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Book of the Month

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Alshahrani, K. M., Johnson, J., Prudenzi, A., & O’Connor, D. B. (2022). The effectiveness of psychological interventions for reducing PTSD and psychological distress in first responders: A systematic review and meta-analysis. Plos one, 17(8), e0272732. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272732

Open Access: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272732

Khalid M. Alshahrani, School of Psychology, University of Leeds, Leeds, United Kingdom. E-mail: kalshahrani@kau.edu.sa

Abstract

Background
First responders are faced with stressful and traumatic events in their work that may affect their psychological health. The current review examined the effectiveness of psychological interventions to treat posttraumatic stress disorder (PTSD), anxiety, depression, stress and burnout in first responders.
Methods
Four databases were searched to identify controlled studies that examined the efficacy of psychological interventions to reduce PTSD symptoms (primary outcome) in first responders (including firefighters, police/law enforcement officers, search and rescue personnel, emergency and paramedics teams). Secondary outcomes were anxiety, depression, burn- out, and stress.
Results
15 studies were identified, including 10 studies that measured PTSD, 7 studies for anxiety, 10 studies for depression, 7 studies for stress and 1 for burnout. Interventions were associated with a significant reduction in PTSD (SDM = -0.86; 95% CI = -1.34 –- 0.39), depression (SDM = -0.63; 95% CI = -0.94 –-0.32), and anxiety (SDM = -0.38; 95% CI = -0.71 –-0.05) but not stress (SDM = -0.13; 95% CI = -0.51–0.25). CBT-based and clinician-delivered interventions were associated with significantly greater reductions in PTSD than other types of interventions and non-clinician interventions, but no differences were found for depression. There was evidence of moderate to high risk of bias across all studies.
Conclusions
Psychological interventions are effective in reducing PTSD, depression and anxiety symptoms but not stress in first responders. Further research is needed using high quality randomised designs over longer periods of follow-up.

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Bongaerts, H., Voorendonk, E. M., Van Minnen, A., Rozendaal, L., Telkamp, B. S. D., & de Jongh, A. (2022). Fully remote intensive trauma-focused treatment for PTSD and Complex PTSD. Eur J Psychotraumatol, 13(2), 2103287. https://doi.org/10.1080/20008066.2022.2103287

Open Access: https://pubmed.ncbi.nlm.nih.gov/36186161

H. Bongaerts, Research Department PSYTREC, Bilthoven, The Netherlands. E-mail: h.bongaerts@psytrec.nl, hanneliesbongaerts@xs4all.nl

Abstract

Background: It is unknown whether remotely delivered intensive trauma-focused therapy not only is an effective treatment for PTSD, but also for Complex PTSD. Objective: Testing the hypothesis that a brief, fully remotely administered intensive trauma-focused treatment programme for individuals with PTSD and Complex PTSD would be safe, and associated with a significant decline of the corresponding symptoms and diagnostic status.
Method: The treatment sample consisted of 73 consecutive patients diagnosed with PTSD according to the CAPS-5. According to the ITQ (n = 70) 33 (47.1%) patients also fulfilled the diagnostic criteria of Complex PTSD. The 4-day treatment programme contained a combination of prolonged exposure, EMDR therapy, physical activities and psycho-education. Treatment response was measured using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ) for classifying Complex PTSD and indexing disturbances in self-organization (DSO).
Results: Overall CAPS-5, PCL-5, and ITQ-DSO scores decreased significantly from pre- to post-treatment (Cohen's ds 2.12, 1.59, and 1.18, respectively), while the decrease was maintained to six months follow-up. At post-treatment, 60 patients (82.2%) no longer met the diagnostic criteria of PTSD, while the proportion of patients with Complex PTSD decreased from 47.1% to 10.1%. No drop out, and no personal adverse events occurred.
Conclusions: The results support the notion that intensive, trauma-focused treatment is feasible, safe and associated with a large decrease in PTSD and Complex PTSD symptoms, even when it is brief, and applied fully remote.
HIGHLIGHTS Second study to examine the effectiveness of a fully remote intensive trauma-focused treatment for PTSD and Complex PTSD. Significant decrease of DSO symptoms. Over 80 percent of the patients no longer met the diagnostic criteria of PTSD and Complex PTSD following treatment.

