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Auren, T. J. B., Klæth, J. R., Jensen, A. G., & Solem, S. (2022). Intensive outpatient treatment for PTSD: an open trial combining prolonged exposure therapy, EMDR, and physical activity. Eur J Psychotraumatol, 13(2), 2128048. https://doi.org/10.1080/20008066.2022.2128048

Open Access: https://doi.org/10.1080/20008066.2022.2128048


Trude Julie Brynhildsvoll Auren, Regional Unit for Treatment of Severe Posttraumatic Stress Disorder, Nidaros DPS, St. Olavs Hospital, Trondheim 7040, Norway. E-mail: trude.auren@stolav.no

Abstract

Background: Intensive outpatient treatment could be a promising option for patients with post-traumatic stress disorder (PTSD).
Objective: The aim of the study was to test the effectiveness of an eight-day (two-week) intensive treatment for PTSD within a public health care setting (open trial design).
Method: Eighty-nine patients were offered the choice between intensive treatment and spaced individual treatment, of which 34 (38.2%) chose the intensive format. Patients were assessed with self-report batteries and interviews at pre-treatment, start of treatment, post- treatment and three-month follow-up. Each day consisted of individual Prolonged Exposure therapy, Eye Movement Desensitization and Reprocessing therapy, group psychoeducation, and physical activity. Therapists rotated between patients.
Results: Between 55 and 62% of the patients showed a clinically significant change (recovery) in symptoms of PTSD, and the effect sizes were large (d = 1.38–1.52). Patients also showed reduction in symptoms of depression and anxiety, along with improved well-being and interpersonal functioning. Changes in social and work functioning were more ambiguous. There were no dropouts, attendance was high, and patients were highly satisfied with the treatment. Conclusions: The intensive programme was an attractive and effective treatment option for patients with PTSD.

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Bahji, A., Di Nota, P. M., Groll, D., Carleton, R. N., & Anderson, G. S. (2022). Psychological interventions for post-traumatic stress injuries among public safety personnel: a systematic review and meta-analysis. Syst Rev, 11(1), 255. https://doi.org/10.1186/s13643-022-02112-1

Open Access: https://doi.org/10.1186/s13643-022-02112-1


Gregory S. Anderson, Faculty of Science, Thompson Rivers University, Kamloops, BC, Canada. E-mail: ganderson@tru.ca

Abstract

Background: Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear.
Objectives: The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs.
Methods: A systematic review and random-effects meta-analysis were performed on the effectiveness and accept- ability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, post-traumatic stress disorder) among
PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen’s d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative
d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, heterogeneity was quantified using I2, and publication bias was evaluated using Egger’s test.
Results: The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d = − 1.23; 95% CI − 1.81, − 0.65; 7 studies; I2 = 81%), anxiety (− 0.76; 95% CI − 1.28, − 0.24; 3 studies; I2 = 47%), and depression (d = − 1.10; 95% CI − 1.62, − 0.58; 5 studies; I2 = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = − 1.29 [− 2.31, − 0.27]), anxiety (d = − 0.82 [− 1.20, − 0.44]), and depression (d = − 0.46 [− 0.77, − 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions.
Conclusions: There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP.

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Banz, L., Stefanovic, M., von Boeselager, M., Schäfer, I., Lotzin, A., Kleim, B., & Ehring, T. (2022). Effects of current treatments for trauma survivors with posttraumatic stress disorder on reducing a negative self-concept: a systematic review and meta-analysis. Eur J Psychotraumatol, 13(2), 2122528. https://doi.org/10.1080/20008066.2022.2122528

Open Access: https://doi.org/10.1080/20008066.2022.2122528

Thomas Ehring, Department of Psychology, LMU Munich, Leopoldstr. 13, Munich 80802, Germany. E-mail: thomas.ehring@lmu.de

Abstract

Background: A negative self-concept is characterised by dysfunctional cognitions about the self and has been suggested to be a key factor involved in the development and maintenance of posttraumatic stress disorder (PTSD). In addition, the current definitions of PTSD according to DSM-5 and the new ICD-11 diagnosis of Complex PTSD (CPTSD) include aspects of negative self-concept in their diagnostic criteria.
Objective: The aim of this meta-analysis was to synthesise the currently available evidence on the effects of psychological interventions for PTSD on negative self-concept.
Methods: PubMed, PsychINFO, PSYNDEX, PTSDpubs and Cochrane Library were searched for randomised controlled trials (RCTs) of psychological treatments for PTSD symptoms in adults, published up to February 2021. A systematic review and meta-analysis were conducted, with risk of bias assessed by the Cochrane Risk of Bias Assessment Tool.
Results: A total of 25 RCTs (N = 2585) were included in the meta-analysis. Results showed that psychological interventions significantly improve a negative self-concept with a moderate to large controlled effect size (k = 30, g = 0.67, 95% CI [0.31, 1.02], p < .001) at post-treatment. Heterogeneity between studies was large but could not be accounted for by moderators included in the current analysis, i.e. different types of interventions (e.g. with vs. without a cognitive restructuring component, trauma-focused vs. not).
Conclusions: Current treatments for PTSD are effective in reducing a negative self-concept. However, more research is needed to identify moderators of this effect and identify interventions that are most effective for reducing negative self-concept.

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Castle, D., Feusner, J., Laposa, J. M., Richter, P. M. A., Hossain, R., Lusicic, A., & Drummond, L. M. (2023). Psychotherapies and digital interventions for OCD in adults: What do we know, what do we need still to explore. Compr Psychiatry, 120, 152357. https://doi.org/10.1016/j.comppsych.2022.152357

Open Access: https://doi.org/10.1016/j.comppsych.2022.152357


David Castle, Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, Ontario M6J 1H4, Canada. E-mail: david.castle@camh.ca

