---

Aarts, I., Thorsen, A. L., Vriend, C., Planting, C., van den Heuvel, O. A., & Thomaes, K. (2023). Effects of psychotherapy on brain activation during negative emotional processing in patients with posttraumatic stress disorder: a systematic review and meta-analysis. Brain Imaging and Behavior. https://doi.org/10.1007/s11682-023-00831-0

URL: https://doi.org/10.1007/s11682-023-00831-0

Inga Aarts, Sinai Centrum, Arkin, Amstelveen, The Netherlands.
E-mail: inga.aarts@sinaicentrum.nl

Abstract

Post-traumatic stress disorder (PTSD) is a debilitating condition which has been related to problems in emotional regulation, memory and cognitive control. Psychotherapy has a non-response rate of around 50% and understanding the neurobiological working mechanisms might help improve treatment. To integrate findings from multiple smaller studies, we performed the first meta-analysis of changes in brain activation with a specific focus on emotional processing after psychotherapy in PTSD patients. We performed a meta-analysis of brain activation changes after treatment during emotional processing for PTSD with seed-based d mapping using a pre-registered protocol (PROSPERO CRD42020211039). We analyzed twelve studies with 191 PTSD patients after screening 3700 studies. We performed systematic quality assessment both for the therapeutic interventions and neuroimaging methods. Analyses were done in the full sample and in a subset of studies that reported whole-brain results. We found decreased activation after psychotherapy in the left amygdala, (para)hippocampus, medial temporal lobe, inferior frontal gyrus, ventrolateral prefrontal cortex, right pallidum, anterior cingulate cortex, bilateral putamen, and insula. Decreased activation in the left amygdala and left ventrolateral PFC was also found in eight studies that reported whole-brain findings. Results did not survive correction for multiple comparisons. There is tentative support for decreased activation in the fear and cognitive control networks during emotional processing after psychotherapy for PTSD. Future studies would benefit from adopting a larger sample size, using designs that control for confounding variables, and investigating heterogeneity in symptom profiles and treatment response.

---

Alting van Geusau, V. V. P., de Jongh, A., Nuijs, M. D., Brouwers, T. C., Moerbeek, M., & Matthijssen, S. J. M. A. (2023). The effectiveness, efficiency, and acceptability of EMDR vs. EMDR 2.0 vs. the Flash technique in the treatment of patients with PTSD: study protocol for the ENHANCE randomized controlled trial. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1278052

Open Access: https://doi.org/10.3389/fpsyt.2023.1278052


Valentijn V. P. Alting van Geusau E-mail: v.alting-van-geusau@altrecht.nl

Abstract

Background
Several widely studied therapies have proven to be effective in the treatment of post-traumatic stress disorder (PTSD). However, there is still room for improvement because not all patients benefit from trauma-focused treatments. Improvements in the treatment of PTSD can be achieved by investigating ways to enhance existing therapies, such as eye movement desensitization and reprocessing (EMDR) therapy, as well as exploring novel treatments. The purpose of the current study is to determine the differential effectiveness, efficiency, and acceptability of EMDR therapy, an adaptation of EMDR therapy, referred to as EMDR 2.0, and a novel intervention for PTSD, the so-called Flash technique. The second aim is to identify the moderators of effectiveness for these interventions. This study will be conducted among individuals diagnosed with PTSD using a randomized controlled trial design.

Methods
A total of 130 patients diagnosed with (complex) PTSD will be randomly allocated to either six sessions of EMDR therapy, EMDR 2.0, or the Flash technique. The primary outcomes used to determine treatment effectiveness include the presence of a PTSD diagnosis and the severity of PTSD symptoms. The secondary outcomes of effectiveness include symptoms of depression, symptoms of dissociation, general psychiatric symptoms, and experiential avoidance. All patients will be assessed at baseline, at 4-week post-treatment, and at 12-week follow-up. Questionnaires indexing symptoms of PTSD, depression, general psychopathology, and experiential avoidance will also be assessed weekly during treatment and bi-weekly after treatment, until the 12-week follow-up. Efficiency will be assessed by investigating the time it takes both to lose the diagnostic status of PTSD, and to achieve reliable change in PTSD symptoms. Treatment acceptability will be assessed after the first treatment session and after treatment termination.

Discussion
This study is the first to investigate EMDR 2.0 therapy and the Flash technique in a sample of participants officially diagnosed with PTSD using a randomized controlled trial design. This study is expected to improve the available treatment options for PTSD and provide therapists with alternative ways to choose a therapy beyond its effectiveness by considering moderators, efficiency, and acceptability.
Trial registration
The trial was retrospectively registered in the ISRCTN registry at 10th November 2022 under registration number ISRCTN13100019.

---

Bashir, H. A., Wilson, J. F., Ford, J. A., & Hira, N. (2023). Treatment of PTSD and SUD for the incarcerated population with EMDR: A pilot study. Journal of Addictions & Offender Counseling, 44(2), 132-144. https://doi.org/10.1002/jaoc.12123

Open Access: https://doi.org/10.1002/jaoc.12123

Huma A Bashir, School of Social Work and Human Services, Wright State University, Dayton, OH, USA. E-mail: huma.bashir@wright.edu

Abstract

Adverse childhood experiences predict recidivism. In incarcerated individuals, post‐traumatic stress disorder (PTSD) rates are higher. A study with 122 inmates with PTSD and substance use disorder explored eye movement desensitization and reprocessing (EMDR)’s effectiveness. EMDR worked across gender and race, reducing PCL‐C scores posttreatment and at 2 and 4 weeks. IER‐R scores lowered from weeks 1 to 9. EMDR boosted affect, reasoning, and attitudes posttreatment.

---

Bates, A., Golding, H., Rushbrook, S., Shapiro, E., Pattison, N., Baldwin, D. S., Grocott, M. P. W., & Cusack, R. (2023). A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19. Journal of the Intensive Care Society, 24(3), 309-319. https://doi.org/10.1177/17511437221136828

Open Access: https://doi.org/10.1177/17511437221136828

Andrew Bates, NIHR Southampton Biomedical Research Centre, University Hospitals Southampton National Health Service Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK. E-mail: a.bates@soton.ac.uk

Abstract

Background: Approximately 50% of intensive care survivors experience persistent psychological symptoms. Eye-movement desensitisation and reprocessing (EMDR) is a widely recommended trauma-focussed psychological therapy, which has not been investigated systematically in a cohort of intensive care survivors: We therefore conducted a randomised pilot feasibility study of EMDR, using the Recent Traumatic Episode Protocol (R-TEP), to prevent psychological distress in intensive care survivors. Findings will determine whether it would be possible to conduct a fully-powered clinical effectiveness trial and inform trial design.
Method: We aimed to recruit 26 patients who had been admitted to intensive care for over 24h with COVID-19 infection. Consenting participants were randomised (1:1) to receive either usual care plus remotely delivered EMDR R-TEP or usual care alone (controls). The primary outcome was feasibility. We also report factors related to safety and symptom changes in post-traumatic stress disorder, (PTSD) anxiety and depression.
Results: We approached 51 eligible patients, with 26 (51%) providing consent. Intervention adherence (sessions offered/ sessions completed) was 83%, and 23/26 participants completed all study procedures. There were no attributable adverse events. Between baseline and 6-month follow-up, mean change in PTSD score was −8 (SD=10.5) in the intervention group versus +0.75 (SD=15.2) in controls (p=0.126). There were no significant changes to anxiety or depression. Conclusion: Remotely delivered EMDR R-TEP met pre-determined feasibility and safety objectives. Whilst we achieved group separation in PTSD symptom change, we have identified a number of protocol refinements that would improve the design of a fully powered, multi-centre randomised controlled trial, consistent with currently recommended rehabilitation clinical pathways.
Trial registration: ClinicalTrials.gov: NCT04455360.

---

Begum, M. (2023). EMDR Therapy in Specific Phobia of Vomiting (SPOV). Journal of EMDR Practice and Research, 17(4), 239-249. https://doi.org/10.1891/emdr-2023-0010

URL: https://doi.org/10.1891/emdr-2023-0010

Millia Begum, Consultant Psychiatrist (NHS & Private), EMDR Europe Accredited Consultant Royal College of Psychiatrists; General Medical Council EMDR Association, Glasgow, UK. Email: millia.begum@gmail.com

Abstract

Specific phobia of vomiting (SPOV), commonly known as emetophobia, is a subtype of “Specific Phobia” (other type) in the DSM-5(American Psychiatric Association, 2013). Individuals with this condition have a persistent and disproportionate fear of vomiting that runs a chronic course limiting their social, occupational, and leisure-based functioning. There are several case reports of SPOV demonstrating positive therapeutic outcomes and a single randomized controlled trial (RCT) demonstrating the efficacy of cognitive behavioral therapy (CBT) incorporating exposure work and imagery rescripting. However, a large internet survey also suggests that most SPOV individuals would not try exposure treatments. This article provides the readers with an overview of SPOV followed by the application of the standard eye movement desensitization and reprocessing (EMDR) protocol supplemented with the flash-forward technique as a treatment for SPOV using a single-case example. Client outcomes were monitored for 20 months with a self-rating tool, the SPOV inventory, and associated comorbidity assessed using a patient health questionnaire (PHQ-9) and generalized anxiety disorder rating scales.

---

Billings, J., Zhan Yuen Wong, N., Nicholls, H., Burton, P., Zosmer, M., Albert, I., Grey, N., El-Leithy, S., Murphy, D., Tehrani, N., Wheatley, J., Bloomfield, M. A. P., & Greene, T. (2023). Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2281751

Open Access: https://doi.org/10.1080/20008066.2023.2281751

Jo Billings, Division of Psychiatry, University College London, Wing A, 6th Floor, Maple House, 149 Tottenham Court Billings Road, London, UK. E-mail: j.billings@ucl.ac.uk

Abstract

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.
Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence- base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.
Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.
Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers. Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

---

Bizouerne, C., Dozio, E., Dlasso, E., Letzelter, A., Abuzeid, A., Le Roch, K., & Farrell, D. (2023). Randomized controlled trial: Comparing the effectiveness of brief group cognitive behavioural therapy and group eye movement desensitisation and reprocessing interventions for PTSD in internally displaced persons, administered by paraprofessionals in Northern Iraq. European Journal of Trauma & Dissociation, 7(4), 100362. https://doi.org/10.1016/j.ejtd.2023.100362

URL: http://dx.doi.org/10.1016/j.ejtd.2023.100362

Cécile Bizouerne, 14 rue Villiers de l‘Isle Adam, 75020, Paris, France. E-mail: cecilebizouerne@hotmail.com

Abstract

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.
Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence- base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.
Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.
Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers. Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

---

Bonano-Broussard, D., Simmons, R., & Ager, R. (2023). The effects of trauma-informed yoga as an enhancement to the practice of EMDR for posttraumatic stress disorder: an exploratory pilot study. Social Work in Mental Health, 21(6), 656-675. https://doi.org/10.1080/15332985.2023.2201366

URL: https://doi.org/10.1080/15332985.2023.2201366

Deslie Bonano-Broussard, School of Social Work, Tulane University, New Orleans, LA, USA. E-mail: dbonanobroussard@tulane.edu

Abstract

This novel pilot study assesses if Trauma-Informed Yoga (TIY) provides a platform for promoting the preparatory and regulatory skills necessary for EMDR when treating PTSD. Nine clients completed two EMDR sessions per week for three weeks. One EMDR session was preceded by TIY. Surveys and exit interviews were administered to therapists and clients following each EMDR session. We found that practicing TIY prior to EMDR encouraged interoception, mind-body connectedness, tolerance, and relaxation, thus suggesting it is beneficial to EMDR.