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Bækkelund, H., Endsjø, M., Peters, N., Babaii, A., & Egeland, K. (2022). Implementation of evidence-based treatment for PTSD in Norway: clinical outcomes and impact of probable complex PTSD. Eur J Psychotraumatol, 13(2), 2116827. https://doi.org/10.1080/20008066.2022.2116827

Open Access: https://doi.org/10.1080/20008066.2022.2116827


Harald Bækkelund, Section for Implementation and Treatment Research, Norwegian Center for Violence and Traumatic Stress Studies, Pb. 181 Nydalen, Oslo 0409, Norway. E-mail: harald.bakkelund@nkvts.no

Abstract

Background: Posttraumatic stress disorder (PTSD) is a long-lasting and debilitating psychological disorder that affects a large portion of the population. Treatments such as Cognitive therapy for PTSD (CT-PTSD) and Eye movement desensitization and reprocessing (EMDR) have been shown to be effective and cost-efficient in clinical trials, but uptake and evidence of positive outcomes in real-world clinical services are limited. Implementation efforts have been hampered by providers' concerns about the feasibility of trauma-focused treatments in more complex presentations (i.e. Complex PTSD).
Objective: To evaluate the effectiveness of CT-PTSD and EMDR in a real-world setting, as implemented in Norwegian outpatient mental health clinics for adults, and investigate the impact of probable Complex PTSD status on treatment outcomes.
Methods: Clinicians from 15 different outpatient clinics received training and supervision in EMDR or CT-PTSD as part of a national implementation project. 104 clinicians recruited and treated 196 participants with PTSD. Symptoms of PTSD, depression and anxiety were assessed session-by-session and used to estimate pre-post effect sizes. Mixed-models were employed to investigate the impact of complex PTSD.
Results: Both EMDR and CT-PTSD were associated with significant reductions in PTSD symptoms, with large effect sizes. Probable Complex PTSD was associated with higher levels of symptoms before and after treatment but did not significantly impact the effectiveness of treatment. Conclusion: The use of evidence-based treatments for PTSD in routine clinical service is associated with good treatment outcomes, also for patients with Complex PTSD.

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Conijn, T., De Roos, C., Vreugdenhil, H. J. I., Van Dijk-Lokkart, E. M., Wijburg, F. A., & Haverman, L. (2022). Effectiveness of time-limited eye movement desensitization reprocessing therapy for parents of children with a rare life-limiting illness: a randomized clinical trial. Orphanet J Rare Dis, 17(1), 328. https://doi.org/10.1186/s13023-022-02500-9

Open Access: https://doi.org/10.1186/s13023-022-02500-9

F. A. Wijburg, Emma Children’s Hospital and Amsterdam Lysosome Center “Sphinx”, Amsterdam UMC, Pediatric Metabolic Diseases, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands. E-mail: f.a.wijburg@amsterdamumc.nl

Abstract

BACKGROUND: Parents of children with a rare progressive life-limiting illness are at risk for parental posttraumatic stress disorder (PTSD). Studies on the treatment of parental PTSD with eye movement and desensitization reprocessing (EMDR) therapy in pediatric practice are lacking. Therefore this study aims to evaluate the feasibility and effectiveness of time-limited EMDR therapy in reducing PTSD symptoms, comorbid psychological symptoms, distress, and parental stress.
METHODS: Mono-center randomized clinical trial conducted between February 2020 and April 2021. Fourteen parents (N = 7 mothers, N = 7 fathers) of mucopolysaccharidosis type III patients reporting PTSD symptoms on a (sub)clinical level were assigned to EMDR or a wait-list control condition followed by EMDR. Four sessions of EMDR (each 90 min) divided over two half-days were offered. Measurements were conducted at baseline, post-treatment/post-waitlist, and 3-months post-treatment. The primary outcome was PTSD symptom severity (PTSD Check List for DSM-5). Secondary outcomes included comorbid psychological symptoms (Brief Symptom Inventory), distress (Distress Thermometer for Parents) and parenting stress (Parenting Stress Questionnaire). Between-group comparisons pre-to-post treatment (N = 7 EMDR vs. N = 7 wait-list) and within-group comparisons (EMDR, N = 14) from pre-to-post treatment and from pre-treatment to 3-months follow-up were carried out per intent-to-treat linear mixed model analyses.
RESULTS: Compared to wait-list, EMDR resulted in a significant reduction on total PTSD symptom severity (d = 1.78) and on comorbid psychological symptoms, distress and parenting stress (d = .63-1.83). Within-group comparisons showed a significant effect on all outcomes at post-treatment (d = 1.04-2.21) and at 3-months follow-up (d = .96-2.30) compared to baseline. EMDR was well-tolerated, associated with a low drop-out rate, a high therapy adherence and no adverse events.
CONCLUSION: Time-limited EMDR reduces PTSD symptoms, psychological comorbidity, distress and parenting stress in parents of children with a rare progressive life-limiting illness. This treatment was feasible for these overburdened parents. Recurrent monitoring of PTSD symptoms, and, if needed, offering this time-limited type of trauma treatment should be introduced in everyday pediatric practice. Trial registration Netherlands Trial Register, NL8496. Registered 01-04-2020,

