EMDR Research News October 2018
3 are Randomized Controlled Trials
- EMDR Versus Treatment as Usual in the Treatment of Depression
- EMDR Integrative Group Treatment Protocol Adapted for Ongoing Traumatic Stress for Patients With Cancer-Related PTSD Symptoms
- EMDR Improves Depressive Symptoms, Quality of Life, and Heart Rate Variability in Patients with Heart Failure
5 are Quasi-experimental Studies
- Effective Treatment of Veterans With PTSD: Comparison Between Intensive Daily and Weekly EMDR Approaches
- EMDR Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events
- A trauma-focused approach for patients with tinnitus: the effectiveness of EMDR
- The Effects of the EMDR Group Traumatic Episode Protocol With Cancer Survivors
- Effectiveness of an intensive treatment programme combining prolonged exposure and EMDR for severe post-traumatic stress disorder
1 is a Case Series report
- Intervening in the Intergenerational Transmission of Trauma by Targeting Maternal Emotional Dysregulation With EMDR Therapy
1 is a general survey
- Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder
2 are individual case reports
- EMDR in Older Adults With Posttraumatic Stress Disorder
- EMDR Therapy on a Patient with Schizophrenia and Clinical Effects: A Case Study
6 are Review or Meta-analysis articles
- Psychotherapeutic treatment and HPA axis regulation in posttraumatic stress disorder: A systematic review and meta-analysis
- EMDR for Depression, Anxiety, and Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness
- EMDR to Treat Functional Neurological Disorder: A Review
- Veteran Treatments: PTSD Interventions
- Highlights on the state of the art of EMDR therapy
- CBT versus EMDR in Patients with PTSD: Systematic Review and Meta-analysis of Randomized Clinical Trials
2 are an Analogue (non-clinical) outcome study
- Eye-movement intervention enhances extinction via amygdala deactivation
- Changing negative autobiographical memories in the lab: A comparison of three eye-movement tasks
1 is a Theoretical Paper
- Transference and Countertransference in EMDR Therapy
1 is a Physiological study
- Eye movements support the link between conscious memory and medial temporal lobe function
1 is on Mechanism of action
- How Does EMDR Therapy Work? A Systematic Review on Suggested Mechanisms of Action
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.
Banerjee, S., & Argaez, C. (2017). Eye Movement Desensitization and Reprocessing for Depression, Anxiety, and Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health.
Open access: https://www.ncbi.nlm.nih.gov/books/NBK519861/
The purpose of this report is to review the clinical effectiveness of eye-movement desensitization and reprocessing (EMDR) compared with other psychological treatments, treatment as usual, or no treatment for adult patients with depression, anxiety, or posttraumatic stress disorder (PTSD).
Cope, S. R., Mountford, L., Smith, J. G., & Agrawal, N. (2018). EMDR to Treat Functional Neurological Disorder: A Review. Journal of EMDR Practice and Research, 12(3), 118-132.
Sarah R. Cope, Neuropsychiatry Service, St. George’s Hospital, Blackshaw Road, London SW17 0QT, UK. E-mail: firstname.lastname@example.org
Eye movement desensitization and reprocessing (EMDR) therapy is an established treatment for posttraumatic stress disorder (PTSD), but there is increasing evidence for its use beyond PTSD. EMDR can be effective at treating distressing memories not associated with PTSD, as well as somatic symptoms (like chronic pain), and as such could potentially be used as a treatment for patients with functional neurological disorder (FND). Searches were conducted for published peer-reviewed articles on the use of EMDR for FND. The databases selected and searched were Medline, Embase, Cochrane Library, CINAHL Plus, Web of Science, PsychINFO, PubMed, and Francine Shapiro Library. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Three relevant articles were found. The studies included are one case series and two case studies. Of the five participants included in the studies, four experienced functional non-epileptic attacks; and one experienced functional movement disorder. Four out of the five patients were successfully treated with EMDR. EMDR is potentially a useful treatment of FND, but further research, including controlled trials, is required. The authors propose that EMDR could be useful in treating patients with FND and comorbid PTSD, as well as patients without comorbid PTSD. We discuss the clinical implications and propose how EMDR could fit into the FND treatment pathway.
de Voogd, L. D., Kanen, J. W., Neville, D. A., Roelofs, K., Fernández, G., & Hermans, E. J. (2018). Eye-movement intervention enhances extinction via amygdala deactivation. The Journal of Neuroscience, 0703-0718.