Abstract

Background: Despite significant advances in the understanding and treatment of obsessive compulsive disorder (OCD), current treatment options are limited in terms of efficacy for symptom remission. Thus, assessing the potential role of iterative or alternate psychotherapies is important. Also, the potential role of digital technol- ogies to enhance the accessibility of these therapies, should not be underestimated. We also need to embrace the idea of a more personalized treatment choice, being cognisant of clinical, genetic and neuroimaging predictors of treatment response.
Procedures: Non-systematic review of current literature on emerging psychological and digital therapies for OCD, as well as of potential biomarkers of treatment response.
Findings: A number of ‘third wave’ therapies (e.g., Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy) have an emerging and encouraging evidence base in OCD. Other approaches entail employment of elements of other psychotherapies such as Dialectical Behaviour Therapy; or trauma-focussed therapies such as Eye Movement Desensitisation and Reprocessing, and Imagery Rescripting and Narrative Therapy. Further strategies include Danger Ideation Reduction Therapy and Habit Reversal. For these latter approaches, large-scale randomised controlled trials are largely lacking, and the precise role of these therapies in treating people with OCD, remains to be clarified. A concentrated 4-day program (the Bergen program) has shown promising short- and long-term results. Exercise, music, and art therapy have not been adequately tested in people with OCD, but may have an adjunctive role. Digital technologies are being actively investigated for enhancing reach and efficacy of psychological therapies for OCD. Biomarkers, including genetic and neuro- imaging, are starting to point to a future with more ‘personalised medicine informed’ treatment strategizing for OCD.
Conclusions: There are a number of potential psychological options for the treatment of people with OCD who do not respond adequately to exposure/response prevention or cognitive behaviour therapy. Adjunctive exercise, music, and art therapy might be useful, albeit the evidence base for these is very small. Consideration should be given to different ways of delivering such interventions, including group-based, concentrated, inpatient, or with outreach, where appropriate. Digital technologies are an emerging field with a number of potential applications for aiding the treatment of OCD. Biomarkers for treatment response determination have much potential capacity and deserve further empirical testing.

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Faretta, E., Maslovaric, G., Garau, M. I., Marmondi, G., Piras, L., Rezzola, S., Incerti, A., Nardoni, A., Pagani, M., & Gallina, E. (2022). The psychological impact of the COVID emergency on Italian nursing homes staff and the effectiveness of eye movement desensitization and reprocessing. Front Psychol, 13, 969028. https://doi.org/10.3389/fpsyg.2022.969028

Open Access: https://doi.org/10.3389/fpsyg.2022.969028


Eugenio Gallina, Centro di Ricerca e Studi in Psicotraumatologia, Milan, Italy. E-mail:
eugenioggallina@gmail.com

Abstract

Residential nursing homes were particularly badly affected by the first wave of COVID-19, with large numbers of their frail person getting infected with COVID-19 and dying. The staff in these structures were catapulted into a reality very different from what they were used to. They had to adapt the way they used to take care of their patients in a very short space of time and in a scenario that was continually changing. In this manuscript we describe the subjective experience of staff in a number of Italian nursing homes during the first wave of the COVID-19 pandemic; and we report data showing the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) treatment provided to support them during this Pandemic.

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Hogg, B., Gardoki-Souto, I., Valiente-Gómez, A., Rosa, A. R., Fortea, L., Radua, J., Amann, B. L., & Moreno-Alcázar, A. (2022). Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. Eur Arch Psychiatry Clin Neurosci. https://doi.org/10.1007/s00406-022-01495-5

URL: https://doi.org/10.1007/s00406-022-01495-5


Benedikt L. Amann, Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019 Barcelona, Spain. E-mail: benedikt.amann@gmail.com

Abstract

This umbrella review is the first to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions. We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classified the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-effects p value, the 95% confidence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study effect, and excess significance bias. Additional outcomes were the association between specific trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines. Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across different diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR = 2.92) and between childhood trauma and any mental disorder (OR = 2.90). Regarding specific trauma types, convincing evidence linked physical abuse (OR = 2.36) and highly suggestive evidence linked sexual abuse (OR = 3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR = 3.05); there were no data for emotional abuse with other disorders. These findings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.

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Hoppen, T. H., & Morina, N. (2022). Psychological Interventions for Adult Post-Traumatic Stress Disorder Are Effective Irrespective of Concurrent Psychotropic Medication Intake: A Meta-Analysis of Randomized Controlled Trials. Psychother Psychosom, 1-11. https://doi.org/10.1159/000527850

URL: https://doi.org/10.1159/000527850


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

Abstract

Background: Participants are allowed to stay on their prescribed psychotropic medication in most trials examining psychological interventions for adult post-traumatic stress disorder (PTSD).
Objectives: We aimed to conduct the first meta-analysis investigating the potential influence of such concurrent medication on efficacy.
Method: To this end, we searched Medline, PsycINFO, Web of Science, and PTSDpubs from inception to April 21, 2022, for trials meeting the following criteria: (1) randomized controlled trial (RCT), (2) PTSD as primary treatment focus, (3) interview-based PTSD baseline rate ≥70%, (4) N ≥ 20, (5) mean age ≥18 years. Trials were excluded when intake of psychotropics was not (sufficiently) reported.
Results: Most published trials did not report on the intake of psychotropic medication. A total of 75 RCTs (N = 4,901 patients) met inclusion criteria. Trauma-focused cognitive behavior therapy (TF-CBT) was the most well-researched intervention. Short-term efficacy of psycho- logical treatments did not differ by the proportion of participants taking concurrent psychotropic medication during psychological treatment in all but one analysis. In trials comparing TF-CBT and active control conditions at posttreatment, TF-CBT was more effective when most participants were concurrently medicated (g = 0.87, 95% CI 0.53–1.22) rather than unmedicated (g = 0.27; 95% CI 0.01–0.54, p = 0.017), with younger age (b1 = −0.04, p = 0.008) and higher proportion of females (b1 = 0.01, p = 0.014) being associated with higher efficacy only in trials with high proportions of medicated participants. No differences in efficacy by proportions of participants taking concurrent psychotropic medication were found at follow-up.
Conclusions: Results suggest that psychological interventions are effective for PTSD irrespective of concurrent intake of psychotropics.

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Kaliman, P., Cosín-Tomás, M., Madrid, A., Roque López, S., Llanez-Anaya, E., Papale, L. A., Alisch, R. S., & Davidson, R. J. (2022). Epigenetic impact of a 1-week intensive multimodal group program for adolescents with multiple adverse childhood experiences. Sci Rep, 12(1), 17177. https://doi.org/10.1038/s41598-022-21246-9

Open Access: https://doi.org/10.1038/s41598-022-21246-9


Perla Kaliman, Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI 53703, USA. E-mail: pkaliman@uoc.edu; pkaliman@wisc.edu