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Fernandez, I., Pagani, M., & Gallina, E. (2022). Post-traumatic stress disorder among healthcare workers during the COVID-19 pandemic in Italy: Effectiveness of an eye movement desensitization and reprocessing intervention protocol. Front Psychol, 13, 964334. https://doi.org/10.3389/fpsyg.2022.964334

Open Access: https://doi.org/10.3389/fpsyg.2022.964334

Eugenio Gallina, Centro di Ricerca e Studi in Psicotraumatologia (CRSP), Milan, Italy. E-mail: eugenioggallina@gmail.com

Abstract

Aim: The Coronavirus 2019 (COVID-19) pandemic represents one of the most catastrophic events of recent times. Due to the hospitals' emergency situation, the population of healthcare workers was the most affected. Healthcare workers who were exposed to COVID-19 patients are most likely to develop psychological distress and post-traumatic stress disorder (PTSD). The present study aimed at investigating PTSD in a sample of Italian healthcare workers during this outbreak and to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) Therapy with this population.
Methods: A total of 744 healthcare workers were included. 587 healthcare workers were treated with EMDR, while the other 157 were not treated. Participants were asked to provide sociodemographic information; the post-traumatic symptomatology was evaluated through Impact of Event Scale-Revised (IES-R) and to investigate the level of intensity of emotional activation was used The Emotion Thermometer (THERMO) at two time points (pre-post treatment).
Results: The results obtained between EMDR treatment and non-EMDR treatment were evaluated on only 2 hospitals. Treatment group n = 68 vs. waitlist non-treatment group n = 157. All scores pre- and post-EMDR decreased significantly (p < 0.001) showing an evident effect of EMDR. The differences between pre- and post-treatment of the IES-R scores of subjects in which EMDR was performed as compared to the scores pre- and post-12 weeks of waiting list subjects in which it was not performed were significantly different (p < 0.001).
Limitation: The emergency situation did not provide an opportunity to explore further aspects that would have been important for research. One limitation is the use and analysis of only two standardized tests. In addition, other psychopathologies were not investigated as outcome measures. A limitation is the comparison of subjects treated online and de visu. Although the protocol used was the same, the mode of intervention may have influenced the results. In addition, the effectiveness of EMDR treatment was only evaluated at two time points (pre-post) with no possibility of follow-up and the lack of a control group.
Discussion/conclusion: The findings of the present study suggest that healthcare workers were at high risk of developing PTSD when confronted with COVID-19 outbreak and suggest the importance of psychological support during this humanitarian emergency.