Lycia D. de Voogd, Donders Institute for Brain, Cognition and Behaviour (Radboudumc), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. E-mail: email@example.com
Improving extinction learning is essential to optimize psychotherapy for persistent fear-related disorders. In two independent studies (both n=24), we found that goal-directed eye movements activate a dorsal fronto-parietal network and transiently deactivate the amygdala ([graphic1]=.17). Connectivity analyses revealed that this down-regulation potentially engages a ventromedial prefrontal pathway known to be involved in cognitive regulation of emotion. Critically, when eye movements followed memory reactivation during extinction learning, it reduced spontaneous fear recovery 24 hours later ([graphic2]=.21). Stronger amygdala deactivation furthermore predicted a stronger reduction in subsequent fear recovery after reinstatement (r=.39). In conclusion, we show that extinction learning can be improved with a non-invasive eye-movement intervention that triggers a transient suppression of the amygdala. Our finding that another task which taxes working memory leads to a similar amygdala suppression furthermore indicates that this effect is likely not specific to eye movements, which is in line with a large body of behavioral studies. This study contributes to the understanding of a widely used treatment for traumatic symptoms by providing a parsimonious account for how working memory tasks and goal-directed eye movements can enhance extinction-based psychotherapy, namely through neural circuits (e.g., amygdala deactivation) similar to those that support cognitive control of emotion.
Gielkens, E., Vink, M., Sobczak, S., Rosowsky, E., & Van Alphen, B. (2018). EMDR in Older Adults With Posttraumatic Stress Disorder. Journal of EMDR Practice and Research, 12(3), 132-141.
Ellen Gielkens, Psychologist, Psychologist, Mondriaan Hospital, Heerlen, 6401 CX, The Netherlands. E-mail: e. firstname.lastname@example.org
Recognition of posttraumatic stress disorder (PTSD) in older adults is often difficult due to its complicated presentation. Once recognized, trauma symptoms can, in accordance with (inter)national guidelines, be successfully treated with eye movement desensitization and reprocessing (EMDR) therapy. However, limited empirical research has been done on the expression and treatment of PTSD in older adults. This article explains trauma and age in the context of psychotherapy. It discusses the interaction between age and pathology and summarizes the cognitive issues related to age, PTSD, and anxiety. It provides practical suggestions for how these can be addressed in treatment. Age-related challenges related to motivation are identified with practical suggestions for addressing them. The case illustrates the necessary additions and subtractions for older adults, with clear explanations and instructions. This article points the way for future research.
Hase, M., Plagge, J., Hase, A., Braas, R., Ostacoli, L., Hofmann, A. et al. (2018). Eye Movement Desensitization and Reprocessing Versus Treatment as Usual in the Treatment of Depression: A Randomized-Controlled Trial. Front Psychol, 9, 1384.
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30186192
Michael Hase, Lüneburg Center for Stress Medicine, Lüneburg, Germany,
Eye movement desensitization and reprocessing (EMDR) is a well-established treatment for post-traumatic stress disorder. Recent research suggested that it may be effective in treating depressive disorders as well. The present study is part of a multicenter randomized-controlled trial, the EDEN study, in which a homogenous group of 30 patients was treated to test whether EMDR plus treatment as usual (TAU) would achieve superior results compared to TAU only in a psychosomatic-psychotherapeutic inpatient treatment setting. Both groups were assessed by the Beck Depression Inventory-II (BDI-II) and the Global Severity Index and depression subscale of the Symptom Checklist 90-Revised. The EMDR + TAU group improved significantly better than the TAU group on the BDI-II and Global Severity Index, while a marginally significant difference favoring the EMDR + TAU group over the TAU group was found on the depression subscale. In the EMDR + TAU group, seven out of 14 patients improved below nine points on the BDI-II, which is considered to be a full remission, while four out of 16 in the TAU group did so. These findings confirm earlier suggestions that EMDR therapy may provide additional benefit in the treatment of depression. The present study strengthens the previous literature on EMDR therapy in the treatment of depression due to the randomized-controlled design of the EDEN study.
Hurley, E. C. (2018). Effective Treatment of Veterans With PTSD: Comparison Between Intensive Daily and Weekly EMDR Approaches. Front Psychol, 9, 1458.
