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Gkintoni E, Kourkoutas E, Yotsidi V, Stavrou PD, Prinianaki D. Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:579. [PMID: 38790574 PMCID: PMC11119036 DOI: 10.3390/children11050579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
Background: This systematic review aggregates research on psychotherapeutic interventions for Post-Traumatic Stress Disorder (PTSD) in children and adolescents. PTSD in this demographic presents differently from adults, necessitating tailored therapeutic approaches. In children and adolescents, PTSD arises from exposure to severe danger, interpersonal violence, or abuse, leading to significant behavioral and emotional disturbances that jeopardize long-term development. The review focuses on describing PTSD within two age groups, children (6 to 12 years) and adolescents (12 to 18 years), while evaluating the effectiveness of various clinical interventions aimed at this condition. Methods: Utilizing the PRISMA guidelines, this review systematically examines studies that assess clinical interventions for PTSD in the younger population. Results: Key symptoms of PTSD in children and adolescents include avoidance, overstimulation, flashbacks, depression, and anxiety. The review identifies several effective treatments, including Cognitive Behavioral Therapy (CBT), Trauma-Focused CBT (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy. Particularly, TF-CBT is highlighted as the most effective and commonly used method in treating childhood and adolescent PTSD, as supported by most of the studies reviewed. Conclusions: A significant outcome of this study is the short-term effectiveness of CBT in reducing PTSD symptoms in children and adolescents. The findings underline the importance of psychotherapeutic interventions and mark a substantial advancement in understanding PTSD in young populations. It is crucial for practitioners to integrate various psychotherapeutic strategies into their practice to improve patient outcomes and treatment efficacy.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece
| | - Elias Kourkoutas
- Department of Primary Education, Research Center for the Humanities, Social and Education Sciences, University of Crete, 74100 Rethymno, Greece;
| | - Vasiliki Yotsidi
- Department of Psychology, Panteion University, 17671 Athens, Greece;
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Moghimi E, Stephenson C, Agarwal A, Nikjoo N, Malakouti N, Layzell G, O'Riordan A, Jagayat J, Shirazi A, Gutierrez G, Khan F, Patel C, Yang M, Omrani M, Alavi N. Efficacy of an Electronic Cognitive Behavioral Therapy Program Delivered via the Online Psychotherapy Tool for Depression and Anxiety Related to the COVID-19 Pandemic: Pre-Post Pilot Study. JMIR Ment Health 2023; 10:e51102. [PMID: 37993984 PMCID: PMC10760511 DOI: 10.2196/51102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened the population's mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioral therapy (e-CBT) is a cost-effective and evidence-based treatment for anxiety and depression and can be accessed remotely. OBJECTIVE The objective of the study was to investigate the efficacy of online psychotherapy tailored to depression and anxiety symptoms during the pandemic. METHODS The pilot study used a pre-post design to evaluate the efficacy of a 9-week e-CBT program designed for individuals with depression and anxiety affected by the pandemic. Participants were adults (N=59) diagnosed with major depressive disorder and generalized anxiety disorder, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed. RESULTS Participants demonstrated significant improvements in symptoms of anxiety (P=.02) and depression (P=.03) after the intervention. Similar trends were observed in the intention-to-treat analysis. No significant differences were observed in resilience and quality-of-life measures. The sample comprised mostly females, making it challenging to discern the benefits of the intervention in males. Although a pre-post design is less rigorous than a controlled trial, this design was selected to observe changes in scores during a critical period. CONCLUSIONS e-CBT for COVID-19 is an effective and accessible treatment option. Improvements in clinical symptoms of anxiety and depression can be observed in individuals whose mental health is affected by the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04476667; https://clinicaltrials.gov/study/NCT04476667. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/24913.
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Affiliation(s)
- Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Anika Agarwal
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Niloofar Nikjoo
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Niloufar Malakouti
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Gina Layzell
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Anne O'Riordan
- Patient and Family Centered Care, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- OPTT Inc, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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Strelchuk D, Turner K, Smith S, Bisson J, Wiles N, Zammit S. Provision of online eye movement and desensitisation therapy (EMDR) for people with post-traumatic stress disorder (PTSD): a multi-method service evaluation. Eur J Psychotraumatol 2023; 14:2281182. [PMID: 38073540 PMCID: PMC10990439 DOI: 10.1080/20008066.2023.2281182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023] Open
Abstract
Background: The evidence for the effectiveness of online EMDR for PTSD is scarce.Objective: This service evaluation aimed to assess how online EMDR compared to in-person EMDR, in terms of its potential effectiveness and acceptability to therapists and patients.Method: The evaluation was carried out in the Cardiff and Vale University Health Board Traumatic Stress Service. We compared the outcome of therapy (PTSD scores at end of treatment), number of sessions, drop-out rate, and adverse events using linear/logistic regression in those receiving online EMDR over a 12-month period with those who had received in-person therapy in the year previous to that. Interviews with therapists and clients who had provided or undertaken online EMDR explored their views and experiences of treatment. Interviews were analysed thematically.Results: 33 people received in-person EMDR (15.3 sessions, SD = 1.4), and 45 received online EMDR (12.4 sessions, SD = 0.9). 24 individuals completed therapy in-person, and 32 online. There was no evidence of a difference in therapy completion, drop-out rates or adverse events between the two delivery modes. There was weak evidence that those who completed EMDR online and had available data (N = 29), had slightly lower PTSD scores at the end of therapy compared to those who received in-person EMDR (N = 24) (17.1 (SD = 3.2) versus 24.5 (SD = 3.0), mean difference = 7.8, 95% CI -0.3, 15.9, p = .06). However, groups were not randomised and only those who completed treatment were analysed, so estimates may be biased. 11 patients and five therapists were interviewed. Overall, both therapists and clients viewed online EMDR as safe and effective. Benefits mentioned by clients included feeling more in control and not having to travel. Clients' concerns related to lack of privacy and 'transition time/space' between therapy and their daily lives.Conclusion: Results suggest that online EMDR is an acceptable, safe and effective alternative to in-person EMDR for PTSD in this service.
