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Book of the Month

EMDR Therapy Treatment for Grief and Mourning: Transforming the Connection to the Deceased Loved One by Roger M. Solomon offers EMDR trained clinicians a comprehensive and practical guide to working through grief and mourning.

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Bates, A., Golding, H., Rushbrook, S., Highfield, J., Pattison, N., Baldwin, D., Grocott, M. P. W., & Cusack, R. (2024). Mixed-methods randomised study exploring the feasibility and acceptability of eye-movement desensitisation and reprocessing for improving the mental health of traumatised survivors of intensive care following hospital discharge: protocol. BMJ Open, 14(1), e081969. https://doi.org/10.1136/bmjopen-2023-081969

Open Access: https://pubmed.ncbi.nlm.nih.gov/38286705

Andrew Bates, Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. E-mail: a.bates@soton.ac.uk

Abstract

INTRODUCTION: Post-traumatic symptoms are common among patients discharged from intensive care units (ICUs), adversely affecting well-being, increasing healthcare utilisation and delaying return to work. Non-pharmacological approaches (eg, music, therapeutic touch and patient diaries) have been suggested as candidate interventions and trauma-focused psychological interventions have been endorsed by international bodies. Neither category of intervention is supported by definitive evidence of long-term clinical effectiveness in patients who have been critically ill. This study assesses the feasibility and acceptability of using eye-movement desensitisation and reprocessing (EMDR) to improve the mental health of ICU survivors.
METHODS AND ANALYSIS: EMERALD is a multicentre, two-part consent, pilot feasibility study, recruiting discharged ICU survivors from three hospitals in the UK. We are gathering demographics and measuring post-traumatic symptoms, anxiety, depression and quality of life at baseline. Two months after discharge, participants are screened for symptoms of post-traumatic stress disorder (PTSD) using the Impact of Events Scale-Revised (IES-R). Patients with IES-R scores<22 continue in an observation arm for 12 month follow-up. IES-R scores≥22 indicate above-threshold PTSD symptoms and trigger invitation to consent for part B: a randomised controlled trial (RCT) of EMDR versus usual care, with 1:1 randomisation. The study assesses feasibility (recruitment, retention and intervention fidelity) and acceptability (through semistructured interviews), using a theoretical acceptability framework. Clinical outcomes (PTSD, anxiety, depression and quality of life) are collected at baseline, 2 and 12 months, informing power calculations for a definitive RCT, with quantitative and qualitative data convergence guiding RCT refinements.
ETHICS AND DISSEMINATION: This study has undergone external expert peer review and is funded by the National Institute for Health and Care Research (grant number: NIHR302160). Ethical approval has been granted by South Central-Hampshire A Research Ethics Committee (IRAS number: 317291). Results will be disseminated through the lay media, social media, peer-reviewed publication and conference presentation. TRIAL REGISTRATION NUMBER: NCT05591625.

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Blackie, M., De Boer, K., Seabrook, L., Bates, G., & Nedeljkovic, M. (2024). Digital-Based Interventions for Complex Post-Traumatic Stress Disorder: A Systematic Literature Review. Trauma Violence & Abuse, 0(0). https://doi.org/10.1177/1357633X17730443

Open Access: https://journals.sagepub.com/doi/full/10.1177/15248380241238760

Meg Blackie, Department of Psychological Sciences, Swinburne University, John Street, Hawthorn, VIC 3122, Australia. E-mail: mblackie@swin.edu.au

Abstract

Research has shown that complex post-traumatic stress disorder (cPTSD) differs from post-traumatic stress disorder (PTSD) on core symptoms relating to the individual’s sense of self, and this has driven the need for treatment approaches to address these specific features of cPTSD. The COVID-19 pandemic has led to the increased use of digital-based interventions (DBIs) to treat mental illnesses, including trauma-related disorders. However, while evidence for the use of DBIs for PTSD has previously been synthesized, the current review is the first synthesis of research on the use of DBIs for cPTSD. A systematic search of Scopus, Psych INFO, and EBSCOhost was conducted, using search terms targeting “cPTSD” and “DBIs,” to identify research on the use of DBIs to treat cPTSD symptoms. Ten papers were identified, which provided preliminary evidence for the efficacy of DBIs to reduce cPTSD symptoms. Further, DBIs were reported as acceptable by individuals with a history of complex trauma. The paper also provides insight into the therapeutic approaches adopted, digital modalities utilized, safety measures included, and whether/to what degree support was provided. While DBIs show promise for treating cPTSD, there is substantial room for advancement of the empirical evidence base for these approaches. Both clinical and research-based recommendations are provided separately.

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Borst, M., Moeyaert, M., & van Rood, Y. (2024). The effect of eye movement desensitization and reprocessing on fibromyalgia: A multiple-baseline experimental case study across ten participants. Neuropsychol Rehabil, 1-33. https://doi.org/10.1080/09602011.2024.2314883

Open Access: https://doi.org/10.1080/09602011.2024.2314883

Yanda van Rood, Department of Psychiatry, University Medical Center of Leiden, Leiden, Netherlands. E-mail: yrvanrood@lumc.nl

Abstract

Fibromyalgia (FM) is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and stiffness in muscles and joints. Traumatic life experiences and post-traumatic stress symptoms play a role in its development and persistence. Although previous research suggests that pain and FM symptoms decrease after eye movement desensitization and reprocessing (EMDR) therapy, its effectiveness has not been investigated in a controlled manner. The present study investigated the effectiveness of a six-session, 90-minute EMDR therapy using a multiple baseline single-case experimental design (SCED) across ten adult females with FM. The SCED involved a baseline, intervention, one- and three-month follow-up phase. The primary outcome was pain. Secondary outcomes included post-traumatic stress symptoms, other FM symptoms (fatigue, stiffness in muscles and joints), and the impact of FM on daily activities and sleep. Data were statistically analyzed by primarily testing means across phases on an individual and group level. Post-traumatic stress symptoms improved significantly in seven participants. Pain severity decreased significantly in six participants, with three of them maintaining significant improvement three months later. One participant showed clinically relevant change one month later. Furthermore, improvements were observed in secondary outcome measures. The findings support the efficacy of EMDR in reducing FM symptoms.

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Burback, L., Yap, S., Purdon, S. E., Abba-Aji, A., O’Shea, K., Brémault-Phillips, S., Greenshaw, A. J., & Winkler, O. (2024). Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation. Front Psychiatry, 15, 1361086. https://doi.org/10.3389/fpsyt.2024.1361086

Open Access: https://pubmed.ncbi.nlm.nih.gov/38435978

Lisa Burback, Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. E-mail: burback@ualberta.ca

Abstract

INTRODUCTION: Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition.
METHODS: This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989).
RESULTS: Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group.
CONCLUSION: Study results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results.
CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047.