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Gielkens, E. M. J., Turksma, K., Kranenburg, L. W., Stas, L., Sobczak, S., van Alphen, S. P. J., & Rossi, G. (2022). Feasibility of EMDR in Older Adults with PTSD to Reduce Frailty and Improve Quality of Life. Clin Gerontol, 1-11. https://doi.org/10.1080/07317115.2022.2114397

URL: https://doi.org/10.1080/07317115.2022.2114397

Ellen M. J. Gielkens, Clinical center of excellence for older adults with personality disorders, Mondriaan Mental Health Center, Heerlen-Maastricht, Kloosterkensweg, 6419 PJ Heerlen, The Netherlands. E-mail: ellengielkens@hotmail.com

Abstract

OBJECTIVES: Posttraumatic stress disorder (PTSD) after exposure to multiple (childhood) trauma's is strongly associated with accelerated aging and high psychiatric and somatic comorbidity, influencing frailty and Quality of Life (QoL) in older adults. Eye Movement Desensitization therapy (EMDR) addresses psychological and physiologic symptoms stemming from adverse life events and therefore could influence frailty and QoL in older adults.
METHODS: We conducted a multi-center feasibility study (two psychiatric hospitals) in Dutch older outpatients (N = 24; ≥60 years) with PTSD. Participants received weekly EMDR-treatment during the course of the trial (3 months to a maximum of 9 months). Frailty (Groninger Frailty Indicator) and QoL (EuroQol 5D-3L), were assessed pre- and posttreatment.
RESULTS: A linear mixed-model approach showed significant reduction of frailty (F(1,23) = 9.019, p = .006) and improvement of QoL (F(1,23) = 13.787, p = .001). For both frailty and QoL, there was no significant influence of Clinician-Administered PTSD Scale (CAPS-5) pre-treatment score, therapy duration, and neither an interaction effect of therapy duration x CAPS-5 pre-treatment score.
CONCLUSIONS: EMDR with older adults with PTSD showed a significant reduction of frailty and improvement of QoL. Randomized controlled studies are needed to more precisely study the impact of trauma-focused treatment in older adults on frailty and QoL and the implications this might have for lessening disease burden.
CLINICAL IMPLICATIONS: Screening for PTSD in older frail adults is important to treat PTSD as a possible way to reduce frailty and improve QoL.

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Johansson, R., Nyström, M., Dewhurst, R., & Johansson, M. (2022). Eye-movement replay supports episodic remembering. Proc Biol Sci, 289(1976), 20220964. https://doi.org/10.1098/rspb.2022.0964

Open Access: https://doi.org/10.1098/rspb.2022.0964

Roger Johansson, Department of Psychology, Lund University, Lund, Sweden. E-mail: roger.johansson@psy.lu.se

Abstract

When we bring to mind something we have seen before, our eyes spontaneously unfold in a sequential pattern strikingly similar to that made during the original encounter, even in the absence of supporting visual input. Oculomotor movements of the eye may then serve the opposite purpose of acquiring new visual information; they may serve as self-generated cues, pointing to stored memories. Over 50 years ago Donald Hebb, the forefather of cognitive neuroscience, posited that such a sequential replay of eye movements supports our ability to mentally recreate visuospatial relations during episodic remembering. However, direct evidence for this influential claim is lacking. Here we isolate the sequential properties of spontaneous eye movements during encoding and retrieval in a pure recall memory task and capture their encoding-retrieval overlap. Critically, we show that the fidelity with which a series of consecutive eye movements from initial encoding is sequentially retained during subsequent retrieval predicts the quality of the recalled memory. Our findings provide direct evidence that such scanpaths are replayed to assemble and reconstruct spatio-temporal relations as we remember and further suggest that distinct scanpath properties differentially contribute depending on the nature of the goal-relevant memory.

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Kaptan, S. K., Varese, F., Yilmaz, B., Andriopoulou, P., & Husain, N. (2022). “Online delivery gave me privacy and distance from others”: feasibility trial and qualitative evaluation of an online intervention for refugees and asylum seekers; LTP + EMDR G‐TEP. Counselling and Psychotherapy Research, 22(4), 876-888. https://doi.org/10.1002/capr.12580

Open Access: https://doi.org/10.1002/capr.12580

Safa Kemal Kaptan, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. E-mail: safa.kaptan@manchester.ac.uk; safakemalkaptan@gmail.com

