---

Barnicot, K., Michael, C., Trione, E., Lang, S., Saunders, T., Sharp, M., & Crawford, M. J. (2020). Psychological interventions for acute psychiatric inpatients with schizophrenia-spectrum disorders: A systematic review and meta-analysis. Clin Psychol Rev, 82, 101929. doi:10.1016/j.cpr.2020.101929

Open access: https://pubmed.ncbi.nlm.nih.gov/33126038

Kirsten Barnicot, School of Health Sciences, City University of London, Myddleton Street Building, 1 Myddleton Street, London, United Kingdom EC1R 1UW. E-mail: Kirsten.Barnicot@city.ac.uk

Abstract

BACKGROUND: Acute inpatient psychiatric wards are important yet challenging environments in which to implement psychological interventions for people with schizophrenia-spectrum disorders. No meta-analysis to date has evaluated whether psychological interventions are effective in this context.
METHODS: We systematically searched Embase, Medline and PsycInfo databases for randomised controlled trials (RCTs) of psychological interventions implemented in acute inpatient psychiatric settings with individuals with schizophrenia-spectrum disorders. We conducted random effects meta-analyses of between-groups outcomes at post-intervention and relapse/re-hospitalisation rates by follow-up.
RESULTS: Twenty-nine trials were suitable for meta-analysis. Psychological interventions improved post-intervention positive symptoms, social functioning and treatment compliance and reduced the risk of relapse/ re-hospitalisation, relative to control conditions. Analyses of specific intervention effects found positive effects of psychoeducation on several key outcomes (power > 80%) and preliminary evidence for positive effects of acceptance and commitment therapy (ACT), cognitive behaviour therapy (CBT) and metacognitive training (MCT) on some outcomes (power < 80%).
CONCLUSION: Psychological interventions can be helpful for acute inpatients with schizophrenia-spectrum disorders. However, risk of bias was often high or unclear, and some analyses were underpowered. Further research should use more rigorous RCT designs and publish meta-analysable data on positive symptoms, general psychopathology, relapse/ re-hospitalisation, social functioning and treatment compliance.

---

Bates, A., Rushbrook, S., Shapiro, E., Grocott, M., & Cusack, R. (2020). CovEMERALD: Assessing the feasibility and preliminary effectiveness of remotely delivered Eye Movement Desensitisation and Reprocessing following Covid-19 related critical illness: A structured summary of a study protocol for a randomised controlled trial. Trials, 21(1). doi:10.1186/s13063-020-04805-1

Open access: http://dx.doi.org/10.1186/s13063-020-04805-1

Contact: Michael Grocott, University Hospital Southampton NHS Foundation Trust, Southampton, UK. E-mail: mike.grocott@soton.ac.uk