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Carvalho Silva, R., Martini, P., Hohoff, C., Mattevi, S., Bortolomasi, M., Menesello, V., Gennarelli, M., Baune, B. T., & Minelli, A. (2024). DNA methylation changes in association with trauma-focused psychotherapy efficacy in treatment-resistant depression patients: a prospective longitudinal study. Eur J Psychotraumatol, 15(1), 2314913. https://doi.org/10.1080/20008066.2024.2314913

Open Access: https://pubmed.ncbi.nlm.nih.gov/38362742

Alessandra Minelli, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. E-mail: alessandra.minelli@unibs.it

Abstract

Background: Stressful events increase the risk for treatment-resistant depression (TRD), and trauma-focused psychotherapy can be useful for TRD patients exposed to early life stress (ELS). Epigenetic processes are known to be related to depression and ELS, but there is no evidence of the effects of trauma-focused psychotherapy on methylation alterations.
Objective: We performed the first epigenome-wide association study to investigate methylation changes related to trauma-focused psychotherapies effects in TRD patients.
Method: Thirty TRD patients assessed for ELS underwent trauma-focused psychotherapy, of those, 12 received trauma-focused cognitive behavioural therapy, and 18 Eye Movement Desensitization and Reprocessing (EMDR). DNA methylation was profiled with Illumina Infinium EPIC array at T0 (baseline), after 8 weeks (T8, end of psychotherapy) and after 12 weeks (T12 - follow-up). We examined differentially methylated CpG sites and regions, as well as pathways analysis in association with the treatment.
Results: Main results obtained have shown 110 differentially methylated regions (DMRs) with a significant adjusted p-value area associated with the effects of trauma-focused psychotherapies in the entire cohort. Several annotated genes are related to inflammatory processes and psychiatric disorders, such as LTA, GFI1, ARID5B, TNFSF13, and LST1. Gene enrichment analyses revealed statistically significant processes related to tumour necrosis factor (TNF) receptor and TNF signalling pathway. Stratified analyses by type of trauma-focused psychotherapy showed statistically significant adjusted p-value area in 141 DMRs only for the group of patients receiving EMDR, with annotated genes related to inflammation and psychiatric disorders, including LTA, GFI1, and S100A8. Gene set enrichment analyses in the EMDR group indicated biological processes related to inflammatory response, particularly the TNF signalling pathway.
Conclusion: We provide preliminary valuable insights into global DNA methylation changes associated with trauma-focused psychotherapies effects, in particular with EMDR treatment. Stressful events increase treatment-resistant depression, and trauma-focused psychotherapy can be useful for these patients. Epigenome-wide data shows changes associated with trauma-focused psychotherapies, especially eye movement desensitization and reprocessing therapy, in treatment-resistant depression patients. Genes and biological pathways related to inflammatory and immune systems are among the most statistically significant results.

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Ciappina, S., Roccia, E., Concas, D., Faretta, E., Fernandez, I., Quarello, P., Zucchetti, G., & Fagioli, F. (2024). EMDR in pediatric hospital setting: a case report of an adolescent with cancer. Front Psychol, 15, 1347822. https://doi.org/10.3389/fpsyg.2024.1347822

Open Access: https://pubmed.ncbi.nlm.nih.gov/38586287

Giulia Zucchetti, Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy.
E-mail: giulia.zucchetti@unito.it

Abstract

INTRODUCTION: Childhood cancer is rare, but it is the most frequent serious event with a high risk of traumatization for children, adolescents, parents and siblings. EMDR is widely studied as clinical intervention that addressed cancer-related stressors among cancer adult population, but to our knowledge, no researches have been conducted among children and adolescent with cancer.
METHODS: The purpose of this case study is to describe for the first time the application of the EMDR protocol in a pediatric hospital setting with a 17-years-old Italian adolescent who received a diagnosis of leukemia. He accessed the psychological support service complaining of feelings of anxiety and general discomfort. EMDR protocol started after the diagnosis and ended after the usual eight phases. The Impact of Event Scale-Revised (IES-R) was used to assess stress disorders symptoms as outcome at the baseline (before the First Phase) and at the end of the EMDR protocol (after the Eight Phase).
RESULTS: By using EMDR protocol the patient reported a decrease of emotional activation after a few EMDR sessions.
CONCLUSION: EMDR protocol may be effective for pediatric cancer patients in treating stress disorders symptoms and it can be proposed immediately after diagnosis as a standard care also in pediatric hospital setting.

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de Jongh, A., de Roos, C., & El-Leithy, S. (2024). State of the science: Eye movement desensitization and reprocessing (EMDR) therapy. J Trauma Stress, 37(2), 205-216. https://doi.org/10.1002/jts.23012

Open Access: https://pubmed.ncbi.nlm.nih.gov/38282286

Ad de Jongh, PSYTREC, Professor Bronkhorstlaan 2, 3723 MB Bilthoven, the Netherlands. E-mail: a.d.jongh@acta.nl addejonghx@outlook.com

Abstract

Eye movement desensitization and reprocessing (EMDR) therapy is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), with support from more than 30 published randomized controlled trials (RCTs) demonstrating its effectiveness in both adults and children. Most international clinical practice guidelines recommend EMDR therapy as a first-line treatment for PTSD. This paper describes the current state of the evidence for EMDR therapy. We begin with a brief description of EMDR therapy and its theoretical framework. Next, we summarize the scientific support for its efficacy, effectiveness, and safety and discuss its applicability across cultures and with diverse populations. We conclude with suggestions for future directions to develop the research base and applications of EMDR therapy.

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Desbiendras, N. (2024). EMDR therapy before PTSD The benefit of treating Acute Stress Disorder from a recent event [Thérapie EMDR avant TSPT L’intérêt de traiter le Trouble Stress Aigu d’un événement récent]. European Journal of Trauma & Dissociation, 8(1), 100385. https://doi.org/10.1016/j.ejtd.2024.100385

URL: http://dx.doi.org/10.1016/j.ejtd.2024.100385

Nicholas Desbiendras, Psychologue clinicien, Dr en Psycholinguistique, Praticien et superviseur EMDR Europe, Toulouse, France.

Abstract

[From Google translate]
This article is clinical research based on our practice. This study examined the possibility of early treatment of patients who have experienced trauma with EMDR therapy. EMDR (Eyes Movement Desensitization and Reprocessing) therapy is a neuro-emotional integration therapy using eye movements to treat trauma. The objective of this study is to see if early specialized treatment can prevent the onset of Post-Traumatic Stress Disorder (PTSD). All patients (N = 31) were treated a few days to a few weeks after experiencing a traumatic event. They were evaluated before and after therapy with a PCL-5. The results show that 96.8% of patients did not develop PTSD and that for 77.4% of patients, 5 sessions or less were sufficient with a mean of 4.29 sessions and a standard deviation of 2.08. EMDR therapy is recommended for the management of PTSD but nothing has yet been specified for the management of Acute Stress Disorder (ASD). The elements of this study allow us to suggest that EMDR therapy would be an avenue for treating patients early and preventing the onset of PTSD.