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Affiliation(s)
- Daniela Strelchuk
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Katrina Turner
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sophie Smith
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan Bisson
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Nicola Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Stan Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Wertheim B, Aarts EE, de Roos C, van Rood YR. The effect of eye movement desensitization and reprocessing (EMDR) on abdominal pain in patients with irritable bowel syndrome (IBS): a study protocol for a randomized controlled trial (EMDR4IBS). Trials 2023; 24:785. [PMID: 38049872 PMCID: PMC10696837 DOI: 10.1186/s13063-023-07784-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a highly prevalent disorder for which treatment options such as medication, diets, and hypnotherapy either have shown limited effect or relieve symptoms in only a limited subset of patients. Abdominal pain is the key criterion for the diagnosis and is deemed the most distressing IBS symptom, and the most disruptive of everyday life. A growing body of research demonstrates the effect of Eye Movement Desensitization and Reprocessing (EMDR) on chronic pain. EMDR is known as a safe and successful treatment for disorders in which unresolved traumatic memories play a role in the cause or maintenance of symptoms. In IBS, activated memories may increase pain through pain flashbacks and the stress generated by unresolved memories. The aim of this study is to ascertain whether applying EMDR to traumatic memories including pain memories will reduce abdominal pain in IBS patients. METHODS This study is a randomized controlled trial which will be conducted at a city hospital in the Netherlands. Adult patients with considerable IBS pain (pain intensity at least 60/100 during at least 5/10 days) will be randomly assigned to either EMDR therapy or the wait list. We aim to include 34 participants. The EMDR condition comprises seven sessions, around 90 min in length delivered weekly, the first of which is a case conceptualization session. All participants will be assessed at baseline, post-treatment, and at 3 months follow-up. The primary outcome measure is pain intensity on a Likert scale which is self-reported daily during a 2-week period. Secondary outcomes include similar daily ratings on other IBS symptoms and reported hindrance of valued activities, and also standardized questionnaires on IBS symptoms and Quality of Life. Data will be analyzed by a Linear Mixed Effects Model for repeated measures. DISCUSSION The results are expected to gain insight into the effectiveness of EMDR treatment on abdominal pain in IBS. As there are very few effective treatment options for IBS-related abdominal pain, this study could have important implications for clinical practice. TRIAL REGISTRATION Human ethics committee MEC-U NL71740.100.20. International Clinical Trial Registry Platform: NL8894. Prospectively registered on 28 January 2020.
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Affiliation(s)
- B Wertheim
- Diakonessenhuis Utrecht, Utrecht, The Netherlands.
| | - E E Aarts
- Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands
| | - C de Roos
- Amsterdam UMC, Academic Center for Child and Adolescent Psychiatry Levvel, Amsterdam, The Netherlands
| | - Y R van Rood
- Leiden University Medical Centre, Leiden, The Netherlands
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Riaz K, Suneel S, Hamza Bin Abdul Malik M, Kashif T, Ullah I, Waris A, Di Nicola M, Mazza M, Sani G, Martinotti G, De Berardis D. MDMA-Based Psychotherapy in Treatment-Resistant Post-Traumatic Stress Disorder (PTSD): A Brief Narrative Overview of Current Evidence. Diseases 2023; 11:159. [PMID: 37987270 PMCID: PMC10660711 DOI: 10.3390/diseases11040159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that causes significant dysfunction in individuals. Currently, there are many approved pharmacotherapy and psychotherapy treatment options for PTSD, but unfortunately, half of the patients do not respond to traditional therapies. In this article, we review clinical trials and research on 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in PTSD patients, its pharmacokinetics, and current treatment guidelines for PTSD. Our findings are based on the results of the efficacy of MDMA-assisted psychotherapy from six phase II randomized controlled trials. MDMA-assisted psychotherapy for PTSD has received the "breakthrough therapy" designation from the FDA. MDMA can reduce PTSD symptoms even in treatment-resistant cases by increasing certain neurohormones, i.e., dopamine, serotonin, norepinephrine, and oxytocin. It also modulates activities in the brain regions involved in fear and anxiety. Future research is needed to show whether the advantages outweigh the disadvantages and whether its use can be integrated into available treatment options for PTSD.
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Affiliation(s)
- Kainat Riaz
- Dow Medical College, Dow University of Health Sciences, Karachi 75700, Pakistan; (K.R.); (S.S.)
| | - Sejal Suneel
- Dow Medical College, Dow University of Health Sciences, Karachi 75700, Pakistan; (K.R.); (S.S.)
| | | | - Tooba Kashif
- Jinnah Sindh Medical University, Karachi 75510, Pakistan;
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar 25120, Pakistan; (I.U.); (A.W.)
| | - Abdul Waris
- Kabir Medical College, Gandhara University, Peshawar 25120, Pakistan; (I.U.); (A.W.)
| | - Marco Di Nicola
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.D.N.); (M.M.); (G.S.)
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.D.N.); (M.M.); (G.S.)
| | - Gabriele Sani
- Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.D.N.); (M.M.); (G.S.)
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging, and Clinical Sciences, University G. D’Annunzio, 66100 Chieti-Pescara, Italy;
| | - Domenico De Berardis
- Department of Psychiatry, Azienda Sanitaria Locale 4, 64100 Teramo, Italy
- School of Nursing, University of L’Aquila, 67100 L’Aquila, Italy
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, 443100 Samara, Russia
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Poli A, Cappellini F, Sala J, Miccoli M. The integrative process promoted by EMDR in dissociative disorders: neurobiological mechanisms, psychometric tools, and intervention efficacy on the psychological impact of the COVID-19 pandemic. Front Psychol 2023; 14:1164527. [PMID: 37727746 PMCID: PMC10505816 DOI: 10.3389/fpsyg.2023.1164527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/07/2023] [Indexed: 09/21/2023] Open
Abstract
Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic-related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID-19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.
