EMDR Research News May 2012
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
Each month I also feature an EMDR video. This month we showcase a video series for potential clients. “About EMDR” was produced by the EMDR Association of the United Kingdom and Ireland. This series consists of four slide presentations with a pleasant voice over sound track. While not as visually interesting as videos featuring interviews, this series is accurate and concise. Potential clients viewing these videos are exposed to comprehensive, yet succinct, and scientifically accurate information. Part 1: What is EMDR? Part 2: How does EMDR work with memories? Part 3: What happens in EMDR Therapy? Part 4: Choosing a Therapist.
Pub. Date: 06/20/2012
All too often children are diagnosed and medicated without the consideration that their symptoms may actually be a healthy response to stressful life events. This integrative guide for mental health practitioners who work with children underscores the importance of considering the etiology of a child's symptoms within a developmental framework before making a diagnosis. Providing advanced training and skills for working with children, the book guides the therapist, step-by-step, through assessment, case conceptualization, and treatment with a focus on the tenets of child development and a consideration of the impact of distressing life events.
The book first addresses child development and the evolution of child psychotherapy from the perspectives of numerous disciplines, including recent findings in neurodevelopmental trauma and neurobiology. It discusses assessment measures, the impact of divorce and the forensic/legal environment on clinical practice, recommendations for HIPAA compliance, evidence-based best practices for treating children, and the requirements for an integrated treatment approach. Woven throughout are indications for case conceptualization including consideration of a child's complete environment.
Haugen, P. T., Evces, M., & Weiss, D. S. (2012). Treating posttraumatic stress disorder in first responders: A systematic review. Clinical Psychology Review, 32(5), 370-380. doi:doi: 10.1016/j.cpr.2012.04.001
Peter T. Haugen, World Trade Center Health Program NYU School of Medicine Clinical Center of Excellence at Bellevue Hospital Center, Bellevue Hospital Center, Room A720, 462 First Ave., New York, NY 10016, USA. Tel.: + 1 212 562 6148. E-mail: email@example.com
First responders are generally considered to be at greater risk for full or partial posttraumatic stress disorder (PTSD) than most other occupations because their duties routinely entail confrontation with traumatic stressors. These critical incidents typically involve exposure to life threat, either directly or as a witness. There is a substantial literature that has examined the risk factors, symptom presentation, course, and comorbidities of PTSD in this population. However, to our knowledge, there are no systematic reviews of treatment studies for first responders. We conducted a systematic review of the PTSD treatment literature (English and non-English) in order to evaluate such treatment proposals based on what is known about treating PTSD in first responders. We especially sought to identify randomized controlled trials (RCTs) whose primary outcome was PTSD. Our search identified 845 peer-reviewed articles of which 0.002% (n = 2) were bona fide RCTs of PTSD treatment in first responders. Both studies tested a psychosocial treatment. We did not locate a single psychopharmacologic RCT for PTSD in first responders. An additional 2 psychosocial studies and 13 case or observational studies comprised the remaining extant literature. Though both RCTs showed significant large treatment effects (d = 1.37; h = 0.92), the literature is startlingly sparse and is not sufficient for evidence-based recommendations for first responders.
Panko, T. R., & George, B. P. (2012). Child sex tourism: Exploring the issues. Criminal Justice Studies: A Critical Journal of Crime, Law & Society. doi:10.1080/1478601X.2012.657904
Thomas R. Panko, School of Criminal Justice, The University of Southern Mississippi, 118 College Drive, #5127, Hattiesburg, MS, 39406, USA.
Child sex tourism (CST) refers to a particular kind of tourism organized to satisfy the need among certain customer segments for establishing commercial sexual relationships with children. It is an expression of contemporary slavery and a major human rights challenge facing our generation. In this paper, the trauma experienced by child victims of commercial sexual abuse in the touristic setting is discussed. An overview of treatment modalities for the victims such as trauma-focused cognitive behavioral therapy and eye movement desensitization and reprocessing are presented. The efforts of outstanding movements around the world in eradicating CST are highlighted. The paper also considers the complex web of relationships that constitutes the CST distribution system.