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Driessen, H. P. A., Busschbach, J. J. V., Blokhuis, M., & Kranenburg, L. W. (2024). The effectiveness of Eye Movement Desensitization and Reprocessing (EMDR)-therapy on Posttraumatic Stress Disorder (PTSD) symptoms and quality of life in patients with cancer. Gen Hosp Psychiatry, 88, 83-85. https://doi.org/10.1016/j.genhosppsych.2024.02.007

URL: https://doi.org/10.1016/j.genhosppsych.2024.02.007

Helen P A Driessen, Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, the Netherlands. E-mail: h.driessen@erasmusmc.nl.

Abstract

No abstract for this article. [A letter to the Editor describing a case series with standardized measures.]

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El-Barazi, A. S. (2023). Psychological Support for Earthquake Survivors in Turkey and Syria. J Emerg Trauma Shock, 16(4), 171-176. https://doi.org/10.4103/jets.jets_46_23

Open Access: https://pubmed.ncbi.nlm.nih.gov/38292286

Dr. Amani Safwat El-Barazi, Clinical Pharmacy Practice Department, Faculty of Pharmacy, The British University in Egypt, P.O. Box 43, El-Sherouk City, Cairo 11837, Egypt. E-mail: amani.safwat@bue.edu.eg

Abstract

INTRODUCTION: Thousands of children and families are in danger after two powerful earthquakes and dozens of aftershocks struck the border between Turkey and Syria. Thus, earthquake survivors in Turkey and Syria have an urgent need for psychological help. The objectives of this study were to (1) describe the mental health support services offered to people affected by the earthquakes that ravaged parts of Turkey and Syria, (2) discuss the challenges faced by the psychological support services, and (3) highlight recommendations for improving mental health services for earthquake survivors.
METHODS: A questionnaire with open-ended questions was E-mailed to nongovernmental organizations that provide mental health and psychological support to earthquake-affected individuals in Turkey and Syria. The organizations were requested to describe their activities and the obstacles they had to face to deliver these psychological support services. Using content analysis, the gathered statements were examined.
RESULTS: Mental health professionals from 23 nongovernmental organizations responded. The earthquake survivors were mostly provided with Eye Movement Desensitization and Reprocessing and spiritual support. Human resources and financial issues were the most reported concerns among the organizations that responded to the current study.
CONCLUSIONS: While dealing with the long-term consequences of a disaster, it is essential to coordinate the efforts of many organizations.

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Gjerstad, S. F., Nordin, L., Poulsen, S., Spadaro, E. F. A., & Palic, S. (2024). How is trauma-focused therapy experienced by adults with PTSD? A systematic review of qualitative studies. BMC Psychol, 12(1), 135. https://doi.org/10.1186/s40359-024-01588-x

Open Access: https://pubmed.ncbi.nlm.nih.gov/38459602


Stig Poulsen, Department of Psychology, University of Copenhagen, 2A Oester Farim- agsgade, 1353 Copenhagen, Denmark. E-mail: stig.poulsen@psy.ku.dk

Abstract

BACKGROUND: Trauma-focused therapies (TFTs) are first-line treatments for posttraumatic stress disorder (PTSD). However, TFTs are under-utilised, partly due to clinicians' and patients' fear that TFT is too challenging or harmful. We review the qualitative studies on how adults with PTSD experience TFTs to enhance the understanding of user perspectives, therapeutic processes, and outcomes.
METHODS: PubMed, PsychINFO and PTSDPubs were searched between October 1st and November 30th, 2021. Study quality assessments were undertaken, and studies were analysed using a descriptive-interpretative approach. Nine studies were included.
RESULTS: The analysis resulted in the identification of four key domains, representing a temporal sequence of TFT stages: Overcoming ambivalence towards TFT, Experience of treatment elements, Motivation for dropout/retention, and Perceived changes post-treatment.
CONCLUSION: Although many participants reported high levels of distress and considered dropping out, only a minority did eventually drop out and most patients expressed that the hardships in therapy were necessary for PTSD improvement. Establishing a safe therapeutic environment and working with the ambivalence towards treatment was essential for retention. This review serves a dual purpose, to shed light on diverse TFT experiences found to be important for treatment satisfaction, and to elucidate common treatment patterns. The results can be used in preparing patients for therapy and in training TFT therapists. Studies had moderate to high quality, and more studies of experiences of TFT non-responders and dropouts in a non-veteran population are needed to further our understanding of the utility and limitations of TFTs.

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Haddad, R. H., Alhusamiah, B. K., Haddad, R. H., Hamdan-Mansour, A. M., & Abuhashish, Y. H. (2024). The Effectiveness of Using Eye Movement Desensitization and Reprocessing Therapy on Reducing the Severity of Symptoms among Individuals Diagnosed with Post-Traumatic Stress Disorder: A Systematic Review. Research Square, 0. https://doi.org/10.21203/rs.3.rs-3902418/v2

Open Access: http://dx.doi.org/10.21203/rs.3.rs-3902418/v2

Preprint

Abstract

Abstract Background: Post Traumatic Stress Disorder (PTSD) is a global-concern mental illness that occurs due to exposure to a traumatic life experience such as a natural disaster, a severe accident, or a physical or sexual assault in adulthood or childhood. The consequence of PTSD warrants mental health professionals to find effective interventions to maintain and restore mental-well-being. Therefore, selection of intervention is a cornerstone element in deciding successful interventions.
Objectives: The aim of this systematic review was to evaluate and summarize the effectiveness of using eye movement desensitization and reprocessing (EMDR) intervention among individuals diagnosed with PTSD. As well as to highlight the standardized EMDR-based-interventional protocol. Data source: The relevant literature was extracted and conducted using the following online bibliographic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, MEDLINE, Google Scholar, SAGE Journals, and Science Direct and by hand checking reference lists of past similar reviews.
Methods: This Systematic review is guided according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Several online databases were used in searching for eligible studies in peer-reviewed journals relevant to the study keywords. The included studies were Systematic reviews and clinical trials which used EMDR intervention among patients experiencing PTSD symptoms, older than 18 years and were published in the English language from 2017 to 2022. Three researchers independently contributed to study selections, data extraction and study evaluations from different aspects: including quality assessment, risk of bias, and study synthesis. Results: A total of eight published studies met the inclusion criteria and were included in this systematic review; four articles were randomized controlled trials and four were systematic review and meta-analysis studies. In all included studies, the EMDR was utilized as a primary psychotherapy intervention for PTSD symptoms. The results of this extensive and comprehensive review showed that EMDR is an effective psychotherapeutic intervention to reduce and control the severity of symptoms among individuals with PTSD.
Conclusions: This Systematic review gives an overview and explains strong supportive evidence for effectiveness of the EMDR interventions among individuals with PTSD. Therefore, EMDR therapy could be assumed as one standard treatment option for PTSD aiming at reducing treatment duration, and cost of treatment, and restoring the mental well-being and functionality of those suffering from PTSD.