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30197612
E. C. Hurley, Soldier Center, Clarksville, TN, United States. Email: email@example.com
The effectiveness of EMDR therapy in treating veterans diagnosed with PTSD was evaluated in this study using two treatment formats: intensive daily EMDR treatment provided twice a day during a 10-day period and a second format of one session each week. The study used archived outcome data previously collected and stored at Soldier Center. Both formats provided 18-20 treatment sessions of EMDR therapy to veterans diagnosed with PTSD that included dissociative exhibitions and moral injury issues. Questions addressed included: (1) does EMDR therapy administered twice daily ameliorate veterans' PTSD symptoms; (2) does EMDR therapy administered twice daily provide equivalent outcome results as EMDR therapy administered weekly for 18-20 sessions; and (3) does the treatment outcome persist. The effectiveness of the weekly treatment group was also evaluated. Both groups' results were assessed at pre-treatment, post-treatment and 1-year follow-up. The results indicated that both weekly treatment and intensive daily treatment groups produced statistically significant treatment effects (p < 0.001) that were maintained at 1-year follow-up. The10-day EMDR intensive daily treatment (EMDR therapy twice a day for 10 days) produced a similar outcome as to that of the weekly treatment with a 1-year follow-up. Results support the effectiveness of EMDR therapy when offered in both weekly treatment format as well as the intensive 10-day format on an outpatient basis. While recognizing the limitations of this study the results are significant to warrant additional research.
Jarero, I., Givaudan, M., & Osorio, A. (2018). Randomized Controlled Trial on the Provision of the EMDR Integrative Group Treatment Protocol Adapted for Ongoing Traumatic Stress to Female Patients With Cancer-Related Posttraumatic Stress Disorder Symptoms. Journal of EMDR Practice and Research, 12(3), 94-104.
Ignacio Jarero, PhD, EdD, Latin American & Caribbean Foundation for Psychological Trauma Research, Boule- vard de la Luz 771, Jardines del Pedregal, Álvaro Obregón, México City, Mexico 01900. E-mail: nacho@amamecrisis. com.mx
This randomized controlled trial extended the investigation previously conducted by Jarero et al. (2015) which found that the eye movement desensitization and reprocessing Integrative Group Treatment Protocol adapted for ongoing traumatic stress (EMDR-IGTP-OTS) was effective in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. The current study sought to determine if the results could be replicated and if the treatment would also be effective in reducing symptoms of anxiety and depression. Participants in treatment (N = 35) and no-treatment control (N = 30) groups completed pre, post, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed that the EMDR-IGTP-OTS was effective in significantly reducing symptoms of PTSD, anxiety, and depression, with symptoms maintained at 90-day follow-up and with large effect sizes (e.g., d = 1.80). A comparison of the treatment and no-treatment control groups showed significantly greater decreases for the treatment group on symptoms of PTSD, anxiety, and depression. No significant correlation was found when exploring the relationship between scores on the Adverse Life Experiences scale and scores indicating pretreatment severity of PTSD, anxiety, and depression. This study suggests that EMDR-IGTP-OTS may be an efficient and effective way to address cancer-related posttraumatic, depressive, and anxious symptoms.
Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive Behavioral Therapy versus Eye Movement Desensitization and Reprocessing in Patients with Post-traumatic Stress Disorder: Systematic Review and Meta-analysis of Randomized Clinical Trials. Cureus.
Open access: http://dx.doi.org/10.7759/cureus.3250
Vijaya Padma Kotapati, firstname.lastname@example.org
Post-traumatic stress disorder (PTSD) is prevalent in children, adolescents and adults. It can occur alone or in comorbidity with other disorders. A broad range of psychotherapies such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) have been developed for the treatment of PTSD.
Through quantitative meta-analysis, we aimed to compare the efficacy of CBT and EMDR: (i) relieving the post-traumatic symptoms, and (ii) alleviating anxiety and depression, in patients with PTSD.
We systematically searched EMBASE, Medline and Cochrane central register of controlled trials (CENTRAL) for articles published between 1999 and December 2017. Randomized clinical trials (RCTs) that compare CBT and EMDR in PTSD patients were included for quantitative meta- analysis using RevMan Version 5.
Fourteen studies out of 714 were finally eligible. Meta-analysis of 11 studies (n = 547) showed that EMDR is better than CBT in reducing post-traumatic symptoms [SDM (95% CI) = -0.43 (- 0.73 – -0.12), p = 0.006]. However, meta-analysis of four studies (n = 186) at three-month follow-up revealed no statistically significant difference [SDM (95% CI) = -0.21 (-0.50 – 0.08), p = 0.15]. The EMDR was also better than CBT in reducing anxiety [SDM (95% CI) = -0.71 (-1.21 – -0.21), p = 0.005]. Unfortunately, there was no difference between CBT and EMDR in reducing depression [SDM (95% CI) = -0.21 (-0.44 – 0.02), p = 0.08].