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Farrell D, Moran J, Zat Z, Miller PW, Knibbs L, Papanikolopoulos P, Prattos T, McGowan I, McLaughlin D, Barron I, Mattheß C, Kiernan MD. Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury—An RCT study. Front Psychol 2023; 14:1129912. [PMID: 37063579 PMCID: PMC10100089 DOI: 10.3389/fpsyg.2023.1129912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
ObjectiveFrontline mental health, emergency, law enforcement, and social workers have faced unprecedented psychological distress in responding to the COVID-19 pandemic. The purpose of the RCT (Randomized Controls Trial) study was to investigate the effectiveness of a Group EMDR (Eye Movement Desensitization and Reprocessing) therapy (Group Traumatic Episode Protocol—GTEP) in the treatment of Post-Traumatic Stress Disorder (PTSD) and Moral Injury. The treatment focus is an early intervention, group trauma treatment, delivered remotely as video-conference psychotherapy (VCP). This early intervention used an intensive treatment delivery of 4x2h sessions over 1-week. Additionally, the group EMDR intervention utilized therapist rotation in treatment delivery.MethodsThe study’s design comprised a delayed (1-month) treatment intervention (control) versus an active group. Measurements included the International Trauma Questionnaire (ITQ), Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire (PHQ-9), Moral Injury Events Scale (MIES), and a Quality-of-Life psychometric (EQ-5D), tested at T0, T1: pre—treatment, T2: post-treatment, T3: 1-month follow-up (FU), T4: 3-month FU, and T5: 6-month FU. The Adverse Childhood Experiences – International version (ACEs), Benevolent Childhood Experience (BCEs) was ascertained at pre-treatment only. N = 85 completed the study.ResultsResults highlight a significant treatment effect within both active and control groups. Post Hoc comparisons of the ITQ demonstrated a significant difference between T1 pre (mean 36.8, SD 14.8) and T2 post (21.2, 15.1) (t11.58) = 15.68, p < 0.001). Further changes were also seen related to co-morbid factors. Post Hoc comparisons of the GAD-7 demonstrated significant difference between T1 pre (11.2, 4.91) and T2 post (6.49, 4.73) (t = 6.22) = 4.41, p < 0.001; with significant difference also with the PHQ-9 between T1 pre (11.7, 5.68) and T2 post (6.64, 5.79) (t = 6.30) = 3.95, p < 0.001, d = 0.71. The treatment effect occurred irrespective of either ACEs/BCEs during childhood. However, regarding Moral Injury, the MIES demonstrated no treatment effect between T1 pre and T5 6-month FU. The study’s findings discuss the impact of Group EMDR therapy delivered remotely as video-conference psychotherapy (VCP) and the benefits of including a therapist/rotation model as a means of treatment delivery. However, despite promising results suggesting a large treatment effect in the treatment of trauma and adverse memories, including co-morbid symptoms, research results yielded no treatment effect in frontline/emergency workers in addressing moral injury related to the COVID-19 pandemic.ConclusionThe NICE (2018) guidance on PTSD highlighted the paucity of EMDR therapy research used as an early intervention. The primary rationale for this study was to address this critical issue. In summary, treatment results for group EMDR, delivered virtually, intensively, using therapist rotation are tentatively promising, however, the moral dimensions of trauma need consideration for future research, intervention development, and potential for further scalability. The data contributes to the emerging literature on early trauma interventions.Clinical Trial Registration:Clinicaltrials.gov, ISRCTN16933691.
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Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
- *Correspondence: Derek Farrell,
| | - Johnny Moran
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul W. Miller
- School of Nursing, Magee Campus, Ulster University, Northern Ireland, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Penny Papanikolopoulos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Tessa Prattos
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Iain McGowan
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Derek McLaughlin
- School of Nursing and Midwifery, Queen’s University, Belfast, Northern Ireland, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Cordula Mattheß
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Matthew D. Kiernan
- Northern Hub for Veteran and Military Families’ Research, Northumbria University, Newcastle upon Tyne, United Kingdom
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van Schie K, van Veen SC. Omitting continuous memory recall from dual-task interventions does not reduce intervention effectiveness. Behav Res Ther 2023; 164:104291. [PMID: 36933473 DOI: 10.1016/j.brat.2023.104291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/19/2023] [Accepted: 03/09/2023] [Indexed: 03/11/2023]
Abstract
In Eye Movement Desensitization and Reprocessing a patient recalls a traumatic memory, while simultaneously performing a dual-task (e.g., making horizontal eye movements, tapping a pattern). Earlier lab studies show that increasing the load of a dual-task -and leaving fewer resources for memory recall-results in larger decreases in memory vividness and emotionality compared to control conditions. Therefore, we investigated whether it is necessary to continuously and deliberately recall the memory next to performing high taxing dual-tasks. In two online experiments, participants (N = 172, N = 198) recalled a negative autobiographical memory and were randomly assigned to (1) Memory Recall + Dual-Tasks, (2) Dual-Tasks Only, or (3) No Intervention Control. The dual-tasks were complex pattern tapping and spelling out loud. Before and after the intervention the memory was rated on vividness, emotionality, and accessibility. High taxing dual-tasks, regardless of whether there was continuous memory recall, resulted in the largest reductions in all dependent variables compared to control. Unexpectedly, there was no evidence that the addition of continuous memory recall added to these reductions. These results suggest that continuous memory recall might not, or only minimally be needed for the beneficial effects of the dual-task procedure in EMDR might not be beneficial per se. We discuss the necessity of memory (re)activation, alternative explanations, and implications for practice.
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Affiliation(s)
- Kevin van Schie
- Department of Psychology, Education & Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
| | - Suzanne C van Veen
- Kenter Jeugdhulp, Hoofddorp, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
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Patural C, Lefort H. [Covid-19 caregivers, psychotraumatized superheroes]. Soins Psychiatr 2023; 44:41-44. [PMID: 36871976 DOI: 10.1016/j.spsy.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The Covid-19 pandemic has taken its toll on health care teams faced with deaths and hospital overcrowding. Some caregivers suffered from vicarious trauma. Analyzing the impact of this trauma, its inclusion in a context of tension, fatigue and increased lassitude, is imperative in order to propose adjusted care. Eye Movement Desensitization and Reprocessing therapy seems to have a relevant place in this context.