Smeets, M. A., Dijs, M. W., Pervan, I., Engelhard, I. M., & van den Hout, M. A. (2012). Time-course of eye movement-related decrease in vividness and emotionality of unpleasant autobiographical memories. Memory (Hove, England), 20(4), 346-57. doi:10.1080/09658211.2012.665462
Monique A. M. Smeets, Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands.
The time-course of changes in vividness and emotionality of unpleasant autobiographical memories associated with making eye movements (eye movement desensitisation and reprocessing, EMDR) was investigated. Participants retrieved unpleasant autobiographical memories and rated their vividness and emotionality prior to and following 96 seconds of making eye movements (EM) or keeping eyes stationary (ES); at 2, 4, 6, and 10 seconds into the intervention; then followed by regular larger intervals throughout the 96-second intervention. Results revealed a significant drop compared to the ES group in emotionality after 74 seconds compared to a significant drop in vividness at only 2 seconds into the intervention. These results support that emotionality becomes reduced only after vividness has dropped. The results are discussed in light of working memory theory and visual imagery theory, following which the regular refreshment of the visual memory needed to maintain it in working memory is interfered with by eye movements that also tax working memory, which affects vividness first.
van den Berg, D. P., & van der Gaag, M. (2012). Treating trauma in psychosis with EMDR: A pilot study. J Behav Ther Exp Psychiatry, 43(1), 664-671. doi:10.1016/j.jbtep.2011.09.011
David PG van den Berg, Parnassia Psychiatric Institute, Prinsegracht 63, 2512 EX Den Haag, The Netherlands. E-mail: firstname.lastname@example.org
BACKGROUND: Initial studies have shown that posttraumatic stress disorder (PTSD) can be effectively treated in patients with a psychotic disorder. These studies however used adapted treatment protocols, avoided direct exposure to trauma related stimuli or preceded treatment with stabilizing techniques making treatment considerably longer in duration.
METHOD: An open trial in which adult subjects with a psychotic disorder and a comorbid PTSD (n = 27) received a maximum of six Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions. PTSD symptoms, psychotic symptoms and additional symptoms were assessed at baseline and end-of-treatment.
RESULTS: The dropout rate was 18.5 percent (five subjects). Only five of the twenty-two completers (22.7%) still met criteria for PTSD after treatment. PTSD symptoms, auditory verbal hallucinations, delusions, anxiety, depression, and self-esteem all improved significantly. Paranoid ideation and feelings of hopelessness did not improve significantly. Treatment did not lead to symptom exacerbation in subjects. There were no adverse events, such as suicide attempts, self-mutilation, aggressive behavior or admission to a general or psychiatric hospital.
CONCLUSIONS: This pilot study shows that a short EMDR therapy is effective and safe in the treatment of PTSD in subjects with a psychotic disorder. Treatment of PTSD has a positive effect on auditory verbal hallucinations, delusions, anxiety symptoms, depression symptoms, and self-esteem. EMDR can be applied to this group of patients without adapting the treatment protocol or delaying treatment by preceding it with stabilizing interventions.
van Rens, L. W., de Weert-van Oene, G. H., van Oosteren, A. A., & Rutten, C. (2012). [Clinical treatment of posttraumatic stress disorder in patients with serious dual diagnosis problems]. Tijdschrift Voor Psychiatrie, 54(4), 383-8.
L. Van Rens, IrisZong, Dubbele Diagnose Klinikek Wolfheze Klinische Behandeling Arnhem. E-mail: email@example.com
Three patients with severe addiction problems, early sexual trauma, posttraumatic stress disorder PTSD comorbid psychotic vulnerability and personality problems received integrated treatment following admission to a clinic specialising in the care of patients with a dual diagnosis. Treatment was administered in accordance with current guidelines and involved either imaginal exposure or eye movement desensitization and reprocessing EMDR, integrated with relapse management of addiction problems. It is concluded that the current evidence-based guidelines regarding PTSD and addiction can also be applied successfully and effectively to an extremely vulnerable patient population.