Abstract

Objectives: Primary Objective: To determine the feasibility of delivering a protocolised, remote, online, Eye Movement Desensitisation and Reprocessing (EMDR) intervention, within 12-weeks of hospital discharge, for adult survivors of Covid-19 related critical illness.
Secondary objectives: To investigate whether remotely delivered EMDR can improve psychological outcome following Covid-19 related critical illness, specifically Post-Traumatic Stress Disorder (PTSD), anxiety and depression.
Trial design: This is a single centre, randomised controlled cohort feasibility trial.
Participants: Participants will be recruited following discharge from the Intensive Care Unit at University Hospital Southampton, United Kingdom. Eligible patients will have received mechanical ventilation for a minimum of 24 hours, tested Covid-19 positive by polymerase chain reaction, will be over the age of 18 years and have the capacity to provide informed consent. Patients will be excluded if they have pre-existing cognitive impairment, pre- existing psychotic diagnosis or are not expected to survive post-hospital discharge.
Intervention and comparator: Group one: patients in the control arm will receive their standard package of prescribed care, following discharge home from hospital. If they experience any adverse physical or psychological health-conditions, they will access care through the usual available channels.
Group two: patients randomly allocated to the intervention arm will receive their standard package of prescribed care, following discharge home from hospital. In addition, they will be referred to the Intensive Psychological
Therapies Service in Poole, United Kingdom. They will receive an online appointment within 12-weeks of discharge home from hospital. They will receive a maximum of eight, weekly sessions of EMDR, delivered by a trained psychological therapist, following the Recent Traumatic Episode Protocol (R-TEP). Appendices 1 and 2 of the attached trial protocol contain a detailed description of the R-TEP intervention, written in accordance with the Template for Intervention Description and Replication (TIDieR) checklist and guide.
Main outcomes: The primary outcome from this trial will be feasibility. Feasibility will be determined by recruitment rates, expressed as a percentage of eligible patients approached, completion of the EMDR intervention, completion of final assessment at 6-months, incidence of attributable adverse events and protocol adherence by the psychological therapists. Secondary, exploratory outcomes will be assessed by comparison between the control and intervention groups at 6-months post-hospital discharge. Psychometric evaluation will consist of the PTSD Checklist-Civilian Version and Hospital Anxiety and Depression Scale. In addition, we will assess health-related quality of life using the EQ5D-5L, physical activity using wrist worn activity monitors and nutritional state using the Council of Nutrition Appetite Questionnaire.
Randomisation: Consenting participants will be randomly allocated to intervention or usual care using an internet- based system (ALEATM). Participants will be randomly assigned, on a 1:1 ratio, to receive either standard care (control) or the standard care plus online EMDR R-TEP (Intervention)
Blinding (masking): Due to the nature of the intervention, participants cannot be blinded to group allocation. 6- month patient reported outcome measures will be completed using an online, electronic case report form. Group allocation will be masked during data analysis.
Numbers to be randomised (sample size): This is a feasibility study, the results of which will be used to power a definitive study if appropriate. We anticipate a 25% mortality /loss to follow-up. A total of 26 patients will be recruited to this study, 13 patients in each arm.
Trial Status: CovEMERALD opened to recruitment on 23rd September 2020 with an anticipated recruitment period of 6-months. We are using protocol version number 1.2 (1st June 2020)
Trial registration: CovEMERALD was registered on clinicaltrials.gov NCT04455360 on 2nd July 2020
Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.
The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).

---

Camacho-Conde, J. A. (2020). Cognitive Function Assessment of a Patient with PTSD Before and After EMDR Treatment. Journal of EMDR Practice and Research, 14(4), 216-228. doi:10.1891/EMDR-D-20-00022

URL: http://dx.doi.org/10.1891/EMDR-D-20-00022

José Antonio Camacho Conde, University of Malaga, Center of Medical and Health Research, Malaga, Spain 29071. E-mail: jacamacho@uma.es

Abstract

The current case study investigates whether successful psychotherapy for posttraumatic stress disorder (PTSD) symptoms will also ameliorate cognitive deficits. We describe the treatment response of a 37-year- old woman diagnosed with PTSD who received eight weekly EMDR sessions. At pre-treatment, the patient reported emotional disturbance on the Beck Depression Inventory-II, and problems with anxiety and sleep. Testing showed high scores on the State-Trait Anxiety Inventory and the Symptoms Scale of Post-traumatic Stress Disorder Scale-Revised. An evaluation of her attention profile and other executive functions was conducted with dual execution tasks using a virtual reality program, Nesplora Aquarium. The attention testing data indicated attention-deficit disorder. At the end of the therapy, testing showed improvements in sleep problems and in emotional disturbance and anxiety symptoms on all measures. The attention testing revealed normal scores for her age range in the Nesplora Aquarium test. A follow-up assessment was carried out at 1 month, and it was observed that the patient maintained the improvement achieved. We discuss the relationship between PTSD and cognitive impairment and the value of the Nesplora Aquarium test for cognitive assessments. Our results suggest attentional deficits in this case when performing a continuous execution test with dual execution components that involve the participation of the central executive system of working memory.