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Affiliation(s)
- Christophe Patural
- Centre hospitalier spécialisé de l'Yonne, 4 avenue Pierre Scherrer 89000 AUXERRE.
| | - Hugues Lefort
- Structure des urgences, Hôpital d'instruction des armées Lavéran, 34 boulevard Lavéran, 13013 Marseille, France
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Dinapoli L, Ferrarese D, Belella D, Carnevale S, Camardese G, Sani G, Chieffo DPR. Psychological treatment of traumatic memories in COVID-19 survivors. Clin Psychol Psychother 2023; 30:225-233. [PMID: 35916065 DOI: 10.1002/cpp.2771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/31/2022] [Accepted: 07/24/2022] [Indexed: 02/03/2023]
Abstract
The COVID-19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID-19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID-19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID-19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8-16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up.
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Affiliation(s)
- Loredana Dinapoli
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniele Ferrarese
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Medicina Interna e Gastroenterologia, Area di Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Belella
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,UOC di Medicina Interna e Gastroenterologia, Area di Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Stefania Carnevale
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Centro Integrato di Senologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Camardese
- UOC Psichiatria Clinica e d'urgenza, Dipartimento di Scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d'urgenza, Dipartimento di Scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.,Istituto di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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11
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Wu JY, Ching CTS, Wang HMD, Liao LD. Emerging Wearable Biosensor Technologies for Stress Monitoring and Their Real-World Applications. BIOSENSORS 2022; 12:1097. [PMID: 36551064 PMCID: PMC9776100 DOI: 10.3390/bios12121097] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
Wearable devices are being developed faster and applied more widely. Wearables have been used to monitor movement-related physiological indices, including heartbeat, movement, and other exercise metrics, for health purposes. People are also paying more attention to mental health issues, such as stress management. Wearable devices can be used to monitor emotional status and provide preliminary diagnoses and guided training functions. The nervous system responds to stress, which directly affects eye movements and sweat secretion. Therefore, the changes in brain potential, eye potential, and cortisol content in sweat could be used to interpret emotional changes, fatigue levels, and physiological and psychological stress. To better assess users, stress-sensing devices can be integrated with applications to improve cognitive function, attention, sports performance, learning ability, and stress release. These application-related wearables can be used in medical diagnosis and treatment, such as for attention-deficit hyperactivity disorder (ADHD), traumatic stress syndrome, and insomnia, thus facilitating precision medicine. However, many factors contribute to data errors and incorrect assessments, including the various wearable devices, sensor types, data reception methods, data processing accuracy and algorithms, application reliability and validity, and actual user actions. Therefore, in the future, medical platforms for wearable devices and applications should be developed, and product implementations should be evaluated clinically to confirm product accuracy and perform reliable research.
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Affiliation(s)
- Ju-Yu Wu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan Township, Miaoli County 35053, Taiwan
- Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, South District, Taichung City 402, Taiwan
| | - Congo Tak-Shing Ching
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, South District, Taichung City 402, Taiwan
- Department of Electrical Engineering, National Chi Nan University, No. 1 University Road, Puli Township, Nantou County 545301, Taiwan
| | - Hui-Min David Wang
- Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, South District, Taichung City 402, Taiwan
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, South District, Taichung City 402, Taiwan
| | - Lun-De Liao
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan Township, Miaoli County 35053, Taiwan
- Program in Tissue Engineering and Regenerative Medicine, National Chung Hsing University, South District, Taichung City 402, Taiwan
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12
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Faretta E, Maslovaric G, Garau MI, Marmondi G, Piras L, Rezzola S, Incerti A, Nardoni A, Pagani M, Gallina E. The psychological impact of the COVID emergency on Italian nursing homes staff and the effectiveness of eye movement desensitization and reprocessing. Front Psychol 2022; 13:969028. [PMID: 36312101 PMCID: PMC9605733 DOI: 10.3389/fpsyg.2022.969028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
Residential nursing homes were particularly badly affected by the first wave of COVID-19, with large numbers of their frail person getting infected with COVID-19 and dying. The staff in these structures were catapulted into a reality very different from what they were used to. They had to adapt the way they used to take care of their patients in a very short space of time and in a scenario that was continually changing. In this manuscript we describe the subjective experience of staff in a number of Italian nursing homes during the first wave of the COVID-19 pandemic; and we report data showing the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) treatment provided to support them during this Pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Eugenio Gallina
- Centro di Ricerca e Studi in Psicotraumatologia, Milan, Italy
- *Correspondence: Eugenio Gallina,
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13
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Yurtsever A, Bakalim O, Karaman Ş, Kaya S, Konuk E. The effect of the online eye movement desensitization and reprocessing early intervention protocol (EMDR R-TEP) for the risk groups with post-traumatic stress symptoms during the COVID-19 pandemic. Front Psychol 2022; 13:935782. [PMID: 36248508 PMCID: PMC9559741 DOI: 10.3389/fpsyg.2022.935782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of the research is to investigate the effect of eye movement desensitization and reprocessing (EMDR) therapy on post-traumatic stress disorder (PTSD) levels of individuals who can be defined as high-risk groups during the pandemic. Therefore, the online EMDR R-TEP Protocol was applied to a total of 154 individuals working with coronavirus patients, frontline professionals (Doctors, Nurses, Paramedics, Polices, Red Crescent), relatives of coronavirus patients, coronavirus patients, and relatives of someone who died from coronavirus and the PTSD symptom level before, after, and 1 month after therapy was measured and examined. A personal information form and impact of events scale were used to collect data. Analyses showed that EMDR therapy was effective in reducing the PTSD level in all groups. The PTSD levels of frontline professionals continued to decrease until the follow-up test but remained the same in the other groups.
