex, 34(5), bhae190. https://doi.org/10.1093/cercor/bhae190

URL: https://doi.org/10.1093/cercor/bhae190

Yingying Wang, Department of Psychology and Behavioral Sciences, Zhejiang University, No. 388 Yuhangtang Road, Hangzhou 310058, Zhejiang, China.
E-mail: ywang15@zju.edu.cn

Abstract

A widely used psychotherapeutic treatment for post-traumatic stress disorder (PTSD) involves performing bilateral eye movement (EM) during trauma memory retrieval. However, how this treatment-described as eye movement desensitization and reprocessing (EMDR)-alleviates trauma-related symptoms is unclear. While conventional theories suggest that bilateral EM interferes with concurrently retrieved trauma memories by taxing the limited working memory resources, here, we propose that bilateral EM actually facilitates information processing. In two EEG experiments, we replicated the bilateral EM procedure of EMDR, having participants engaging in continuous bilateral EM or receiving bilateral sensory stimulation (BS) as a control while retrieving short- or long-term memory. During EM or BS, we presented bystander images or memory cues to probe neural representations of perceptual and memory information. Multivariate pattern analysis of the EEG signals revealed that bilateral EM enhanced neural representations of simultaneously processed perceptual and memory information. This enhancement was accompanied by heightened visual responses and increased neural excitability in the occipital region. Furthermore, bilateral EM increased information transmission from the occipital to the frontoparietal region, indicating facilitated information transition from low-level perceptual representation to high-level memory representation. These findings argue for theories that emphasize information facilitation rather than disruption in the EMDR treatment.

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Wang, Y., & Li, X. (2024). Online Eye Movement Desensitization and Reprocessing for the Treatment of Post-Traumatic Stress Disorder. Alpha Psychiatry, 25(1), 113-114. https://doi.org/10.5152/alphapsychiatry.2024.231411

Open Access: https://doi.org/10.5152/alphapsychiatry.2024.231411

Xianbin Li. E-mail: xianbinli@ccmu.edu.cn

Abstract

None

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Woodruff, E., Park, J., Howard, H., Gonzalez, M., & Jaber, T. (2024). Feasibility and Efficacy of Addiction-Focused Eye Movement Desensitization Reprocessing in Adults with Substance Use Disorder. J Evid Based Soc Work (2019), 21(3), 282-299. https://doi.org/10.1080/26408066.2023.2271927

URL: https://doi.org/10.1080/26408066.2023.2271927

Elizabeth Woodruff, Phyllis and Harvey Sandler School of Social Work, 777 Glades Road, Boca Raton, FL 33431-0900, USA. E-mail: ewoodru2@fau.edu

Abstract

PURPOSE: Addiction-focused eye movement desensitization reprocessing (AF-EMDR) is a viable add-on therapy to treat memories that drive addiction cravings. However, little research has explored AF-EMDR and its effects in people with substance abuse disorder (SUD). The purposes of this study were to determine the feasibility of conducting AF-EMDR and to test the preliminary efficacy of AF-EMDR on overall cravings experienced by persons with SUD, craving, perseverations associated with addiction, and irrational cognitions related to addiction.
METHODS: This pilot study used a two-arm randomized controlled trial (RCT) design with an experimental group (AF-EMDR + cognitive behavioral therapy [CBT]) and a control group (CBT Only). Thirty participants were recruited from a residential program or a partial hospitalization program in a recovery center in Florida, from October 2021 through January 2022 and randomly assigned to the experimental group (n = 15) or the control group (n = 15).
RESULTS: All participants adhered to the four-session 60-min AF-EMDR intervention and post-intervention data collection; 98.33% completed all four sessions. Results indicated significant reductions in cravings, perseverative thoughts about substance of choice, and irrational cognitions among participants in both the experimental (AF-EMDR + CBT) and control (CBT Only) groups during the intervention; however, there was no significant difference between groups.
CONCLUSIONS: The results showed positive trends in decreasing craving. However, more clinical trials with a larger sample are necessary to assess the efficacy and sustainability of such effects in persons with SUD.

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Xie, Y., Zhu, X., Wang, L., Wan, Z., Yang, J., Su, C., Duan, S., Xu, C., & Kan, B. (2024). A network meta-analysis of psychological interventions for children and adolescents after natural and man-made disasters. BMC Psychiatry, 24(1), 468. https://doi.org/10.1186/s12888-024-05924-8

Open Access: https://doi.org/10.1186/s12888-024-05924-8

Binbin Kan, School of Educational Science, Anhui Normal University, Wuhu, China. E-mail: bin2023_we@163.com