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Hoogstad, A., Mevissen, L., & Didden, R. (2024). EMDR in Three Adults With Severe Intellectual Disability and Posttraumatic Stress Disorder: A Multiple-Baseline Evaluation. Journal of EMDR Practice and Research, 18(1), 18-30. https://doi.org/10.1891/emdr-2023-0042

URL: http://dx.doi.org/10.1891/emdr-2023-0042

Annemieke Hoogstad, Expertise Center Amerpoort, Nieuwenoordlaan 12, 3744 PA, Baarn, The Netherlands. E-mail: a.hoogstad@amerpoort.nl

Abstract

Research on trauma treatment in people with severe intellectual disability (SID; IQ 20–35) is scarce, and controlled studies are lacking. This study examined the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy using the storytelling method in three adults with SID and posttraumatic stress disorder (PTSD). A multiple-baseline design was used to examine the effects of the EMDR storytelling method on PTSD classification, PTSD symptoms, challenging behaviors, and dysfunctional behaviors in three adults with SID and PTSD, EMDR resulted in a significant decrease in PTSD symptoms, challenging behaviors, and most dysfunctional behaviors. None of the participants had a PTSD classification after EMDR. Findings suggest EMDR to be effective in the treatment of PTSD in adults with SID. Follow-up research with a larger sample size is required.

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Horesh, D., & Lahav, Y. (2024). When one tool is not enough: An integrative psychotherapeutic approach to treating complex PTSD. J Clin Psychol. https://doi.org/10.1002/jclp.23688

Open Access: https://pubmed.ncbi.nlm.nih.gov/38577793

Danny Horesh, Department of Psychology, Bar‐Ilan University, Ramat Gan, Israel. E-mail: Danny.Horesh@biu.ac.il

Abstract

Complex posttraumatic stress disorder (CPTSD) is a term representing the psychopathological implications of exposure to chronic, inter-personal trauma. These include the main symptoms of PTSD, as well as changes in identity, emotion regulation, and inter-personal relationships. Self-harm and dissociation (i.e., disintegration of mental processes) are also quite common in CPTSD. Considering this complex and often severe clinical picture, mental health professionals often find it difficult to effectively treat CPTSD. In this paper, we present an integrative approach to the treatment of CPTSD based on a combination of techniques from several psychotherapy approaches. The case described here illustrates the need for therapeutic flexibility and eclecticism when treating individuals exposed to chronic trauma. We show the advantages of flexible therapeutic attunement, which enables the therapist to respond to the changing need of the patient, as well as her fluid clinical picture and symptom manifestation. The case also illustrates how interventions taken from psychodynamic therapy, Dialectical behavior therapy, and Eye Movement Desensitization and Reprocessing may be applicable in various stages of treatment, alleviating the patient's distress in several psychological and physical domains.

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Jhai, Z.-T. (2024). The Impact and Adaptation of EMDR Therapy on the Taiwanese Deaf University Students. Journal of EMDR Practice and Research, 18(1), 31-43. https://doi.org/10.1891/emdr-2023-0043

URL: https://doi.org/10.1891/emdr-2023-0043

Zong-Ti Jhai, Department of Counseling and Guidance, National University of Tainan, 33, Sec. 2, Shu-Lin St. Tainan, 700301, Taiwan. E-mail: rubyjai@mail.nutn.edu.tw

Abstract

Deaf adolescents from schools for the deaf face a difficult challenge adapting to hearing-dominated universities. They harbor stress or trauma from past interactions with the hearing. To understand the impact and adaptation of eye movement desensitization and reprocessing (EMDR) therapy on such students, a pilot study and a formal study were executed for this case study using Taiwanese sign language for all interactions. The client’s changes were documented through diverse sources, while adherence to the standard protocol was verified using the EMDR Fidelity Rating Scale. Results showed that EMDR therapy helped the client in the formal study to maintain calm with the hearing and become capable of overcoming communication barriers, stabilizing emotional arousal quickly, and finally appreciating his academic journey. This study examined the adaptation of EMDR’s various stages for the Deaf and the beneficial environmental support for Deaf university students.

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Klaeth, J. R., Jensen, A. G., Auren, T. J. B., & Solem, S. (2024). 12-month follow-up of intensive outpatient treatment for PTSD combining prolonged exposure therapy, EMDR and physical activity. BMC Psychiatry, 24(1), 225. https://doi.org/10.1186/s12888-024-05656-9

Open Access: https://pubmed.ncbi.nlm.nih.gov/38532374

Julie Rendum Klaeth, Regional Unit for Treatment of Severe Posttraumatic Stress Disorder, Nidaros DPS, St. Olavs Hospital, Trondheim 7040, Norway. E-mail: julie.rendum.kleth@stolav.no

Abstract

BACKGROUND: Preliminary evidence shows promising treatment outcomes at short-term follow-up for intensive posttraumatic stress disorder (PTSD) treatment, but long-term follow-up studies are sparse. This study is a sequel to a previous pilot study and open trial, set out to investigate treatment outcomes at 12-month follow-up for outpatients completing an 8-day intensive treatment for PTSD.
METHODS: All patients were diagnosed with PTSD and had multiple previous psychotherapy attempts (M = 3.1). Patients were assessed at pre-treatment, post-treatment, 3- and 12-month follow-up. Of 35 treated patients, 32 (91.4%) attended the long-term follow-up assessment. The treatment programme combined prolonged exposure therapy, eye movement desensitization and reprocessing, and physical activity.
RESULTS: The effect sizes indicated large reductions in symptoms of PTSD, depression, anxiety, interpersonal problems, and well-being. Changes in functioning showed a small-medium effect. Results were stable across the follow-up period. The treatment response rates showed that 46-60% of patients achieved recovery with respect to PTSD symptoms, and that 44-48% no longer met diagnostic criteria for PTSD.
CONCLUSIONS: Time-limited and concentrated outpatient treatment for PTSD can yield large and enduring positive outcomes. Controlled trials are needed to establish relative efficacy.
TRIAL REGISTRATION: The study was registered in Current Research Information System In Norway (Cristin). Cristin-project-ID: 654,790. Date of registration: 18.03.2019.