---

Hafkemeijer, L., de Jongh, A., van der Palen, J., & Starrenburg, A. (2020). Eye movement desensitization and reprocessing (EMDR) in patients with a personality disorder. European Journal of Psychotraumatology, 11(1), 1838777. doi:10.1080/20008198.2020.1838777

Open access: http://dx.doi.org/10.1080/20008198.2020.1838777

Laurian Hafkemeijer, GGZ Delfland, Delft 2612, The Netherlands. E-mail: l.hafkemeijer@ggz-delfland.nl

Abstract

Background: Little is known about the effects of targeting memories of adverse (childhood) events in people with a personality disorder (PD).
Objective: Determining the effectiveness of brief EMDR therapy in individuals with PD. Method: In a randomized-controlled trial, 97 outpatients with a PD as main diagnosis were allocated to either five (90 minutes) sessions of EMDR therapy (n = 51) or a waiting list (WL) control condition (n = 46) followed by 3 months of treatment as usual for their PD. Individuals with posttraumatic stress disorder (PTSD) were excluded. Measurements were performed on psychological symptoms, psychological distress, and personality dysfunctioning. Outcomes were compared at baseline, post-treatment, and at 3-month follow up. Data were analysed as intent-to-treat with linear mixed models.
Results: EMDR therapy yielded significant improvements with medium to large effect sizes for the primary outcomes after treatment, i.e. psychological symptoms (EMDR: d =.42; control group: d =.07), psychological distress (EMDR: d =.69; control group: d =.29), and personality functioning (EMDR: d =.41; control group: d = −.10) within groups. At 3-month follow-up, after 3 months of TAU, improvements were maintained. Significant differences were found between both groups regarding all outcome measures in favour of the EMDR group at post-treatment (ds between −.62 and −.65), and at follow-up, after 3 months of TAU (ds between −.45 and −.53).
Conclusions: The results suggest that EMDR therapy can be beneficial in the treatment of patients with PDs. More rigorous outcome research examining long-term effects and using a longer treatment track is warranted.

---

Galvan, M. S., Lueke, A. E., Mansfield, L.-T. E., & Smith, C. A. (2020). A systematic research review: How to best treat post-traumatic stress disorder in children post-natural disaster. Journal of Human Behavior in the Social Environment, 1-15. doi:10.1080/10911359.2020.1804513

URL: http://dx.doi.org/10.1080/10911359.2020.1804513

Amanda E. Jueke, Department of Social Work, San Diego State University, San Diego, CA, USA. E-mail: aluek1643@sdsu.edu

Abstract

This paper is a systematic research review examining the best treatment intervention for children experiencing post-traumatic stress disorder (PTSD) or PTSD-like symptoms after a natural disaster event. Research articles (12) were reviewed using a checklist that assesses face, content, and criterion validity: 9 quantitative, 2 mixed-methods, and 1 qualitative, to determine best screening and intervention practices to reduce the negative symptoms resulting from trauma. Researchers in the cited studies collected data via phone interviews, face-to-face interviews, surveys, self-evaluations, observation methods, teacher and social worker assessments, and parent assessments. For the purpose of this paper, we focused on the question: What is the best way to screen for and treat PTSD in children in post-natural disaster areas? Based on these studies, we identified three major themes: 1) the treatment of PTSD is necessary in post-natural disaster children; 2) school-based screenings (with considerations) are the most viable way to screen children for PTSD; and 3) CBT is the most universal intervention for children post-disaster. We included additional findings on EMDR and parenting techniques. More research needs to be done on the impact of family dynamics in post-natural disaster treatment and the long-term effects of experiencing a natural disaster.

---

Luyten, T. R., Jacquemin, L., Van Looveren, N., Declau, F., Fransen, E., Cardon, E., . . . Gilles, A. (2020). Bimodal Therapy for Chronic Subjective Tinnitus: A Randomized Controlled Trial of EMDR and TRT Versus CBT and TRT. Front Psychol, 11, 2048. doi:10.3389/fpsyg.2020.02048

Open access: https://pubmed.ncbi.nlm.nih.gov/33013517

Tine Roanna Luyten, Faculty of Medicine and Health Sciences, Department Translational Neuroscience, University of Antwerp, Antwerp, Belgium. E-mail: luytentine@hotmail.com