---

Bremer, S., van Vliet, N. I., Van Bronswijk, S., Huntjens, R., de Jongh, A., & van Dijk, M. K. (2023). Predicting optimal treatment outcomes in phase‐based treatment and direct trauma‐focused treatment among patients with posttraumatic stress disorder stemming from childhood abuse. Journal of Traumatic Stress, 36(6), 1044-1055. https://doi.org/10.1002/jts.22980

URL: https://doi.org/10.1002/jts.22980

Noortje I. van Vliet, Dimence Mental Health Group, Pikeursbaan 3, 7411GT Deventer, the Netherlands. E-mail: n.vanvliet@dimence.nl

Abstract

Research over the last few decades has demonstrated the effectiveness of various treatments for posttraumatic stress disorder (PTSD). However, the question of which treatment works best remains, especially for patients with PTSD stemming from childhood abuse. Using the Personalized Advantage Index (PAI), we explored which patients benefit more from phase-based treatment and which benefit more from direct trauma-focused treatment. Data were obtained from a multicenter randomized controlled trial (RCT) comparing a phase-based treatment condition (i.e., eye-movement desensitization and reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) and a direct trauma-focused treatment (EMDR only; n = 64) among individuals with PTSD related to childhood abuse. Machine learning techniques were used to examine all pretreatment variables included in the trial as potential predictors and moderators, with selected variables combined to build the PAI model. The utility of the PAI was tested by comparing actual posttreatment outcomes of individuals who received PAI-indicated treatment with those allocated to a non–PAI-indicated treatment. Although eight pretreatment variables between PTSD treatment outcome and treatment condition were selected as moderators, there was no significant difference between participants assigned to their PAI-indicated treatment and those randomized to a non–PAI-indicated treatment, d = 0.25, p = .213. Hence, the results of this study do not support the need for personalized medicine for patients with PTSD and a history of childhood abuse. Further research with larger sample sizes and external validation is warranted.

---

Colbert, S. (2023). The Impact On Eye Movement And Desensitization Reprocessing Of Incomplete Memory In A Drug-Facilitated Rape: A Single Case Study. Journal of Trauma & Dissociation, 1-14. https://doi.org/10.1080/15299732.2023.2289193

URL: http://dx.doi.org/10.1080/15299732.2023.2289193


Susannah Colbert, Speedwell, South London and Maudsley Mental Health NHS Trust, London, UK of Great Britain and Northern Ireland; Salomons Institute for Applied Psychology, Tunbridge Wells, Kent, UK of Great Britain and Northern Ireland. E-mail: susannah.colbert@canterbury.ac.uk

Abstract

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

---

Dekel S, Papadakis JE, Quagliarini B, Jagodnik KM, Nandru R. A Systematic Review of Interventions for Prevention and Treatment of Post-Traumatic Stress Disorder Following Childbirth. medRxiv [Preprint]. 2023 Aug 23:2023.08.17.23294230. doi: 10.1101/2023.08.17.23294230. PMID: 37693410; PMCID: PMC10485880.

Open Access: http://dx.doi.org/10.1101/2023.08.17.23294230


Sharon Dekel, Ph.D., Department of Psychiatry, Harvard Medical School & Massachusetts General Hospital, Boston, USA, E-mail: sdekel@mgh.harvard.edu

Abstract

Objective:
Postpartum women can develop post-traumatic stress disorder (PTSD) in response to complicated, traumatic childbirth; prevalence of these events remains high in the U.S. Currently, there is no recommended treatment approach in routine peripartum care for preventing maternal childbirth-related PTSD (CB-PTSD) and lessening its severity. Here, we provide a systematic review of available clinical trials testing interventions for the prevention and indication of CB-PTSD.

Data Sources:
We conducted a systematic review of PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, and Scopus through December 2022 to identify clinical trials involving CB-PTSD prevention and treatment.

Study Eligibility Criteria:
Trials were included if they were interventional, evaluated CB-PTSD preventive strategies or treatments, and reported outcomes assessing CB-PTSD symptoms. Duplicate studies, case reports, protocols, active clinical trials, and studies of CB-PTSD following stillbirth were excluded.

Study Appraisal and Synthesis Methods:
Two independent coders evaluated trials using a modified Downs and Black methodological quality assessment checklist. Sample characteristics and related intervention information were extracted via an Excel-based form.

Results:
A total of 33 studies, including 25 randomized controlled trials (RCTs) and 8 non-RCTs, were included. Trial quality ranged from Poor to Excellent. Trials tested psychological therapies most often delivered as secondary prevention against CB-PTSD onset (n=21); some examined primary (n=3) and tertiary (n=9) therapies. Positive treatment effects were found for early interventions employing conventional trauma-focused therapies, psychological counseling, and mother-infant dyadic focused strategies. Therapies’ utility to aid women with severe acute traumatic stress symptoms or reduce incidence of CB-PTSD diagnosis is unclear, as is whether they are effective as tertiary intervention. Educational birth plan-focused interventions during pregnancy may improve maternal health outcomes, but studies remain scarce.

Conclusions:
An array of early psychological therapies delivered in response to traumatic childbirth, rather than universally, in the first postpartum days and weeks, may potentially buffer CB-PTSD development. Rather than one treatment being suitable for all, effective therapy should consider individual-specific factors. As additional RCTs generate critical information and guide recommendations for first-line preventive treatments for CB-PTSD, the psychiatric consequences associated with traumatic childbirth could be lessened.

---

Dowllah IM, Melville C. Effectiveness of psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in low- and middle-income countries: A systematic review and meta-analysis. Journal of Health Psychology. 2023;0(0). doi:10.1177/13591053231199254

URL: https://journals.sagepub.com/doi/10.1177/13591053231199254

Istiaque Mahmud Dowllah, University of Glasgow, 59A Townsend Lane, Anfield, Liverpool L6 0AX, UK. E-mail: saaddowllah@gmail.com

Abstract

Refugees and asylum seekers are more prone to posttraumatic stress disorder (PTSD) than the general population. This systematic review aims to determine which psychosocial interventions effectively treat PTSD among refugees and asylum seekers in low- and middle-income countries (LMIC). Relevant papers were retrieved from the bibliographic databases. PTSD symptoms post-intervention was the primary outcome. Ten studies were selected with 1981 participants. In meta-analyses of Randomised control trials (RCTs), psychosocial interventions for PTSD (SMD −0.60, 95% CI −0.96 to −0.23; I2 = 91%; 95% CI 75–100; nine studies, 1789 participants) were shown to be clinically effective. Also, in case of depression (SMD −0.59, 95% CI −0.95 to −0.22; I2=84%; 95% CI 50–90; seven studies, 1248 participants). Eye Movement Desensitization and Reprocessing (EMDR) had the greatest effect size among psychosocial therapies for this demographic. However, the number of studies is small, and their methodological rigour is limited, thus future study should concentrate on performing more rigorous trials.

---

Eapen, N. A. (2023). Brain-Based Changes and Therapeutic Effectiveness of the Eye Movement Desensitisation and Reprocessing Approach: A Mini Review. The International Journal of Indian Psychology, 11(3). https://doi.org/10.25215/1103.126

Open Access: https://ijip.in/articles/brain-based-changes-and-therapeutic-effectiveness-of-the-eye-movement-desensitisation-and-reprocessing-approach-a-mini-review/


Nitya Ann Eapen. E-mail: nitya.eapen@psy.christuniversity.in

Abstract

The Eye Movement Desensitisation and Reprocessing or the EMDR approach, developed by F. Shapiro has been considered one of the most effective treatment options for PTSD. This mini review conceptualises the theoretical underpinnings of the effectiveness of EMDR with respect to PTSD as well for Substance Use Disorders (SUD), while looking into the neural correlates of the both these conditions. The Adaptive Information Processing (AIP) theory proposed by Shapiro herself views pathology as a product of maladaptive processing of information leading to its storage in a maladaptive form, which manifests outwardly as reliving a traumatic experience. Another theory that explains process of EMDR is the REM hypothesis, which posits that the bilateral stimulation arising out of the eye movements triggers the process of memory consolidation that is very much similar to the memory consolidation that occurs during REM sleep. Additionally, there is evidence showing promising findings for EMDR as a approach to treat SUDs. However, EMDR as a therapeutic approach works most efficiently when there are underlying traumatic reasons, such as intrusive memories, for the substance use.

---

Every-Palmer, S., Flewett, T., Dean, S., Hansby, O., Freeland, A., Weatherall, M., & Bell, E. (2023). Eye movement Desensitization and Re-processing (EMDR) Therapy Compared to Usual Treatment for Post-Traumatic Stress Disorder in Adults with Psychosis in Forensic Settings: Randomized Controlled Trial (PREPRINT). https://doi.org/10.31234/osf.io/rdm53

Open Access: https://doi.org/10.31234/osf.io/rdm53

Susanna Every-Palmer, Department of Psychological Medicine, University of Otago, Wellington, New Zealand. E-mail: susanna.every-palmer@otago.ac.nz

Abstract

Objective: Little direct evidence supports any particular treatment for post-traumatic stress disorder (PTSD) in people with schizophrenia, forensic histories, and/or multiple comorbidities. This trial assesses the efficacy and risks of Eye Movement Desensitization and Reprocessing (EMDR) for people with PTSD and psychotic disorders receiving forensic care, including inpatients and prisoners.
Method: Single-blind randomized controlled trial comparing EMDR therapy to wait-list (routine care) in forensic-treated adults with psychotic disorders and PTSD. The primary outcome was clinician-rated PTSD symptoms. Secondary outcomes included participant-rated PTSD symptoms, psychotic symptoms, social functioning, disability level, self-esteem, depressive symptoms, post-trauma cognitions, complex post-traumatic difficulties, and adverse events. Blinded investigators assessed outcomes at baseline, and after 10 weeks and 6 months. Analysis of the primary outcome was by a mixed linear model. Twenty-four participants were randomized, recruitment being hindered by COVID-19 restrictions.
Results: Clinician-Administered PTSD Scale mean (SD) scores after 6 months were lower (better) in the EMDR group, 21.3 (13.3), compared with the control group, 31.5 (20.7). The point estimate (95% CI) difference, averaged over two measurement times, was 11.4 (1.3–21.4), P=0.028, favoring EMDR. Self-esteem increased in the EMDR group and depressive symptoms and disability reduced. There were no statistically significant differences in psychotic symptoms or adverse events, although point estimates favored EMDR.
Conclusions: This is the first EMDR trial in mental health inpatient, forensic, or custodial settings, where PTSD is common. There were improvements in PTSD and other symptomatology consistent with EMDR being a safe and effective treatment for PTSD in these settings.