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Kleinschmitt, A. (2024). Research on psychotherapy for refugees in Germany: A systematic review on its transdisciplinary and transregional opening. Transcult Psychiatry, 61(2), 151-167. https://doi.org/10.1177/13634615231187255

Open Access: https://pubmed.ncbi.nlm.nih.gov/38234182

Annika Kleinschmitt, KomRex (Center for Research on Right-wing Extremism, Democracy Education and Social Integration), Friedrich Schiller University Jena, Humboldtstr. 11, Jena 07743, Germany. Email: annika.kleinschmitt@uni-jena.de

Abstract

Recently, an increasing amount of research has focused on adapting psychotherapy concepts for refugees moving to Germany. For a long time, research from disciplines like anthropology and cultural studies has problematized the eurocentrism of psychology's theoretical premises and methodologies. Currently, scholarship around Global Mental Health and decolonization emphasizes how knowledge production from various disciplines and regions relates to this topic and could contribute to improving respective approaches. Consequently, this review aims at evaluating the actual transdisciplinary and transregional opening of studies on psychotherapeutic interventions for refugees in Germany. It provides a theoretically as well as empirically informed basis for looking at disciplinary premises, practices, and boundaries as well as the regional locatedness of respective research. Fourteen relevant studies, published between January 1, 2007 and March 4, 2022, were identified by systematically searching the databases PubPsych and Web of Science. The studies were reviewed regarding study design, choice and characterization of target groups, regional origin and target group specific adaptations of the therapeutic concepts, integration of elements from and connections to other disciplines, and use of references to scholarship from the Global South. The findings show a pronounced focus on the development of trauma therapy approaches and moreover a broad variety of concept adaptations in response to the assumed characteristics, situations, and needs of the target groups. While the findings reveal a complex transregional pattern of development and adaptation of the therapeutic concepts, transdisciplinary opening and reference to the Global South appear scarce.

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Krentzel, C. P., & Tattersall, J. (2024). The Distancing Approach: A Comprehensive Eye Movement Desensitization and Reprocessing Psychotherapy for Obsessive-Compulsive Disorder. Journal of EMDR Practice and Research, 18(1), 5-17. https://doi.org/10.1891/emdr-2023-0035

URL: https://doi.org/10.1891/emdr-2023-0035

C. Paula Krentzel, 600 Worcester Road, Suite 501 Framingham, MA 01702, USA. E-mail: drcpaula@gmail.com

Abstract

The Distancing Approach is a comprehensive psychotherapy, rooted in the principles and practices of eye movement desensitization and reprocessing (EMDR) therapy. It aims to address the complex symptoms of obsessive-compulsive disorder (OCD), through insight enhancement, skill development, desensitization of triggers, and reprocessing of related memories. Building on prior OCD research with cognitive behavioral therapy (CBT) and with EMDR, it combines EMDR’s Phobia Protocol with two new EMDR-derived techniques: the Distancing Technique and Future Rehearsal. The Distancing Technique is designed to develop insight through the creation of adaptive coping statements. It identifies and strengthens these adaptive statements in EMDR’s preparation phase so that they can be available as resources during EMDR’s reprocessing phases and in daily life. Future Rehearsal is a technique that combines EMDR methods with CBT’s exposure response prevention to desensitize OCD triggers. EMDR’s Phobia Protocol is applied according to standard procedures. Consistent with the psychotherapy approach, the therapeutic relationship is optimized, and treatment is individualized, to best meet the needs of the client. A case example illustrates the application of the approach.

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Kuzman, R. M., Padberg, F., Amann, B. L., Schouler-Ocak, M., Bajic, Z., Melartin, T., James, A., Beezhold, J., Artigue Gómez, J., Arango, C., Jendricko, T., Ismayilov, J., Flannery, W., Chumakov, E., Başar, K., Vahip, S., Dudek, D., Samochowiec, J., Mihajlovic, G., . . . Gorwood, P. (2024). Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries. Eur Psychiatry, 67(1), e24. https://doi.org/10.1192/j.eurpsy.2024.19

Open Access: https://pubmed.ncbi.nlm.nih.gov/38450651

Martina Rojnic Kuzman, Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia. E-mail: mrojnic@gmail.com

Abstract

BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD).
METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).
RESULTS: About 82% would use antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.
CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

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Malandrone, F., Catrambone, V., Carletto, S., Rossini, P. G., Coletti Moja, M., Oliva, F., Pagani, M., Valenza, G., & Ostacoli, L. (2024). Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder. J Affect Disord, 351, 143-150. https://doi.org/10.1016/j.jad.2024.01.172

Open Access: https://pubmed.ncbi.nlm.nih.gov/38281599

Sara Carletto, Department of Clinical and Biological Sciences, University of Turin, Italy.
E-mail: sara.carletto@unito.it

Abstract

BACKGROUND: The psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes.
METHODS: We enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment.
RESULTS: We found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment.
CONCLUSIONS: TF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.

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Matthijssen, S. J. M. A., Brouwers, T. C., & de Jongh, A. (2024). Visual Schema Displacement Therapy versus Eye Movement Desensitization and Reprocessing therapy versus waitlist in the treatment of post-traumatic stress disorder: results of a randomized clinical trial. Front Psychiatry, 15, 1377108. https://doi.org/10.3389/fpsyt.2024.1377108

Open Access: https://pubmed.ncbi.nlm.nih.gov/38651013

Suzy J. M. A. Matthijssen, Altrecht Academic Anxiety Centre, Altrecht Geestelijke Gezondheidszorg (GGz). E-mail: s.matthijssen@altrecht.nl

Abstract

INTRODUCTION: Visual Schema Displacement Therapy (VSDT) is a novel approach showing promise in mitigating distressing memories, akin to Eye Movement Desensitization and Reprocessing (EMDR).
OBJECTIVES: This study aimed to determine the safety, feasibility, and effectiveness of VSDT in individuals with post-traumatic stress disorder (PTSD), comparing it to EMDR therapy and a waitlist control condition (WLCC). It was hypothesized that the application of VSDT would be safe and PTSD symptoms significantly be reduced from both baseline to post-treatment and from baseline to follow-up in the VSDT and EMDR therapy conditions. Furthermore, we expected both treatments to be significantly more effective than the waitlist control. Moreover, we hypothesized that VSDT and EMDR therapy would be associated with significant improvements in symptoms of depression and general psychopathology.
METHOD: Forty-six adults with PTSD were randomly assigned to VSDT, EMDR therapy, or WLCC, receiving six 90-minute sessions. Assessments included the Clinician Administered PTSD Scale for the Diagnostic Statistical Manual (DSM)-5 (CAPS-5), PTSD Checklist for DSM-5 (PCL-5), Beck Depression Inventory-II (BDI-II) and Brief Symptom Inventory (BSI) before, during, and 3 months post-treatment. RESULTS: Bayesian analysis found no differences between VSDT and EMDR in PTSD symptom reduction but both outperformed WLCC. EMDR was superior to the WLCC in reducing symptoms of depression and general psychopathology. At 3-month follow-up, 58.3% of the participants in the VSDT condition no longer met the PTSD diagnostic criteria (41.2% EMDR therapy and 15.4% WLCC) with no difference between the two therapy conditions. Self-reported PTSD symptom reduction was significant in VSDT (d = 1.38) and EMDR (d = 1.40) but modest in WLCC (d = 0.39). Dropout rate was 19.3%, with no adverse events.
CONCLUSION: This study supports VSDT's efficacy in treating PTSD, offering a valuable therapeutic option comparable to EMDR, with significant reductions in PTSD symptoms and no difference with EMDR or the control condition for depressive symptoms and general psychopathology, and no reported adverse events.