Abstract

Introduction: To date, guidelines recommend the use of a stepped care approach to treat tinnitus. The current clinical management of tinnitus frequently consists of audiologic interventions and tinnitus retraining therapy (TRT) or cognitive behavioral therapy (CBT). Due to the high heterogeneity of the tinnitus population and comorbidity of tinnitus with insomnia, anxiety, and depression, these interventions may not be sufficient for every patient. The current study aims to determine whether a bimodal therapy for chronic, subjective tinnitus consisting of the combination of TRT and eye movement desensitization reprocessing (EMDR) results in a clinically significant different efficacy in comparison with the prevailing bimodal TRT and CBT therapy.
Methods: Patients were randomized in two treatment groups. The experimental group received the bimodal therapy TRT/EMDR and the active control group received the bimodal therapy TRT/CBT. Evaluations took place at baseline (T|0|), at the end of the treatment (T|1|), and 3 months after therapy (T|2|). The tinnitus functional index (TFI) was used as primary outcome measurement. Secondary outcome measurements were the visual analog scale of tinnitus loudness (VAS|Loudness|), tinnitus questionnaire (TQ), hospital anxiety and depression scale (HADS), hyperacusis questionnaire (HQ), global perceived effect (GPE), and psychoacoustic measurements.
Findings: The TFI showed clinically significant improvement in both bimodal therapies (mean decrease 15.1 in TRT/CBT; p < 0.001 vs. 16.2 in TRT/EMDR; p < 0.001). The total score on the TQ, HADS, HQ, and VAS|Loudness| all demonstrated significant decrease after treatment and follow-up (p < 0.001) in the experimental and the active control group. GPE-measurements revealed that more than 80% (i.e., 84% in TRT/CBT vs. 80% in TRT/EMDR) of the patients experienced substantial improvement of tinnitus at follow up. Treatment outcome remained stable after 3 month follow-up and no adverse events were observed.
Conclusion: Both psychotherapeutic protocols result in a clinically significant improvement for patients with chronic subjective tinnitus. No significant different efficacy was found for the TRT/EMDR treatment compared to the combination of TRT and CBT.
Clinical Trial registration: ClinicalTrials.gov, ID: NCT03114878. April 14, 2017.

---

Matthijssen, S. J. M. A., Lee, C. W., de Roos, C., Barron, I. G., Jarero, I., Shapiro, E., . . . de Jongh, A. (2020). The Current Status of EMDR Therapy, Specific Target Areas, and Goals for the Future. Journal of EMDR Practice and Research, 14(4), 241-284. doi:10.1891/emdr-d-20-00039

URL: http://dx.doi.org/10.1891/emdr-d-20-00039

Suzy Matthijssen, Altrecht Academic Anxiety Centre, Altrecht GGZ, Utrecht, The Netherlands, Utrecht University, Utrecht, The Netherlands. E-mail: s.matthijssen@altrecht.nl

Abstract

While eye movement desensitization and reprocessing (EMDR) is considered an evidence-based treatment for posttraumatic stress disorder (PTSD) in adults, there are differences as to how various international treatment guidelines judge the strength of this evidence base. Furthermore, in areas other than adult PTSD, major guidelines differ even more as to the strength of the evidence base and when to use EMDR. In 2019, the Council of Scholars: The Future of EMDR Therapy Project was initiated. Several working groups were established, with one assigned to the focus area of research. This article is a product of that working group. Firstly the group concluded that there were five areas where there was some base that EMDR was effective, but more data were needed to increase the likelihood that it would be considered in future international treatment guidelines. These areas were PTSD in children and adolescents, early EMDR interventions, combat PTSD, unipolar depression, and chronic pain. In addition, research into cost- effectiveness of EMDR therapy was identified as one of the priorities. A hierarchical system was used for classifying and rating evidence in the focus areas. After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level. Some general recommendations for improving the quality of future research on the effectiveness of EMDR therapy are formulated.