Abstract

INTRODUCTION: Children and adolescents, after natural and man-made disasters, often exhibit various psychological, emotional, and behavioral issues, showing a range of clinical symptoms related to post-traumatic stress disorder (PTSD) and depression. This review used a network meta-analysis (NMA) approach to compare and rank psychological interventions for PTSD and depression in children and adolescents after exposure to natural and man-made disasters.
METHODS: Randomized studies of psychosocial interventions for PTSD and depression in children and adolescents exposed to natural and man-made disasters were identified. PTSD and depression symptoms at postintervention and 1-12 month follow-up are the outcomes. The standardized mean differences (SMDs) between pairs of interventions at postintervention and follow-up were pooled. Mean effect sizes with 95% credible intervals (CI) were calculated, and the ranking probabilities for all interventions were estimated using the surface under the cumulative ranking curve. Study quality was assessed with version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2).
RESULTS: In total, 26 studies with 4331 participants were included in this NMA. Eye movement desensitization and reprocessing therapy (EMDR) (SMD = - 0.67; 95% CI - 1.17 to - 0.17), exposure therapy (ET) (SMD = - 0.66; 95% CI - 1.11 to - 0.22), and cognitive behavioral therapy (CBT) (SMD = - 0.62; 95% CI - 0.90 to - 0.34) were significantly more effective for PTSD at postintervention than inactive intervention. EMDR (SMD = - 0.72; 95% CI - 1.11 to - 0.33) and ET (SMD = - 0.62; 95% CI - 0.97 to - 0.27) were associated with a higher reduction in PTSD symptoms at follow-up than inactive intervention. EMDR (SMD = - 0.40; 95% CI - 0.78 to - 0.03) and play therapy (PT) (SMD = - 0.37; 95% CI - 0.62 to - 0.12) were significantly more effective for depression at postintervention than inactive intervention. For all psychological interventions in reducing depression symptoms at follow-up compared with inactive intervention, the differences were not significant.
CONCLUSION: EMDR appears to be most effective in reducing PTSD and depression in children and adolescents exposed to natural and man-made disasters. In addition, ET and CBT are potentially effective in reducing PTSD symptoms at postintervention, while PT is beneficial in managing depression symptoms at the treatment endpoint.

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Yasar, A., Yanartas, O., Cam, C., Budak, C., Topcuoglu, V., & Ergun, T. (2022). Use of Therapist Rotation Model for Eye Movement Desensitization and Reprocessing (EMDR) in a Patient with Atopic Dermatitis. Psychiatry and Behavioral Sciences, 12(1), 45. https://doi.org/10.5455/pbs.20211215090126

Open Access: https://doi.org/10.5455/pbs.20211215090126

Alisan Burak Yasar, Istanbul Gelisim University, Department of Psychology, Istanbul, Turkey. E-mail: burakyasar54@hotmail.com

Abstract

Atopic dermatitis (AD) is described by lichenification, pruritus and excoriation of the skin. Up to 70% of patients may experience stressful life events before onset of AD. In this study, we aimed to present use of Eye Movement Desensitization and Reprocessing (EMDR) for psychotherapy of an AD patient. Our second goal is to demonstrate the effect of therapist rotation model (TRM) for this group of patients. We used EMDR and TRM based on Van Minnen’s model. We compared test results including depression, anxiety, and AD disease severity before and after EMDR sessions. Our patient’s depression and anxiety scores decreased after EMDR therapy. EMDR may be useful for psychogenic component and itching complaint of AD. TRM may be rational, effective and tolerable for these patients.

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Zucchetti, G., Ciappina, S., Roccia, E., Concas, D., Giordano, M., Battaglini, C., Geuna, T., Peirolo, C., Faretta, E., Fernandez, I., Quarello, P., & Fagioli, F. (2024). EMDR and standard psychotherapy for paediatric cancer patients and their families: a pilot study. Front Psychol, 15, 1407985. https://doi.org/10.3389/fpsyg.2024.1407985

Open Access: https://doi.org/10.3389/fpsyg.2024.1407985

Giulia Zucchetti, Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy. E-mail: giulia.zucchetti@unito.it

Abstract

INTRODUCTION: This study examined the efficacy of eye movement desensitisation and reprocessing (EMDR) therapy compared with standard psychotherapy (SP) in treating post-traumatic stress disorder (PTSD) in paediatric oncology patients and their families in the early stage of cancer treatment. The secondary aim of this study was to assess whether EMDR therapy has a different impact on post-traumatic growth compared to SP.
METHODS: Forty patients were randomly assigned to EMDR or SP groups. The Impact of Event Scale - Revised (IES-R) and the Distress Thermometer (DT) were used to assess PTSD symptoms at pre-treatment (at cancer diagnosis) and in the post-treatment stages (after 8 sessions). The Post-traumatic Growth Inventory-PTGI was administered in the post-treatment stage in order to evaluate positive changes.
RESULTS: Both EMDR and SP are effective in reducing PTSD, but EMDR was significantly more effective than the SP in reducing scores on the IES-R, especially regarding the intrusive symptom subscale. Also, in the EMDR group there were higher scores of PTGI than in the standard group.
CONCLUSION: EMDR thus represents a promising treatment in the paediatric psycho-oncology setting.

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