Abstract

Adverse childhood experiences (ACEs, i.e., abuse, neglect, household dysfunction) represent a potential risk factor for a wide range of long‐lasting diseases and shorter life expectancy. We recently described a 1‐week residential group program, based on mindfulness training, artistic expression and EMDR group therapy, that significantly reduced PTSD‐related symptoms and increased attention/ awareness‐related outcomes in adolescent girls with multiple ACEs in a randomized controlled
study. Since epigenetic mechanisms (i.e., DNA methylation) have been associated with the long‐ lasting effects of ACEs, the present report extends these prior findings by exploring genome‐wide DNA methylation changes following the program. Saliva samples from all participants (n = 44) were collected and genomic DNA was extracted prior (T1) and following (T2) the intervention. Genome‐ wide DNA methylation analysis using the Methylation EPIC beadchip array (Illumina) revealed 49 differentially methylated loci (DML; p value < 0.001; methylation change > 10%) that were annotated to genes with roles in biological processes linked to early childhood adversity (i.e., neural, immune, and endocrine pathways, cancer and cardiovascular disease). DNA sequences flanking these DML showed significant enrichment of transcription factor binding sites involved in inflammation, cancer, cardiovascular disease, and brain development. Methylation changes in SIRT5 and TRAPPC2L genes showed associations with changes in trauma‐related psychological measures. Results presented here suggest that this multimodal group program for adolescents with multiple victimization modulates the DNA methylome at sites of potential relevance for health and behavioral disorders associated with ACEs.

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Kearney, B. E., & Lanius, R. A. (2022). The brain-body disconnect: A somatic sensory basis for trauma-related disorders. Frontiers in Neuroscience, 16. https://doi.org/10.3389/fnins.2022.1015749

Open Access: https://doi.org/10.3389/fnins.2022.1015749


Breanne E. Kearney E-mail: bkearne3@uwo.ca
Ruth A. Lanius E-mail: ruth.lanius@lhsc.on.ca

Abstract

Although the manifestation of trauma in the body is a phenomenon well- endorsed by clinicians and traumatized individuals, the neurobiological underpinnings of this manifestation remain unclear. The notion of somatic sensory processing, which encompasses vestibular and somatosensory processing and relates to the sensory systems concerned with how the physical body exists in and relates to physical space, is introduced as a major contributor to overall regulatory, social-emotional, and self-referential functioning. From a phylogenetically and ontogenetically informed perspective, trauma-related symptomology is conceptualized to be grounded in brainstem-level somatic sensory processing dysfunction and its cascading influences on physiological arousal modulation, affect regulation, and higher-order capacities. Lastly, we introduce a novel hierarchical model bridging somatic sensory processes with limbic and neocortical mechanisms regulating an individual’s emotional experience and sense of a relational, agentive self. This model provides a working framework for the neurobiologically informed assessment and treatment of trauma-related conditions from a somatic sensory processing perspective.

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Kolthof, K. A., Voorendonk, E. M., Van Minnen, A., & De Jongh, A. (2022). Effects of intensive trauma-focused treatment of individuals with both post-traumatic stress disorder and borderline personality disorder. European Journal of Psychotraumatology, 13(2). https://doi.org/10.1080/20008066.2022.2143076

Open Access: https://doi.org/10.1080/20008066.2022.2143076


Ad De Jongh, (ACTA), University of Amsterdam. E-mail: a.de.jongh@acta.nl

Abstract

Background: Research indicates that intensive trauma-focused therapy can be effective in alleviating symptoms of post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). However, these studies have relied on self-report of BPD symptoms and follow-up data are scarce.
Objective: The purpose of this feasibility study was to determine the effects of an intensive trauma-focused treatment programme on the severity of PTSD and BPD symptoms and the diagnostic status up to a 12-month follow-up.
Methods: A total of 45 (60% female) individuals meeting the diagnostic criteria of both PTSD and BPD participated in an intensive eight-day trauma-focused treatment programme which combined prolonged exposure and EMDR therapy in an inpatient treatment setting. Severity of PTSD and BPD symptoms were assessed at pre-treatment, post-treatment, 6 months, and 12 months after treatment (CAPS-5, BPDSI-IV). Diagnostic status was determined using clinical interviews (CAPS-5 and SCID-5-P) at pre-treatment and 12-month follow-up.
Results: Of all participants, 93.3% had been exposed to physical abuse, and 71.1% to sexual abuse prior to the age of 12 years. PTSD and BPD symptom severity significantly decreased from pre- to post-treatment (Cohen's ds: 1.58 and 0.98, respectively), and these results were maintained at 6- (ds: 1.20 and 1.01) and 12-month follow-up (ds: 1.53 and 1.36). Based upon CAPS-5, 69.2% no longer met the diagnostic criteria of PTSD at 12-month follow-up, while according to the SCID-5-P 73.1% no longer fulfilled the diagnostic criteria of BPD at that time. No significant worsening of symptoms occurred.
Conclusion: The findings of this study, which is the first to examine the effects of psychotherapeutic treatment of PTSD on the presence of a borderline personality disorder one year after treatment, add support to the notion that a brief intensive trauma-focused treatment can be a valuable option for individuals suffering from both PTSD and BPD.

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Leeds, A. M. (2022). The Positive Affect Tolerance and Integration Protocol: A Novel Application of EMDR Therapy Procedures to Help Survivors of Early Emotional Neglect Learn to Tolerate and Assimilate Moments of Appreciation, Praise, and Affection. Journal of EMDR Practice and Research, EMDR-2022. https://doi.org/10.1891/emdr-2022-0015

URL: http://dx.doi.org/10.1891/emdr-2022-0015


Andrew M. Leeds, Director of Training, Sonoma Psychotherapy Training Institute, 1049 Fourth St, Suite G Santa Rosa, CA 95404. E-mail: andrewmleeds @ gmail.com

Abstract

Survivors of early neglect and other adverse childhood experiences often struggle with general and social anxiety, depressive states, and negative self-concept. Trauma informed treatment strategies for survivors, such as EMDR therapy, exposure therapy, and cognitive processing therapy tend to focus on resolving memories of adverse and traumatic experiences. Coping skills development models, such as Dialectical Behavior Therapy and Skills Training in Affective and Interpersonal Regulation (STAIR) emphasize training in mindfulness, assertiveness, or self-soothing skills for patients with persistent negative affect states. In the era of trauma-informed psychotherapy, an often-overlooked clinical issue is the impaired ability of survivors of early neglect to tolerate and integrate moments of shared positive interpersonal experience into positive emotional states and positive self-concepts. Survivors of neglect tend to make use overt or covert avoidance strategies and minimization responses to avoid the discomfort, anxiety, or confusion they experience in what others find to be pleasurable and enriching social interactions. The Positive Affect Tolerance and Integration (PAT) Protocol focuses on helping survivors of early emotional neglect to learn to tolerate and assimilate moments of appreciation, praise, and affection. This paper offers principles and a specific series of interventions that incorporate standard EMDR therapy procedures with minor adaptations. In addition to a summary of the PAT protocol, three case studies are described to illustrate selection criteria and potential clinical responses.