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Affiliation(s)
- Asena Yurtsever
- Institute AY, Istanbul, Turkey
- *Correspondence: Asena Yurtsever,
| | - Orkide Bakalim
- Guidance and Psychological Counseling Department, Educational Sciences Institute, Izmir Democracy University, İzmir, Turkey
| | | | - Sefa Kaya
- Psychological Counseling and Guidance Department, Educational Sciences Institute, Pamukkale University, Denizli, Turkey
| | - Emre Konuk
- Institute for Behavioral Studies, Istanbul, Turkey
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14
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Bursnall M, Thomas BD, Berntsson H, Strong E, Brayne M, Hind D. Clinician and Patient Experience of Internet-Mediated Eye Movement Desensitisation and Reprocessing Therapy. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022; 9:251-262. [PMID: 35136713 PMCID: PMC8812350 DOI: 10.1007/s40737-022-00260-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/14/2022] [Indexed: 11/26/2022]
Abstract
Many eye movement desensitization and reprocessing (EMDR) therapists moved their practice online during COVID-19. We conducted surveys and interviews to understand the implementation and acceptability of online EMDR therapy. From 17 June to 2nd August 2021 an online survey was open to EMDR therapists from the EMDR Association UK & Ireland and EMDR International Association email lists, and, through them, their clients. Questions related to determinants of implementation (for therapists) and acceptability (for clients) of online EMDR. Semi-structured interviews were conducted with a sample of therapist respondents to provide a deeper understanding of survey responses. Survey responses were received from therapists (n = 562) from five continents, and their clients (n = 148). 88% of clients responded as being extremely or very comfortable receiving EMDR therapy online. At the initial point of ‘social distancing’, 54% of therapists indicated strong or partial reluctance to deliver online EMDR therapy compared to 11% just over one year later. Four fifths of therapists intended to continue offering online therapy after restrictions were lifted. Free-text responses and interview data showed that deprivation and clinical severity could lead to exclusion from online EMDR. Internet connectivity could disrupt sessions, lead to cancellations, or affect the therapy process. Therapists benefited from training in online working. Online EMDR is generally acceptable to therapists and clients, with reservations about digital exclusion, case severity, poor internet connectivity and the need for training. Further research is needed to confirm that online EMDR is clinically non-inferior to in-person working.
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Affiliation(s)
- Matthew Bursnall
- School of Health and Related Research (ScHARR), University of Sheffield. Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Benjamin D. Thomas
- School of Health and Related Research (ScHARR), University of Sheffield. Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Hannah Berntsson
- School of Health and Related Research (ScHARR), University of Sheffield. Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | | | | | - Daniel Hind
- School of Health and Related Research (ScHARR), University of Sheffield. Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
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15
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COVID-19 and Healthcare Professionals: The Psychological Impact of the Pandemic on Healthcare Professionals and the Use of EMDR Early Interventions. JOURNAL OF EMDR PRACTICE AND RESEARCH 2022. [DOI: 10.1891/emdr-2022-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Recent research has provided new information on the impact of COVID-19 and previous pandemics on the mental health of healthcare professionals (HCP). Several studies have found that HCP are greatly affected by pandemics and may develop anxiety disorders, mood disorders, and posttraumatic stress disorder. The stress caused by the intense working conditions and the fear of contracting and transmitting the virus are major vulnerability factors for these workers, increasing their risk of developing a mental health condition. It is therefore essential to provide appropriate support to this population in order to reduce and avoid the psychological burden of the current pandemic on their mental health. Considering the data previously published on the COVID-19 pandemic and past epidemics, the present article aims to provide an epidemiological review of the psychological impact of a pandemic on healthcare professionals. Furthermore, it examines, from a theoretical perspective, whether EMDR early interventions (EEI) may constitute an effective solution in order to provide psychological support to HCP in hospitals. Lastly, the article will identify various protocols for EEI, which, it argues, should be the approaches of choice for providing early support following a potentially traumatic event.
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16
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Psychological Intervention in Women Victims of Childhood Sexual Abuse: An Open Study-Protocol of a Randomized Controlled Clinical Trial Comparing EMDR Psychotherapy and Trauma-Based Cognitive Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127468. [PMID: 35742717 PMCID: PMC9223360 DOI: 10.3390/ijerph19127468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 06/15/2022] [Indexed: 02/06/2023]
Abstract
Introduction: Most victims of sexual abuse have symptoms that may lead to post-traumatic stress disorder. This study aims to offer evidence-based psychological treatment to women who have been sexually abused earlier in life and currently have sequelae from that trauma. With this treatment, each of the women in the study will hopefully improve their overall quality of life and, more specifically, it is expected that post-traumatic stress symptoms will decrease, as found in recent studies, as well as strengthening their security, confidence, and coping with the situations they have experienced. Methods and analysis: The effect of two therapeutic approaches focused on the improvement of trauma will be evaluated in a sample of 30–50 women victims of childhood sexual abuse, with a randomized clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy. According to the literature reviewed, both approaches will considerably improve self-esteem when the appropriate number of sessions are conducted, significantly reducing general psychiatric symptoms and depression. Furthermore, the effects are sustained over time. It should be noted that this study will be carried out comparing both therapies, analyzing both the differential benefit of each and the cumulative effect of receiving both treatments and in which order. It is also intended to demonstrate that implementing the protocols presented in this study will help improve the quality of life of the women who benefit from them, and after this study, it will be possible to replicate this program in other people with the same problems. Each of the therapeutic benefits of each of them will be analyzed, and clinical and logistical guidance will be provided to implement both, including a session-by-session protocol.
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17
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Vanderschoot T, Dessel PV. EMDR Therapy and PTSD: A Goal-Directed Predictive Processing Perspective. JOURNAL OF EMDR PRACTICE AND RESEARCH 2022. [DOI: 10.1891/emdr-2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Eye movement desensitization and reprocessing (EMDR) therapy is a widely used evidence-based treatment for posttraumatic stress disorder (PTSD). The mental processes underlying both PTSD and EMDR treatment effects are often explained by drawing on processes that involve the automatic formation and change of mental associations. Recent evidence that contrasts with these explanations is discussed and a new perspective to PTSD and EMDR treatment effects is proposed that draws on automatic inferential processes and can be readily integrated with the dominant (Adaptive Information Processing) model. This new perspective incorporates insights from cognitive theories that draw on predictive processing and goal-directed processes to elucidate (changes in) automatic inferences that underlie PTSD symptoms and EMDR treatment effects. Recommendations for clinical practice are provided based on this new perspective.