Abstract

Rates of mental health difficulties are high among refugees and asylum seekers who are parents, which makes their family members vulnerable to further negative out- comes such as behavioural problems or withdrawal. Maternal health and responsive parenting can stimulate the well-being of family members. However, displaced parents may fail to fulfil this role due to their own personal emotional issues. This current study is the first trial that tested the acceptability and feasibility of a remote multi-component parenting intervention for refugees and asylum seekers: Learning Through Play and EMDR Group Traumatic Episode Protocol. The study was a single-arm feasibility trial with an embedded qualitative component, and took place in the UK. We recruited caregivers of children under three years of age and offered eight sessions of a remote group Learning Through Play parenting intervention and Eye Movement Desensitisation Reprocessing Group Traumatic Episode Protocol (LTP+ EMDR G-TEP). We administered assessments, including the Parenting Sense of Competence Scale, International Trauma Questionnaire, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9, followed by qualitative interviews. Of the 16 participants approached, 14 consented and were eligible to participate. Both qualitative and quantitative results showed the acceptability and feasibility of the intervention based on a recruitment rate of 88% of eligible participants and a 78% attendance rate for all sessions. Participants showed improvements in all outcome measures, an increase in pa- rental self-esteem and a reduction in mental health symptoms. Findings also suggest that remote interventions are promising as a scalable approach for displaced families.

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Lin, Y., Lv, W., Xu, J., Jiang, Y., & Chen, Z. (2022). Effectiveness of Cognitive Behavior Therapy Combined with Eye Movement Desensitization and Reprocessing on Psychological Problems and Life Quality in Patients’ Postfacial Trauma. Comput Math Methods Med, 2022, 7822847. https://doi.org/10.1155/2022/7822847

Open Access: https://doi.org/10.1155/2022/7822847

Wang Lv, Department of Emergency, Wenzhou People’s Hospital, Wenzhou, Zhejiang 325000, China. lvwangwz@outlook.com

Abstract

Objective: To investigate the effectiveness of cognitive behavior therapy (CBT) combined with eye movement desensitization and reprocessing (EMDR) on the esteem, anxiety, depression, posttrauma stress disorder (PTSD), and posttraumatic growth in patients with facial trauma.
Methods: A total of 92 facial trauma patients in Wenzhou People's Hospital from January 2017 to December 2019 were enrolled in this study. The patients were randomly divided into control group (n = 46) and intervention group (n = 46). Both of the control group and the intervention group received routine treatment, while the intervention group further received CBT combined with EMDR. Questionnaires were used to explore and record the general patient information. The Self-Esteem Scale (SES), Self-Anxiety Scale (SAS), Self-Depression Scale (SDS), Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), and World Health Organization Quality of Life-brief (WHOQOL-BREF) scores between the two groups were compared.
Results: After CBT combined with EMDR intervention, the SDS and SAS scores in the intervention group were significantly decreased compared with the scores before intervention with statistically significance (P < 0.001). Furthermore, the PCL-C score in the intervention group showed significant decrease in comparison with the control group (P < 0.001), while the PTGI score in the intervention group was significantly higher than the control group (P < 0.001). The WHOQOL-BREF scores were increased after treatment in the two groups compared with the scores before treatment, and the scores in the intervention group were higher than those in the control group after treatment (P < 0.01).
Conclusion: Psychological intervention therapy can effectively alleviate the anxiety, depression, and PTSD and improve the life quality and the recovery of facial trauma patients.

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Papola, D., Ostuzzi, G., Tedeschi, F., Gastaldon, C., Purgato, M., Del Giovane, C., Pompoli, A., Pauley, D., Karyotaki, E., Sijbrandij, M., Furukawa, T. A., Cuijpers, P., & Barbui, C. (2022). Comparative efficacy and acceptability of psychotherapies for panic disorder with or without agoraphobia: systematic review and network meta-analysis of randomised controlled trials. Br J Psychiatry, 221(3), 507-519. https://doi.org/10.1192/bjp.2021.148

Open Access: https://doi.org/10.1192/bjp.2021.148


Davide Papola, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, Italy. E-mail: davide.papola@univr.it

