EMDR Research News September 2013
This month there are five articles from the special issue on Breaking New Ground of Volume 7 Issue 3 of the Journal of EMDR Practice and Research (JEMDR) for which I served as guest editor. While I do not normally include listings for editorials, I make an exception to also list my editorial below. Members of EMDRIA can access my editorial on “The Future of EMDR” in the Journal of EMDR Practice and Research in the member’s area on the EMDRIA website.
This special issue includes two controlled pilot studies of EMDR versus CBT. The first by Faretta examines the treatment of panic attacks. This is the first direct treatment comparison of panic by EMDR and CBT. The second controlled study by Capezzani, et al. explores the application of EMDR for cancer patients. Amano et al. present a case report of a woman with phantom limb pain after anesthesia failed during surgery in which near-infrared spectroscopy was used to identify real-time brain changes during successful EMDR treatment. Gauvry et al. present a case report of successful hospital based treatment of complex regional pain syndrome (CRPS) in a boy. Finally, there is a case study from Italian psychologists Maria Zaccagnino and Martina Cussino of a depressed mother who presented with a dismissing attachment style (with regard to both parents) who showed adaptive changes in caregiving capabilities and attachment organization following treatment with EMDR as measured by the Parent Development Interview.
There is also an abstract for a registered research proposal to study EMDR with non-specific chronic back pain in a randomized controlled trial. 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.
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Journal Articles
Amano, T., Seiyama, A., & Toichi, M. (2013). Brain activity measured with near-infrared spectroscopy during EMDR treatment of phantom limb pain. Journal of EMDR Practice and Research, 7(3), 144-153. doi:10.1891/1933-3196.7.3.144
Tamaki Amano, 954-2 Tokiwa, Nojima, Awaji-city, Hyogo 656-726, Japan. E-mail: tamaki_amano@awaji.ac.jp
Abstract
This report describes a female client with phantom limb pain (PLP), who was successfully treated by eye movement desensitization and reprocessing (EMDR) using a PLP protocol, as well as her cerebral activities, measured by near-infrared spectroscopy (NIRS), throughout the therapeutic session. She suffered from paralysis in the left lower limb because of sciatic nerve damage caused by a surgical accident, in which she awoke temporarily from anesthesia during surgery and felt intense fear. When recalling this experience, the superior temporal sulcus was activated. However, at the end of the session, her PLP was almost eliminated, with a generalized decrease in cerebral blood flow. This case suggests the possibility of involvement of a posttraumatic stress disorder (PTSD)-like mechanism in the pathogenesis of PLP, as well as the possible efficacy of EMDR for this type of PLP.
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Capezzani, L., Ostacoli, L., Cavallo, M., Carletto, S., Fernandez, I., Solomon, R., . . . Cantelmi, T. (2013). EMDR and CBT for cancer patients: Comparative study of effects on PTSD, anxiety, and depression. Journal of EMDR Practice and Research, 7(3), 134-143. doi:10.1891/1933-3196.7.3.134
Liuva Capezzani, UOSD Psichiatria-Area di Supporto alla Persona, IRE-ISG (Istituto Fisioterapici Ospitalieri [IFO]), Via Elio Chianesi, 53, 00144 Roma—Italy. E-mail: Liuva@libero.it or Capezzani@ifo.it
Abstract
This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the follow-up stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR or CBT groups, and 10 patients in the active treatment phase were assigned to EMDR group. The Impact of Event Scale—Revised (IES-R) and Clinician-Administered PTSD Scale (CAPS) were used to assess PTSD at pretreatment and 1 month posttreatment. Anxiety, depression, and psychophysiological symptoms were also evaluated. For cancer patients in the follow-up stage, the absence of PTSD after the treatment was associated with a significantly higher likelihood of receiving EMDR rather than CBT. EMDR was significantly more effective than CBT in reducing scores on the IES-R and the CAPS intrusive symptom subscale, whereas anxiety and depression improved equally in both treatment groups. Furthermore, EMDR showed the same efficacy both in the active cancer treatment and during the follow-up of the disease.
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Faretta, E. (2013). EMDR and cognitive behavioral therapy in the treatment of panic disorder: A comparison. Journal of EMDR Practice and Research, 7(3), 121-133. doi:10.1891/1933-3196.7.3.121
Elisa Faretta, P.I.I.E.C. Centre, Via Settembrini n. 56-20124, Milano, Italy. E-mail: e.faretta@piiec.com
Abstract
A pilot comparison was made between two treatments for panic disorder, eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT). Treatment was provided in the private practice settings of 7 credentialed therapists, whose treatment fidelity was monitored throughout the study. Five outcome measures were administered at pretreatment, posttreatment, and 1-year follow-up. There was significant improvement for participants in both groups (N = 19) after 12 sessions of treatment. No significant differences in outcome were seen between the 2 therapies, except for lower frequency of panic attacks reported by those in the EMDR group. The current study reanalyzed the data previously reported in Faretta (2012). Further research in this area is suggested.