The results of this meta-analysis suggested that EMDR is better than CBT in reducing post- traumatic symptoms and anxiety. However, there was no difference reported in reducing depression. Large population randomized trials with longer follow-up are recommended to build conclusive evidence.
Koven, S. G. (2018). Veteran Treatments: PTSD Interventions. Healthcare (Basel), 6(3).
Open access: https://www.mdpi.com/2227-9032/6/3/94
Steven G. Koven, Urban Studies Institute, University of Louisville, 426 West Bloom Street, Louisville, KY 40208, USA. E-mail: email@example.com
Post-traumatic stress disorder (PTSD) has resulted in high social costs in terms of the lingering inability of veterans to adapt to societal norms. These costs accrue to individual veterans, their families, friends, and others. In addition, society suffers from the lost productivity of veterans. There is a need to pay greater attention to the extant literature regarding the effectiveness or ineffectiveness of various interventions. This study reviews the most relevant research regarding PTSD, veterans, interventions, treatment, counseling, job training and medication. Increasing awareness of the existing state of knowledge can lead to better targeting of resources and better health outcomes.
Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action. Frontiers in Psychology, 9.
Open access: http://dx.doi.org/10.3389/fpsyg.2018.01395
Ramon Landin-Romero. ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia. Email: firstname.lastname@example.org
Background: Eye movement desensitization and reprocessing [EMDR] is an innovative, evidence-based and effective psychotherapy for post-traumatic stress disorder [PTSD]. As with other psychotherapies, the effectiveness of EMDR contrasts with a limited knowledge of its underlying mechanism of action. In its relatively short life as a therapeutic option, EMDR has not been without controversy, in particular regarding the role of the bilateral stimulation as an active component of the therapy. The high prevalence of EMDR in clinical practice and the dramatic increase in EMDR research in recent years, with more than 26 randomized controlled trials published to date, highlight the need for a better understanding of its mechanism of action.
Methods: We conducted a thorough systematic search of studies published until January 2018, using PubMed, ScienceDirect, Web of Knowledge and Scopus databases that examined the mechanism of action of EMDR or provided conclusions within the framework of current theoretical models of EMDR functioning.
Results: Eighty-seven studies were selected for review and classified into three overarching models; (i) psychological models (ii) psychophysiological models and (iii) neurobiological models. The evidence available from each study was analyzed and discussed. Results demonstrated a reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy. Recently, more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy.
Discussion: Despite the increasing number of studies that published in recent years, the research into the mechanisms underlying EDMR therapy is still in its infancy. Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions.
Lobregt-van Buuren, E., Sizoo, B., Mevissen, L., & de Jongh, A. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events. J Autism Dev Disord.
Ella Lobregt-van Buuren, Centre for Developmental Disorders, Dimence Institute of Mental Health, Nico Bolkesteinlaan 1, 7416 SB, Deventer, The Netherlands. E-mail: email@example.com.
The study investigated whether EMDR is a feasible therapy for adults with ASD and a history of adverse events, and whether it is associated with reductions in symptoms of PTSD, psychological distress and autism. Participants received 6 to 8 weeks treatment as usual (TAU), followed by a maximum of 8 sessions EMDR added to TAU, and a follow-up of 6-8 weeks with TAU only. Results showed a significant reduction of symptoms of post-traumatic stress (IES-R: d = 1.16), psychological distress (BSI: d = 0.93) and autistic features (SRS-A: d = 0.39). Positive results were maintained at follow-up. The results suggest EMDR therapy to be a feasible and potentially effective treatment for individuals with ASD who suffer from the consequences of exposure to distressing events.
Mertens, G., Krypotos, A.-M., van Logtestijn, A., Landkroon, E., Veen, S. C. V., & Engelhard, I. M. (2018). Changing negative autobiographical memories in the lab: A comparison of three eye-movement tasks. Memory.
Open access: doi.org/10.1080/09658211.2018.1507041
Gaëtan Mertens, Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, room H1.29, Utrecht 3584CS, the Netherlands. E-mail: firstname.lastname@example.org
There is strong evidence that executing eye-movement (EM) tasks that load working memory (WM) while thinking of an emotional memory reduces the emotionality and vividness of this memory. According to WM theory, EM tasks that load WM more should be more effective to devalue emotional memories. In this study, we compared three EM tasks: dot tracking, letter identification, and a combination of dot tracking and letter identification. First, participants completed a reaction time (RT) task to assess the WM load of the three EM tasks relative to a control task (viewing a black screen). Then, participants were asked to think of a negative autobiographical memory while executing one of these EM tasks and asked to recall another negative memory while executing the control task. Before and after each task, participants rated emotionality and vividness of the memory. All EM tasks slowed down RTs relative to the control task, and the letter identification task induced the largest RTs. Reductions of vividness relative to the control task, however, were comparable across the EM tasks, and there were no reliable reductions of emotionality. We discuss these findings in light of the WM theory and alternative theories for the effects of dual-task interventions.
