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Burback L, Yap S, Purdon SE, Abba-Aji A, O’Shea K, Brémault-Phillips S, Greenshaw AJ, Winkler O. Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation. Front Psychiatry 2024; 15:1361086. [PMID: 38435978 PMCID: PMC10904458 DOI: 10.3389/fpsyt.2024.1361086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition. Methods This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989). Results Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group. Conclusion Study results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results. Clinical Trial Registration https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
| | - Sidney Yap
- 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
| | - Adam Abba-Aji
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Katie O’Shea
- Eye Movement Desensitization and Reprocessing International Association, Austin, TX, United States
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Olga Winkler
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
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Flatot-Blin D, Rey A, Derynck F, Fossard O, Khalfa S. Clinical Efficiency and Acceptability of EMDR and MOSAIC Therapy for PTSD. Healthcare (Basel) 2023; 11:2226. [PMID: 37570464 PMCID: PMC10418657 DOI: 10.3390/healthcare11152226] [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: 07/07/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
Eye movement desensitization and reprocessing (EMDR) therapy is one of the therapies recommended by the World Health Organization (2013) to treat posttraumatic stress disorder (PTSD). Although efficient, repeated exposure to the traumatic memory may reduce its acceptability to patients. The therapy "eye movement and alternate stimulation for brain integration" (MOSAIC in French) was developed to improve acceptability and reduce pain by drawing on the patient's internal resources. MOSAIC therapy focuses on the body sensations that the patient wants to experience and avoids having to relive the traumatic memories. This observational study aimed to compare the clinical efficiency of EMDR and MOSAIC therapy for PTSD and to measure the well-being generated by both therapies. Twenty-six PTSD patients (17 females and 9 males, mean age 37.01 years, SD = 13.06) received treatment by psychiatrists and/or psychologists trained with EMDR or MOSAIC therapy. Both patient groups achieved a significant decrease in PTSD symptoms as measured with the PCL-5. However, fewer sessions were required with the MOSAIC therapy than with EMDR therapy. As expected, the level of well-being experienced by the patient during the therapy, assessed using the Lickert scale, was higher with MOSAIC than with EMDR therapy from the first session. These findings provide the first evidence of the efficacy of MOSAIC therapy treatment, which now needs to be corroborated in a larger randomized clinical trial.
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Affiliation(s)
- Deborah Flatot-Blin
- Laboratoire de Psychologie Cognitive, CNRS, Aix Marseille University, 13003 Marseille, France
- Laboratoire de Neurosciences Cognitives, CNRS, Aix Marseille University, 13003 Marseille, France
- Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France
| | - Arnaud Rey
- Laboratoire de Psychologie Cognitive, CNRS, Aix Marseille University, 13003 Marseille, France
- Institute of Language and Communication and the Brain, CNRS, Aix Marseille University, 13604 Aix-en-Provence, France
| | - Flavie Derynck
- Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France
| | | | - Stephanie Khalfa
- Laboratoire de Neurosciences Cognitives, CNRS, Aix Marseille University, 13003 Marseille, France
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Pierce ZP, Black JM. The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1106-1123. [PMID: 34866515 DOI: 10.1177/15248380211048446] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as 'childhood trauma', 'adolescent trauma', and 'adulthood trauma', to 'PTSD', 'fMRI', and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)-areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.
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Affiliation(s)
- Zachary P Pierce
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
| | - Jessica M Black
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
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Pierce ZP, Johnson ER, Kim IA, Lear BE, Mast AM, Black JM. Therapeutic interventions impact brain function and promote post-traumatic growth in adults living with post-traumatic stress disorder: A systematic review and meta-analysis of functional magnetic resonance imaging studies. Front Psychol 2023; 14:1074972. [PMID: 36844333 PMCID: PMC9948410 DOI: 10.3389/fpsyg.2023.1074972] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/20/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction The present systematic review and meta-analysis explores the impacts of cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), and prolonged exposure (PE) therapy on neural activity underlying the phenomenon of post-traumatic growth for adult trauma survivors. Methods We utilized the following databases to conduct our systematic search: Boston College Libraries, PubMed, MEDLINE, and PsycINFO. Our initial search yielded 834 studies for initial screening. We implemented seven eligibility criteria to vet articles for full-text review. Twenty-nine studies remained for full-text review after our systematic review process was completed. Studies were subjected to several levels of analysis. First, pre-and post- test post-traumatic growth inventory (PTGI) scores were collected from all studies and analyzed through a forest plot using Hedges' g. Next, Montreal Neurological Institute (MNI) coordinates and t-scores were collected and analyzed using an Activation Likelihood Estimation (ALE) to measure brain function. T-scores and Hedges' g values were then analyzed using Pearson correlations to determine if there were any relationships between brain function and post-traumatic growth for each modality. Lastly, all studies were subjected to a bubble plot and Egger's test to assess risk of publication bias across the review sample. Results Forest plot results indicated that all three interventions had a robust effect on PTGI scores. ALE meta-analysis results indicated that EMDR exhibited the largest effect on brain function, with the R thalamus (t = 4.23, p < 0.001) showing robust activation, followed closely by the R precuneus (t = 4.19, p < 0.001). Pearson correlation results showed that EMDR demonstrated the strongest correlation between increased brain function and PTGI scores (r = 0.910, p < 0.001). Qualitative review of the bubble plot indicated no obvious traces of publication bias, which was corroborated by the results of the Egger's test (p = 0.127). Discussion Our systematic review and meta-analysis showed that CPT, EMDR, and PE each exhibited a robust effect on PTG impacts across the course of treatment. However, when looking closer at comparative analyses of neural activity (ALE) and PTGI scores (Pearson correlation), EMDR exhibited a more robust effect on PTG impacts and brain function than CPT and PE.