---

Every-Palmer, S., Ross, B., Flewett, T., Rutledge, E., Hansby, O., & Bell, E. (2023). Eye movement desensitisation and reprocessing (EMDR) therapy in prison and forensic services: a qualitative study of lived experience. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2282029

Open Access: https://doi.org/10.1080/20008066.2023.2282029

Susanna Every-Palmera Department of Psychological Medicine, University of Otago, Wellington, New Zealand. E-mail: susanna.every-palmer@otago.ac.nz

Abstract

Background: Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives.
Objective: This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care.
Method: Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants.
Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis (‘giving the voices something to feed on’). Second, EMDR was regarded with Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future.
Conclusions: The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy.
Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235.
Study registration: The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682

---

Fiani, F., Russo, S., & Napoli, C. (2023). An Advanced Solution Based on Machine Learning for Remote EMDR Therapy. Technologies, 11(6), 172. https://doi.org/10.3390/technologies11060172

Open Access: https://doi.org/10.3390/technologies11060172

Christian Napoli, Department of Computer, Control and Management Engineering, Sapienza University of Rome, 00185 Roma, Italy. E-mail: fiani@diag.uniroma1.it

Abstract

For this work, a preliminary study proposed virtual interfaces for remote psychotherapy and psychology practices. This study aimed to verify the efficacy of such approaches in obtaining results comparable to in-presence psychotherapy, when the therapist is physically present in the room. In particular, we implemented several joint machine-learning techniques for distance detection, camera calibration and eye tracking, assembled to create a full virtual environment for the execution of a psychological protocol for a self-induced mindfulness meditative state. Notably, such a protocol is also applicable for the desensitization phase of EMDR therapy. This preliminary study has proven that, compared to a simple control task, such as filling in a questionnaire, the application of the mindfulness protocol in a fully virtual setting greatly improves concentration and lowers stress for the subjects it has been tested on, therefore proving the efficacy of a remote approach when compared to an in-presence one. This opens up the possibility of deepening the study, to create a fully working interface which will be applicable in various on-field applications of psychotherapy where the presence of the therapist cannot be always guaranteed.

---

Firat, S., Specialist, C. A. A. P., Medicalpark Samsun Hospital, Atik, S., Herguner, S., Specialist, P., Private Clinic Doktor, & Associate Professor, C. A. A. P., Private Clinic Doktor. (2023). Autism spectrum disorder and specific phobia. Treatment with Eye Movement Desensitization and Reprocessing: report of two cases. Psychiatria Danubina, 35(3), 440-444. https://doi.org/10.24869/psyd.2023.440

Open Access: https://doi.org/10.24869/psyd.2023.440

Sumeyra Firat, Specialist, Child and Adolescent Psychiatrist, Medicalpark Samsun Hospital, Samsun Turkey. E-mail: drsumeyrafirat@gmail.com

Abstract

Autism spectrum disorder (ASD) is characterized by deficits in social functioning and the presence of restricted interests and repetitive behaviors (American Psychiatric Association 2013). One of the most common psychiatric comorbidities of ASD is anxiety disorder; one study has found that 40% of children with ASD also present with specific phobias (SP) (Mayes et al. 2013).

The purpose of the present case report is to explore the viability and effectiveness of EMDR as a treatment for two cases of patients with ASD and specific phobias. EMDR may be an appropriate therapy for patients with ASD as this treatment is largely non-verbal and can be adjusted for specific conditions, such as age and autism.

---

Gahnfelt, H., Carlsson, P. F. G., & Blomdahl, C. (2023). Is it safe enough? A pilot feasibility study of an 8-day intensive treatment for severe PTSD. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1200411

Open Access: http://dx.doi.org/10.3389/fpsyt.2023.1200411


Hannes Gahnfelt, Department of Research, Education and Innovation, Södra Älvsborg Hospital, Region Västra Götaland, Borås, Sweden. E-mail: hannes.gahnfelt@vgregion.se

Abstract

Intensive treatments for posttraumatic stress disorder (PTSD) are gaining increased research support. Treatment models targeting Complex PTSD and previously treatment-resistant PTSD have shown a good effect. A pilot study was performed to assess the feasibility of an 8-day intensive treatment program for severe PTSD in a Swedish public healthcare setting. Eleven participants completed treatment, and overall, the reduction in PTSD symptoms was considerable. Also, loss of diagnosis at 3-month follow-up was 100%. No adverse events occurred, and no elevation of suicidal intentions was reported. Symptom exacerbation could not be observed in the data and dropout due to the intensity of the treatment format did not occur. Based on these positive results, it is recommended that further research with larger samples is conducted. If found safe and effective, the 8-day treatment program could be an important addition to psychiatric healthcare.

---

Gielkens, E. M. J., Rossi, G., van Alphen, S. P. J., & Sobczak, S. (2023). A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder. Journal of Geriatric Psychiatry and Neurology. https://doi.org/10.1177/08919887231207639

URL: http://dx.doi.org/10.1177/08919887231207639

Ellen M. J. Gielkens, Department Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan Mental Health Center, Kloosterkensweg 10, Heerlen 6419 PJ, the Netherlands. E-mail: e.gielkens@mondriaan.eu

Abstract

Objectives: In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events).
Design: Multicenter design with pre-post measurements. Setting Psychiatric Dutch hospitals Mondriaan Mental Health Center and Altrecht.
Participants: 22 treatment-seeking PTSD-outpatients (60-84 years). Intervention Weekly one-hour EMDR session during 3, 6, or 9 months.
Measurements: PTSD was assessed with Clinician-Administered PTSD-scale for DSM-5 (CAPS-5). Verbal learning memory was measured with Auditory Verbal Learning Test (RAVLT), interference with Stroop Colour-Word Test (SCWT) and working memory with Wechsler Adult Intelligence Scale-Digit Span (WAIS-IV-DS).
Results: A Linear mixed-model showed significant improvement on RAVLT immediate-recall (F (1, 21) = 15.928, P = .001, 95% CI -6.98-2.20), delayed-recall (F (1, 21) = 7.095, P = .015, 95% CI -2.43-.30), recognition (F (21) = 8.885, P = .007, 95% CI -1.70– -.30), and SCWT (F (1 ,21) = 5.504, P = .029, 95% CI 4.38-72.78) but not on WAIS-IV-DS (F (20) = -1.237, P = .230, 95% CI -3.07-.78). There was no significant influence of therapy duration and CAPS-5 pre-treatment scores. There were small-medium nonsignificant correlations between CAPS-5 and cognitive performance pre-post differences, and between most cognitive measures and sleep problems, depressive disorder, and physical inactivity.
Conclusions: Cognitive functioning on memory and attention possible increased in older adults with PTSD after EMDR treatment. Further research is needed with a larger sample and a control condition to corroborate these findings and to identify the possible mediating role of modifiable risk factors.

---

Hammond, M., Ryan, C., & Dwyer, A. (2023). Clients’ Experiences of Eye Movement Desensitization and Reprocessing Therapy. Journal of EMDR Practice and Research, 17(4), 250-264. https://doi.org/10.1891/emdr-2023-0018

URL: https://doi.org/10.1891/emdr-2023-0018

Dr. Michaela Hammond, School of Applied Psychology, University College Cork, Cork, Ireland. Email: 119224823@umail.ucc.ie

Abstract

This study aimed to explore clients’ unique phenomenological experiences of eye movement desensitization and reprocessing (EMDR) and their meaning-making regarding this therapeutic approach within the context of an adult mental health service in Ireland. Interpretative phenomenological analysis was employed to collect and analyze data from six interviews with individuals who had completed an EMDR intervention. Three Group Experiential Themes were identified: “Trapped in trauma—self-disorganization,” “Being ‘in’ the process of processing,” and “Moving on—adaptive resolution of trauma.” The study provides an in-depth insight into clients’ experiences of EMDR in terms of the many processes and outcomes, and clinical implications are discussed.

---

Hardy, A., Keen, N., van den Berg, D., Varese, F., Longden, E., Ward, T., & Brand, R. M. (2023). Trauma therapies for psychosis: A state‐of‐the‐art review. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12499

Open Access: http://dx.doi.org/10.1111/papt.12499


Amy Hardy, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, de Crespigny Park, London SE5 8AF, UK.
E-mail: amy.hardy@kcl.ac.uk

Abstract

Background: Traumatic events, particularly childhood interpersonal victimisation, have been found to play a causal role in the occurrence of psychosis and shape the phenomenology of psychotic experiences. Higher rates of post‐traumatic stress disorder (PTSD) and other trauma‐related mental health problems are also found in people with psychosis diagnoses compared to the general population. It is, therefore, imperative that therapists are willing and able to address trauma and its consequences when supporting recovery from distressing psychosis.
Method: This paper will support this need by providing a state‐of‐the‐art overview of the safety, acceptability and effects of trauma therapies for psychosis.
Results: We will first introduce how seminal cognitive‐behavioural models of psychosis shed light on the mechanisms by which trauma may give rise to psychotic experiences, including a putative role for trauma‐related emotions, beliefs and episodic memories. The initial application of prolonged exposure and eye movement and desensitation and reprocessing therapy (EMDR) for treating PTSD in psychosis will be described, followed by consideration of integrative approaches. These integrative approaches aim to address the impact of trauma on both post‐traumatic stress symptoms and trauma‐related psychosis. Integrative approaches include EMDR for psychosis (EMDRp) and trauma‐focused Cognitive‐Behavioural Therapy for psychosis (tf‐CBTp). Finally, emerging dialogic approaches for targeting trauma‐related voice‐hearing will be considered, demonstrating the potential value of adopting co‐produced (Talking with Voices) and digitally augmented (AVATAR) therapies.
Conclusion: We will conclude by reflecting on current issues in the area, and implications for research and clinical practice.

---

Hayward, D., Richardson, T., Beattie, D., & Bayliss, P. (2023). Comparing the Predictors of Disengagement for Trauma Therapy (TF-CBT and EMDR) in an Adult Mental Health Service. Journal of EMDR Practice and Research, 17(4), 216-227. https://doi.org/10.1891/emdr-2023-0004

URL: https://doi.org/10.1891/emdr-2023-0004

David Hayward, School of Psychology, University of Southampton Faculty of Environmental and Life Sciences, Highfield Campus, University Road, Southampton, Hampshire, SO17 1BJ, UK. Email: dh2n21@soton.ac.uk

Abstract

In this retrospective service evaluation, the predictors of disengagement from trauma therapy are investigated, as previous research suggests that disengagement rates may be higher than other therapies. Clients on the posttraumatic stress disorder treatment pathway received either eye movement desensitization and reprocessing (EMDR) or trauma-focused cognitive behavioral therapy (TF-CBT). Preexisting data from 105 cases at a National Health Service Adult Community Mental Health Team were collected, and disengagement rates were compared based on demographic therapy and Health of the Nation Outcome Scales scores to investigate the impact they have on disengagement rates. Results found a different proportion of those receiving EMDR disengaged (62.8%) than those who received TF-CBT (55.3%), though this difference was nonsignificant. There was a significant association between disengagement rates and depressed mood (77.8% in moderate to severe group vs 51.2% in no to mild group). There was also a significant association between disengagement rates and living conditions (84.0% in minor to severe group vs 53.7% in no problem group). No significant associations were found between disengagement and demographic variables (age, gender, and ethnicity) or time spent waiting for intervention. The implications of these findings and practice recommendations are discussed.

---

Hogg, B., Radua, J., Gardoki-Souto, I., Fontana-McNally, M., Lupo, W., Reinares, M., Jiménez, E., Madre, M., Blanco-Presas, L., Cortizo, R., Massó-Rodriguez, A., Castaño, J., Argila, I., Castro-Rodriguez, J. I., Comes, M., Macias, C., Sánchez-González, R., Mur-Mila, E., Novo, P., . . . Amann, B. L. (2023). EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial. Spanish Journal of Psychiatry and Mental Health. https://doi.org/10.1016/j.sjpmh.2023.11.005

URL: https://doi.org/10.1016/j.sjpmh.2023.11.005


A. Valiente-Gómez, Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain. E-mail: avalientego@gmail.com

Abstract

Introduction: Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates.
Materials and methods: This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines.

---

Hoppen, T. H., Meiser-Stedman, R., Kip, A., Birkeland, M. S., & Morina, N. (2023). The short-, mid-, and long-term efficacy of psychological interventions for adult PTSD following exposure to single vs. multiple traumatic events: A meta-analysis of randomised controlled trials. The Lancet Psychiatry.

