EMDR Research News July 2014
There are three case reports for: grief, specific phobia and for the treatment of sexual offenders trauma experiences.
There are four randomized controlled trials (RCT). Two are pilot studies: EMDR for trauma experiences in Bipolar I and II patients; and there is a variation on the Feeling State Protocol for tobacco smoking relapse. There is a PTSD vs health control group exploring EMDR therapy effects on PTSD regarding mood, anxiety, subjective, and objective sleep (evaluated by polysomnographic recording). There is a much needed RCT studying treatment of PTSD in children comparing trauma-focused cognitive behavioral therapy versus EMDR therapy which found that both TF-CBT and EMDR are effective and efficient in reducing PTSD symptoms in children.
Finally, there is 25th anniversary review article by Francine Shapiro that appeared in the APA Division 56 (Trauma Psychology) Newsletter.
The video of the month is a recently released 2009 video from the Netherlands of Joany Spierings in conversation with Francine Shapiro at the 10th annual EMDR Europe Conference.
With each reference below, you will find the citation, abstract and author contact information (when available). Prior quarterly summaries of journal articles can be found on the EMDRIA website and a comprehensive listing of all EMDR-related research is available at the Francine Shapiro Library. EMDRIA members can access recent Journal of EMDR Practice and Research articles in the member’s area on the EMDRIA website. JEMDR issues older than 12 months are available open access on IngentaConnect.
Video of the month
The video this month is a recently released 2009 video from the Netherlands of Joany Spierings in an extended conversation with Francine Shapiro. The occasion was the 10th Annual EMDR Europe Conference and the 20th anniversary of the first (1989) publications on EMD(R) therapy.
Beaumont, E. (2014). Healing the wounds of trauma, shame and grief. Healthcare Counselling & Psychotherapy Journal, 14(2), 14-19.
The article discusses how counsellors and therapists can heal the wounds of trauma, shame, and grief through compassion-focused eye movement desensitisation and reprocessing (EMDR). According to the author, Shapiro's adaptive information processing model (AIP)2 indicates that the body and mind possess a natural processing system and that traumatic events can overwhelm the nervous system and lead to repression and negative emotions.
Clark, L., Tyler, N., Gannon, T. A., & Kingham, M. (2014). Eye movement desensitisation and reprocessing for offence-related trauma in a mentally disordered sexual offender. Journal of Sexual Aggression: An International, Interdisciplinary Forum for Research, Theory and Practice, 20(2), 240-249. doi:10.1080/13552600.2013.822937
Lauren Clark, Kent Forensic Psychiatry Services, Kent & Medway NHS & Social Care Partnership Trust, Hermitage Lane, Maidstone, UK.
Research demonstrates a high incidence of offence-related trauma in mentally disordered offenders convicted of violent and sexual offences. The adaptive information processing (AIP) model offers a theoretical framework for understanding the hypothesised relationship between offence-related trauma and reoffending. Evidence suggests that for a sub-population of offenders presenting with offence-related trauma: (1) therapy may retraumatise them, and (2) unresolved trauma severely blocks the positive benefits of talking therapies. Thus, it is postulated that traumatised violent and sexual offenders may be released into the community when they are still at risk of reoffending. A single case study is presented, which describes the application of eye movement desensitisation and reprocessing (EMDR) for a sexual offender presenting with offence-related trauma, whose offences occurred in the context of serious mental disorder. The identification of offence-related trauma and subsequent resolution of trauma symptomatology are discussed in regard to effective offender rehabilitation. Furthermore, the idiosyncratic nature of offence-related trauma and the application of the standard EMDR protocol for a single traumatic event are considered.