Musett, A., & Magnani, B. (2018). Highlights on the state of the art of EMDR therapy. Psicoterapia Cognitiva e Comportamentale, 24(2), 189-196.
Alessandro Musetti, Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi, 10, 43121 Parma, Italy. E-mail: email@example.com
A recent paper by Dominguez and Lee (2017) discussed several methodological and statistical errors made by the American Psychological Association (APA) in defining Eye Movement Desensitisation and Reprocessing (EMDR) efficacy for PTSD as weaker than cognitive behavioural therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT) and exposure therapy. In this commentary, starting from the study of Dominguez and Lee (2017) we are going to express our position and state that the limits which make the results on EMDR treatment efficacy controversial are not merely methodological and statistical but, rather, theoretical.
Okawara, M., & Paulsen, S. L. (2018). Intervening in the Intergenerational Transmission of Trauma by Targeting Maternal Emotional Dysregulation With EMDR Therapy. Journal of EMDR Practice and Research, 12(3), 142-157.
Mii Okawara, PhD, Tokyo Gakugei University, 4-1-1, Nukui-kitamati, Koganei-shi, Tokyo, Japan 184-8501. E-mail: firstname.lastname@example.org
Many studies have shown that the relationship between child and caregivers is critical for healthy development of the child’s brain function, and for intergenerational transmission of attachment. Here, we propose a useful eye movement desensitization and reprocessing (EMDR) target for treatment of maternal emotional dysregulation that can cause maltreatment of the child, with the goal of interrupting intergenerational transmission of attachment trauma. First, we use schematics to demonstrate a hypothetical model of the interaction between a child’s attachment behavior and a mother’s bonding behavior. This schematic shows that the child’s physiologic reaction activates or triggers the mother’s negative affect and somatic sensations in her limbic system and brain stem and that, in turn, evokes the mother’s maltreatment behavior. The negative affect and somatic sensation (maternal emotional dysregulation) are Dysfunctionally Stored Information (DSI) that was produced in the mother’s past experience. We propose that the mother’s negative affect and somatic sensations activated by the child’s behaviors can be useful targets for EMDR therapy based on this hypothetical model. Two Japanese case reports (mothers with 4-year-old daughters) are described to illustrate this application. Further discussion highlights the feature of Japanese cultural relationship and the dissociation, and the meaning and scope of targeting maternal emotional dysregulation with EMDR therapy.
Piedfort-Marin, O. (2018). Transference and Countertransference in EMDR Therapy. Journal of EMDR Practice and Research, 12(3), 158-172.
Olivier Piedfort-Marin, MSc, University of Lorraine, Metz, France, APEMAC/EPSAM, EA 4360. E-mail: email@example.com
Just like any other psychotherapy method, eye movement desensitization and reprocessing (EMDR) should conceptualize the intersubjective phenomena that are active during EMDR therapy, especially in the treatment of complex cases. This article describes the concepts of transference and countertransference and how to integrate them in the Adaptive Information Processing (AIP) model. In this article, research on mirror neurons, the concept of action systems, and recent considerations on attachment theory for patients with disorganized attachment are incorporated into the concepts of transference and countertransference. Input from each of these theories is illustrated with a clinical vignette that depicts how the client’s and the therapist’s conscious and unconscious processes are intertwined and how they may affect the efficacy of EMDR therapy. We propose the countertransference-based interweave to release the AIP when countertransference issues block the process. Integrating knowledge on transference and countertransference in EMDR therapy could increase the efficacy of EMDR, especially in complex cases.
Rikkert, M., van Rood, Y., de Roos, C., Ratter, J., & van den Hout, M. (2018). A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing - a multicentre pilot trial. Eur J Psychotraumatol, 9(1), 1512248.
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30220982
Marian Rikkert, Ziekenhuis Rivierenland, Pres. Kennedylaan 1, Tiel, WP 4002, The Netherlands. E-mail: firstname.lastname@example.org
Background: While normal tinnitus is a short-term sensation of limited duration, in 10-15% of the general population it develops into a chronic condition. For 3-6% it seriously interferes with many aspects of life.