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18
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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19
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Liou H, Lane C, Huang C, Mookadam M, Joseph M, Hecker DuVal J. Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods. Telemed J E Health 2022; 28:1359-1366. [PMID: 35133887 DOI: 10.1089/tmj.2021.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Eye movement desensitization and reprocessing (EMDR) is an evidence-based psychotherapy method designed to treat distress associated with traumatic memories. The COVID-19 pandemic has challenged providers to shift EMDR to telehealth platforms. Objectives: This research had to aims. (1) To compare EMDR in conjunction with cognitive behavioral therapy (CBT) with CBT alone for treatment of a patient population with prevalent anxiety and (2) to compare the efficacy of virtual EMDR with that of in-person EMDR in the primary care setting. Methods: Retrospective chart review of all adult patients seen by a single therapist at a primary care center was conducted from January 2018 to December 2020. Charts were reviewed for demographics, psychiatric diagnoses, number of visits, number and type of EMDR treatments, and patient health questionnaire (PHQ)-9 and general anxiety disorder (GAD-7) scores pre- and post-treatment. Results: Patients who underwent EMDR with CBT demonstrated greater decreases in PHQ-9 and GAD-7 scores than patients who had only CBT (2.4, 2.5 vs. 0.9, 1.1). However, after adjusting for total number of sessions, post-traumatic stress disorder, grief, and pain, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent EMDR with CBT and CBT-exclusive patients were not statistically significant. Similarly, the adjusted mean differences of change in PHQ-9 and GAD-7 scores between those who underwent virtual EMDR and those who had in-person EMDR were not statistically significant. Conclusions: To our knowledge, this is the first study describing the use of virtual EMDR in a primary care setting. Although our data did not provide evidence for the superiority of EMDR with CBT over CBT alone, we demonstrate that both in-person and virtual EMDR led to significantly improved GAD-7 scores.
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Affiliation(s)
- Harris Liou
- Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Colton Lane
- Research Services, Mayo Clinic, Scottsdale, Arizona, USA
| | - Crystal Huang
- Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Martina Mookadam
- Department of Family Medicine, Mayo Clinic, Phoenix, Arizona, USA
| | - Malin Joseph
- Research Services, Mayo Clinic, Scottsdale, Arizona, USA
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20
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McGowan IW, Fisher N, Havens J, Proudlock S. An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid-19 pandemic. BMC Psychiatry 2021; 21:560. [PMID: 34763697 PMCID: PMC8581955 DOI: 10.1186/s12888-021-03571-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/26/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In addition to having a negative impact on the physical and emotional health of the population, the global Covid-19 pandemic has necessitated psychotherapists moving their practice to online environments. This service evaluation examines the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) Therapy delivered via the internet. METHODS A real-world service evaluation was conducted from a self-selecting group of EMDR therapists that subscribe to either a JISCMail discussion list or either the UK or All Ireland National EMDR Associations. Author designed questionnaires were used to gather information on the efficacy of EMDR delivered online as well as client and therapist characteristics. RESULTS Thirty-three therapists provided efficacy data on a total of 93 patients. Statistically significant and clinically meaningful reductions were found in all four-psychometrics used both in adult and children and young people populations. Client outcome was not related to therapist experience. CONCLUSIONS EMDR delivered via the internet can be an effective treatment for clients experiencing mental health issues.
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Affiliation(s)
- Iain W. McGowan
- grid.4777.30000 0004 0374 7521School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Naomi Fisher
- Clinical Psychologist, Private Therapy Practice, Hove, UK
| | - Justin Havens
- Dr. Justin Havens Psychological Therapy, Cheltenham, UK
| | - Simon Proudlock
- Counselling Psychology Solutions, Stratfield Saye, Reading, UK
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21
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Winkler O, Dhaliwal R, Greenshaw A, O'Shea K, Abba-Aji A, Chima C, Purdon SE, Burback L. Web-Based Eye Movement Desensitization and Reprocessing for Adults With Suicidal Ideation: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e30711. [PMID: 34734835 PMCID: PMC8603176 DOI: 10.2196/30711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/23/2021] [Accepted: 09/10/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Adversity and traumatic experiences increase the likelihood of suicidal thoughts and behaviors. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based, trauma-focused psychotherapy that desensitizes painful memories, so that reminders in the present no longer provoke overwhelming emotional responses. Preliminary evidence suggests that EMDR can be used as an acute intervention in suicidal patients, including those with major depressive disorder. In addition, because of social distancing restrictions during the COVID-19 pandemic, clinicians have been using EMDR on the web and, in the absence of formal evaluations of web-based EMDR, informal reports indicate good results. OBJECTIVE The primary aim of this randomized controlled trial is to investigate whether remotely delivered EMDR (targeting experiences associated with suicidal thinking) reduces suicidal thoughts. Secondary aims include examining the impact of remotely delivered EMDR on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation. We will also report on adverse events in the EMDR group to explore whether targeting suicidal ideation with EMDR is safe. Finally, we will compare dropout rates between the treatment groups. METHODS In this randomized controlled trial, 80 adults who express suicidal ideation and meet the study criteria will receive either 12 sessions of twice weekly EMDR plus treatment as usual or treatment as usual alone. EMDR sessions will focus on the most distressing and intrusive memories associated with suicidal ideation. Data for primary and secondary objectives will be collected at baseline, 2 months, and 4 months after enrollment. A subsequent longer-term analysis, beyond the scope of this protocol, will examine differences between the groups with respect to the number of posttreatment emergency room visits, hospitalizations, and overall health care use in the year before and after therapy. RESULTS The protocol was approved by the University of Alberta Research Health Ethics Board (protocol ID Pro00090989). Funding for this study was provided by the Mental Health Foundation (grant RES0048906). Recruitment started in May 2021, with a projected completion date of March 2023. CONCLUSIONS The results of this trial will contribute to knowledge on whether web-based delivery of EMDR is a safe and effective treatment for reducing suicidal ideation and potentially reducing the incidence of suicide attempts in this patient population. TRIAL REGISTRATION ClinicalTrials.gov NCT04181047; https://clinicaltrials.gov/ct2/show/NCT04181047. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30711.