---

Moore, T., Phillips, J. S., Erskine, S. E., & Nunney, I. (2020). What Has EMDR Taught Us About the Psychological Characteristics of Tinnitus Patients. Journal of EMDR Practice and Research, 14(4), 229-240. doi:10.1891/emdr-d-19-00055

URL: http://dx.doi.org/10.1891/emdr-d-19-00055

Sally Erskine, Norfolk and Norwich University Hospital, Department of Otolaryngology, Colney Lane, Norwich, Norfolk, NR4 7UY, United Kingdom. E-mail: sally.erskine@doctors.org.uk

Abstract

Tinnitus is a common and distressing symptom affecting at least 10% of the population. It is poorly understood. There are many proposed therapies but a significant lack of well-controlled trials. This study is a secondary analysis from our recent study to determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for tinnitus. It was designed as a single-site prospective interventional clinical trial and took place at a teaching hospital in the United Kingdom. Participants received a maximum of 10 sessions of EMDR. The EMDR used was a bespoke protocol: EMDR-for-tinnitus protocol (tEMDR). Outcome measures included evidence-based tinnitus and mood questionnaires recorded at baseline, discharge, and at 6 months post-discharge. The main outcome measure was the Tinnitus Handicap Inventory, and scores demonstrated a statistically significant improvement. Secondary analyses conducted indicate statistically significant improvement for tinnitus patients with and without probable posttraumatic stress disorder (PTSD) diagnoses. There was no significant decrease in depression and anxiety measures, however these were at the minimal range at the start. The purpose of this article is to describe the rationale behind the use of EMDR in tinnitus, the process of administrating a bespoke EMDR protocol, and the differences between tinnitus sufferers with differing experiences of trauma. To date our study is one of only two published studies investigating the use of EMDR for tinnitus; we therefore introduce an evolving and exciting application for EMDR therapy.

---

Palumbo, R., Protokowicz, J., & Roberto, A. (2020). What You Need to Know: Eye Movement Desensitization and Reprocessing Therapy as a Path to Recovery for Patients with Substance Use Disorder. J Addict Nurs, 31(3), 225-226. doi:10.1097/JAN.0000000000000354

URL: https://pubmed.ncbi.nlm.nih.gov/32868615

Ruthanne Palumbo, DNP, RN, CNE, College of Health and Human Services, UNCW School of Nursing, 601 South College Road, Wilmington, NC 28403-5995. E-mail: palumbor@uncw.edu

Abstract

Studies show a direct correlation between traumatic experiences and the development of substance abuse disorders (SUD). Some estimating 67-92% of the patients with a SUD reported having experienced at least one traumatic event (according to the DSMIV PTSD criterion A) in their lifetime (Carletto et al., 2018). Trauma is a contributing factor inhibiting the lifelong process of recovery and its long-term goal of abstinence. Without a focus on interventions that address both the SUD and underlying trauma, health care providers may not be providing the best possible evidence-based care and limiting the chance of recovery for patients (DiPirro, 2017). EMDR is a level A trauma treatment endorsed by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the World Health Organization (WHO) as an evidence-based approach in treating those who suffer from trauma and its related symptoms. Adding EMDR methodology to treatment as usual approach {TAU) can allow for adaptive information processing to take place while reprocessing traumatic memories that may trigger maladaptive coping strategies such as overuse, and misuse of substances.

---

Suárez, N. A., Pérez, J. M., Redolar-Ripoll, D., Hogg, B. M., Gardoki-Souto, I., Guerrero, F. G., . . . Moreno-Alcázar, A. (2020). EMDR versus treatment-as-usual in patients with chronic non-malignant pain: A randomized controlled pilot study. Journal of EMDR Practice and Research, 14(4), 190-205. doi:10.1891/EMDR-D-20-00004

URL: http://dx.doi.org/10.1891/EMDR-D-20-00004

Ana Moreno-Alcázar, Carrer Llull, 410 – 08019 – Barcelona, Spain. E-mail: amoreno.centreforum@gmail.com

Abstract

In recent years, different studies have observed a strong association between chronic pain (CP) and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), could be an innovative treatment option. The aim of this pilot study was to assess whether a specific EMDR protocol for CP leads to (a) a reduction in pain intensity, (b) an improvement in anxiety and depressive symptoms, and (c) an improvement in quality of life. About 28 CP patients were randomly assigned to EMDR + treatment as usual (TAU; n = 14) or to TAU alone (n = 14). Patients in the EMDR group received 12 psychotherapeutic sessions of 90 minutes over 3 months. Pain intensity was measured using the Visual Analog Scale and the Pain Disability index, quality of life using the EQ-5D-5L, and anxiety and depressive symptoms using the Hamilton Anxiety and Depression Scale. Measures were taken for both conditions at pre- and post-treatment, and a follow-up in the EMDR condition was taken at 3 months post-treatment. Patients in the EMDR group showed significantly reduced pain intensity and improved quality of life and anxiety and depressive symptoms compared to TAU alone at post-treatment. Improvements were largely maintained at 3-month follow-up. This study suggests that EMDR may be an effective and safe psychological intervention to be used within the multidisciplinary treatment plan of patients with CP.