Objective: The aim of this trial was to assess effectiveness of a trauma-focused approach, eye movement desensitization and reprocessing (EMDR), in reducing tinnitus distress. Methods: The sample consisted of 35 adults with high levels of chronic tinnitus distress from five general hospitals in the Netherlands. Participants served as their own controls. After pre-assessment (T1), participants waited for a period of 3 months, after which they were assessed again (T2) before they received six 90 min manualized EMDR treatment sessions in which tinnitus-related traumatic or stressful events were the focus of treatment. Standardized self-report measures, the Tinnitus Functional Index (TFI), Mini-Tinnitus Questionnaire (Mini-TQ), Symptom Checklist-90 (SCL-90) and the Self-Rating Inventory List for Post-traumatic Stress Disorder (SRIP), were completed again halfway through treatment (T3), post-treatment (T4) and at 3 months' follow-up (T5).
Results: Repeated measures analysis of variance revealed significant improvement after EMDR treatment on the primary outcome, TFI. Compared to the waiting-list condition, scores significantly decreased in EMDR treatment [t(34) = -4.25, p < .001, Cohen's d|z| = .72]. Secondary outcomes, Mini-TQ and SCL-90, also decreased significantly. The treatment effects remained stable at 3 months' follow-up. No adverse events or side effects were noted in this trial.
Conclusions: This is the first study to suggest that EMDR is effective in reducing tinnitus distress. Randomized controlled trials are warranted.
Roberts, A. K. P. (2018). The Effects of the EMDR Group Traumatic Episode Protocol With Cancer Survivors. Journal of EMDR Practice and Research, 12(3), 105-117.
Amanda Karen Patricia Roberts, PhD, MA, Private Practice, Amherst, MA 01001. E-mail: email@example.com
The purpose of this pre-experimental case study was to explore the efficacy and safety of the Eye Movement Desensitization and Reprocessing (EMDR) Group Traumatic Episode Protocol (G-TEP) in the psychological treatment of cancer survivors and its potential effects on posttraumatic stress, anxiety, and depressive symptoms. Participants (N = 35) were patients with various types of cancer, in different stages, initial or recurring, with diagnosis or oncology treatment received within the past year. Following an individual psychoeducational intake session, participants received two 90-minute EMDR G-TEP sessions, administered on consecutive days. They were randomly assigned to a treatment group or a delayed treatment group. Assessments were administered at pre, post, and follow-up using the Short PostTraumatic Stress Disorder Interview (SPRINT), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Repeated measures comparisons of PTSD symptoms, anxiety, and depression revealed significant differences between pretest and posttest, with most results maintained at follow-up. Pre-follow-up effect sizes showed medium effects. These promising results suggest the value in providing a lengthier course of treatment. They support the need for research with large sample, randomized clinical trials to examine the viability of providing EMDR G-TEP in the psychological treatment of cancer survivors. No serious adverse effects were reported and we conclude that the EMDR G-TEP may be effective and safe in the psychological treatment of an oncology population.
Schumacher, S., Niemeyer, H., Engel, S., Cwik, J. C., & Knaevelsrud, C. (2018). Psychotherapeutic treatment and HPA axis regulation in posttraumatic stress disorder: A systematic review and meta-analysis. Psychoneuroendocrinology, 98, 186-201.
Sarah Schumacher, Division of Clinical Psychological Intervention Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany. Email: firstname.lastname@example.org
Posttraumatic stress disorder (PTSD) has been associated with dysregulation of the hypothalamic-pituitary- adrenal (HPA) axis. Research over the past years has investigated potential changes of these alterations in the context of psychotherapy. Yet, no systematic review has been conducted. To summarize the current state of research on psychotherapy and HPA hormones, namely cortisol, dehydroepiandrosterone and its sulfate form (DHEA(S)), we searched for studies investigating predictions or changes in hormones over treatment course within the databases PubMed, Scopus, Medline, PsychINFO, Pilots/ProQuest, and Web of Science, and in the grey literature up to May 2018. Controlled and uncontrolled trials investigating adult samples with a clinical status of PTSD were eligible for inclusion. Twelve studies (428 participants) were included. Study quality was overall sufficient. Hormone assessment designs differed considerably. Treatment efficacy on PTSD symptom reduction was mostly high, but predictions of pre-treatment hormone concentrations on treatment efficacy were largely non-significant. Changes from pre- to post-test in basal cortisol (g = -0.07, 95% CI = -0.36; 0.21) and in the cortisol awakening response (g = -0.07, 95% CI = -0.48; 0.35) were also non-significant. Future studies require comparable designs and need to be sufficiently powered to be able to detect potential associations with HPA regulation.