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Affiliation(s)
- Zachary P. Pierce
- School of Social Work, Boston College, Chestnut Hill, MA, United States
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
| | - Emily R. Johnson
- School of Social Work, Boston College, Chestnut Hill, MA, United States
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
| | - Isabelle A. Kim
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Brianna E. Lear
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
| | - A. Michaela Mast
- School of Social Work, Boston College, Chestnut Hill, MA, United States
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
| | - Jessica M. Black
- School of Social Work, Boston College, Chestnut Hill, MA, United States
- The Cell to Society Laboratory, Chestnut Hill, MA, United States
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Weiland F, Schul K, Klatt S. Using the wingwave® Method of Aural Stimulations Through Music for Stress Reduction and Performance Improvement: An Exploratory Study. ZEITSCHRIFT FUR SPORTPSYCHOLOGIE 2022. [DOI: 10.1026/1612-5010/a000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Goga N, Boiangiu CA, Vasilateanu A, Popovici AF, Drăgoi MV, Popovici R, Gancea IO, Pîrlog MC, Popa RC, Hadăr A. An Efficient System for Eye Movement Desensitization and Reprocessing (EMDR) Therapy: A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10010133. [PMID: 35052299 PMCID: PMC8776167 DOI: 10.3390/healthcare10010133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/07/2022] [Indexed: 11/16/2022] Open
Abstract
In this paper, we describe an actuator-based EMDR (eye movement desensitization and reprocessing) virtual assistant system that can be used for the treatment of participants with traumatic memories. EMDR is a psychological therapy designed to treat emotional distress caused by a traumatic event from the past, most frequently in post-traumatic stress disorder treatment. We implemented a system based on video, tactile, and audio actuators which includes an artificial intelligence chatbot, making the system capable of acting autonomously. We tested the system on a sample of 31 participants. Our results showed the efficiency of the EMDR virtual assistant system in reducing anxiety, distress, and negative cognitions and emotions associated with the traumatic memory. There are no such systems reported in the existing literature. Through the present research, we fill this gap by describing a system that can be used by patients with traumatic memories.
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Affiliation(s)
- Nicolae Goga
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
| | - Costin-Anton Boiangiu
- Faculty of Automatics and Computer Science, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (C.-A.B.); (I.O.G.)
| | - Andrei Vasilateanu
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
| | - Alexandru-Filip Popovici
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
- Faculty of Psychology and Educational Sciences, University of Bucharest, 90 Panduri Street, 050657 Bucharest, Romania
- Correspondence:
| | - Marius-Valentin Drăgoi
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
| | - Ramona Popovici
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
- Faculty of Psychology and Educational Sciences, University of Bucharest, 90 Panduri Street, 050657 Bucharest, Romania
| | - Ionatan Octavian Gancea
- Faculty of Automatics and Computer Science, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (C.-A.B.); (I.O.G.)
| | - Mihail Cristian Pîrlog
- Department of Sociology, University of Medicine and Pharmacy of Craiova, Petru Rares 2, 200349 Craiova, Romania;
| | - Ramona Cristina Popa
- Faculty of Engineering in Foreign Languages, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania; (N.G.); (A.V.); (M.-V.D.); (R.P.); (R.C.P.)
| | - Anton Hadăr
- Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, Splaiul Independentei 313, 060032 Bucharest, Romania;
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Reichel V, Sammer G, Gruppe H, Hanewald B, Garder R, Bloß C, Stingl M. Good vibrations: Bilateral tactile stim1ulation decreases startle magnitude during negative imagination and increases skin conductance response for positive imagination in an affective startle reflex paradigm. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [DOI: 10.1016/j.ejtd.2020.100197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Khalfa S, Poupard G. MOSAIC: A New Pain-Free Psychotherapy for Psychological Trauma. Am J Psychother 2021; 74:40-43. [PMID: 33302705 DOI: 10.1176/appi.psychotherapy.202020200018] [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: 11/30/2022]
Abstract
Eye movements and alternating stimuli for brain integration (MOSAIC) is a promising but untested new therapy. Its four-step protocol is based on the effects of bilateral alternating stimulation (BAS) (as in eye movement desensitization and reprocessing therapy) on the brain. This solution-oriented therapy promotes experiencing solutions through bodily sensations. Through BAS and bodily sensations, MOSAIC therapy aims to enrich the traumatic memory neuronal network with new information so that the client's psychological trauma is no longer distressing. Thus, MOSAIC can be used to treat psychological trauma without the pain associated with reliving the traumatic situation. This method may be particularly adaptive for patients who have experienced complex trauma and who have dissociative experiences.
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Affiliation(s)
- Stéphanie Khalfa
- Laboratory of Cognitive and Sensory Neuroscience, Aix Marseille University, Marseille, France (Khalfa); Way Inside, Monteux, France (Poupard)
| | - Guillaume Poupard
- Laboratory of Cognitive and Sensory Neuroscience, Aix Marseille University, Marseille, France (Khalfa); Way Inside, Monteux, France (Poupard)
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Carr P. The value of visioning: Augmenting EMDR with alpha-band alternating bilateral photic stimulation for trauma treatment in schizophrenia. Med Hypotheses 2020; 144:110184. [DOI: 10.1016/j.mehy.2020.110184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
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