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Melegkovits, E., Blumberg, J., Dixon, E., Ehntholt, K., Gillard, J., Kayal, H., Kember, T., Ottisova, L., Walsh, E., Wood, M., Gafoor, R., Brewin, C., Billings, J., Robertson, M., & Bloomfield, M. (2022). The Effectiveness of Trauma-Focused Psychotherapy for Complex Post-Traumatic Stress Disorder: A Retrospective Study. Eur Psychiatry, 1-36. https://doi.org/10.1192/j.eurpsy.2022.2346

Open Access: https://doi.org/10.1192/j.eurpsy.2022.2346


Michael Bloomfield, Division of Psychiatry, University College London, London, UK.
E-mail: m.bloomfield@ucl.ac.uk

Abstract

Objective: We retrospectively evaluated the effectiveness of trauma-focused psychotherapy versus stabilisation and waiting in a civilian cohort of patients with an ICD-11 diagnosis of Complex Post-Traumatic Stress Disorder (CPTSD).
Methods: We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilisation consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual trauma-focused psychotherapy in the form of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), or Eye Movement Desensitisation and Reprocessing (EMDR) or TF-CBT plus
EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 vs phase 1.
Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded.
Results: 59 patients were included. Compared to receiving only phase 1, patients completing trauma-focused psychotherapy showed statistically significant reductions in PTSD [t(58) = -3.99, p < .001], depressive symptoms [t(58) = -4.41, p < .001], functional impairment [t(58)= -2.26, p = .028] and proxy scores for CPTSD [t(58) = 4.69, p < .001] . There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment.
Conclusions: This study suggests that trauma-focused psychotherapy effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.

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Mooren, K., Smit, K., Engels, Y., Janssen, D., & Godschalx, J. (2022). “When I am breathless now, I don’t have the fear that’s linked to it”: a case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD. BMC Pulm Med, 22(1), 456. https://doi.org/10.1186/s12890-022-02250-1

Open Access: https://doi.org/10.1186/s12890-022-02250-1

Kris Mooren, Department of Pulmonology, Spaarne Gasthuis, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands. E-mail: k.mooren@spaarnegasthuis.nl

Abstract

BACKGROUND: Expectations can enhance the intensity and the neural processing of breathlessness. Previous breathlessness episodes may influence the perception of subsequent episodes because of psycho-traumatic consequences. In post-traumatic stress disorder, eye movement desensitization and reprocessing (EMDR) is the therapy of choice.
AIMS AND OBJECTIVES: We explored the hypothesis that EMDR in patients with chronic obstructive pulmonary disease (COPD) and previous severe breathlessness episodes, improves breathlessness mastery by decreasing the anxiety component.
METHODS: As we found no literature on previous research on this subject, we undertook a qualitative case series on four patients with COPD GOLD 4/D and refractory breathlessness who wished to undergo EMDR for psychotraumatic breathlessness episodes. Amongst others, we used the Chronic Respiratory Disease Questionnaire (CRQ) before and after EMDR, and semi-structured, face-to-face, in-depth interviews.
RESULTS: All patients had between three and five EMDR sessions. On CRQ, subset mastery, three patients had a large improvement and one patient a moderate improvement. On subset emotional functioning, three patients showed a large improvement and one showed no change. All patients made a distinction between 'regular' breathlessness and breathlessness intertwined with anxiety. They all stated that the anxiety component of their breathlessness diminished or disappeared. All four would recommend EMDR for other COPD patients.
CONCLUSION: There is ground for a randomized controlled clinical trial to test the effects of EMDR on breathlessness mastery in a subset of COPD patients with previous severe breathlessness episodes and high levels of anxiety.

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Nicolle, M., Perez, M. C., Amalia, O., Martha, G., & Jarero, I. (2022). Multisite Clinical Trial on the ASSYST Individual Treatment Intervention Provided to General Population with Non-Recent Pathogenic Memories. Psychology and Behavioral Science International Journal, 19(5), 1-9. https://doi.org/10.19080/PBSIJ.2022.19.556024

Open Access: https://juniperpublishers.com/pbsij/pdf/PBSIJ.MS.ID.556024.pdf


Ignacio Jarero, Department of Research, Mexican Association for Mental Health Support in Crisis, Mexico City, Mexico.

Abstract

This multisite clinical trial had two objectives: 1) to evaluate the effectiveness, efficacy, and safety of the Acute Stress Syndrome Stabilization Individual (ASSYST-I) treatment intervention in reducing posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in the adult general population with pathogenic memories over three months old, and 2) to explore the correlation coefficient between the PCL-5 total 20 items score and the PCL-5 PTSD Cluster B five intrusion symptoms score with the Anxiety and Depression variables. A total of 43 adults (39 females and 4 males) met the inclusion criteria and participated in the study. Participants’ ages ranged from 20 to 78 years old (M =47.34 years). Repeated-measures ANOVA were carried out to observe the effect of the intervention on the variables across three time points (Time 1 Pre- treatment, Time 2 Post-treatment, and Time 3 Follow-up). Results showed significant effects of the ASSYST-I on PTSD symptoms, (F (2, 84), 76.17, p= .001, η2 =.645, β-1=1); intrusion symptoms (F (2, 84), 27.53, p= .000, η2 =.360, β-1=1); Anxiety, (F (2, 84), 28.99, p= .000, η2 =.500, β-1=1) and Depression, (F (2, 84), 14.71, p= .000, η2 =.239, β-1=.99). A positive relationship on Times 2 and 3 between the PCL-5 intrusion symptoms and the anxiety and depression symptoms was also found. Findings provide evidence of the effectiveness, efficacy, and safety of the ASSYST-I in reducing posttraumatic stress, anxiety, and depression symptoms in the general adult population with non-recent pathogenic memories.