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

Abstract

Background:
Previous meta-analyses of psychological interventions for adult PTSD did not investigate whether efficacy is diminished in individuals with PTSD related to multiple (vs. single) traumatic events. The present work aimed to close this gap.
Methods:
A pre-registered meta-analysis (CRD42023407754) was conducted. PsycINFO, MEDLINE, Web of Science, and PTSDpubs were searched from inception to April 18 2023. Randomised controlled trials (RCTs) involving adult clinical samples (≥70% meeting full PTSD criteria) with adequate size (N≥20) were included. We extracted data on trial characteristics, demographics, and outcome data. Random effects meta-analyses were run to summarize standardized mean differences (Hedges’ g). Trials involving 0% vs. ≥50% participants with multiple-event-related PTSD (i.e., tied to ≥2 traumatic events)
were categorized as single vs. multiple trauma trials, respectively. Quality of evidence was assessed using the Cochrane criteria.
Findings:
Overall, 137 RCTs (Nbaseline=10 692, Nposttreatment data=9477) were included in quantitative synthesis. Of those randomised, 5772 participants identified as female (54%), 4917 as male (46%), and 3 as transgender or other (0%). Thirty-four trials (25%) exclusively involved women, 15 trials exclusively men (11%) and the remaining mixed samples. Mean age across trials was 40·2 (SD=9·0) ranging from 18·0 to 65·4. Approximately a fifth of the accumulated evidence involved non-Western samples (k=23, 17%). Data on ethnicity were not extracted. At treatment endpoint, psychological interventions were highly effective for PTSD when compared to passive control conditions in both samples with single-event-related PTSD (Hedges’ g 0·92 [95% CI 0·60–1·25]; k=11; I²=62%) and multiple-event-related PTSD (Hedges’ g 1·13 [95% CI 0·90–1·35]; k=55, I²=87%), with no efficacy difference between these categories (p=0·48). Heterogeneity between studies was substantial and outlier-corrected analysis yielded similar results. Moderate-sized effects were found compared to active control conditions with, again, no significant difference between single and multiple trauma trials. Results were robust in various sensitivity analyses (e.g., 90% cut-off for multiple trauma trials) and analyses of follow-up data. The quality of evidence was moderate to high.
Interpretation:
Contrary to our hypothesis, we found strong evidence that psychological interventions
are highly effective treatments for PTSD in patients with a history of multiple traumatic
events. Results are encouraging for clinical practice and may counteract common misconceptions regarding treatment and treatment-barriers.

---

Janssen, E. P. J., Spauwen, P. J. J., Rijnen, S. J. M., & Ponds, R. W. H. M. (2023). Exploration of eye movement desensitization and reprocessing in treating posttraumatic stress-disorder in patients with acquired brain injury: a retrospective case series. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2264117

Open Access: https://doi.org/10.1080/20008066.2023.2264117

E. P. J. Janssen, Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands.
E-mail: epj.janssen@ggzoostbrabant.nl

Abstract

Background: Posttraumatic stress disorder (PTSD) is prevalent in people with acquired brain injury (ABI). Despite the established efficacy of eye movement desensitization and reprocessing (EMDR) for PTSD in general, evaluation studies on EMDR in ABI patients with PTSD are limited.
Objective: The aim of this study is to explore clinical features, treatment characteristics, feasibility and first indications of efficacy of EMDR in adult ABI patients with PTSD.
Method: This retrospective consecutive case series included ABI patients, who received at least one session of EMDR for PTSD between January 2013 and September 2020. PTSD symptoms were measured using the Impact of Event Scale (IES) pre- and post-treatment. Affective distress was measured using the Subjective Units of Distress (SUD) pre- and post-treatment of the first target.
Results: Sixteen ABI patients (median age 46 years, 50% males), with predominantly moderate or severe TBI (50%) or stroke (25%) were included. Treatment duration was a median of seven sessions. Post-treatment IES scores were significantly lower than pre-treatment scores (p <.001). In 81% of the cases there was an individual statistically and clinically relevant change in IES score. Mean SUD scores of the first target were significantly lower at the end of treatment compared to scores at the start of treatment (p < .001). In 88% of the patients full desensitization to a SUD of 0–1 of the first target was accomplished. Only few adjustments to the standard EMDR protocol were necessary.
Conclusions: Findings suggest that EMDR is a feasible, well tolerated and potentially effective treatment for PTSD in ABI patients. For clinical practice in working with ABI patients, it is advised to consider EMDR as a treatment option.

---

Kalra, N., Rathore, A., Tyagi, R., Khatri, A., Khandelwal, D., & Yangdol, P. (2023). Management of anxiety using eye movement desensitization and reprocessing therapy in children undergoing extraction: a randomized controlled pilot study. Journal of Dental Anesthesia and Pain Medicine, 23(6), 347. https://doi.org/10.17245/jdapm.2023.23.6.347

Open Access: http://dx.doi.org/10.17245/jdapm.2023.23.6.347

Apoorva Rathore, Department of Pedodontics and Preventive Dentistry, University College of Medical Sciences & GTB Hospital, New Delhi, India
E-mail: apoorvarathore555@gmail.com

Abstract

Background: Eye movement desensitization and reprocessing (EMDR) therapy has been reported to be very efficacious for treating post-traumatic stress disorder (PTSD) and other anxiety-related conditions. However, a review of the literature reveals the sparse use of this therapy in the field of pediatric dentistry. This study aimed to evaluate anxiety trends in pediatric dental patients during local anesthesia and extraction with and without EMDR therapy.
Methods: Children in the age range of 8–12 years who required dental extractions were assigned randomly into two groups: an EMDR group (group 1) and a routine behavior management therapy group (group 2; receiving more traditional interventions such as tender love and care behavioral modeling, and distraction). Anxiety scores were recorded at four levels using the visual facial anxiety scale (VFAS) preoperatively, after therapy, after the administration of local anesthesia (LA), and after extraction.
Results: Reduced anxiety was observed after the delivery of EMDR therapy, after LA administration, and post-extraction in the EMDR group compared to pre-operative anxiety scores of anxiety (P < 0.001; unpaired Student’s t and Mann-Whitney U tests). In the control group, mild reductions in anxiety after routine behavior management therapy were observed, accompanied by spikes in anxiety levels after LA and extractions. Conclusion: EMDR therapy was found to be valuable for reducing anxiety among pediatric dental patients during tooth extraction procedures.

---

Kaptan, S. K., Dernedde, C., Dowden, T., & Akan, A. (2023). “Without it, I am not sure I would still be here”: a mixed methods service evaluation for online EMDR trauma therapy in a primary care network in England. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1301540

Open Access: https://doi.org/10.3389/fpsyt.2023.1301540

Safa Kemal Kaptan, Department of Psychology, Boğaziçi University, Istanbul, Türkiye.
E-mail: safa.kaptan@manchester.ac.uk
Carsten Dernedde, Hoveton and Wroxham Medical Centre, Norwich, United Kingdom.
E-mail: carsten.dernedde@nhs.net

Abstract

Introduction: Psychological services are typically offered via specialized mental health services, which are often overwhelmed with long waitlists. To address this need and provide patients with a service characterized by shorter waiting times and increased accessibility, online Eye Movement Desensitization and Reprocessing (EMDR) was established in the North Norfolk 4 Primary Care Network.
Methods: This article presents this service’s collaborative funding, development and outcomes within local GP surgeries. It constitutes a mixed-method service evaluation encompassing the future of EMDR in primary care services. Additionally, it includes the assessment of anxiety, depression, and PTSD symptoms as well as work and social adjustment in a cohort of 83 patients alongside a Thematic Analysis involving eighteen patients and six GPs.
Results: The evaluation showed high completion and attendance among service users. Quantitative scores combined with qualitative feedback from patients and practitioners highlight the potential impact of EMDR therapy on General Practice and its broader provision of trauma-focused therapies. The most significant improvements were observed in anxiety and depression scores. Thematic Analysis indicated that the patients found the service helpful, labeling it as a “life-saver.” They also discussed why they found the service effective; some also wished the service had been available earlier.
Discussion: Findings underscore the potential of EMDR and online EMDR as an accessible and effective approach within primary care settings. The assessments showed an elevated level of access and attendance among service users. Therefore, it is recommended that timely EMDR services be extended through primary care networks.

---

Kazennaya, E. V. (2023). Current State of Research on the Effectiveness of Eye Movement Desensitization and Processing (EMDR) in Post-Traumatic Stress Disorder. Консультативная психология и психотерапия, 31(3), 69-90. https://doi.org/10.17759/cpp.2023310304

URL: http://dx.doi.org/10.17759/cpp.2023310304


Elena V. Kazennaya, Childhood Institute of Moscow Pedagogical State University (MPSU), Moscow, Russia. EMDR Russia Association. E-mail: kazennayahelen@gmail.com

Abstract

Relevance. This article provides an overview of studies examining the effectiveness of Eye Movement Desensitization and Processing (EMDR) in treating posttraumatic stress disorder (PTSD). It presents the findings from the latest systematic reviews and meta-analyses. Drawing from recent systematic reviews and meta-analyses, this study underscores the significant impact of untreated PTSD on morbidity, functional impairment, and overall mental health. Therefore, exploring effective treatments for PTSD is vital to enhance the quality of life and the mental and physical well-being of affected individuals.
Purpose of the study. This study aims to analyze the current state of research concerning the effectiveness of EMDR therapy for PTSD.
Results. Eye movement desensitization and processing has been shown to reduce symptoms associated with PTSD, as well as anxiety and depression, among various groups of individuals, including survivors of life threatening diseases (such as cancer), first responders, and internally displaced persons/refugees. The research suggests that EMDR may be more effective than Cognitive Behavioral Therapy (CBT) in reducing the severity of intrusion and arousal symptoms. However, both approaches show relatively similar rates of reduction in avoidance symptoms. Encouragingly, recent studies indicate that EMDR therapy's effectiveness extends beyond trauma-focused applications, emphasizing its potential utility in addressing a broader spectrum of issues. The researchers note that further investigation is needed to determine the effectiveness of EMDR on different samples. Currently, there are no studies available on the effectiveness of EMDR specifically on a Russian sample, based on the best of our knowledge.

---

Kip, A., Schoppe, L., Arntz, A., & Morina, N. (2023). Efficacy of imagery rescripting in treating mental disorders associated with aversive memories – An updated meta-analysis. Journal of Anxiety Disorders, 99, 102772. https://doi.org/10.1016/j.janxdis.2023.102772

URL: http://dx.doi.org/10.1016/j.janxdis.2023.102772


Ahlke Kip, Institute of Psychology, University of Münster, Fliednerstraße 21, 48149 Münster, Germany. E-mail address: a.kip@uni-muenster.de

Abstract

Imagery rescripting (ImRs) is frequently applied to treat different psychological complaints. We conducted an updated meta-analysis based on randomised controlled trials on the efficacy of ImRs for mental disorders associated with aversive memories. Medline, PsycInfo, and Web of Science were searched up to May 2023. Seventeen trials were included with a total of 908 participants (417 in the ImRs condition), suffering from posttraumatic stress disorder, anxiety disorders, depression, or eating disorders. Random effect models yielded an overall effect of g =0.68 (95% CI 0.18 to 1.18; k =7) compared to passive controls (mostly waitlist). The effect compared to (prolonged) exposure, cognitive restructuring, and EMDR was non-significant (g =− 0.01; 95% CI − 0.18 to 0.15; k =11). Follow-up assessments indicated a long-term treatment effect. Results suggest that ImRs can effectively treat a variety of psychological disorders and produce similar treatment effects as evidence-based interventions. Limitations include the bounded number of included trials for each mental disorder. The meta-analysis was registered on PROSPERO (CRD42020220696) and received no funding.