Urgolites, Z. J., Smith, C. N., & Squire, L. R. (2018). Eye movements support the link between conscious memory and medial temporal lobe function. Proc Natl Acad Sci U S A, 115(29), 7599-7604.
Larry R. Squire, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161. Email: email@example.com.
When individuals select the recently studied (and familiar) item in a multiple-choice memory test, they direct a greater proportion of viewing time toward the to-be-selected item when their choice is correct than when their choice is incorrect. Thus, for both correct and incorrect choices, individuals indicate that the chosen item is old, but viewing time nevertheless distinguishes between old and new items. What kind of memory supports this preferential viewing effect? We recorded eye movements while participants made three-alternative, forced-choice recognition memory judgments for scenes. In experiment 1 (n = 30), the magnitude of the preferential viewing effect was strongly correlated with measures of conscious, declarative memory: recognition accuracy as well as the difference in confidence ratings and in response times for correct and incorrect choices. In four analyses that minimized the contribution of declarative memory in order to detect a possible contribution from other processes, the preferential viewing effect was absent. In experiment 2, five memory-impaired patients with medial temporal lobe lesions exhibited a diminished preferential viewing effect. These patients also exhibited poor recognition accuracy and reduced differences in confidence ratings and response times for correct and incorrect choices. We propose that the preferential viewing effect is a phenomenon of conscious, declarative memory and is dependent on the medial temporal lobe. The findings support the link between medial temporal lobe function and declarative memory. When the effects of experience depend on the medial temporal lobe, the effects reflect conscious memory.
Van Minnen, A., Hendriks, L., Kleine, R., Hendriks, G. J., Verhagen, M., & De Jongh, A. (2018). Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder. Eur J Psychotraumatol, 9(1), 1492836.
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30034642
Agnes van Minnen, Professor Bronkhorstlaan 2, 3723 MB Bilthoven, The Netherlands. E-mail: firstname.lastname@example.org
Background: Trauma-focused treatments (TFTs) for patients with post-traumatic stress disorder (PTSD) are highly effective, yet underused by therapists.
Objective: To describe a new way of implementing (adequate use of) TFTs, using a therapist rotation model in which one patient is treated by several therapists.
Method: In this article, we will present two examples of working with therapist rotation teams in two treatment settings for TFT of PTSD patients. We explore the experiences with this model from both a therapist and a patient perspective.
Results: Our findings were promising in that they suggested that this novel approach reduced the therapists' fear of providing TFT to PTSD patients, increased perceived readiness for TFT, and decreased avoidance behaviour within TFT sessions, possibly leading to better implementation of TFT. In addition, the therapeutic relationship as rated by patients was good, even by patients with insecure attachment styles.
Conclusions: We suggest that therapist rotation is a promising novel approach to improve implementation of TFT for PTSD.
Van Woudenberg, C., Voorendonk, E. M., Bongaerts, H., Zoet, H. A., Verhagen, M., Lee, C. W. et al. (2018). Effectiveness of an intensive treatment programme combining prolonged exposure and eye movement desensitization and reprocessing for severe post-traumatic stress disorder. European Journal of Psychotraumatology, 9(1), 1487225.
Open access: https://www.tandfonline.com/doi/abs/10.1080/20008198.2018.1487225
A. De Jongh, PSYTREC, Bilthoven, The Netherlands, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands. E-mail: email@example.com
Background: There is room for improvement regarding the treatment of severe post- traumatic stress disorder (PTSD). Intensifying treatment to increase patient retention is a promising development.
Objective: The aim of this study was to determine the effectiveness of an intensive trauma- focused treatment programme over 8 days for individuals suffering from severe PTSD. Method: Treatment was provided for 347 PTSD patients (70% women; mean age = 38.32 years, SD = 11.69) and consisted of daily sessions of prolonged exposure and eye movement desensitization and reprocessing (EMDR) therapy (16 sessions in total), physical activity, and psycho-education. All participants had experienced multiple traumas, including sexual abuse (74.4%), and suffered from multiple comorbidities (e.g. 87.5% had a mood disorder). Suicidal ideation was frequent (73.9%). PTSD symptom severity was assessed by both clinician-rated [Clinician Administered PTSD Scale (CAPS)] and self-report [PTSD Symptom Scale Self Report (PSS-SR) and Impact of Event Scale (IES)] inventories. For a subsample (n = 109), follow-up data at 6 months were available.