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Nijdam, M. J., Vermetten, E., & McFarlane, A. C. (2022). Toward staging differentiation for posttraumatic stress disorder treatment. Acta Psychiatr Scand. https://doi.org/10.1111/acps.13520

Open Access: https://doi.org/10.1111/acps.13520


Mirjam J. Nijdam, Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden. E-mail: e.vermetten@lumc.nl

Abstract

OBJECTIVES: Several medical and psychiatric disorders have stage-based treatment decision-making methods. However, international treatment guidelines for posttraumatic stress disorder (PTSD) fail to give specific treatment recommendations based on chronicity or stage of the disorder. There is convincing evidence of a finite range of PTSD symptom trajectories, implying that different phenotypes of the disorder can be distinguished, which are highly relevant for a staging typology of PTSD.
METHODS: State-of-the-art review building on prior work on staging models in other disorders as a mapping tool to identify and synthesize toward PTSD.
RESULTS: We propose a four-stage model of PTSD ranging from stage 0: trauma-exposed asymptomatic but at risk to stage 4: severe unremitting illness of increasing chronicity. We favor a symptom description in various chronological characteristics based on neurobiological markers, information processing systems, stress reactivity, and consciousness dimensions. We also advocate for a separate phenomenology of treatment resistance since this can yield treatment recommendations.
CONCLUSION: A staging perspective in the field of PTSD is highly needed. This can facilitate the selection of interventions that are proportionate to patients' current needs and risk of illness progression and can also contribute to an efficient framework to organize biomarker data and guide service delivery. Therefore, we propose that a neurobiologically driven trajectory-based typology of PTSD can help deduct several treatment recommendations leading to a more personalized and refined grid to strategize, plan and evaluate treatment interventions.

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Pink, J., Ghomi, M., Smart, T., & Richardson, T. (2022). Effects of EMDR Group Traumatic Episode Protocol on Burnout Within IAPT HealthCare Professionals: A Feasibility and Acceptability Study. Journal of EMDR Practice and Research, EMDR-2022. https://doi.org/10.1891/emdr-2022-0029

URL: http://dx.doi.org/10.1891/emdr-2022-0029


Jasmin Pink, Devon Partnership NHS Trust, Talkworks, Adult Mental Health, Barnstaple, United Kingdom. E-mail: jasmin.pink@nhs.net

Abstract

Mental health professionals face a high degree of burnout. This study aimed to explore the effectiveness of Eye Movement Desensitisation and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP) at reducing distress and burnout in staff working within an Improving Access to Psychological Therapies (IAPT) service and if outcomes changed over number of sessions attended. Twenty-two staff attended and measures examining burnout, and subjective distress ratings of the targeted memory were taken pre, post and 1 month follow-ups. 95.5% reported finding the sessions helpful. A statistically significant reduction was observed on total burnout, and personal and work-related subscales; and a significant improvement in subjective units of distress. There was no interaction in changes of burnout and number of sessions attended. EMDR G-TEP has the potential to offer a novel method to improve staff wellbeing within mental health settings. Further research is recommended.

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Rew, G., Clark, L., & Rogers, G. (2022). Making Sense of Offence Related Trauma: Exploring Two Patients Lived Experience. Journal of EMDR Practice and Research, EMDR-2022. https://doi.org/10.1891/emdr-2022-0004

URL: http://dx.doi.org/10.1891/emdr-2022-0004


Gemma Rogers, E-mail: gemma.rogers3@nhs.net

Abstract

Offence related trauma refers to a trauma reaction following the perpetration of a violent offence. This research explores the lived experience of offence related trauma, in two forensic patients. The meaning and understanding these individuals make of their own coping strategies, triggers and treatment and how this contributes to their behaviour was explored using a semi-structured interview and analysed using Interpretative Phenomenological Analysis. Two super-ordinate themes emerged from the data: ‘Journey to Forgiveness’ and ‘Living with the Whole Me.’ These themes and their subthemes highlight the nuances of offence related trauma and raise the question of how processes such as complicated grief and associated shame can impact on recovery and rehabilitation. The implications of the findings for professionals providing treatment in forensic settings are considered.

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Sağaltıcı, E., Çetinkaya, M., Kocamer Şahin, Ş., Gülen, B., & Karaman, Ş. (2022). Recent Traumatic Episode Protocol EMDR Applied Online for COVID-19-Related Symptoms of Turkish Health Care Workers Diagnosed with COVID-19-Related PTSD: A Pilot Study. Alpha Psychiatry, 23(3), 121-127. https://doi.org/10.5152/alphapsychiatry.2022.21763

Open Access: https://doi.org/10.5152/alphapsychiatry.2022.21763


Şengül Kocamer Şahin. E-mail: snglkcmr@hotmail.com

Abstract

BACKGROUND: This study investigates the effect of the online Eye Movement Desensitization and Reprocessing Recent Traumatic Episode Protocol on posttraumatic stress disorder, anxiety, depression, and burnout symptoms in healthcare workers diagnosed with pandemic-related post-traumatic stress disorder.
METHODS: The study included healthcare workers who applied to psychiatry outpatient clinics due to the psychiatric symptoms that developed related to the pandemic and who were diagnosed with post-traumatic stress disorder. The Beck Anxiety Inventory, Impact of Event Scale-Revised to evaluate the symptoms of post-traumatic stress disorder (avoidance, intrusion, and hyperarousal), Maslach Burnout Inventory, and Beck Depression Inventory were used for the assessment. The tests were administered 3 times (pre-treatment, post-treatment, and at 1-month follow-up).
RESULTS: This study included 14 healthcare workers diagnosed with post-traumatic stress disorder; 2 (14.3%) physicians, 2 (14.3%) nurses, 4 (28.6%) other-healthcare workers/medical staff, and 6 (42.8%) other healthcare workers/non-medical staff. There was a significant decrease in Impact of Event Scale-Revised total score, the intrusion and hyper-arousal sub-scores between T1 and T2 (P = .018; P = .005; P = .0005, respectively) and between T1 and T3 (P < .001; P < .001; P < .001, respectively), but there was no difference between T2 and T3 (P = .89). A significant difference was found in repeated measurements of both Beck Depression Inventory [P < .001] and Beck Anxiety Inventory [P < .001] scores. There was a significant difference in emotional exhaustion, one of the subscales of Maslach Burnout Inventory (P = .09). However, there was no significant difference in depersonalization (P = .48) and personal accomplishment (P = .66).
CONCLUSIONS: Recent Traumatic Episode Protocol appears to be capable of reducing symptoms of anxiety, depression, intrusion, and hyperarousal symptoms of post-traumatic stress disorder and emotional exhaustion when symptoms that developed are related to the pandemic in healthcare workers.