---

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

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

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

Abstract

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

---

Korpela, S., & Nordquist, H. (2023). Impacts of Post Critical Incident Seminar on emergency service personnel: The critical incident–related experiences and psychological state. Scandinavian Journal of Psychology. https://doi.org/10.1111/sjop.12967

Open Access: https://doi.org/10.1111/sjop.12967

Sanna Korpela, South-Eastern Finland University of Applied Sciences (Xamk), P€a€askysentie 1, 48220 Kotka, Finland. E-mail: sanna.korpela@xamk.fi

Abstract

Introduction
Post Critical Incident Seminar (PCIS) is an intervention originally developed by the Federal Bureau of Investigation (FBI) for supporting law enforcement officers who have faced critical incidents (CIs) at work. In Finland, police forces have arranged modified PCIS regularly since 2012, but the first PCIS for emergency service personnel was organized in 2020. PCIS consists of psychoeducation, peer support, and mental health professional support. Eye Movement Desensitization and Reprocessing (EMDR). Previous international studies of PCIS are scarce. Our research question was this: After 6 months, how do emergency service personnel who have participated in the PCIS describe the impacts of PCIS on experiences and psychological state evoked by the CI that was the reason to apply for it?
Methods
The data consisted of individual interviews 6 months after attending the PCIS. The number of participants in this study was 15 (94%). The data was analyzed qualitatively with inductive content analysis.
Results
The impacts of PCIS on incident-related experiences and state 6 months afterward were divided into five main categories: social changes, new perspectives and sensations, incident-related components, future-oriented processes, and new abilities and actions.
Conclusions
PCIS can have multilevel impacts on the experiences and psychological state caused by a CI. These impacts are reflected, for example, in their inner experience, choices, emotions, actions, and relationships with others in different areas of life. As a result of PCIS, the emergency service personnel’s relationship with CIs in the past and the ability to function in the future can change. Further study is needed to investigate the long-term impacts of the PCIS.

---

Larsen, S. E., Hooyer, K., Kehle-Forbes, S. M., & Hamblen, J. (2023). Patient experiences in making PTSD treatment decisions. Psychological Services. https://doi.org/10.1037/ser0000817

URL: http://dx.doi.org/10.1037/ser0000817

Sadie E. Larsen, Executive Division, National Center for Posttraumatic Stress Disorder, 215 N. Main Street, White River Junction, VT 05009, United States. E-mail: sadie.larsen@va.gov

Abstract

Although there is a range of effective posttraumatic stress disorder (PTSD) treatments, the number of patients who receive those treatments is disappointingly low (Finley et al., 2015; Maguen et al., 2018). Very little research has examined the patient experience of deciding on a PTSD treatment option and how that experience influences treatment preference and selection. In a sample of 12 veterans and 10 providers, we recorded the sessions in which providers discussed PTSD treatment options with their patients and then interviewed patients to ask their impressions of those same sessions. Specifically, using qualitative analysis, we sought to understand (a) patient preferences and experiences of choosing a PTSD treatment option, (b) what information patients retain from treatment planning sessions, and (c) why patients chose a given treatment. Almost all the patients in this sample chose an evidence-based psychotherapy but could remember little about the options afterward. Patients reported that providers presented options neutrally and that they made shared decisions with their providers. Most could talk through their reasons for coming to a decision and felt comfortable with the decision, but decisions were often made heuristically rather than deliberatively. Surprisingly, a few patients had a hard time explaining why they chose a specific treatment, were not conscious of their exact reasons for choosing a treatment, or seemed unable to remember why they chose a treatment. We also noticed subtle ways in which providers’ discussions influenced treatment choice. Implications for practice are discussed.

---

Mansour, M., Joseph, G. R., Joy, G. K., Khanal, S., Dasireddy, R. R., Menon, A., Barrie Mason, I., Kataria, J., Patel, T., & Modi, S. (2023). Post-traumatic Stress Disorder: A Narrative Review of Pharmacological and Psychotherapeutic Interventions. Cureus. https://doi.org/10.7759/cureus.44905

Open Access: https://doi.org/10.7759/cureus.44905

Shivani Modi, General Medicine, University of Debrecen, Debrecen, HUN. E-mail: shvnmd@gmail.com

Abstract

Post-traumatic stress disorder (PTSD) is a complex mental health condition affecting individuals exposed to traumatic events. This paper is a narrative review of the existing literature on pharmacological and psychotherapeutic interventions for PTSD. Treatment includes selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and alpha-1 adrenergic receptor antagonists. By exploring the outcomes of these interventions, the review seeks to provide valuable insights into their potential as PTSD treatment options. The paper also highlights the importance of tailoring treatment plans to individual needs and discusses emerging treatments, such as mindfulness-based therapies, virtual reality therapy, and neurostimulation techniques. By integrating findings from various studies, it aims to offer valuable information to optimize treatment strategies and enhance outcomes for individuals suffering from PTSD. The goal is to support informed decision-making, ultimately leading to more effective and tailored approaches to address the challenges posed by this debilitating condition.

---

Marlow, S., Laugharne, R., Allard, J., Bassett, P., Priebe, S., Ledger, J., Kerr, J., Priest, D., Vanhoorn, A., Boland, C., & Shankar, R. (2024). A pragmatic randomized controlled exploratory trial of the effectiveness of Eye Movement Desensitization and Reprocessing therapy for psychotic disorder. Journal of Psychiatric Research, 169, 257-263. https://doi.org/10.1016/j.jpsychires.2023.11.024

Open Access: https://doi.org/10.1016/j.jpsychires.2023.11.024

Rohit Shankar,Threemilestone Industrial Estate, Truro, TR 4 9LD, UK.
E-mail address: rohit.shankar@plymouth.ac.uk

Abstract

Background: People with severe mental illness are often excluded from trials related to Eye Movement Desensitization and Reprocessing (EMDR) therapy. Principal concerns are that they may not tolerate treatment, might risk relapse or that psychotic symptoms may worsen. There is however building evidence of a traumatogenic etiology of psychotic disorder that may benefit therapeutically from EMDR. However, EMDR in this role is done mainly in specialist tertiary settings.
Aim: To conduct a randomized exploratory trial of prospective treatment of EMDR for people with psychotic disorder and a history of trauma in an adult community mental health service.
Methods: A randomized exploratory trial with a controlled pilot design was employed to conduct a prospective treatment and six-month follow-up study with an interim 10-week analysis in a rural county in the UK (population 538,000). We recruited participants with psychotic disorder who had a reported history of trauma and were interested in receiving trauma therapy. They were then randomized to either receive EMDR or treatment as usual (TAU). The primary instrument used was the Impact of Events Scale (IES) with secondary instruments of Positive and Negative Symptoms of Psychotic Disorder (PANSS), PTSD Checklist (PCL-C), and subjective Quality of Life (MANSA).
Results: IES scores showed significant improvements in the EMDR group (n =24, age 42.0 SD (14.5), 42% male) compared to the TAU group (n =12, age 34.4 SD (11.3), 50% male) at 10 weeks and at six months (p <0.05). There were significant improvements in PCL-C and PANSS negative symptoms scores associated with treatment (p < 0.05). All other scales showed positive trends.
Conclusions: This study demonstrates that EMDR can reduce the impact of traumatic events for patients with a psychotic disorder in a clinical setting in the UK. The improvements in psychotic disorder persisted for six months after treatment.
Trial registration: ISRCTN43816889.

---

Morris, H., Hatzikiriakidis, K., Dwyer, J., Lewis, C., Halfpenny, N., Miller, R., & Skouteris, H. (2023). Early intervention for residential out-of-home care staff using eye movement desensitization and reprocessing (EMDR). Psychological Trauma: Theory, Research, Practice, and Policy, 15(Suppl 2), S456-S464. https://doi.org/10.1037/tra0001418

URL: https://doi.org/10.1037/tra0001418

Heather Morris, Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia. E-mail: heather.morris@monash.edu

Abstract

Objective: Residential out-of-home care (OoHC) staff regularly experience workplace-related trauma. This may contribute to the future development of a trauma- or stressor-related disorder. Eye movement desensitization and reprocessing (EMDR) is an effective treatment for stress disorders but is largely unstudied in OoHC staff. The objective of the current study was to determine if EMDR, provided early within 3 months of an incident, reduced trauma symptom severity in OoHC staff.
Method: During a 3-year pilot study (2018–2020), a trained clinician delivered the Recent Traumatic Episode Protocol (R-TEP) and Group Traumatic Episode Protocol (G-TEP) EMDR to OoHC staff from one community service organization in Victoria, Australia. Retrospective data from the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) were deidentified and analyzed using descriptive statistics and analysis of variance. Due to the COVID-19 pandemic, individual EMDR (R-TEP) was provided via telehealth in 2020 in comparison with face-to-face sessions during 2018– 2019.
Results: Overall, a significant decrease in PCL-5 scores was seen from baseline to follow up, and staff who received R-TEP or G-TEP experienced reductions in symptoms. Both face-to-face and online modalities showed significant reductions in PCL-5 scores. No significant differences were found between the online or face-to-face modes of delivery, suggesting both options are effective. No adverse reactions were reported among the 144 staff who participated.
Conclusion: This study provides evidence for the efficacy of EMDR in reducing traumatic stress symptom severity for residential OoHC staff. A larger, prospective research study is needed.

---

Neill, E. L., Zarling, A., & Weems, C. F. (2023). Therapist use of cognitive behavior therapy and eye movement desensitization and reprocessing components for the treatment of posttraumatic stress disorder in practice settings. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1158344

Open Access: https://doi.org/10.3389/fpsyg.2023.1158344

Carl F. Weems. E-mail: cweems@iastate.edu
Erin L. Neill. E-mail: erinneillphd@gmail.com
Human Development and Family Studies, Iowa State University, Ames, IA, United States

Abstract

Introduction. Treatment practice guidelines for posttraumatic stress disorder (PTSD) recommend both Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavior Therapy (CBT); however, implementation in practice setting remains challenging. Here we aim to foster implementation efforts for PTSD by identifying the relative use of the various components of empirically supported treatments by therapists and the characteristics that predict their use.
Methods. Surveyed 346 therapists (84.07% female) of whom 272 participants (78.61%) were trained primarily in CBT and 135 participants (39.02%) were trained in primarily in EMDR. Assessed relative use of various EMDR and CBT components as well as several training and personality factors.
Results. Psychoeducation about trauma was the most common element used. “Off label” use of components was also identified with application of EMDR techniques to other diagnoses. Findings also suggest underutilization of in vivo exposure techniques across therapists. EMDR therapists reported relatively high use of core EMDR techniques (i.e., greater use of EMDR core techniques). Big five personality factors, therapy efficacy, and anxiety were associated with differential component use.
Discussion. Results identify trends in empirically supported component use and therapist characteristics that are associated with the use of various techniques for PTSD. The findings suggest implementation efforts could foster training in underused techniques, address barriers to their utilization and develop knowledge of effective packages of components.

