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Schäflein E, Mardin C, Morawa E, Rudolf S, Erim Y, Rhein C. Exacerbation of central serous chorioretinopathy during trauma-confronting psychotherapy- a case report. BMC Psychiatry 2024; 24:368. [PMID: 38755608 PMCID: PMC11100044 DOI: 10.1186/s12888-024-05756-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Psychotherapy for post-traumatic stress disorder, in particular trauma-confronting psychotherapy, can be associated with increased stress. However, research on the somatic impact and psychosomatic interactions of these psychological stress reactions is lacking. We report on a 43-year old man whose central serous chorioretinopathy exacerbated upon trauma-confronting psychotherapy. CASE PRESENTATION We report on a man with pre-diagnosed, asymptomatic central serous chorioretinopathy who underwent inpatient psychosomatic therapy. He disclosed a history of sexual abuse by a family member and consequently showed intrusions, flashbacks, nightmares, avoidance behavior, and hyperarousal. Thus, we diagnosed post-traumatic stress disorder. After a stabilization phase, he underwent trauma-focused psychotherapy including trauma confrontation. In the course of this treatment, acute vision loss with blurred vision and image distortion of his right eye occurred. An ophthalmologic visit confirmed a relapse of a pre-diagnosed central serous chorioretinopathy. The analysis of stress biomarkers showed a decrease in testosterone levels and a noon peak in diurnal cortisol secretion, which is indicative of a stress reaction. CONCLUSION Central serous chorioretinopathy may exacerbate upon psychotherapeutic treatment. In this case, an exacerbation of chorioretinopathy was observed in direct relation to the therapeutic intervention. Psychotherapists and ophthalmologists should collaborate in the psychotherapeutic treatment of patients with chorioretinopathy. Our case demonstrates the need to consider the possible increased stress levels during psychotherapy and resulting physical side effects, such as exacerbation of an existing condition. It is advisable to adjust the level of generated stress particularly well in the presence of stress-inducible physical diseases. Our case is a good example of the interplay between psychological and physical stress.
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Affiliation(s)
- Eva Schäflein
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - Christian Mardin
- Department of Ophthalmology, University Hospital of Erlangen, Friedrich-Alexander University Erlangen- Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sophia Rudolf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Cosima Rhein
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich- Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Inci Izmir SB, Çitil Akyol C. EMDR Flash Technique in adolescents with depression: A twelve-week follow-up study. Clin Child Psychol Psychiatry 2024:13591045241247701. [PMID: 38631366 DOI: 10.1177/13591045241247701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This study aims to investigate the specific effects of the EMDR Flash Technique on adolescents with depression. This follow-up study consists of 32 adolescents, 12-17 years of age (M = 14.34, SD = 1.56), including 7 males and 25 females. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, the Beck Depression Inventory (BDI), and Children Revised Impact of Event Scale-8 (Crıes-8). These were administered at baseline, at the end of the 4th and 12th weeks of treatment. The EMDR Flash Technique which can be utilized in the preparation phase of Eye Movement Desensitization and Reprocessing (EMDR) to reduce the intensity of highly distressing memories rapidly and relatively painlessly was applied for 12 weeks, one session per week as a free-standing intervention. Also, the EMDR Flash Technique can be effective in decreasing the rate of noncompliance and drop-outs of adolescents. The baseline means of total BDI scores decreased from 48.19 to 2.16 at the end of the 12th week of treatment. Also, the CRIES scores decreased from 31.78 to 0.44 at the end of the 12th week of treatment. In addition, the baseline means of SUD scores decreased from 9.53 to zero at the end of the 12th week of treatment. Overall, our results underscore the effectiveness of the EMDR-Flash Technique in adolescents with depression.
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Affiliation(s)
- Sevim Berrin Inci Izmir
- Institute on Social Science, Department of Child and Adolescent Clinical Psychology, Isık University, Turkey
| | - Canan Çitil Akyol
- Faculty of Letters, Department of Psychology, Sivas Cumhuriyet University, Turkey
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Bal Z, Uçar T. The effect of cognitive behavioural therapy and eye movement desensitization and reprocessing techniques on infertile women: a randomized controlled trial. Reprod Biomed Online 2024; 48:103612. [PMID: 38199076 DOI: 10.1016/j.rbmo.2023.103612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/09/2023] [Accepted: 10/09/2023] [Indexed: 01/12/2024]
Abstract
RESEARCH QUESTION What effects do training programmes based on cognitive behavioural therapy (CBT) and eye movement desensitization and reprocessing (EMDR) techniques applied to infertile women affected psychologically and emotionally by infertility have on post-traumatic stress disorder (PTSD) and psychological development? DESIGN This randomized controlled study was conducted between May 2021 and August 2022. The study population included 90 infertile women referred to the IVF unit of a hospital in a province in eastern Turkey: 30 in the CBT group, 30 in the EMDR group and 30 in the control group. Data were collected using a personal information form, the Subjective Units of Disturbance Scale (SUDS), the Validity of Cognition (VoC) scale, the Infertility Distress Scale (IDS), the Impact of Event Scale-Revised (IES-R) and the Post-traumatic Growth Inventory (PTGI). Women in the experimental groups (CBT and EMDR groups) received the intervention in six sessions over 3 weeks. Pre-tests were administered to both experimental groups and the control group, and post-tests were conducted 3 weeks after the intervention. RESULTS The mean scores on the SUDS, IDS and IES-R for women in the experimental groups were significantly lower compared with those for women in the control group following the interventions (P < 0.001). The mean scores on the VoC scale and PTGI for women in the experimental groups were significantly higher compared with those for women in the control group following the interventions (P < 0.001). CONCLUSION The use of CBT and EMDR techniques reduced the negative psychological and emotional effects of infertility among infertile women.