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Serfioti, D., Murphy, D., Greenberg, N., & Williamson, V. (2022). Effectiveness of treatments for symptoms of post-trauma related guilt, shame and anger in military and civilian populations: a systematic review. BMJ Mil Health. https://militaryhealth.bmj.com/content/early/2022/11/27/military-2022-002155.abstract

URL: https://militaryhealth.bmj.com/content/early/2022/11/27/military-2022-002155.abstract


Dr V Williamson, KCMHR, Institute of Psychiatry Psychology and Neuroscience Department of Basic and Clinical Neuroscience, London SE5 8AF, UK. E-mail: victoria.williamson@kcl.ac.uk

Abstract

Introduction Individuals who have been exposed to a traumatic event can develop profound feelings of guilt, shame and anger. Yet, studies of treatments for post- traumatic stress disorder (PTSD) have largely investigated changes in PTSD symptoms relating to a sense of ongoing fear or threat and the effectiveness of such treatments for post-trauma related guilt, shame or anger symptom reduction is comparatively not well understood. Methods This review systematically examined the effectiveness of existing treatment approaches for three symptoms associated with exposure to traumatic events: guilt, shame and anger. Studies included had to be published after 2010 with a sample size of n=50 or greater to ensure stable treatment outcome estimates.
Results 15 studies were included, consisting of both civilian and (ex-) military population samples exposed to a wide range of traumatic events (eg, combat-related, sexual abuse). Findings indicated a moderate strength of evidence that both cognitive-based and exposure-based treatments are similarly effective in reducing symptoms. Cognitive-based treatments were found to effectively reduce post-trauma related guilt and anger, while exposure-based treatments appeared effective for post- trauma related guilt, shame and anger.
Conclusions The findings suggest the importance of confronting and discussing the traumatic event during therapy, rather than using less directive treatments (eg, supportive counselling).Nonetheless, while these results are promising, firm conclusions regarding the comparative effectiveness and long-term impact of these treatments could not be drawn due to insufficient evidence. Further empirical research is needed to examine populations exposed to traumatic events and investigate which treatment approaches (or combination thereof) are more effective in the long-term.

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Silvestre, M., & Tarquinio, C. L. (2022). Systemic family therapy and EMDR therapy: An integrative approach. European Journal of Trauma & Dissociation, 6(4), 100291. https://doi.org/10.1016/j.ejtd.2022.100291

URL: https://doi.org/10.1016/j.ejtd.2022.100291


Camille Louise Tarquinio. E-mail: camille.tarquinio@univ-lorraine.fr

Abstract

Introduction
The objective of this article is to demonstrate the clinical effectiveness of combining systemic family therapy with EMDR therapy. To do so, we consider how current and past traumatic experiences impact the family system and the interest of taking a broader, integrative approach to treating the child and the family as a whole.
Method
Two case studies are described to illustrate the basis for establishing a two-phase approach to caring for the child and the family.
Result
Taking an integrative clinical approach improves the ability to address the complexities of family trauma and plays a role in enabling the child to construct a congruent narrative allowing for the release of negative emotions connected to a traumatic or stressful event.
Conclusion
The integrative approach of combining systemic family therapy and EMDR therapy allows for a more efficient and comprehensive strategy for addressing trauma and its impact on family dynamics and individual functioning.

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Smart, C. M. (2022). Eye movement desensitization and reprocessing for post-stroke post-traumatic stress disorder: Case report using the three-phase approach. Brain Inj, 36(12-14), 1372-1381. https://doi.org/10.1080/02699052.2022.2140833

URL: https://doi.org/10.1080/02699052.2022.2140833


Colette M. Smart, Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada. E-mail: csmart@uvic.ca

Abstract

Medically-induced post-traumatic stress disorder (PTSD) is substantially more prevalent than PTSD in the general population. In people with stroke, it can impact as many as 23% of patients, with negative effects on mental health as well as stroke-related disability. Medically-induced PTSD may have unique features compared to other forms of PTSD, and therefore there is a pressing need to evaluate existing treatments for PTSD in this context. The current study reports on the feasibility, safety, and efficacy of Eye Movement Desensitization and Reprocessing (EMDR) for PTSD subsequent to a pontine stroke. Using a quasi-experimental case design, a 44-year-old Caucasian woman received EMDR delivered via telehealth. Self-report measures were obtained at baseline, pre-EMDR, and post-EMDR, with brief neuropsychological testing pre/post-EMDR. After 3 sessions of EMDR, the patient no longer met criteria for PTSD, and showed clinically significant reductions in depressive and generalized anxiety symptoms. With proper safety provisions, it is feasible to deliver EMDR via telehealth to alleviate post-stroke PTSD. Reduced linguistic demands of EMDR may be particularly appealing for persons with neurological disorders as compared to other trauma therapies. Further work is also needed to understand the parameters of baseline neuropsychological function that could impact response to intervention.

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Snyder, M., & Trang, D. (2022). Is EMDR effective in treatment of PTSD. Evidence-Based Practice, 25(3), 14-15. https://doi.org/10.1097/ebp.0000000000001258

URL: https://doi.org/10.1097/ebp.0000000000001258

Abstract

In adults with posttraumatic stress disorder (PTSD), eye movement desensitization and reprocessing (EMDR) appears as effective as the standard of care (trauma- based cognitive behavioral therapy [CBT]) in improving PTSD. EMDR may be minimally to moderately superior to CBT in decreasing intrusion, arousal, anxiety, and posttraumatic symptoms of PTSD (SOR: B, meta- analyses of small randomized controlled trials [RCTs]). EMDR is more effective than fluoxetine in achieving long-term PTSD symptom reduction at six months for adult-onset compared with child-onset trauma survivors (SOR: C, small RCT).

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Staton, A., Wilde, S., & Dawson, D. L. (2022). The Effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) for Medically Unexplained Symptoms: A Systematic Literature Review. Journal of EMDR Practice and Research, EMDR-2022. https://doi.org/10.1891/emdr-2022-0017

URL: http://dx.doi.org/10.1891/emdr-2022-0017


Amelia Staton, Trent DClinPsy Programme, Division of Psychiatry & Applied Psychology, University of Nottingham, YANG Fujia Building, B Floor, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK. E-mail: amelia.staton@nottingham.ac.uk

Abstract

Introduction: It has been hypothesised that certain persistent physical symptoms (PPS) may be linked to unresolved traumatic or distressing somatic-symptom related memories. EMDR intervention targets and reintegrates distressing memories, thus reducing the re-experiencing of physical sensations. The primary aim of this review was to examine effectiveness of EMDR for PPS. Secondary aims were to investigate effectiveness of EMDR on secondary outcomes (post-traumatic stress, anxiety, and depression), and to evaluate the acceptability of EMDR for this client group.