---

O’Doherty, L., Whelan, M., Carter, G. J., Brown, K., Tarzia, L., Hegarty, K., Feder, G., & Brown, S. J. (2023). Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood. Cochrane Database of Systematic Reviews, 2023(10). https://doi.org/10.1002/14651858.cd013456.pub2

Open Access: https://doi.org/10.1002/14651858.cd013456.pub2

Lorna O'Doherty, Institute for Health and Wellbeing, Coventry University, Coventry, UK
lorna.odoherty@coventry.ac.uk

Abstract

Background
Exposure to rape, sexual assault and sexual abuse has lifelong impacts for mental health and well‐being. Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitisation and Reprocessing (EMDR) are among the most common interventions offered to survivors to alleviate post‐traumatic stress disorder (PTSD) and other psychological impacts. Beyond such trauma‐focused cognitive and behavioural approaches, there is a range of low‐intensity interventions along with new and emerging non‐exposure based approaches (trauma‐sensitive yoga, Reconsolidation of Traumatic Memories and Lifespan Integration). This review presents a timely assessment of international evidence on any type of psychosocial intervention offered to individuals who experienced rape, sexual assault or sexual abuse as adults.
Objectives
To assess the effects of psychosocial interventions on mental health and well‐being for survivors of rape, sexual assault or sexual abuse experienced during adulthood.
Search methods
In January 2022, we searched CENTRAL, MEDLINE, Embase, 12 other databases and three trials registers. We also checked reference lists of included studies, contacted authors and experts, and ran forward citation searches.
Selection criteria
Any study that allocated individuals or clusters of individuals by a random or quasi‐random method to a psychosocial intervention that promoted recovery and healing following exposure to rape, sexual assault or sexual abuse in those aged 18 years and above compared with no or minimal intervention, usual care, wait‐list, pharmacological only or active comparison(s). We classified psychosocial interventions according to Cochrane Common Mental Disorders Group’s psychological therapies list.
Data collection and analysis
We used the standard methodological procedures expected by Cochrane.
Main results
We included 36 studies (1991 to 2021) with 3992 participants randomly assigned to 60 experimental groups (3014; 76%) and 23 inactive comparator conditions (978, 24%).
The experimental groups consisted of: 32 Cognitive Behavioural Therapy (CBT); 10 behavioural interventions; three integrative therapies; three humanist; five other psychologically oriented interventions; and seven other psychosocial interventions. Delivery involved 1 to 20 (median 11) sessions of traditional face‐to‐face (41) or other individual formats (four); groups (nine); or involved computer‐only interaction (six). Most studies were conducted in the USA (n = 26); two were from South Africa; two from the Democratic Republic of the Congo; with single studies from Australia, Canada, the Netherlands, Spain, Sweden and the UK. Five studies did not disclose a funding source, and all disclosed sources were public funding.
Participants were invited from a range of settings: from the community, through the media, from universities and in places where people might seek help for their mental health (e.g. war veterans), in the aftermath of sexual trauma (sexual assault centres and emergency departments) or for problems that accompany the experience of sexual violence (e.g. sexual health/primary care clinics). Participants randomised were 99% women (3965 participants) with just 27 men. Half were Black, African or African‐American (1889 participants); 40% White/Caucasian (1530 participants); and 10% represented a range of other ethnic backgrounds (396 participants). The weighted mean age was 35.9 years (standard deviation (SD) 9.6). Eighty‐two per cent had experienced rape or sexual assault in adulthood (3260/3992). Twenty‐two studies (61%) required fulfilling a measured PTSD diagnostic threshold for inclusion; however, 94% of participants (2239/2370) were reported as having clinically relevant PTSD symptoms at entry.
The comparison of psychosocial interventions with inactive controls detected that there may be a beneficial effect at post‐treatment favouring psychosocial interventions in reducing PTSD (standardised mean difference (SMD) ‐0.83, 95% confidence interval (CI) ‐1.22 to ‐0.44; 16 studies, 1130 participants; low‐certainty evidence; large effect size based on Cohen’s D); and depression (SMD ‐0.82, 95% CI ‐1.17 to ‐0.48; 12 studies, 901 participants; low‐certainty evidence; large effect size). Psychosocial interventions, however, may not increase the risk of dropout from treatment compared to controls, with a risk ratio of 0.85 (95% CI 0.51 to 1.44; 5 studies, 242 participants; low‐certainty evidence). Seven of the 23 studies (with 801 participants) comparing a psychosocial intervention to an inactive control reported on adverse events, with 21 events indicated. Psychosocial interventions may not increase the risk of adverse events compared to controls, with a risk ratio of 1.92 (95% CI 0.30 to 12.41; 6 studies; 622 participants; very low‐certainty evidence).
We conducted an assessment of risk of bias using the RoB 2 tool on a total of 49 reported results. A high risk of bias affected 43% of PTSD results; 59% for depression symptoms; 40% for treatment dropout; and one‐third for adverse events. The greatest sources of bias were problems with randomisation and missing outcome data. Heterogeneity was also high, ranging from I2 = 30% (adverse events) to I2 = 87% (PTSD).
Authors' conclusions
Our review suggests that survivors of rape, sexual violence and sexual abuse during adulthood may experience a large reduction in post‐treatment PTSD symptoms and depressive symptoms after experiencing a psychosocial intervention, relative to comparison groups. Psychosocial interventions do not seem to increase dropout from treatment or adverse events/effects compared to controls. However, the number of dropouts and study attrition were generally high, potentially missing harms of exposure to interventions and/or research participation. Also, the differential effects of specific intervention types needs further investigation.
We conclude that a range of behavioural and CBT‐based interventions may improve the mental health of survivors of rape, sexual assault and sexual abuse in the short term. Therefore, the needs and preferences of individuals must be considered in selecting suitable approaches to therapy and support. The primary outcome in this review focused on the post‐treatment period and the question about whether benefits are sustained over time persists. However, attaining such evidence from studies that lack an active comparison may be impractical and even unethical. Thus, we suggest that studies undertake head‐to‐head comparisons of different intervention types; in particular, of novel, emerging therapies, with one‐year plus follow‐up periods. Additionally, researchers should focus on the therapeutic benefits and costs for subpopulations such as male survivors and those living with complex PTSD.

---

Paridaen, P., Voorendonk, E. M., Gomon, G., Hoogendoorn, E. A., van Minnen, A., & de Jongh, A. (2023). Changes in comorbid depression following intensive trauma-focused treatment for PTSD and complex PTSD. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2258313

Open Access: https://doi.org/10.1080/20008066.2023.2258313



Ad de Jongh, (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands School of Psychology, Queen’s University, Belfast, Northern Ireland Institute of Health and Society, University of Worcester, UK. E-mail: a.de.jongh@acta.nl

Abstract

Background:
The extent to which intensive trauma-focused treatment for individuals with post-traumatic stress disorder (PTSD) is also effective in treating comorbid major depressive disorder (MDD) remains unclear.
Objective:
The purpose of the present study was to test the hypothesis that brief intensive trauma-focused therapy for PTSD is associated with significant reductions in depressive symptoms and loss of diagnostic status of MDD.
Methods:
A total of 334 adult patients with PTSD (189 patients who were also diagnosed with MDD) underwent a brief intensive trauma-focused treatment programme consisting of EMDR therapy, prolonged exposure, physical activity, and psychoeducation. At pre-treatment, post-treatment and 6-month follow-up, severity and diagnostic status of PTSD and MDD were assessed. A linear mixed model was used to analyze changes in the severity of PTSD and depressive symptoms, whereas a generalized linear mixed model was used to determine changes in the MDD diagnostic status.
Results:
Treatment resulted in a significant and strong decrease of PTSD and MDD symptoms at post-treatment (d = 2.34 and 1.22, respectively), and at 6-month follow-up (d = 1.67 and 0.73, respectively). The proportion of patients fulfilling the diagnostic status of MDD changed from 57% at pre-treatment to 33% at the 6-month follow-up. Although the initial response to treatment did not differ between patients with and without comorbid MDD, for both groups a significant relapse in depressive symptoms was found after six months, which could be explained almost entirely by the presence of CPTSD at baseline.
Conclusions:
The results support the notion that brief, intensive trauma-focused treatment is highly effective for individuals with PTSD and comorbid MDD. Because patients with CPTSD are vulnerable to relapse in depressive symptoms, this target group may require additional treatment.

---

Park, K. W., Kullar, P., Malhotra, C., & Stankovic, K. M. (2023). Current and Emerging Therapies for Chronic Subjective Tinnitus. Journal of Clinical Medicine, 12(20), 6555. https://doi.org/10.3390/jcm12206555

Open Access: https://doi.org/10.3390/jcm12206555


Konstantina M. Stankovic. Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA. E-mail: kstankovic@stanford.edu

Abstract

Importance: Chronic subjective tinnitus, the perception of sound without an external source for longer than six months, may be a greatly debilitating condition for some people, and is associated with psychiatric comorbidities and high healthcare costs. Current treatments are not beneficial for all patients and there is a large need for new therapies for tinnitus. Observations: Unlike rarer cases of objective tinnitus, chronic subjective tinnitus often has no obvious etiology and a diverse pathophysiology. In the absence of objective testing, diagnosis is heavily based on clinical assessment. Management strategies include hearing aids, sound masking, tinnitus retraining therapy, cognitive behavioral therapy, and emerging therapies including transcranial magnetic stimulation and electrical stimulation. Conclusions and relevance: Although current treatments are limited, emerging diagnostics and treatments provide promising avenues for the management of tinnitus symptoms.

---

Poli, A., Cappellini, F., Sala, J., & Miccoli, M. (2023). The integrative process promoted by EMDR in dissociative disorders: neurobiological mechanisms, psychometric tools, and intervention efficacy on the psychological impact of the COVID-19 pandemic. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1164527

Open Access: https://doi.org/10.3389/fpsyg.2023.1164527

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

Abstract

Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic- related events, such as sickness, isolation, losing loved ones, and fear for one’s life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID- 19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.

---

Rasines-Laudes, P., Serrano-Pintado, I., & de Bizkaia, R. D. S. M. (2023). Efficacy of EMDR in Post-Traumatic Stress Disorder: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Psicothema, 35(4), 385-396.

Open Access: https://doi.org/10.7334/psicothema2022.309



Pedro Rasines-Laudes, Red de Salud Mental de Bizkaia (Spain). E-mail: pedrojrasines@gmail.com

Abstract

Background: In recent years, eye movement desensitization and reprocessing (EMDR) has spread, in both the number of publications and professionals who use this technique in the clinical setting. The objective of this meta-analysis was to verify the efficacy of EMDR in treatment of post-traumatic stress disorder. Method: Based on the inclusion/ exclusion criteria, 18 articles were selected (n = 1213 subjects), published between 1991-2022. Results: The effect sizes found in the meta-analysis were small in the reduction of symptoms associated with PTSD, anxiety and depression, both in post-treatment and in maintenance. The analysis of the moderating variables revealed that both intervention time, the number and duration of the sessions, the experience of the therapist, and the type of therapist in charge of the intervention play an important role in the size of the final effect. No statistically significant data were found in the meta-regression analysis. Conclusions: Although the study had restrictive criteria for study selection, there is a certain risk of bias in the selected articles, which lack sufficient methodological quality to be extrapolated to the clinical field.