---

Varese, F., Sellwood, W., Aseem, S., Awenat, Y., Bird, L., Bhutani, G., . . . Bentall, R. (2020). Eye movement desensitization and reprocessing therapy for psychosis (EMDRp): Protocol of a feasibility randomized controlled trial with early intervention service users. Early Interv Psychiatry. doi:10.1111/eip.13071

Open access: https://pubmed.ncbi.nlm.nih.gov/33225584

Dr Filippo Varese, 2nd floor, Zochonis Building, 2 Brunswick Street, University of Manchester, Manchester, M13 9PL, UK. E-mail: filippo.varese@manchester.ac.uk

Abstract

AIM: Traumatic events are involved in the development and maintenance of psychotic symptoms. There are few trials exploring trauma-focused treatments as interventions for psychotic symptoms, especially in individuals with early psychosis. This trial will evaluate the feasibility and acceptability of conducting a definitive trial of Eye Movement Desensitization and Reprocessing for psychosis (EMDRp) in people with early psychosis. METHODS: Sixty participants with first episode psychosis and a history of a traumatic/adverse life event(s)will be recruited from early intervention services in the North West of England and randomized to receive16 sessions of EMDRp + Treatment as Usual (TAU) or TAU alone. Participants will be assessed at baseline, 6 and 12 months post-randomization using several measures of psychotic symptoms, trauma symptoms, anxiety, depression, functioning, service-user defined recovery, health economics indicators and quality of life. Two nested qualitative studies to assess participant feedback of therapy and views of professional stakeholders on the implementation of EMDRp into services will also be conducted. The feasibility of a future definitive efficacy and cost-effectiveness evaluation of EMDRp will be tested against several outcomes, including ability to recruit and randomize participants, trial retention at 6- and 12-month follow-up assessments, treatment engagement and treatment fidelity. CONCLUSIONS: If it is feasible to deliver a multi-site trial of this intervention, it will be possible to evaluate whether EMDRp represents a beneficial treatment to augment existing evidence-based care of individuals with early psychosis supported by early intervention services.

---

Whitson, M. L., Champine, R. B., Griffin, A., Corto-Mergins, C., Lusa, J., Jaffe, J., . . . Kaufman, J. S. (2020). Impact of an Integrated EMDR Treatment Program for Children and Youth Exposed to Potentially Traumatic Events: The Village Collaborative Trauma Center. Journal of EMDR Practice and Research, 14(4), 206-215. doi:10.1891/EMDR-D-20-00002

URL: http://dx.doi.org/10.1891/EMDR-D-20-00002

Joy S. Kaufman, Yale University School of Medicine, Divi- sion of Prevention and Community Research, Department of Psychiatry, 389 Whitney Avenue, New Haven, CT 06511. E-mail: joy.kaufman@yale.edu

Abstract

Exposure to adverse events during childhood and adolescence is associated with problematic outcomes across the life span, including the development of posttraumatic stress disorder (PTSD). A growing body of research examining the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in treating PTSD among young people has yielded mixed findings. More work is needed that elucidates whether EMDR is linked to positive and sustained reductions in symptoms among youth who experience potentially traumatic events. For this open trial, we analyzed data from 143 youth (Mage = 12.9, standard deviation [SD] = 3.4, Range = 6–18) who received outpatient behavioral health clinic services, including EMDR. We assessed whether the number of types of exposure to family-related and non-family-related traumatic events, as well as differences in severity of PTSD symptomatology, was associated with changes in internalizing and externalizing problem behaviors from intake to 6 months. Results indicated that youth with (a) fewer exposures to non-family-related potentially traumatic events and (b) more severe PTSD symptoms, showed greater improvements in externalizing problem behaviors. We discuss limitations of the present study and implications for future research.