de Castro Lopes, C., Carvalho, S. C., & Barbosa, M. R. (2014). Tratamento de fobia específica por dessensibilização e reprocessamento por meio dos movimentos oculares/ treatment of specific phobia through eye movement desensitization and reprocessing. Psicologia: Teoria E Prática, 1(1), 31-42. doi:10.15348/1980-6906/psicologia.v16n1p31-42
Catarina de Castro Lopes, Departamento de Psicologia Clínica, Clínica White, Rua Dr. António Loureiro Borges, Edificio 5, 1º andar, Arquipark, Miraflores, Algés - Portugal. CEP: 1495-131. E-mail: email@example.com
The specific phobia is characterized by a persistent and recurring fear that is excessive and irrational to a specific object or situation, triggering a strong anxiety reaction. Several studies have been conducted in order to assess the effectiveness of eye movement desensitization and reprocessing (EMDR) and it has been proven to be a successful method for the treatment of specific phobias, anxiety, depression, trauma and somatic complaints. The case of this article describes the therapeutic work done with a forty-two years old’ woman that has phobia to dentures using the intervention of EMDR. At the end of the intervention, the patient lost the fear of prosthetics, no longer revealing responses of anxiety and discomfort and remained stable during the follow-up one month after the intervention. These results had an impact on improving their quality of life, in terms of her personal, social and professional life.
Diehle, J., Opmeer, B. C., Boer, F., Mannarino, A. P., & Lindauer, R. J. (2014). Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: What works in children with posttraumatic stress symptoms? A randomized controlled trial. European Child & Adolescent Psychiatry. doi:10.1007/s00787-014-0572-5
Julia Diehle, Department of Child and Adolescent Psychiatry, Academic Medical Centre, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands, E-mail: firstname.lastname@example.org
To prevent adverse long-term effects, children who suffer from posttraumatic stress symptoms (PTSS) need treatment. Trauma-focused cognitive behavioral therapy (TF-CBT) is an established treatment for children with PTSS. However, alternatives are important for non-responders or if TF-CBT trained therapists are unavailable. Eye movement desensitization and reprocessing (EMDR) is a promising treatment for which sound comparative evidence is lacking. The current randomized controlled trial investigates the effectiveness and efficiency of both treatments. Forty-eight children (8-18 years) were randomly assigned to eight sessions of TF-CBT or EMDR. The primary outcome was PTSS as measured with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary outcomes included parental report of child PTSD diagnosis status and questionnaires on comorbid problems. The Children's Revised Impact of Event Scale was administered during the course of treatment. TF-CBT and EMDR showed large reductions from pre- to post-treatment on the CAPS-CA (-20.2; 95 % CI -12.2 to -28.1 and -20.9; 95 % CI -32.7 to -9.1). The difference in reduction was small and not statistically significant (mean difference of 0.69, 95 % CI -13.4 to 14.8). Treatment duration was not significantly shorter for EMDR (p = 0.09). Mixed model analysis of monitored PTSS during treatment showed a significant effect for time (p < 0.001) but not for treatment (p = 0.44) or the interaction of time by treatment (p = 0.74). Parents of children treated with TF-CBT reported a significant reduction of comorbid depressive and hyperactive symptoms. TF-CBT and EMDR are effective and efficient in reducing PTSS in children.
Gerger, H., Munder, T., & Barth, J. (2014). Specific and nonspecific psychological interventions for PTSD symptoms: A meta-analysis with problem complexity as a moderator. Journal of Clinical Psychology, 70(7), 601-615. doi:10.1002/jclp.22059
Heike Gerger, Institute of Social and Preventive Medicine (ISPM), University of Bern, Niesenweg 6, 3012 Bern, Switzerland. E-mail: email@example.com
The necessity of specific intervention components for the successful treatment of patients with posttraumatic stress disorder is the subject of controversy.
To investigate the complexity of clinical problems as a moderator of relative effects between specific and nonspecific psychological interventions.
We included 18 randomized controlled trials, directly comparing specific and nonspecific psychological interventions. We conducted moderator analyses, including the complexity of clinical problems as predictor.
Our results have confirmed the moderate superiority of specific over nonspecific psychological interventions; however, the superiority was small in studies with complex clinical problems and large in studies with noncomplex clinical problems.
For patients with complex clinical problems, our results suggest that particular nonspecific psychological interventions may be offered as an alternative to specific psychological interventions. In contrast, for patients with noncomplex clinical problems, specific psychological interventions are the best treatment option.
Novo, P., Landin-Romero, R., Radua, J., Vicens, V., Fernandez, I., Garcia, F., . . . Amann, B. L. (2014). Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: A randomized, controlled pilot-study. Psychiatry Research, 219(1), 122-128. doi:10.1016/j.psychres.2014.05.012
Benedikt L. Amann. E-mail: firstname.lastname@example.org
Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients.