Results: A significant decline in symptom severity was found (e.g. CAPS intention-to-treat sample Cohen’s d = 1.64). At post-treatment, 82.9% showed a clinically meaningful response and 54.9% a loss of diagnosis. Dropout was very low (2.3%).
Conclusions: Intensive trauma-focused treatment programmes including prolonged expo- sure, EMDR therapy, and physical activity can be effective for patients suffering from severe PTSD and are associated with low dropout rates.
Wen Kao, C., Cheng, S. M., Jung Wan, F., Shiang Lin, W., & Cune Chang, Y. (2018). Eye Movement Desensitization and Reprocessing Improves Depressive Symptoms, Quality of Life, and Heart Rate Variability in Patients with Heart Failure. Neuropsychiatry, 08(03), 1073-1082.
Open access: http://dx.doi.org/10.4172/neuropsychiatry.1000435
Chi-Wen Kao, PhD, RN, Director of Nursing Department, Tri-Service General Hospital, Associate Professor, National Defense Medical Center, School of Nursing, No.325, Sec.2, Chenggong Rd., Taipei 114, Taiwan. E-mail: firstname.lastname@example.org
Background: Depression is a common co-morbidity in patients with heart failure. Eye movement desensitization and reprocessing (EMDR) has been identified as an effective intervention for severe psychological distress.
Objective: The purpose of this study was to examine the effect of an EMDR intervention on depressive symptoms, health-related quality of life, and heart rate variability (HRV) in patients with heart failure.
Methods: For this longitudinal experimental study, 57 consecutive patients were randomly assigned to an experimental (n = 25, EMDR intervention) or control (n = 32, routine care) group through blocked randomization. Data were collected at four times (pre-intervention, post- intervention, and one-month and three-month follow-up) and analyzed with the generalized estimating equation approach.
Results: Most participants were male (57.9%), with a mean age of 63.14 ± 14.53 years and mean ejection fraction of 49.86 ± 15.18%. The majority of them were NYHA class II (n = 41, 71.9%) with a clinical history of hypertension (n = 38, 66.7%). Participants receiving the EMDR intervention showed significantly greater improvement in depressive symptoms (p < 0.001), health-related quality of life (p = 0.007), and High Frequency (HF) (p = 0.003), Low Frequency (LF) (p < 0.001), and LF/HF ratio (p = 0.001) in HRV at post-intervention compare with controls. Furthermore, the intervention effects were sustained at one month and three months after completion of the intervention.
Conclusion: The EMDR intervention may improve depressive symptoms, health-related quality of life, and HRV in patients with heart failure. The improvements can be maintained three months later.
Yaşar, A. B., Kiraz, S., Usta, D., Abamor, A. E., Zengin Eroğlu, M., & Kavakcı, Ö. (2018). [Eye Movement Desensitization and Reprocessing (EMDR) Therapy on a Patient with Schizophrenia and Clinical Effects: A Case Study]. Turk Psikiyatri Derg, 29(2), 138-142.
Open access: https://www.ncbi.nlm.nih.gov/pubmed/30215843
Alişan Burak Yaşar, MD, Psychiatry Specialist, Marmara University Hospital, Department of Psychiatry, İstanbul. E-mail: email@example.com
Being exposed to traumatic experiences is rather common in patients with schizophrenia. Adverse experiences may induce the onset of psychotic symptoms or trigger current symptoms to be exacerbated. Eye Movement Desensitization Reprocessing (EMDR) is an effective therapy in the treatment of incidences with underlying traumatic experiences, thereby it can be conducted on various cases in addition to other treatments such as psycho-medication or another therapy method. It was developed by Shapiro in 1980s. Although desensitization is widely applied on patients with Post-Traumatic Stress Disorder, it is unusual for EMDR therapy to be safely and effectively performed in the treatment of psychotic disorders or symptoms. In the present case study, EMDR treatment process and course of psychiatric state in a patient with history of childhood abuse and forced psychiatric residency will be discussed. The patient who had a diagnosis of schizophrenia for 8 years was treated with antipsychotic treatment as well as 2 sessions of EMDR, and as a result, a positive change was observed in her general clinical course. Our thoughts on this phenomenon are that EMDR treatment is an effective, safe and short-term intervention in the comorbidity of PTSD and psychotic disorders. However, the literature about the place of EMDR in the treatment of schizophrenia cases is rather limited and much more research is needed.