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Affiliation(s)
- Olga Winkler
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Raman Dhaliwal
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Katie O'Shea
- Eye Movement Desensitization and Reprocessing International Association, Austin, TX, United States
| | - Adam Abba-Aji
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Chidi Chima
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Scot E Purdon
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Neuropsychology, Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Lisa Burback
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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22
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Mischler C, Hofmann A, Behnke A, Matits L, Lehnung M, Varadarajan S, Rojas R, Kolassa IT, Tumani V. Therapists' Experiences With the Effectiveness and Feasibility of Videoconference-Based Eye Movement Desensitization and Reprocessing. Front Psychol 2021; 12:748712. [PMID: 34675854 PMCID: PMC8525547 DOI: 10.3389/fpsyg.2021.748712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Research on the effectiveness and applicability of eye movement desensitization and reprocessing (EMDR) via videoconference is sparse. Considering the emerging use of internet-based psychotherapy during the COVID-19 pandemic, information on videoconference-based EMDR (eEMDR) would be beneficial for many therapists. In this study, 23 therapists from the EMDR-Institute in Germany provided information about their experiences with eEMDR in a questionnaire-based survey. Information on the effectiveness and the course of 102 eEMDR sessions was recorded. Results showed the potential of eEMDR as an effective and viable method. The decrease in the subjective unit of disturbance (SUD), which is an important indicator of treatment outcome, was found to be at a similar level compared to that of previous EMDR studies that were not administered in eEMDR format. The most important predictor of the SUD decrease was the type of bilateral stimulation used in eEMDR sessions. Eye movements resulted in significantly greater SUD reductions than tapping. Perceived disadvantages and impediments for the implementation of eEMDR were mainly of bureaucratic and technical concerns. In addition, about one-third of the therapists stated that some patients were not willing to engage in eEMDR. In our study, eEMDR proved to be a practically applicable therapy method and therefore, therapists can consider using eEMDR. These findings will hopefully encourage EMDR therapists and their patients to use eEMDR due to its effectiveness and viability as an online treatment approach.
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Affiliation(s)
- Corinna Mischler
- Department of Psychiatry, Ulm University Hospital, Ulm, Germany
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm, Germany
| | - Arne Hofmann
- EMDR-Institute Germany, Gezeitenhaus Traumahospital Schloss Eichholz, Wesseling, Germany
| | - Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm, Germany
| | - Lynn Matits
- Department of Psychiatry, Ulm University Hospital, Ulm, Germany
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm, Germany
| | - Maria Lehnung
- EMDR-Institute Germany, Private Practice, Eckernfoerde, Germany
| | - Suchithra Varadarajan
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm, Germany
| | - Visal Tumani
- Department of Psychiatry, Ulm University Hospital, Ulm, Germany
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23
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Lazzaroni E, Invernizzi R, Fogliato E, Pagani M, Maslovaric G. Coronavirus Disease 2019 Emergency and Remote Eye Movement Desensitization and Reprocessing Group Therapy With Adolescents and Young Adults: Overcoming Lockdown With the Butterfly Hug. Front Psychol 2021; 12:701381. [PMID: 34512458 PMCID: PMC8424043 DOI: 10.3389/fpsyg.2021.701381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has represented an individual and collective trauma with an impact on mental health. Restrictive measures such as lockdowns have increased risk factors for the development or triggering of various psychopathologies. Timely psychological intervention has constituted a protective factor that has been indicated as a form of prevention. The main objective of this study was to measure changes in the levels of traumatic stress and anxiety in a clinical population of adolescents and young adults aged 13 to 24 years – already assisted by the local primary and specialty care services before the pandemic – following a trauma-focused psychotherapeutic group intervention according to the eye movement desensitization and reprocessing protocol, conducted remotely before the end of the first lockdown. The Impact of Event Scale-Revised (IES-R), State-Trait Anxiety Inventory (STAI) scales, and the Emotion Thermometer were administered pre- and post-treatment. At the end of the treatment, the Post-Traumatic Growth Inventory (PTGI) questionnaire was administered. The results show that there was a significant improvement pre- and post-intervention in the scores of the scales STAI, IES-R, and Emotion Thermometer with a reduction in post-traumatic symptoms related in particular to the domains of intrusiveness and hyperarousal. The domain of avoidance was less significantly modified by therapy. This overall clinical improvement did not correlate with any of the demographic variables of the sample. In addition, the results show a significant positive global perceived change (PTGI) that did not correlate with the reduction of anxiety or post-traumatic symptoms measured by the other self-report scales. The explored use of telemedicine has revealed a valuable clinical opportunity.
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Affiliation(s)
| | | | | | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
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24
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Hendrix YMGA, van Dongen KSM, de Jongh A, van Pampus MG. Postpartum Early EMDR therapy Intervention (PERCEIVE) study for women after a traumatic birth experience: study protocol for a randomized controlled trial. Trials 2021; 22:599. [PMID: 34488847 PMCID: PMC8419663 DOI: 10.1186/s13063-021-05545-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Up to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience. Negative and traumatic childbirth experiences can also lead to fear of childbirth, avoiding or negatively influencing a subsequent pregnancy, mother-infant bonding problems, problems with breastfeeding, depression and reduced quality of life. For PTSD in general, eye movement desensitization and reprocessing (EMDR) therapy has proven to be effective. However, little is known about the preventive effects of early intervention EMDR therapy in women after a traumatic birth experience. The purpose of this study is to determine the effectiveness of early intervention EMDR therapy in preventing PTSD and reducing PTSD symptoms in women with a traumatic birth experience. METHODS The PERCEIVE study is a randomized controlled trial. Women suffering from the consequences of a traumatic birth experience will be randomly allocated at maximum 14 days postpartum to either EMDR therapy or 'care-as-usual'. Patients in the EMDR group receive two sessions of therapy between 14 (T0) and 35 days postpartum. All participants will be assessed at T0 and at 9 weeks postpartum (T1). At T1, all participants will undergo a CAPS-5 interview about the presence and severity of PTSD symptoms. The primary outcome measure is the severity of PTSD symptoms, whereas the secondary outcomes pertain to fear of childbirth, mother-infant bonding, breastfeeding, depression and quality of life. The study will be conducted at a large city hospital and at multiple midwifery practices in Amsterdam, the Netherlands. DISCUSSION It is to be expected that the results of this study will provide more insight about the safety and effectiveness of early intervention EMDR therapy in the prevention and reduction of PTSD (symptoms) in women with a traumatic birth experience. TRIAL REGISTRATION Netherlands Trial Register NL73231.000.20 . Registered on 21 August 2020.