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Gauvry, S. B., Lesta, P., Alonso, A. L., & Pallia, R. (2013). Complex regional pain syndrome (CRPS), sudeck's dystrophy: EMDR reprocessing therapy applied to the psychotherapeutic strategy. Journal of EMDR Practice and Research, 7(3), 167-172. doi:10.1891/1933-3196.7.3.167
Silvia B. Gauvry, Mendoza 4650, Ciudad Autónoma de Buenos Aires, Argentina 1431. E-mail: silvia.gauvry@hospitalitaliano.org.ar
Abstract
Complex regional pain syndrome (CRPS) Type 1, formerly termed Sudeck's dystrophy, is a disproportionate pain condition after a minor injury in a limb, with sensory, autonomic, motor dysfunction, and muscular atrophy without a demonstrated peripheral nerve injury. In children, its course can be self limiting or evolve chronically and be accompanied with psychological distress and deterioration in life quality. CRPS may occur in association with posttraumatic stress disorder (PTSD) and may benefit from multidisciplinary treatment. The eye movement desensitization and reprocessing (EMDR) approach, with demonstrated efficacy in PTSD, has also been reported to be helpful with chronic pain. The application of EMDR in a case of uncontrolled pain during an adolescent's hospitalization for CRPS is presented and its potential benefits are discussed.
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Leeds, A. M. (2013). The future of EMDR. Journal of EMDR Practice and Research, 7(3), 118-120. doi:10.1891/1933-3196.7.3.118
Andrew M. Leeds, PhD, 1049 Fourth Street, Suite G, Santa Rosa, CA 95404-4345.
Abstract
The articles in this special issue entitled “Breaking NeGround” represent noteworthy efforts to open up new fertile ground for the brain-based science of eye movement desensitization and reprocessing (EMDR). These articles offer preliminary findings and recommendations for further experimental studies to confirm (or disconfirm) results. The idea for this special issue arose in a moment of abounding optimism at the annual meeting of the journal’s editorial board during the August 2011 EMDRIA Conference in Orange County, California. Jim Costello, Springer Publishing Company’s Vice President for Journal Publishing, was reviewing strategies to address the continuing challenge of obtaining sufficient quality articles to meet the journal’s publication schedule. The notion of special issues to be developed by guest editors was mentioned. In its fifth year of publication, the journal had already published four special issues—all edited by the Editor in Chief, Louise Maxfield. I volunteered to be the first guest editor and began to cultivate a vision for a special issue. Let me share with you some of the backstory related to the development of this vision.
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Tesarz, J., Gerhardt, A., Leisner, S., Janke, S., Hartmann, M., Seidler, G. H., & Eich, W. (2013). Effects of eye movement desensitization and reprocessing (EMDR) on non-specific chronic back pain: A randomized controlled trial with additional exploration of the underlying mechanisms. BMC Musculoskeletal Disorders, 14(1), 256. doi:10.1186/1471-2474-14-256
Jonas Tesarz, Department of Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg D-69120, Germany. E-mail: jonas.tesarz@med.uni-heidelberg.de
Abstract
BACKGROUND: Non-specific chronic back pain (CBP) is often accompanied by psychological trauma, but treatment for this associated condition is often insufficient. Nevertheless, despite the common co-occurrence of pain and psychological trauma, a specific trauma-focused approach for treating CBP has been neglected to date. Accordingly, eye movement desensitization and reprocessing (EMDR), originally developed as a treatment approach for posttraumatic stress disorders, is a promising approach for treating CBP in patients who have experienced psychological trauma. Thus, the aim of this study is to determine whether a standardized, short-term EMDR intervention added to treatment as usual (TAU) reduces pain intensity in CBP patients with psychological trauma vs. TAU alone.
Methods/design: The study will recruit 40 non-specific CBP patients who have experienced psychological trauma. After a baseline assessment, the patients will be randomized to either an intervention group (n = 20) or a control group (n = 20). Individuals in the EMDR group will receive ten 90-minute sessions of EMDR fortnightly in addition to TAU. The control group will receive TAU alone. The post-treatment assessments will take place two weeks after the last EMDR session and six months later. The primary outcome will be the change in the intensity of CBP within the last four weeks (numeric rating scale 0--10) from the pre-treatment assessment to the post-treatment assessment two weeks after the completion of treatment. In addition, the patients will undergo a thorough assessment of the change in the experience of pain, disability, trauma-associated distress, mental co-morbidities, resilience, and quality of life to explore distinct treatment effects. To explore the mechanisms of action that are involved, changes in pain perception and pain processing (quantitative sensory testing, conditioned pain modulation) will also be assessed. The statistical analysis of the primary outcome will be performed on an intention-to-treat basis. The secondary outcomes will be analyzed in an explorative, descriptive manner.
DISCUSSION: This study adapts the standard EMDR treatment for traumatized patients to patients with CBP who have experienced psychological trauma. This specific, mechanism-based approach might benefit patients. Trial registration: This trial has been registered with ClinicalTrials.gov (NCT01850875)
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Zaccagnino, M., & Cussino, M. (2013). EMDR and parenting: A clinical case. Journal of EMDR Practice and Research, 7(3), 154-166. doi:10.1891/1933-3196.7.3.154
Maria Zaccagnino. C.R.S.P.- Centro di Ricerche e Studi in Psicotraumatologia, Via Nicolò Paganini 50, 20030 Bovisio-Masciago (MI), Italy. E-mail: mariazaccagnino@hotmail.com
Abstract
The theory of attachment underlines how traumatic experiences from the parent's past—when stored in a dysfunctional way—can be reactivated in the parent caregiving system, emerging from an internal working model (IWM) of attachment that holds the memory traces of such traumatic events. This article presents a clinical case report of a mother who was referred to treatment because she presented strong depressive symptoms. Forty sessions were provided, consisting of eye movement desensitization and reprocessing (EMDR) to address maternal trauma issues and cognitive behavioral therapy (CBT) for parenting skill development, debriefing, cognitive restructuring, and psychoeducation. The positive treatment results included distinct evidence of changes in the mother's relationship with her child, and her mental representation of her caregiving system as measured with the Parent Development Interview (Slade et al., 1993).
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