---

Zantvoord, J. B., Zhutovsky, P., Ensink, J. B. M., Op den Kelder, R., van Wingen, G. A., & Lindauer, R. J. L. (2020). Trauma-focused psychotherapy response in youth with posttraumatic stress disorder is associated with changes in insula volume. J Psychiatr Res. doi:10.1016/j.jpsychires.2020.10.037

Open access: https://pubmed.ncbi.nlm.nih.gov/33189355

Jasper B. Zantvoord, Department of psychiatry Amsterdam University Medical Center, Meibergdreef 5, room PA0-226, 1105, AZ, Amsterdam, the Netherlands. E-mail: J.B.Zantvoord@amsterdamumc.nl

Abstract

Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD), but little is known about the relationship between treatment response and alternations in brain structures associated with PTSD. In this study, we longitudinally examined the association between treatment response and pre-to posttreatment changes in structural magnetic resonance imaging (MRI) scans using a voxel-based morphometry approach. We analyzed MRI scans of 35 patients (ages 8-18 years, 21 female) with PTSD (80%) or partial PTSD (20%) before and after eight weekly sessions of trauma-focused psychotherapy. PTSD severity was assessed longitudinally using the Clinician-Administered PTSD scale for Children and Adolescents to divide participants into responders and non-responders. Group by time interaction analysis showed significant differences in grey-matter volume in the bilateral insula due to volume reductions over time in non-responders compared to responders. Despite the significant group by time interaction, there were no significant group differences at baseline or follow-up. As typical development is associated with insula volume increase, these longitudinal MRI findings suggest that treatment non-response is associated with atypical neurodevelopment of the insula, which may underlie persistence of PTSD in youth. The absence of structural MRI changes in treatment responders, while in need of replication, suggest that successful trauma-focused psychotherapy may not directly normalize brain abnormalities associated with PTSD.

---

Zarotti, N., Eccles, F. J. R., Foley, J. A., Paget, A., Gunn, S., Leroi, I., & Simpson, J. (2020). Psychological interventions for people with Parkinson’s disease in the early 2020s: Where do we stand. Psychol Psychother. doi:10.1111/papt.12321

URL: https://pubmed.ncbi.nlm.nih.gov/33174688

Nicolò Zarotti, Division of Health Research, Faculty of Health and Medicine, Lancaster University, UK.

Abstract

PURPOSE: To explore the heterogeneity of the literature on psychological interventions for psychological difficulties in people with Parkinson's disease (PD).
METHODS: A scoping review was performed across five major databases (MEDLINE Complete, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library) up to June 2020. RESULTS: From an initial return of 4911 citations, 56 studies were included, of which 21 were RCTs. A relatively wide range of therapeutic models have been adopted with people with PD, from common therapies such as cognitive behavioural therapy (CBT) and mindfulness, to less frequent approaches, for example, acceptance and commitment therapy (ACT) and psychodrama. The clinical implications of the findings are discussed, and suggestions are provided for future research on intervention studies and key psychological outcomes.
CONCLUSIONS: CBT appears to be effective in treating depression and sleep disorders in people with PD, while psychoeducation programmes alone should be avoided. The use of CBT to improve anxiety, quality of life, and impulse control, as well mindfulness-based interventions, should be undertaken with some caution because of insufficient research and inconsistent results. As we enter the new decade, more high-quality evidence is required for psychological interventions in people with PD in general and to corroborate preliminary positive findings on the adoption of less frequent approaches such as ACT.
PRACTITIONER POINTS: Parkinson's disease is a progressive neurodegenerative condition associated with several psychological difficulties which be targeted by psychological interventions. Currently, cognitive behavioural therapy (CBT) can be recommended to treat depression and sleep disorders in people with Parkinson's, while psychoeducation alone should be avoided. Caution is advised regarding the use of CBT and mindfulness-based interventions to improve anxiety, quality of life, and impulse control. Further evidence is required for less common approaches, such as acceptance and commitment therapy, psychodrama, and EMDR.

---