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Affiliation(s)
- Y M G A Hendrix
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands.
| | - K S M van Dongen
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands
| | - A de Jongh
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands.,Research Department, PSYTREC, Bilthoven, the Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
| | - M G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands
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25
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Sarangi A, Javed S, Karki K, Kaushal A. COVID-19-associated PTSD in the elderly—lessons learned for the next global pandemic. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8242287 DOI: 10.1186/s43045-021-00119-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background When COVID-19 was declared a global pandemic in March 2020, almost all countries implemented strict lockdowns and home quarantine orders in order to prevent spread of the virus. These implementations have severely affected the mental health of people all around the world especially the elderly, who are already physically and mentally fragile. There has been an escalation in the prevalence of depression, suicide, anxiety, substance abuse, domestic abuse, and post-traumatic stress disorder (PTSD). Main body The aim of our review was to highlight PTSD in the elderly population who has recovered from COVID-19 infection and come up with some recommendations for the future. A thorough literature review was conducted focusing on the impact of COVID-19 on development and progression of PTSD during the pandemic. Conclusion Increased allocation of resources by various government and private stakeholders is necessary to prepare for the long-term implications on mental health from the current and future pandemics.
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26
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Chiesa V, Antony G, Wismar M, Rechel B. COVID-19 pandemic: health impact of staying at home, social distancing and 'lockdown' measures-a systematic review of systematic reviews. J Public Health (Oxf) 2021; 43:e462-e481. [PMID: 33855434 PMCID: PMC8083256 DOI: 10.1093/pubmed/fdab102] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/08/2021] [Accepted: 03/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background To systematically review the evidence published in systematic reviews (SR) on the health impact of staying at home, social distancing and lockdown measures. We followed a systematic review approach, in line with PRISMA guidelines. Methods In October 2020, we searched the databases Cochrane Database of Systematic Reviews, Ovid Medline, Ovid Embase and Web of Science, using a pre-defined search strategy. Results The literature search yielded an initial list of 2172 records. After screening of titles and abstracts, followed by full-text screening, 51 articles were retained and included in the analysis. All of them referred to the first wave of the coronavirus disease 2019 pandemic. The direct health impact that was covered in the greatest number (25) of SR related to mental health, followed by 13 SR on healthcare delivery and 12 on infection control. The predominant areas of indirect health impacts covered by the included studies relate to the economic and social impacts. Only three articles mentioned the negative impact on education. Conclusions The focus of SR so far has been uneven, with mental health receiving the most attention. The impact of measures to contain the spread of the virus can be direct and indirect, having both intended and unintended consequences. Highlights
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Affiliation(s)
- Valentina Chiesa
- Local Health Unit of Reggio Emilia, Via Giovanni Amendola, 2, 42122, Reggio Emilia, Italy.,London School of Hygiene & Tropical Medicine London, WC1H 9SH, 15-17 Tavistock Place, United Kingdom
| | - Gabriele Antony
- Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG)
| | - Matthias Wismar
- European Observatory on Health Systems and Policies Place Victor Horta 40/10, 1060 Brussels, Belgium
| | - Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, WC1H 9SH, 15-17 Tavistock Place, United Kingdom
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27
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Weerkamp-Bartholomeus P, Marazziti D, van Amelsvoort T. Remote W.A.R.A. Compared With Face-to-Face W.A.R.A.: A Pilot Study. Front Psychol 2021; 11:620027. [PMID: 33519645 PMCID: PMC7844207 DOI: 10.3389/fpsyg.2020.620027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/21/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Since the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online. METHODS We assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design. RESULTS W.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001). LIMITATIONS The major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing "unpleasant feelings." This conceptualization of negative affect might still be a point of discussion. CONCLUSION The study's findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.
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Affiliation(s)
- Paula Weerkamp-Bartholomeus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- ReAttach Therapy International Foundation, Voerendaal, Netherlands
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
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28
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Siegel A, Mor I, Lahav Y. Profiles in COVID-19: peritraumatic stress symptoms and their relation with death anxiety, anxiety sensitivity, and emotion dysregulation. Eur J Psychotraumatol 2021; 12:1968597. [PMID: 34589177 PMCID: PMC8475101 DOI: 10.1080/20008198.2021.1968597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic might be experienced as an ongoing traumatic event and could result in peritraumatic stress symptoms. Evidence implies that individuals' levels of death anxiety, anxiety sensitivity, and difficulties in emotion regulation may contribute to their peritraumatic stress symptomatology in the aftermath of trauma exposure. OBJECTIVE The current study aimed to explore these hypotheses in the context of the COVID-19 pandemic. METHOD An online survey was conducted among a convenience sample of 846 Israeli adults from April 2 to 19 April 2020. COVID-19-related stressors, death anxiety, anxiety sensitivity, difficulties in emotion regulation, and peritraumatic stress symptoms were assessed via self-report questionnaires. RESULTS Analyses indicated significant relations between death anxiety, anxiety sensitivity, and emotion regulation difficulties, on the one hand, and peritraumatic stress symptoms, on the other. Three distinct profiles were identified. Furthermore, profile type - namely having low, medium, and high levels of death anxiety, anxiety sensitivity, and emotion dysregulation - had a significant effect in explaining peritraumatic stress symptoms. CONCLUSIONS Results suggest that during the pandemic, levels of death anxiety, anxiety sensitivity, and emotion dysregulation may explain heterogeneity in individuals' trauma-related symptomatology.
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Affiliation(s)
- Alana Siegel
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Mor
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lahav
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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