Abstract

BACKGROUND: Psychotherapies are the treatment of choice for panic disorder, but which should be considered as first-line treatment is yet to be substantiated by evidence.
AIMS: To examine the most effective and accepted psychotherapy for the acute phase of panic disorder with or without agoraphobia via a network meta-analysis.
METHOD: We conducted a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the most effective and accepted psychotherapy for the acute phase of panic disorder. We searched MEDLINE, Embase, PsycInfo and CENTRAL, from inception to 1 Jan 2021 for RCTs. Cochrane and PRISMA guidelines were used. Pairwise and network meta-analyses were conducted using a random-effects model. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). The protocol was published in a peer-reviewed journal and in PROSPERO (CRD42020206258).
RESULTS: We included 136 RCTs in the systematic review. Taking into consideration efficacy (7352 participants), acceptability (6862 participants) and the CINeMA confidence in evidence appraisal, the best interventions in comparison with treatment as usual (TAU) were cognitive-behavioural therapy (CBT) (for efficacy: standardised mean differences s.m.d. = -0.67, 95% CI -0.95 to -0.39; CINeMA: moderate; for acceptability: relative risk RR = 1.21, 95% CI -0.94 to 1.56; CINeMA: moderate) and short-term psychodynamic therapy (for efficacy: s.m.d. = -0.61, 95% CI -1.15 to -0.07; CINeMA: low; for acceptability: RR = 0.92, 95% CI 0.54-1.54; CINeMA: moderate). After removing RCTs at high risk of bias only CBT remained more efficacious than TAU.
CONCLUSIONS: CBT and short-term psychodynamic therapy are reasonable first-line choices. Studies with high risk of bias tend to inflate the overall efficacy of treatments. Results from this systematic review and network meta-analysis should inform clinicians and guidelines.

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Porter, J. L. B. (2022). EMDR therapy with people who have intellectual disabilities: process, adaptations and outcomes. Advances in Mental Health and Intellectual Disabilities, 16(1), 32-43. https://doi.org/10.1108/amhid-07-2021-0033

URL: https://doi.org/10.1108/amhid-07-2021-0033


Joanne L.B. Porter, Department of Psychology, Livewell Southwest, Plymouth, Devon, UK. E-mail: jlbp2@hotmail.com

Abstract

Purpose Emerging evidence indicates that adapted eye movement desensitisation and reprocessing (EMDR) can be useful for people with intellectual disabilities in treating post-traumatic stress disorder (PTSD). However, the required adaptations are not described in enough detail across the literature, making it difficult for therapists to easily adapt EMDR for people with intellectual disabilities. This paper aims to address this by describing 14 clinical cases, along with outcome data for six people, and the views of five people with intellectual disabilities about EMDR.
Design/methodology/approach A total of 14 people with mild or moderate intellectual disabilities and varied experiences of trauma were offered EMDR by one clinical psychologist in a UK NHS setting; nine people completed EMDR therapy, six people provided outcome data with pre-post measures and five people were asked two questions about EMDR therapy.
Findings Adaptations are described. The outcome data indicate reductions in symptoms of PTSD following EMDR intervention. EMDR was liked and perceived as useful.
Originality/value This paper provides details about adaptations that can be made to the standard EMDR protocol, reports the views of service users about EMDR and adds evidence that EMDR reduces symptoms of PTSD in people who have intellectual disabilities.

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Rodríguez-Garay, A., & Mosquera, D. (2022). Using EMDR to treat intimate partner relationship break-up issues. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.971856

Open Access: https://doi.org/10.3389/fpsyg.2022.971856

Ainhoa Rodríguez-Garay, Barnapsico, Barcelona, Spain. E-mail: ainhoa.rodriguez.garay@gmail.com

Abstract

The Break-Up Aid Procedure (BUAP) is a proposed EMDR intervention designed to address the difficulties that some patients experience when trying to overcome a complex break-up. The procedure aims to not only target the consequences of the break-up, but also the difficulties that may be present in starting a new relationship. The latter is often the case when there are either unresolved consequences from the previous break-up or untreated early adverse experiences. By structuring the treatment in three sequential stages (outlined in this article) and including interventions and adaptations to the standard EMDR protocol, we aim to facilitate the clinician’s therapeutic approach to intervening for this specific presenting concern and maximizing success.