---

Rolli, N. J. (2023). Integrating EMDR Standard Treatment Protocol into Child Psychotherapy at a Primary School with a 5‐year‐old Boy Who Suffered Complex Trauma: A Single Case Study. British Journal of Psychotherapy, 39(4), 714-731. https://doi.org/10.1111/bjp.12861

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


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

Abstract

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

---

Rosser, B. A., Agostinis, A., & Bond, J. (2023). Online Eye Movement Desensitization and Reprocessing Therapy for Chronic Pain: A Pilot Controlled Trial. Journal of EMDR Practice and Research, 17(4), 186-199. https://doi.org/10.1891/emdr-2023-0009

URL: https://doi.org/10.1891/emdr-2023-0009


Alessio Agostinis, Suite 2.9, Second Floor Lido Medical Centre, St Saviour Road, St Saviour, Jersey JE2 3PH, UK. Email: office@dragostinis.co.uk

Abstract

The study aimed to provide a preliminary evaluation of the acceptability and effectiveness of online eye movement desensitization and reprocessing (EMDR) compared with a waitlist control (WLC). A pilot nonrandomized controlled trial was conducted. Eighteen adults experiencing chronic pain completed the study (n EMDR= 10; n control= 8). The intervention group received up to 10 weekly sessions of online EMDR. The control group received treatment as usual. Participants completed baseline and post-intervention measures assessing posttraumatic stress, pain severity, interference, and catastrophizing, and depression levels. Additionally, the online EMDR group participants provided feedback on intervention acceptability and satisfaction. The online EMDR group demonstrated significant reductions in both trauma and pain-related outcomes; depression levels did not significantly change. No significant change was observed in any outcome within the control group. After the WLC also received the intervention, additional analysis results demonstrated similar effects but did not reach statistical significance, except for depression. Overall, online EMDR appeared acceptable and positively received by participants. The study provides preliminary support that online delivery of EMDR may reduce trauma- and pain-related outcomes in individuals experiencing chronic pain. Further large-scale research is warranted to substantiate these findings. Limitations and implications are discussed. REC ref: 2020/HCSREC/04

---

Rossi, E., Cassioli, E., Cecci, L., Arganini, F., Martelli, M., Redaelli, C. A., Anselmetti, S., Bertelli, S., Fernandez, I., Ricca, V., & Castellini, G. (2023). Eye movement desensitisation and reprocessing as add‐on treatment to enhanced cognitive behaviour therapy for patients with anorexia nervosa reporting childhood maltreatment: A quasi‐experimental multicenter study. European Eating Disorders Review. https://doi.org/10.1002/erv.3044

Open Access: https://doi.org/10.1002/erv.3044

Giovanni Castellini, Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy. E-mail: giovanni.castellini@unifi.it

Abstract

Objective: This quasi‐experimental study aimed to compare the outcome of patients with Anorexia Nervosa (AN) reporting moderate/severe childhood maltreatment (CM) treated exclusively with Enhanced Cognitive Behaviour Therapy (CBT‐E) or with CBT‐E plus Eye Movement Desensitisation and Reprocessing (EMDR).
Method: A total of 75 patients with AN reporting moderate/severe CM were initially assessed regarding body mass index (BMI), general and eating disorder (ED)‐specific psychopathology, and dissociative symptoms, and re‐ evaluated after 40 CBT‐E sessions (T1). Then, 18 patients received EMDR, whereas the others were placed on a waiting list and continued CBT‐E. T2 assessment was performed after 20–25 sessions of EMDR or CBT‐E. A control group of 67 patients without CM was also enrolled and treated with CBT‐E. Results: Contrary to patients without CM, neither of the traumatised groups improved in BMI, general and ED psychopathology, or dissociation at T1. However, at T2, both traumatised groups improved in BMI and ED‐specific psychopathology, with the CBT þ EMDR group demonstrating greater improvements. Moreover, only the CBT + EMDR group improved in general psychopathology and dissociative symptoms. The reduction of ED symptoms in traumatised patients was mediated by the amelioration of dissociation. Discussion: The addition of EMDR to CBT‐E may benefit patients with AN reporting moderate/severe CM.

---

Sopena, S., Silva, J., Miller, C., Hedderly, T., & Diest, C. V. (2023). Eye Movement Desensitization and Reprocessing Therapy for Individuals With Neurodevelopmental Disorders: A Systematic Review. Journal of EMDR Practice and Research, 17(4), 200-215. https://doi.org/10.1891/emdr-2023-0005

URL: https://doi.org/10.1891/emdr-2023-0005


Sara Sopena, Neurosciences Department, Evelina London Children’s Hospital, Guys and St Thomas NHS Trust, London, UK. Email: sara.sopena@gstt.nhs.uk

Abstract

Children, young people, and adults with neurodevelopmental disorders (NDDs), including autism and attention-deficit hyperactivity disorder (ADHD), are known to be at risk of experiencing high rates of traumatic events. EMDR is an evidence-based psychological therapy for trauma and mental health conditions in the general population. A systematic search was conducted to find research studies using EMDR with individuals with certain NDDs across the lifespan. A total of 15 studies were included in this review, 13 of which were case studies/series. Although findings are inconclusive as to whether EMDR can be effective for individuals with NDDs, it is encouraging that all the studies included in the review reported a reduction in posttraumatic stress disorder symptoms. However, more robust research examining the effectiveness of EMDR for people with NDDs is needed.

---

Steuwe, C., Blaß, J., Herpertz, S. C., & Drießen, M. (2023). Personalized psychotherapy of posttraumatic stress disorder: Overview on the selection of treatment methods and techniques using statistical procedures Personalisierte Psychotherapie der posttraumatischen Belastungsstörung: Übersicht zur Auswahl von Behandlungsmethoden und -techniken mittels statistischer Verfahren. Der Nervenarzt, 94(11), 1050-1058. https://doi.org/10.1007/s00115-023-01549-6

Open Access: http://dx.doi.org/10.1007/s00115-023-01549-6

Carolin Steuwe, Universitätsklinik für Psychiatrie und Psychotherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Remterweg 69–71, 33617, Bielefeld, Deutschland. E-mail: carolin.steuwe@evkb.de

Abstract

Background
A relevant heterogeneity of treatment effects in posttraumatic stress disorder (PTSD) is discussed with respect to the debate about the necessity of phase-based treatment and in light of the new diagnosis of complex PTSD and has recently been proven; however, there has been little personalization in the treatment of PTSD. This article presents the current state of research on the personalized selection of specific psychotherapeutic methods for the treatment of PTSD based on patient characteristics using statistical methods.
Methods
A systematic literature search was conducted in the PubMed (including Medline), Embase, Web of Science Core Collection, Google Scholar, PsycINFO and PSYNDEX databases to identify clinical trials and reviews examining personalized treatment for PTSD.
Results
A total of 13 relevant publications were identified, of which 5 articles were predictor analyses in samples without control conditions and 7 articles showed analyses of randomized controlled trials (RCT) with a post hoc comparison of treatment effects in optimally and nonoptimally assigned patients. In addition, one article was a systematic review on the treatment of patients with comorbid borderline personality order and PTSD.
Discussion
The available manuscripts indicate the importance and benefits of personalized treatment in PTSD. The relevant predictor variables identified for personalization should be used as a suggestion to investigate them in future prospective studies.

---

Strelchuk, D., Turner, K., Smith, S., Bisson, J., Wiles, N., & Zammit, S. (2023). Provision of online eye movement and desensitisation therapy (EMDR) for people with post-traumatic stress disorder (PTSD): a multi-method service evaluation. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2281182

Open Access: https://doi.org/10.1080/20008066.2023.2281182


Daniela Strelchuk, Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. E-mail: Daniela.strelchuk@bristol.ac.uk

Abstract

Background: The evidence for the effectiveness of online EMDR for PTSD is scarce. Objective: This service evaluation aimed to assess how online EMDR compared to in-person EMDR, in terms of its potential effectiveness and acceptability to therapists and patients. Method: The evaluation was carried out in the Cardiff and Vale University Health Board Traumatic Stress Service. We compared the outcome of therapy (PTSD scores at end of treatment), number of sessions, drop-out rate, and adverse events using linear/logistic regression in those receiving online EMDR over a 12-month period with those who had received in-person therapy in the year previous to that. Interviews with therapists and clients who had provided or undertaken online EMDR explored their views and experiences of treatment. Interviews were analysed thematically.
Results: 33 people received in-person EMDR (15.3 sessions, SD = 1.4), and 45 received online EMDR (12.4 sessions, SD = 0.9). 24 individuals completed therapy in-person, and 32 online. There was no evidence of a difference in therapy completion, drop-out rates or adverse events between the two delivery modes. There was weak evidence that those who completed EMDR online and had available data (N = 29), had slightly lower PTSD scores at the end of therapy compared to those who received in-person EMDR (N = 24) (17.1 (SD = 3.2) versus 24.5 (SD=3.0), mean difference=7.8, 95% CI −0.3, 15.9, p=.06). However, groups were not randomised and only those who completed treatment were analysed, so estimates may be biased. 11 patients and five therapists were interviewed. Overall, both therapists and clients viewed online EMDR as safe and effective. Benefits mentioned by clients included feeling more in control and not having to travel. Clients’ concerns related to lack of privacy and ‘transition time/space’ between therapy and their daily lives.
Conclusion: Results suggest that online EMDR is an acceptable, safe and effective alternative to in-person EMDR for PTSD in this service.

---

van der Linde, R. P. A., Huntjens, R. J. C., Bachrach, N., Rijkeboer, M. M., de Jongh, A., & van Minnen, A. (2023). The role of dissociation-related beliefs about memory in trauma-focused treatment. European Journal of Psychotraumatology, 14(2). https://doi.org/10.1080/20008066.2023.2265182

Open Access: https://doi.org/10.1080/20008066.2023.2265182

Robin P. A. van der Linde, Clinical Psychology and Experimental Psychopathology, University of Groningen,Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands. E-mail: robinvdlinde@outlook.com

Abstract

Objective: Dysfunctional cognitions play a central role in the development of post-traumatic stress disorder (PTSD). However the role of specific dissociation-related beliefs about memory has not been previously investigated. This study aimed to investigate the role of dissociation- related beliefs about memory in trauma-focused treatment. It was hypothesized that patients with the dissociative subtype of PTSD would show higher levels of dissociation-related beliefs, dissociation-related beliefs about memory would decrease after trauma-focused treatment, and higher pre-treatment dissociation-related beliefs would be associated with fewer changes in PTSD symptoms.
Method: Post-traumatic symptoms, dissociative symptoms, and dissociation-related beliefs about memory were assessed in a sample of patients diagnosed with PTSD (n = 111) or the dissociative subtype of PTSD (n = 61). They underwent intensive trauma-focused treatment consisting of four or eight consecutive treatment days. On each treatment day, patients received 90 min of individual prolonged exposure (PE) in the morning and 90 min of individual eye movement desensitization and reprocessing (EMDR) therapy in the afternoon. The relationship between dissociation-related beliefs about memory and the effects of trauma-focused treatment was investigated.
Results: Dissociation-related beliefs about memory were significantly associated with PTSD and its dissociative symptoms. In addition, consistent with our hypothesis, patients with the dissociative subtype of PTSD scored significantly higher on dissociation-related beliefs about memory pre-treatment than those without the dissociative subtype. Additionally, the severity of these beliefs decreased significantly after trauma-related treatment. Contrary to our hypothesis, elevated dissociation-related beliefs did not negatively influence treatment outcome.
Conclusion: The results of the current study suggest that dissociation-related beliefs do not influence the outcome of trauma-focused treatment, and that trauma-focused treatment does not need to be altered specifically for patients experiencing more dissociation-related beliefs about memory because these beliefs decrease in association with treatment.