Method: Six electronic databases (PsycInfo, PsycArticles, CINAHL, MEDLINE, Web of Science and SCOPUS) were searched for peer-reviewed literature, with no restrictions on publication dates. Twenty-eight studies met inclusion criteria. Studies were included if the primary aim of EMDR intervention was to reduce intensity, frequency or reported distress associated with PPS. Studies were quality appraised using the MMAT tool prior to narrative synthesis of key findings.

Results: Studies varied in design and included RCT, UCT, case study and case series. EMDR treatment length varied between studies; 1–20 sessions. All studies reported significant improvement in PPS at post-test. Effect sizes were available to report in five studies and ranged from moderate to large. Improvement in secondary outcomes were reported in all repeated measure studies. Where available, large effect sizes were reported for reduction in anxiety and depression. Overall drop-out rates in studies with representative samples was low (10.6%). Quality of research varied; low (42.8%), medium (21.4%), and high (35.7%).

Conclusions: There is promising emerging evidence for effectiveness and acceptability of EMDR for a range of PPS. However, firm conclusions on efficacy cannot be made. Whilst comparisons between PPS presentations cannot be drawn due to methodological differences, the findings for pain and tinnitus are the most compelling due to methodological quality. High-quality sufficiently powered RCTs are recommended to determine efficacy.

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Stingl, M., Sammer, G., Hanewald, B., Zinsser, F., Tucha, O., & Pape, V. R. (2022). Constant installation of present orientation and safety (CIPOS) - subjective and physiological effects of an ultrashort-term intervention combining both stabilizing and confrontational elements. Front Psychol, 13, 1035371. https://doi.org/10.3389/fpsyg.2022.1035371

Open Access: https://doi.org/10.3389/fpsyg.2022.1035371


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

Abstract

OBJECTIVES: Constant Installation of Present Orientation and Safety (CIPOS) is a Eye Movements Desensitization and Reprocessing (EMDR)-derived technique, which is often used to prepare for the treatment of post-traumatic stress disorder (PTSD). It differs from the latter by involving cyclically recurring exercises in reorientation to the present, interspersed between brief periods of exposure to the traumatic material. While EMDR is well established as a therapeutic method, the efficacy and mechanisms of action of CIPOS have not been investigated so far. In this pilot study, an experimental setting was used to record the subjective and physiological effects of the CIPOS intervention compared to a control condition with pure mental exposition.
METHODS: The study was performed on 30 healthy volunteers aged from 20 to 30 years. Distress was induced using audio files of subjectively stressful situations. Subjective distress was measured via the Subjective Units of Distress Scale (SUD), while physiological indicators (noise-induced startle reflex, skin conductance level) were used as measures for objective stress. For each condition, pre- and post-intervention comparisons were calculated.
RESULTS: In both groups, startle reflex potentiation and mean skin conductance level significantly decreased. In the group with CIPOS intervention, but not in the control group, a significant decrease in the SUD value was found.
CONCLUSION AND SIGNIFICANCE: The results show that the CIPOS technique is as effective as pure mental exposition in reducing physiological stress. In addition, a superiority in reducing subjective distress (indicating a simplified reassessment of the stressful material) was found compared to pure mental exposition. Possible explanations of these effects are discussed.

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Talbot, J., de la Salle, S., & Jaworska, N. (2022). A Paradigm Shift in Trauma Treatment: Converging Evidence for a Novel Adaptation of Eye Movement Desensitization and Reprocessing (EMDR). Can J Psychiatry, 7067437221142283. https://doi.org/10.1177/07067437221142283

URL: https://doi.org/10.1177/07067437221142283


Jeanne Talbot, MD, PhD, The Royal Ottawa Institute of Mental Health Research, Room 5407, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada. E-mail: jtalbot@uottawa.ca

Abstract

Available treatments for posttraumatic stress disorder (PTSD) result in a significant reduction in symptoms in only 30% of individuals. Residual symptoms frequently persist and relapses occur; this reality has propelled continued research on fear extinction mechanisms, and effective therapies for PTSD. One such advancement has been Eye Movement Desensitization and Reprocessing (EMDR) therapy. Notwithstanding the risks of bias in consensus guidelines and the meta-analyses on which they are based, EMDR is described as equally effective as trauma-focused CBT (TF-CBT) and superior to stress management in the treatment of PTSD in the Canadian Clinical Guidelines put out by the Anxiety Disorders Association of Canada in 2014. Further, EMDR is a first-line recommended treatment, along with TF-CBT, in the National Institute of Care Excellence (NICE) and Australian and New Zealand treatment guidelines. During EMDR, patients are instructed to recall a traumatic memory while simultaneously orienting to alternating bilateral visual stimulation. EMDR appears to interfere with memory reconsolidation after traumatic memory recollection.

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van der Asdonk, S., Kesarlal, A. R., Schuengel, C., Draaisma, N., de Roos, C., Zuidgeest, K., Rippe, R. C. A., & Alink, L. R. A. (2022). Testing an attachment- and trauma-informed intervention approach for parents and young children after interparental violence: protocol for a randomized controlled trial. Trials, 23(1), 973. https://doi.org/10.1186/s13063-022-06902-9

Open Access: https://doi.org/10.1186/s13063-022-06902-9

Sabine van der Asdonk, Institute of Education and Child Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands. E-mail: s.van.der.asdonk@fsw.leidenuniv.nl

Abstract

BACKGROUND: Interparental violence has persistent adverse effects on victimized parents and children. Young children, including infants and toddlers, are at particular risk to develop long-lasting negative outcomes, and yet specific evidence on effective intervention approaches for this vulnerable group is still lacking. This study will test the effectiveness of an attachment- and trauma-informed intervention approach in a sample of parent-child dyads who have experienced severe interparental violence. We test the individual and combined effects of two interventions: (1) (NIKA; Dutch, short-term intervention focused on atypical parenting behavior) aimed at improving the attachment relationship and (2) eye movement desensitization and reprocessing (EMDR) therapy aimed at reducing parental post-traumatic stress disorder (PTSD) symptoms.
METHODS: This study uses a multicenter randomized controlled design across multiple domestic violence shelters in the Netherlands. We aim to recruit 150 parent-child dyads with children aged between 0.5 and 6 years old. The study design consists of two phases. During the first phase for testing the effect of NIKA only, eligible dyads are randomly allocated to either NIKA or a waitlist usual care group. A pre-test is conducted prior to the treatment period and a post-test takes place directly afterwards (6 weeks after the pre-test). Phase 2 follows directly for testing the effects of EMDR and the combination of NIKA and EMDR. Parents who report clinical PTSD symptoms are randomly allocated to either EMDR therapy or a waitlist usual care group. Parents who do not report clinical PTSD symptoms only receive care as usual. Six weeks later, a post-test of phase 2 is conducted for all participating dyads. Primary study outcomes are disrupted parenting behavior, sensitive parenting behavior, and parental PTSD symptoms. Secondary study outcomes include PTSD symptoms and behavioral and emotional problems of the child.
DISCUSSION: This study will inform and enhance the clinical field by providing new insights regarding effective treatment combinations for traumatized parents and their young children after interparental violence. TRIAL REGISTRATION: Netherlands Trial Register (NTR) NL9179 . Registered 7 January 2021.