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Ryan, E. M., Creaven, A. M., Ní Néill, E., & O’Súilleabháin, P. S. (2022). Anxiety following myocardial infarction: A systematic review of psychological interventions. Health Psychol, 41(9), 599-610. https://doi.org/10.1037/hea0001216

URL: https://doi.org/10.1037/hea0001216


Emma M. Ryan, Department of Psychology, University of Limerick, Castletroy, Limerick V94 T9PX, Ireland. E-mail: emma.ryan.d@gmail.com

Abstract

OBJECTIVE: Anxiety is highly prevalent following myocardial infarction (MI) and is linked with adverse effects on a person's recovery, quality of life, physical health, and life expectancy. The primary objective of this systematic review was to assess the effectiveness of psychological interventions for anxiety following MI.
METHOD: CINAHL, Medline, PsycINFO, PsycARTICLES, Cochrane Library, EMBASE, and Web of Science were systematically searched for studies that provided information on anxiety pre and post psychological intervention following MI.
RESULTS: Eighteen studies were included (15 randomized controlled trials [RCTs] and three non-RCTs). Within these studies, psychological interventions comprised cognitive behavioral therapy, eye movement desensitization reprocessing, counseling, psychotherapy, psychological/psychosocial cardiac rehabilitation, illness perception interventions, relaxation training, mindfulness, stress management, and other psychological-based programmes. Ten studies reported a significant decrease in anxiety following a psychological intervention, when compared with usual care. Three studies noted mixed results, and five studies reported no significant difference in anxiety following a psychological intervention. The interventions varied in length, setting, facilitation, and format. Poor reporting of information increased the risk of bias within studies.
CONCLUSION: Psychological interventions may be beneficial to individuals who experience anxiety following a MI. No particular type of psychological intervention appears to be superior to others within the existing literature. Further rigorous research is needed to identify the needs of this population and the specific form of psychological intervention that is most effective in alleviating anxiety following MI. Clinical implications and recommendations for future research are provided.

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Smith, A. N., Laugharne, R., Oak, K., & Shankar, R. (2021). Eye Movement Desensitisation and Reprocessing Therapy for People with Intellectual Disability in the Treatment of Emotional Trauma and Post Traumatic Stress Disorder: A Scoping Review. Journal of Mental Health Research in Intellectual Disabilities, 14(3), 237-284. https://doi.org/10.1080/19315864.2021.1929596

URL: https://doi.org/10.1080/19315864.2021.1929596

Rohit Shankarb, Cornwall Partnership NHS Foundation Trust, Bodmin, Cornwall, UK. E-mail: Rohit.shankar@nhs.net

Abstract

Introduction: Individuals with intellectual disability (ID) are at significant risk of developing emotional trauma and post- traumatic stress disorder (PTSD) due to altered neuropsychological functioning, increased chance of experiencing adverse life events, difficulty expressing emotions, diagnostic overshadowing and institutional failures. Eye Movement Desensitization and Reprocessing Therapy (EMDR) is efficacious in the general population, but research lacks evidence to suggest EMDR remains effective in ID. This paper assesses the evidence available on the use of EMDR to treat PTSD in ID and provide direction for future research.
Methods: A scoping review using PRISMA guidance was conducted. PsychInfo, Embase and Medline were completed using the NICE Health Databases Advanced Search in March 2020. Supplementary searches of Joanna Briggs and ongoing randomized controlled trials were also conducted. The terms used related to Intellectual disability and EMDR therapy. Searches were conducted without the use of PTSD or trauma-related terms to increase the number of identified articles. Inclusion criteria involved the use of EMDR therapy as the primary intervention using a population of individuals with ID. Only articles available in English were included. There were no exclusions related to the study design. All study designs and publication types were included in this review to capture the breadth of information that might be available on the topic. Articles identified were summarized, appraised and collated into tables. Papers were assessed for quality using the GRADE criteria.
Results: Out of 16 identified publications, 13 demonstrated positive results and 3 less favorable. Heterogeneity among participants, variations in EMDR protocol/adaptations, and variation in trauma and PTSD assessment were prevalent.
Conclusions: It is not possible to conclude whether EMDR is efficacious in people with ID. Future studies need to use homogenized populations, standardized EMDR protocol and validated trauma and PTSD assessments.

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