---

Varese, F., Sellwood, W., Pulford, D., Awenat, Y., Bird, L., Bhutani, G., Carter, L.-A., Davies, L., Aseem, S., Davis, C., Hefferman-Clarke, R., Hilton, C., Horne, G., Keane, D., Logie, R., Malkin, D., Potter, F., van den Berg, D., Zia, S., . . . Bentall, R. P. (2023). Trauma-focused therapy in early psychosis: results of a feasibility randomized controlled trial of EMDR for psychosis (EMDRp) in early intervention settings. Psychological Medicine, 1-12. https://doi.org/10.1017/s0033291723002532

Open Access: https://doi.org/10.1017/s0033291723002532

Filippo Varese, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. E-mail: filippo.varese@manchester.ac.uk

Abstract

Background. Trauma is prevalent amongst early psychosis patients and associated with adverse outcomes. Past trials of trauma-focused therapy have focused on chronic patients with psychosis/ schizophrenia and comorbid Post-Traumatic Stress Disorder (PTSD). We aimed to determine the feasibility of a large-scale randomized controlled trial (RCT) of an Eye Movement Desensitization and Reprocessing for psychosis (EMDRp) intervention for early psychosis service users. Methods. A single-blind RCT comparing 16 sessions of EMDRp + TAU v. TAU only was conducted. Participants completed baseline, 6-month and 12-month post-randomization assessments. EMDRp and trial assessments were delivered both in-person and remotely due to COVID-19 restrictions. Feasibility outcomes were recruitment and retention, therapy attendance/engagement, adherence to EMDRp treatment protocol, and the ‘promise of effi- cacy’ of EMDRp on relevant clinical outcomes.
Results. Sixty participants (100% of the recruitment target) received TAU or EMDR + TAU. 83% completed at least one follow-up assessment, with 74% at 6-month and 70% at 12- month. 74% of EMDRp+TAU participants received at least eight therapy sessions and 97% rated therapy sessions demonstrated good treatment fidelity. At 6-month, there were sig- nals of promise of efficacy of EMDRp + TAU v. TAU for total psychotic symptoms (PANSS), subjective recovery from psychosis, PTSD symptoms, depression, anxiety, and general health status. Signals of efficacy at 12-month were less pronounced but remained robust for PTSD symptoms and general health status.
Conclusions. The trial feasibility criteria were fully met, and EMDRp was associated with promising signals of efficacy on a range of valuable clinical outcomes. A larger-scale, multi-center trial of EMDRp is feasible and warranted.

---

Voorendonk, E. M., Sanches, S. A., Tollenaar, M. S., Hoogendoorn, E. A., de Jongh, A., & van Minnen, A. (2023). Adding physical activity to intensive trauma-focused treatment for post-traumatic stress disorder: results of a randomized controlled trial. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1215250

Open Access: https://doi.org/10.3389/fpsyg.2023.1215250

Eline M. Voorendonk, Research Department, PSYTREC, Bilthoven, Netherlands. E-mail: e.voorendonk@psytrec.nl

Abstract

Introduction: This randomized controlled trial examined the effectiveness of physical activity added to an intensive trauma-focused treatment (TFT) for post-traumatic stress disorder (PTSD) in comparison to adding non-physical control
activities.
Methods: A total of 119 patients with PTSD were randomly assigned to a physical activity condition (PA; n = 59) or a non-physical activity control condition (nPA; n = 60). The 8-day intensive TFT programme consisted of daily prolonged exposure, EMDR therapy, and psychoeducation, which was complemented
with physical activities versus controlled mixtures of guided (creative) tasks. As a primary outcome, the change in clinician and self-reported PTSD symptoms from pre-to post-treatment and at 6 months follow-up were measured.
Results: Intent-to-treat linear mixed-effects models showed no significant differences between the PA and nPA conditions on change in PTSD severity.
Clinician and self-reported PTSD symptoms significantly decreased for both conditions, with large effect sizes (e.g., CAPS-5 dpre-post = 2.28). At post-treatment, 80.0% in the PA, and 82.7% in the nPA condition no longer met the diagnostic criteria for PTSD. Regarding the loss of Complex PTSD diagnoses this was 92.5% and 95.0%, respectively.
Conclusion: Either with additional physical or non-physical activities, intensive TFT is very effective for the treatment of (Complex) PTSD, as reflected by large effect sizes and loss of diagnostic status in both groups.
Clinical trial registration: Trialregister.nl Identifier: Trial NL9120.

---

Wertheim, B., Aarts, E. E., de Roos, C., & van Rood, Y. R. (2023). The effect of eye movement desensitization and reprocessing (EMDR) on abdominal pain in patients with irritable bowel syndrome (IBS): a study protocol for a randomized controlled trial (EMDR4IBS). Trials, 24(1). https://doi.org/10.1186/s13063-023-07784-1

Open Access: https://doi.org/10.1186/s13063-023-07784-1

B. Wertheim, Diakonessenhuis Utrecht, Utrecht, The Netherlands. E-mail: bwerthei@diakhuis.nl

Abstract

Background Irritable bowel syndrome (IBS) is a highly prevalent disorder for which treatment options such as medication, diets, and hypnotherapy either have shown limited effect or relieve symptoms in only a limited subset
of patients. Abdominal pain is the key criterion for the diagnosis and is deemed the most distressing IBS symptom, and the most disruptive of everyday life. A growing body of research demonstrates the effect of Eye Movement Desensitization and Reprocessing (EMDR) on chronic pain. EMDR is known as a safe and successful treatment for dis- orders in which unresolved traumatic memories play a role in the cause or maintenance of symptoms. In IBS, activated memories may increase pain through pain flashbacks and the stress generated by unresolved memories. The aim of this study is to ascertain whether applying EMDR to traumatic memories including pain memories will reduce abdominal pain in IBS patients.
Methods This study is a randomized controlled trial which will be conducted at a city hospital in the Netherlands. Adult patients with considerable IBS pain (pain intensity at least 60/100 during at least 5/10 days) will be randomly assigned to either EMDR therapy or the wait list. We aim to include 34 participants. The EMDR condition comprises seven sessions, around 90 min in length delivered weekly, the first of which is a case conceptualization session. All participants will be assessed at baseline, post-treatment, and at 3 months follow-up. The primary outcome measure is pain intensity on a Likert scale which is self-reported daily during a 2-week period. Secondary outcomes include similar daily ratings on other IBS symptoms and reported hindrance of valued activities, and also standardized questionnaires on IBS symptoms and Quality of Life. Data will be analyzed by a Linear Mixed Effects Model for repeated measures.
Discussion The results are expected to gain insight into the effectiveness of EMDR treatment on abdominal pain in IBS. As there are very few effective treatment options for IBS-related abdominal pain, this study could have important implications for clinical practice.
Trial registration Human ethics committee MEC-U NL71740.100.20. International Clinical Trial Registry Platform: NL8894. Prospectively registered on 28 January 2020.

---

Whalley, M., & Lee, D. (2023). Integrating Compassion into EMDR for PTSD. OBM Integrative and Complementary Medicine, 08(04), 1-18. https://doi.org/10.21926/obm.icm.2304058

Open Access: https://doi.org/10.21926/obm.icm.2304058

Matthew Whalley, Psychology Tools, Fourth Floor Suite 3, Reading Bridge House, George Street, Reading, RG1 8LS, UK; E-mail: matthew@psychologytools.com

Abstract

Post-traumatic stress disorder (PTSD) often involves feeling-states of shame and self-loathing. Traditional exposure-based treatments, which are effective for fear-based PTSD, are sometimes limited in effectiveness when working with these emotional experiences: clients with high levels of shame, guilt, or disgust may experience ‘blocks’ in processing when attempting eye movement desensitization and reprocessing (EMDR). Developed to help people who suffer from pervasive shame and self-attack, compassion focused therapy (CFT) is based upon an evolutionary framework, and draws on research from human neurobiology and attachment theory to understand how humans respond to different types of threat. This paper describes a protocol for integrating compassion focused techniques into EMDR therapy with the aim of facilitating adaptive information processing. Two case examples outline the use of the protocol and describe clients’ reflections on the process. We suggest that CFT approaches can be successfully integrated with EMDR when working with experiences of shame and self-blame.

---

Wright, L. C., Palmer, J., Kelly, R., & Derefaka, G. (2023). Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Childhood Sexual Abuse Memories in Men Who Have Sexually Offended Against Children: Changes in Perceptions of Abuse and Offending. Journal of Forensic Psychology Research and Practice, 1-19. https://doi.org/10.1080/24732850.2023.2279318

URL: https://doi.org/10.1080/24732850.2023.2279318


Lisa Catherine Wright, Mersey Forensic Psychology Service, Mersey Care NHS Foundation Trust, Liverpool, UK. E-mail: Lisa.wright@merseycare.nhs.uk

Abstract

Five adult males who had sexually offended against children and had previously been victims of child sex abuse (CSA) were interviewed about their experiences of completing Eye Movement Desensitization and Reprocessing (EMDR) therapy on memories of their CSA. Data were analyzed using Interpretative Phenomenological Analysis. Themes identified encapsulated descriptions of changes in participants’ perspectives of their CSA that led to changes in perspectives of their offending behavior and victims, reduction in sexual preoccupation, increased desire for healthy adult relationships and reduced sexual arousal to children. Therefore EMDR could potentially contribute to the reduction of re-offending in this population.

---

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

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

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

Abstract

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

---

Yilmaz Dinç, S., & Sapmaz, F. (2023). The effect of eye movement desensitization and reprocessing-based online group counseling for university students: Psychological need satisfaction, psychological resilience, psychological well-being, and small ‘t’ trauma. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001629

URL: https://doi.org/10.1037/tra0001629



Safiye Yilmaz Dinç, Gayret, Bankacılar Avenue No: 3C/16, 06170, Yenimahalle, Ankara, Turkey. Email: safiyepdr@hotmail.com

Abstract

Objectives: The present study explored the effect of eye movement desensitization and reprocessing (EMDR)-based online group counseling for university students whose basic psychological needs had not been met in relation to need satisfaction, psychological resilience, psychological well-being, and small “t” trauma. Method: Using three measurements, namely a pretest, posttest, and follow-up test, this study employed a 4 × 3 experimental design comprising four groups, two experiments, one control group, and one placebo group. The data were collected using the Psychological Need Satisfaction Scale, Psychological Well-Being Scale, and Small-t Trauma Effects Scale. A two-way analysis of variance and Bonferroni correction were performed for the data analysis. Results: The findings showed a significant positive time–intervention interaction effect with respect to psychological needs and its subcategories (autonomy, relatedness, and competence), as well as psychological resilience, psychological well-being, and the small-t trauma effect and its two subcategories (negative effects on self and future perception and negative effects on emotions, thoughts, and behaviors). The effect of EMDR-based online group counseling on negative effects on body sense (the subcategory of small-t trauma) showed no significant interaction of time and intervention. Conclusion: The results indicated that, in addition to healing trauma, EMDR was also found to be effective in relation to psychological resilience and well-being.

---

Yim, S. H., Lorenz, H., & Salkovskis, P. (2023). The Effectiveness and Feasibility of Psychological Interventions for Populations Under Ongoing Threat: A Systematic Review. Trauma, Violence, & Abuse, 25(1), 577-592. https://doi.org/10.1177/15248380231156198

Open Access: https://journals.sagepub.com/doi/full/10.1177/15248380231156198

See Heng Yim, Oxford Institute of Clinical Psychology Training, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK.
E-mail: see.yim.13@ucl.ac.uk

Abstract

Current views of psychological therapies for trauma typically assume the traumatic event to be in the past. Yet, individuals who live in contexts of ongoing organized violence or experience intimate partner violence (IPV) may continue to be (re)exposed to related traumatic events or have realistic fears of their recurrence. This systematic review considers the effectiveness, feasibility, and adaptations of psychological interventions for individuals living with ongoing threat. PsychINFO, MEDLINE, and EMBASE were searched for articles that examined psychological interventions in contexts of ongoing threat of either IPV or organized violence and used trauma-related outcome measures. The search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on study population, ongoing threat setting and design, intervention components, evaluation methods, and outcomes were extracted, and study quality was assessed using the Mixed-Method Appraisal Tool. Eighteen papers featuring 15 trials were included (12 on organized violence and 3 on IPV). For organized violence, most studies showed moderate to large effects in reducing trauma-related symptoms when compared to waitlists. For IPV, findings were varied. Most studies made adaptations related to culture and ongoing threat and found that providing psychological interventions was feasible. The findings, albeit preliminary with mixed methodological quality, showed psychological treatments can be beneficial and should not be withheld in the context of ongoing organized violence and IPV. Clinical and research recommendations are discussed.

---