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van Meggelen, M., Morina, N., van der Heiden, C., Brinkman, W. P., Yocarini, I. E., Tielman, M. L., Rodenburg, J., van Ee, E., van Schie, K., Broekman, M. E., & Franken, I. H. A. (2022). A randomized controlled trial to pilot the efficacy of a computer-based intervention with elements of virtual reality and limited therapist assistance for the treatment of post-traumatic stress disorder. Front Digit Health, 4, 974668. https://doi.org/10.3389/fdgth.2022.974668

Open Access: https://pubmed.ncbi.nlm.nih.gov/36329832

Nexhmedin Morina. E-mail: morina@uni-muenster.de Ingmar H. A. Franken. E-mail: franken@essb.eur.nl

Abstract

Although well-established therapies exist for post-traumatic stress disorder (PTSD), barriers to seek mental health care are high. Technology-based interventions may play a role in improving the reach of efforts to treat, especially when therapist availability is low. The goal of the current randomized controlled trial was to pilot the efficacy of a computer-based trauma intervention with elements of virtual reality (VR; 3MR system) and limited therapist involvement for the treatment of PTSD in a childhood sexual abuse (CSA) and war veteran sample and to compare this to (TAU). TAU consisted of evidence-based approaches such as imaginal exposure, EMDR, or narrative exposure therapy. A total of 44 patients with PTSD were included and randomly assigned to 12 sessions of 3MR intervention or TAU (completer n 3MR = 12, TAU = 18). Several measures (PCL-5, BDI-II, OQ-45-2, and the M.I.N.I. 5.0.0.) were administered to measure symptoms of PTSD and depression and scores of overall well-being at pre, post, and a three-month follow-up measurement. Analyses suggest that symptoms of PTSD and depression in the 3MR condition decreased, and overall well-being increased between pre and post measurements. Results did not indicate any clear differences between the treatment conditions over time which suggests that treatment gains of the 3MR intervention seem no less than those of TAU. Finally, both treatment conditions produced similar remission rates of PTSD and depression. Therefore, the 3MR intervention could possibly constitute an appropriate treatment alternative. The small sample size as well as evident drop-out rates in the 3MR condition (45%) do warrant further research. The procedures of this study were approved by the Medical Ethical Research Committee (MERC) of the Erasmus Medical Center in Rotterdam (MEC-NL46279.078.13) and pre-registered via ClinicalTrials.gov (Protocol Record CI1-12-S028-1).

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Verhagen, I., van der Heijden, R., de Jongh, A., Korzilius, H., Mevissen, L., & Didden, R. (2022). Safety, Feasibility, and Efficacy of EMDR Therapy in Adults with PTSD and Mild Intellectual Disability or Borderline Intellectual Functioning and Mental Health Problems: A Multiple Baseline Study. Journal of Mental Health Research in Intellectual Disabilities, 1-23. https://doi.org/10.1080/19315864.2022.2148791

Open Access: http://dx.doi.org/10.1080/19315864.2022.2148791


Inge Verhagen, Center for Mild Intellectual Disability and
Psychiatry, GGZ Oost Brabant, Postbus 3, Boekel, ZG 5427, the Netherlands.
E-mail: IPC.Verhagen@ggzoostbrabant.nl

Abstract

Background: Little is known about the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for post- traumatic stress disorder (PTSD) symptoms in people with mild intellectual disability or borderline intellectual functioning (MID- BIF).
Aims: To explore the safety, feasibility, and efficacy of EMDR therapy in adults with MID-BIF, PTSD, and comorbid mental health and psycho-social problems.
Methods and procedures: Data were collected from nine participants using a non-concurrent multiple baseline design. PTSD symptoms, level of daily life impairment, and possible adverse effect were measured weekly during baseline, treatment, post- treatment, and at three-month follow-up. Depressive symptoms, general psychopathology, and mental health problems were assessed once in every phase.
Outcomes and results: Participants displayed a significant reduction of PTSD symptoms, and the majority of participants no longer met criteria for DSM-5 PTSD diagnosis after therapy. EMDR therapy appeared to be safe, as no adverse events were reported during the study time frame. Further, participants showed a decrease in depressive symptoms as well as less severe general psychopathology and mental health problems following therapy.
Conclusion: EMDR therapy was found to be safe, feasible, and (potentially) efficacious in decreasing PTSD symptoms, loss of PTSD diagnoses, reduction of level of daily life impairment, and general psychopathology for adults with MID-BIF, suffering from both severe mental health and psycho-social problems.

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Wadji, D. L., Martin-Soelch, C., & Camos, V. (2022). Can working memory account for EMDR efficacy in PTSD. BMC Psychol, 10(1), 245. https://doi.org/10.1186/s40359-022-00951-0

Open Access: https://pubmed.ncbi.nlm.nih.gov/36320044

Dany Laure Wadji, Reach Lab, Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland. E-mail: dany.nkonlack@unifr.ch

Abstract

BACKGROUND: Although eye movement desensitization and reprocessing (EMDR) has been shown to be effective in the treatment of PTSD for years, it remains controversial due to the lack of understanding of its mechanisms of action. We examined whether the working memory (WM) hypothesis -the competition for limited WM resources induced by the dual task attenuates the vividness and emotionality of the traumatic memory - would provide an explanation for the beneficial effect induced by bilateral stimulation.
METHODS: We followed the Prisma guidelines and identified 11 articles categorized in two types of designs: studies involving participants with current PTSD symptoms and participants without PTSD diagnosis.
RESULTS: Regardless of the types of studies, the results showed a reduction of vividness and emotionality in the recall of traumatic stimuli under a dual-task condition compared to a control condition, such as recall alone. However, two studies used a follow-up test to show that this effect does not seem to last long.
CONCLUSION: Our results provide evidence for the WM hypothesis and suggest that recalling a traumatic memory while performing a secondary task would shift the individual's attention away from the retrieval process and result in a reduction in vividness and emotionality, also associated with the reduction of symptoms.

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