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McKillop, E., Spencer, A., & Marrington, C. (2024). Clinicians’ experiences of learning to use eye movement desensitisation and reprocessing therapy with people with intellectual disabilities: A qualitative study. J Appl Res Intellect Disabil, 37(2), e13206. https://doi.org/10.1111/jar.13206

Open Access: https://pubmed.ncbi.nlm.nih.gov/38332432

Alison Spencer, Learning Disability Specialist Health Services, Essex Learning Disability Partnership, Reception 2, Kao Park 2, London Road, Harlow, Essex CM17 9NA, UK. E-mail: alison.spencer2@nhs.net

Abstract

BACKGROUND: Eye Movement Desensitisation and Reprocessing therapy (EMDR) is a NICE recommended treatment for post-traumatic stress disorder within the general population. Ongoing research is now investigating the use of EMDR for individuals with intellectual disability. Alongside quantitative research efforts, it is beneficial to explore the qualitative experience of clinicians adopting EMDR in their practice. The current study interviewed newly trained EMDR therapists working in intellectual disability services.
METHOD: Participants (six Clinical Psychologists from an NHS learning disability service) had recently undertaken EMDR training as part of a wider randomised control trial (Trauma-AID). Interviews were qualitatively analysed using thematic analysis.
RESULTS: Three themes emerged; learning EMDR, conducting EMDR and external factors, with respect to clinicians' experiences.
CONCLUSIONS: Further research is needed to provide guidance and reassurance for clinicians currently using or hoping to use this therapy with people with intellectual disabilities.

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Mutti, G., Ait Ali, L., Marotta, M., Nunno, S., Consigli, V., Baratta, S., Orsi, M. L., Mastorci, F., Vecoli, C., Pingitore, A., Festa, P., Costa, S., & Foffa, I. (2024). Psychological Impact of a Prenatal Diagnosis of Congenital Heart Disease on Parents: Is It Time for Tailored Psychological Support? J Cardiovasc Dev Dis, 11(1), 31. https://doi.org/10.3390/jcdd11010031

Open Access: https://pubmed.ncbi.nlm.nih.gov/38276657

Lamia Ait Ali, Fondazione Toscana, G. Monasterio, Via Aurelia Sud, 54100 Massa, Italy. E-mail: lamia.ait-ali@cnr.it

Abstract

The prenatal diagnosis of congenital heart disease (CHD) represents, for both parents, a particularly stressful and traumatic life event from a psychological point of view. The present review sought to summarize the findings of the most relevant literature on the psychological impact of prenatal diagnosis of CHD on parents, describing the most common mechanisms employed in order to face this unexpected finding. We also highlight the importance of counseling and the current gaps in the effects of psychological support on this population.

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Rameckers, S. A., van Emmerik, A. A. P., Boterhoven de Haan, K., Kousemaker, M., Fassbinder, E., Lee, C. W., Meewisse, M., Menninga, S., Rijkeboer, M., Schaich, A., & Arntz, A. (2024). The working mechanisms of imagery rescripting and eye movement desensitization and reprocessing: Findings from a randomised controlled trial. Behav Res Ther, 175, 104492. https://doi.org/10.1016/j.brat.2024.104492

Open Access: https://pubmed.ncbi.nlm.nih.gov/38359658

Sophie A. Rameckers, Department of Clinical Psychology, University of Amsterdam, P.O. Box 15933, 1001 NK Amsterdam, the Netherlands. E-mail: S.A.Rameckers@uva.nl

Abstract

We studied the mechanisms of eye movement desensitization and reprocessing (EMDR) and imagery rescripting (ImRs). We hypothesized that EMDR works via changes in memory vividness, that ImRs works via changes in encapsulated beliefs (EB), and that both treatments work via changes in memory distress. Patients (N = 155) with childhood-related posttraumatic stress disorder (Ch-PTSD) received 12 sessions of EMDR or ImRs. The vividness, distress, and EB related to the index trauma were measured with the Imagery Interview. PTSD severity was assessed with the Impact of Events Scale-Revised and the Clinician-Administered PTSD Scale for DSM-5. We conducted mixed regressions and Granger causality analyses. EMDR led to initially stronger changes in all predictors, but only for distress this was retained until the last assessment. No evidence for vividness as a predictive variable was found. However, changes in distress and EB predicted changes in PTSD severity during ImRs. These findings partially support the hypothesized mechanisms of ImRs, while no support was found for the hypothesized mechanisms of EMDR. Differences in the timing of addressing the index trauma during treatment and the timing of assessments could have influenced the findings. This study provides insight into the relative effectiveness and working mechanisms of these treatments.

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Reid, J., Cole, C., Malik, N., Bell, V., & Bloomfield, M. (2024). The effectiveness and tolerability of trauma-focused psychotherapies for psychotic symptoms: A systematic review of trauma-focused psychotherapies. Int J Methods Psychiatr Res, 33(1), e2005. https://doi.org/10.1002/mpr.2005

Open Access: https://pubmed.ncbi.nlm.nih.gov/38441953

Jordan Reid, Translational Psychiatry Research Group, Division of Psychiatry, Research Department of Mental Health Neuroscience, Institute of Mental Health, University College London, London W1T 7NF, UK. E-mail: ucjteid@ucl.ac.uk

Abstract

INTRODUCTION: Psychological trauma is an established risk factor for psychosis. Trauma-focused psychotherapies (TFPT) have been suggested as a potential treatment for reducing psychotic symptoms in those who have experienced trauma. We therefore sought to investigate the effectiveness, tolerability, and acceptability of TFPT for psychotic symptoms. METHODS: We conducted a systematic review of studies of any form of TFPT that measured psychotic symptoms across a broad range of diagnoses. RESULTS: From 2584 papers initially identified, 17 studies (857 participants) met eligibility criteria. TFPT were found to be well tolerated, with very few adverse events. Acceptability was also high, with a mean dropout rate of 20%. CONCLUSIONS: Whilst the evidence of effectiveness for TFPT in reducing psychotic symptoms is weak, we found tentative evidence in favour of exposure-based interventions. Methodologically rigorous trials investigating the efficacy of TFPT for the treatment of psychotic symptoms are needed to assess this promising intervention.