Raboni, M. R., Alonso, F. F., Tufik, S., & Suchecki, D. (2014). Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing. Frontiers in Behavioral Neuroscience, 8, 209. doi:10.3389/fnbeh.2014.00209
Deborah Suchecki, Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, Vila Clementino - São Paulo, 04024-002, Brazil e-mail: deborah.suchecki@ gmail.com
Posttraumatic stress disorder (PTSD) patients exhibit depressive and anxiety symptoms, in addition to nightmares, which interfere with sleep continuity. Pharmacologic treatment of these sleep problems improves PTSD symptoms, but very few studies have used psychotherapeutic interventions to treat PTSD and examined their effects on sleep quality. Therefore, in the present study, we sought to investigate the effects of Eye Movement Desensitization Reprocessing therapy on indices of mood, anxiety, subjective, and objective sleep. The sample was composed of 11 healthy controls and 13 PTSD patients that were victims of assault and/or kidnapping. All participants were assessed before, and 1 day after, the end of treatment for depressive and anxiety profile, general well-being and subjective sleep by filling out specific questionnaires. In addition, objective sleep patterns were evaluated by polysomnographic recording. Healthy volunteers were submitted to the therapy for three weekly sessions, whereas PTSD patients underwent five sessions, on average. Before treatment, PTSD patients exhibited high levels of anxiety and depression, poor quality of life and poor sleep, assessed both subjectively and objectively; the latter was reflected by increased time of waking after sleep onset. After completion of treatment, patients exhibited improvement in depression and anxiety symptoms, and in quality of life; with indices that were no longer different from control volunteers. Moreover, these patients showed more consolidated sleep, with reduction of time spent awake after sleep onset. In conclusion, Eye Movement Desensitization and Reprocessing was an effective treatment of PTSD patients and improved the associated sleep and psychological symptoms.
Shapiro, F. (2014). EMDR therapy: A brief overview of trauma research, clinical practice and propose neurobiological mechanisms. Trauma Psychology, Spring, 2014, 5-8. doi:10.1037/e514232014-001
Tsoutsa, A., Fotopoulos, D., Zakynthinos, S., & Katsaounou, P. (2014). Treatment of tobacco addiction using the feeling-state addiction protocol (FSAP) of the eye movement desensitization and reprocessing (EMDR) treatment. Tobacco induced diseases (Vol. 12, p. A25). BioMed Central Ltd. doi:10.1186/1617-9625-12-S1-A25
Aikaterini Tsoutsa, Pulmonary & Critical Care Department, Evaggelismos Hospital, Athens, 10676, Greece. E-mail: email@example.com
Compulsions and cravings for smoking have been the subject of behavioral treatment. EMDR  is an established, effective treatment of trauma-based disorders . Its use in the treatment of addictions and compulsions is relatively new. Although there are ways of targeting irrational positive affect via EMDR . Merging the Feeling-State Theory of Compulsions and EMDR, the Eye Movement Compulsion Protocol (EMCP) was developed. EMCP is used for fading both feelings and un-wanted behavior related to smoking. The FSAP hypothesizes that the pleasure during smoking is imprinted in the brain generating feelings like comfort, contentment and happiness .Thus, when craving resurges, the Feeling-State (FS) behavior is re-enacted. The EMCP incorporates the standard eye movement technique of EMDR to reduce the FS associated with impulsion to smoke. This study aims to assess the efficacy of the FSAP in the treatment of tobacco addiction of relapsed smokers with persistent compulsions to smoke
Materials and methods
We studied 2 groups (12 smokers in each), that relapsed (at least 1 m after smoking cessation). Smokers were matched for age, sex, Fagerstrom Test for Nicotine Dependence & pack/d.
The FSAP although brief, results in profound changes in behavior . Consequently, the 1st group was administered 6 sessions of the FSAP protocol. The 2nd group had 6 sessions of Cognitive Behavior Therapy. The 2 groups were compared for smoking cessation (self-reported questionnaire, CO-measurements). The 1st group had a succession rate of 50% vs the second that had only 25%.
Thus, we conclude that EMDR could be a very helpful tool in managing smoking relapses.