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Rovaris, M., Toselli, E., Mendozzi, L., Di Tella, S., Pirastru, A., Blasi, V., Baglio, F., Ostacoli, L., D’Abramo, A., Incerti, A., Fernandez, I., Pagnini, F., & Cavalera, C. (2024). Eye movement desensitization and reprocessing for depressed individuals with multiple sclerosis: A pilot study. Mult Scler, 30(6), 747-750. https://doi.org/10.1177/13524585241230236

URL: https://pubmed.ncbi.nlm.nih.gov/38372030

Cesare Cavalera, Department of Psychology, Università Cattolica del Sacro Cuore, Via Nirone 15, 20123 Milano, Italy. E-mail: cesarem.cavalera@ unicatt.it

Abstract

BACKGROUND: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS.
OBJECTIVE: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS.
METHODS: We conducted a process-outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function.
RESULTS: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found.
CONCLUSION: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being.

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Ruisch, J. E., Havermans, D. C. D., Gielkens, E. M. J., Olff, M., Daamen, M. A. M. J., van Alphen, S. P. J., van Kordenoordt, M., Schols, J. M. G. A., Schruers, K. R. J., & Sobczak, S. (2024). Posttraumatic stress disorder in people with dementia: study protocol. Eur J Psychotraumatol, 15(1), 2320040. https://doi.org/10.1080/20008066.2024.2320040

Open Access: https://pubmed.ncbi.nlm.nih.gov/38488137

J E Ruisch, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, the Netherlands. E-mail: jessica.ruisch@maastrichtuniversity.nl

Abstract

Background: Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the 'TRAuma and DEmentia' interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia.
Methods: This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the 'TRAuma and DEmentia' interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group.
Conclusion: This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities.
Trial registration: NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F. This study protocol describes a two-part study on posttraumatic stress disorder in people with dementia in Dutch care facilities.The primary aim of the study is to validate the ‘TRAuma and DEmentia’ interview as a diagnostic tool for posttraumatic stress disorder in people with dementia.This study aims to test the feasibility of an evidence-based treatment for people with dementia and posttraumatic stress disorder in the form of eye movement desensitisation and reprocessing therapy.

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Schnurr, P. P., Hamblen, J. L., Wolf, J., Coller, R., Collie, C., Fuller, M. A., Holtzheimer, P. E., Kelly, U., Lang, A. J., McGraw, K., Morganstein, J. C., Norman, S. B., Papke, K., Petrakis, I., Riggs, D., Sall, J. A., Shiner, B., Wiechers, I., & Kelber, M. S. (2024). The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Ann Intern Med, 177(3), 363-374. https://doi.org/10.7326/M23-2757

Open Access: https://pubmed.ncbi.nlm.nih.gov/38408360

Abstract

DESCRIPTION: The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. This article summarizes the 2023 clinical practice guideline (CPG) and its development process, focusing on assessments and treatments for which evidence was sufficient to support a recommendation for or against.
METHODS: Subject experts from both departments developed 12 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) method. Recommendations were made after consensus was reached; they were based on quality and strength of evidence and informed by other factors, including feasibility and patient perspectives. Once the draft was peer reviewed by an external group of experts and their inputs were incorporated, the final document was completed.
RECOMMENDATIONS: The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions. Six recommendations on PTSD treatment were rated as strong. The CPG recommends use of specific manualized psychotherapies over pharmacotherapy; prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when that therapy has been validated for use with video teleconferencing or when other options are unavailable. The CPG also recommends against use of benzodiazepines, cannabis, or cannabis-derived products. Providers are encouraged to use this guideline to support evidence-based, patient-centered care and shared decision making to optimize individuals' health outcomes and quality of life.

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Smith, S., Sadykova, A., & Givaudan, Martha. (2024). Clinical Control Trial on the Healing Drawing Procedure (HDP) Trauma Treatment Intervention Provided by Non-Specialist Mental Health Providers to Vulnerable Children Living in Taraz, Republic of Kazakhstan. Psychology and Behavioral Science International Journal, 21(3), 0. https://doi.org/10.19080/pbsij.2024.21.556065

Open Access: http://dx.doi.org/10.19080/pbsij.2024.21.556065


Sadie Smith, Department of Research, Breakout, Denver, Colorado, United States of America.

Abstract

This clinical controlled trial had two objectives: 1) to evaluate the effectiveness, efficacy, and safety of the Healing Drawing Procedure (HDP) group trauma treatment intervention in reducing posttraumatic stress disorder (PTSD) symptoms among vulnerable children living in Taraz, Kazakhstan and 2) to explore the effectiveness and safety of non-specialist mental health providers (MHPs) being trained in and delivering the HDP group trauma treatment intervention as part of the task-sharing focused Trauma Healing Training Program (THTP), which is being developed to safely bring effective mental health treatment interventions to high-need, low-resource contexts, specifically in low-and-middle-income countries (LMICs). A total of 22 children between the ages of 7-14 (M = 10.09 years old) met the inclusion criteria and participated in the study. To evaluate the effectiveness, efficacy, and safety of the HDP treatment intervention in reducing PTSD symptoms in vulnerable children, repeated-measures ANOVA was applied, comparing the Treatment Group (TG) and the Control Group (CG). Results showed that the HDP treatment intervention had a significant effect for time, with a medium effect size (F (2,40) = 17.72 p <.000, η² = 470), and a significant effect for group with a lower effect size (F (1, 20 = 76.66, p<.001, η² = .404). Intragroup comparisons of means showed significant differences for the Treatment Group (TG) between Time 1. Pre-test assessment and Time 2. Post-treatment assessment with a large effect, t (14) = 5.42, p=.00, d = .955. These data confirm the effectiveness, efficacy, and safety of the HDP group trauma treatment intervention in reducing posttraumatic stress disorder (PTSD) symptoms in children. Results also show the Trauma Healing Training Program’s success in safely bringing an effective mental health treatment intervention provided by specially trained non-specialist mental health providers in a low-resource country.

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van Ee, E., de Beijer, D., Florisson, D., & Geuskens, F. (2024). Making Sense of Change after Intensive Trauma Treatment; a Mixed-Method Study into Adolescents Experience of Efficacy. https://doi.org/https://doi.org/10.21203/rs.3.rs-3981761/v1

URL: https://doi.org/10.21203/rs.3.rs-3981761/v1

Elisa van Ee, Radboud University Nijmegen. E-mail: elisa.vanee@ru.nl

Abstract

While evidence-based interventions are effective for children with post-traumatic stress disorder (PTSD), some adolescents may not respond sufficient. Intensive trauma treatment (ITT) has shown promise for adults, but research on its efficacy for adolescents is limited. This study adopts a mixed-method approach, combining clinical data and narratives, to explore the efficacy and subjective experience of change in 22 adolescents participating in ITT. Quantitative analysis revealed a significant reduction in PTSD symptoms post-ITT, aligning with prior research. Qualitative analysis highlighted themes such as negative thoughts impacting treatment success, the importance of social support, and identity-related struggles. The study contributes to understanding ITT efficacy and emphasizes the need for developmental sensitivity, systemic interventions, and continued research to enhance PTSD treatment for adolescents.

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Vock, S., Delker, A., Rinderknecht, J., Engel, F., Wieland, S., Beiner, E., Friederich, H. C., Jarero, I. N., Seidler, G. H., & Tesarz, J. (2024). Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients. Front Psychol, 15, 1264807. https://doi.org/10.3389/fpsyg.2024.1264807

Open Access: https://pubmed.ncbi.nlm.nih.gov/38455119

Günter H. Seidler. E-mail: psychotrauma@guenter-seidler.de
Jonas Tesarz. E-mail: jonas.tesarz@med.uni-heidelberg.de
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany.

Abstract

The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5-5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.

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Wells, S. Y., Patel, T. A., Halverson, T. F., LoSavio, S. T., Morland, L., Wachsman, T., Ponzini, G. T., Kelton, K., Mackintosh, M. A., Powell, A., Kaplan, S., & Dillon, K. H. (2024). The impact of trauma-focused psychotherapies on anger: A systematic review and meta-analysis. Psychol Trauma. https://doi.org/10.1037/tra0001697

URL: https://pubmed.ncbi.nlm.nih.gov/38546592

Stephanie Y. Wells, Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, 508 Fulton Street, Durham, NC 27705, United States. E-mail: sw4618@gmail.com or stephanie.wells2@va.gov

Abstract

Objective: Anger is one of the most prevalent concerns among individuals with posttraumatic stress disorder (PTSD) and is often a residual symptom following PTSD treatment. The purpose of this systematic review and meta-analysis was to determine how effective trauma-focused PTSD psychotherapies are in reducing anger.
Method: The study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This study conducted a systematic review of studies that reported the effect of trauma-focused treatments on anger outcomes. Additionally, a meta-analysis was conducted with a subset of studies that used randomized controlled trials (RCTs) methodologies to compare trauma-focused PTSD treatments to nontrauma-focused and control conditions.
Results: The systematic review included 16 studies with a total of 1,846 participants. In 11 of the studies, there was a significant decrease in an anger dimension following treatment. Eight studies with 417 total participants met inclusion criteria for the meta-analysis. The meta-analysis yielded a pooled effect size of PTSD treatment on anger of Hedges's g = 0.33.
Conclusion: Overall, trauma-focused treatments for PTSD significantly improve anger, but the magnitude of change is small-to-medium. Additional research is needed to determine how best to maximize anger outcomes following trauma-focused treatment or determine if and when targeted anger treatment is needed.

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Woldemariam, S., Ashman, D., Carvalho, E., Wong, S. L., & Hoersting, R. (2024). AIP-based Professional Intervention Program for Adversity for trauma and stress reduction in groups: a pilot study in Ethiopia. Front Psychiatry, 15, 1351713. https://doi.org/10.3389/fpsyt.2024.1351713

Open Access: https://pubmed.ncbi.nlm.nih.gov/38571995

Esly Carvalho, Trauma Clinic, Brasilia, Brazil. E-mail: esly@traumaclinicinternational.com

Abstract

INTRODUCTION: Drawing from the principles of EMDR (Eye Movement Desensitization and Reprocessing) therapy and the AIP model, the Professional Intervention Program for Adversity (PIPA) was developed with the objective of amalgamating low-intensity group exercises into a unified framework, as a comprehensive intervention for group therapy. The PIPA Program integrates various aspects of EMDR therapy-such as stabilization, resourcing, desensitization, reprocessing, and forming beliefs about the self and future-into a cohesive program. The program's structure includes self-regulation exercises, the Pillars of Life, the Flash Technique, and the Quadrants exercise.
METHODS: The PIPA Program was administered to more than 220 individuals with a high probability of traumatization by the two-year civil war in Ethiopia (2020-2022).
RESULTS: The results of this study show a statistically significant improvement in PTSD symptoms on PCL-5 scores (from M = 38.58 to M = 20.59) after completing the entire PIPA Program and statistically significant lower SUDS scores within the program segments of the Flash Technique and the Quadrants exercises.
DISCUSSION: Future studies should explore the long-term effects of the PIPA Program and its broader application across different therapeutic contexts. The findings suggest that the PIPA Program is a promising group-based intervention for trauma treatment that is safe and effective, especially in non-clinical settings and for culturally diverse populations.

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Woolard, A., Boutrus, M., Bullman, I., Wickens, N., Gouveia Belinelo, P., Solomon, T., & Milroy, H. (2024). Treatment for childhood and adolescent dissociation: A systematic review. Psychol Trauma. https://doi.org/10.1037/tra0001615

URL: https://pubmed.ncbi.nlm.nih.gov/38271004

Alix Woolard, Youth Mental Health, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, Perth, WA 6009, Australia. E-mail: Alix.Woolard@telethonkids.org.au

Abstract

OBJECTIVE: Dissociative symptoms are linked to experiences of trauma, often originating in childhood and adolescence. Dissociative disorders are associated with a high burden of illness and a poor quality of life. Despite evidence suggesting that early intervention can improve outcomes, little research exists on the treatment of dissociative disorders in childhood and adolescence. The current study aimed to systematically review the existing body of literature to identify current treatments applied within child and adolescent populations diagnosed with a dissociative disorder.
METHOD: This review was conducted in line with PRISMA guidelines. Databases were searched for relevant publications, resulting in 3,064 papers to be screened. Articles were included if they involved child or adolescent populations experiencing dissociation and undergoing treatment. Seven articles were included in the current review: two quantitative and five case studies.
RESULTS: Treatment duration varied greatly, ranging from 1 to 29 months. Treatments were mostly combinations of psychotherapy, dialectical behavior therapy, eye movement desensitization and reprocessing, as well as adjunctive therapies such as mindfulness and psychoeducation.
CONCLUSIONS: Our study demonstrated that the literature on current treatment for children and adolescents is clearly scarce, with only seven studies, five of which were case studies and two of which were over 20 years old. The treatments used for dissociation in children and adolescents experiencing dissociation were varied, but psychotherapy was the most used treatment method. This review has revealed that there is no clear framework that exists for the treatment of dissociation in child and adolescent patients, despite the need for one.

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