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Affiliation(s)
- Zeynep Bal
- Department of Midwifery, Faculty of Health Sciences, Gaziantep Islamic Science and Technology University, Gaziantep, Turkey.
| | - Tuba Uçar
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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Cotter R, Burns J, Kaufman K, Kudla A, Ehrlich-Jones L, Wafford QE, Heinemann AW. Effectiveness of Behavioral and Pharmacologic Interventions for Depressive Symptoms After Spinal Cord Injury: Findings From a Systematic Review. Arch Phys Med Rehabil 2024:S0003-9993(24)00037-6. [PMID: 38266762 DOI: 10.1016/j.apmr.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/10/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To summarize and evaluate evidence regarding the efficacy of interventions for depressive symptoms in adults living with spinal cord injury (SCI) and comorbid major depressive disorder or significant depressive symptoms to inform the development of clinical practice guidelines. DATA SOURCES Articles published since 2013 and available in Medline, The Cochrane Library, Embase, Scopus, CINAHL, or PsycINFO. Databases were searched in June 2022 and updated November 2023. STUDY SELECTION Inclusion criteria: age 18 years or older, traumatic SCI, and clinically significant depression (Population), mental health interventions including behavioral, pharmacologic, and complementary and alternative medicine (Intervention), inclusion of a control group (Comparator), with a primary outcome of depression symptom reduction (Outcome). Criteria were applied by multiple reviewers and disagreements were reconciled via unanimous decision among the entire research team. Eight articles of 2780 screened met the selection criteria. DATA EXTRACTION Data were extracted independently by multiple reviewers. Two reviewers independently assigned a quality score using the guidelines described by Hawker and associates and independently evaluated the risk of bias of each article using version 2 of the Cochrane risk-of-bias tool. DATA SYNTHESIS All studies assessed depressive symptoms during participant recruitment, screening, and/or at a baseline assessment stage. Pharmacotherapy with venlafaxine XR and several behavioral interventions appear promising, including an online mindfulness course and eye movement desensitization and reprocessing therapy. Remote interventions may be effective in reaching individuals who are unable to travel to in-person therapy sessions. CONCLUSIONS This systematic review provides valuable information for clinicians who treat individuals with SCI and comorbid major depressive disorder or significant depressive symptoms. It highlights the importance of considering a variety of interventions and individualizing treatment to meet individuals' needs and preferences. Future research should aim to identify effective interventions for treating depressive symptoms in individuals with SCI and optimal delivery methods for these interventions.
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Affiliation(s)
- Robert Cotter
- Shirley Ryan AbilityLab, Chicago, IL; Yale University School of Medicine, New Haven, CT.
| | | | | | | | - Linda Ehrlich-Jones
- Shirley Ryan AbilityLab, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Q Eileen Wafford
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, Chicago, IL; Northwestern University Feinberg School of Medicine, Chicago, IL
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Sappok T, Bayer M, Helmes A, Gabriel A, Wagner J, Styp von Rekowski A, Tergeist M. [Psychotherapy in disorders of intellectual development-Current evidence and practical implementation]. Nervenarzt 2023; 94:446-455. [PMID: 37129621 DOI: 10.1007/s00115-023-01472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 05/03/2023]
Abstract
People with a disorder of intellectual development (German draft of the ICD-11, which came into force on 1 January 2022) suffer more frequently from mental illnesses. According to the international treatment guidelines multimodal approaches should include not only psychopharmacological treatment, but also disorder-specific psychotherapeutic methods. These psychotherapeutic interventions have to be adapted to the communicative and cognitive abilities (performance diagnostics with IQ tests) as well as the emotional developmental stage (developmental diagnostics, e.g., with the scale of emotional development, short version, SED-S 2; [1]). To ensure this, the rules of simple language should be observed and when appropriate relatives or caregivers should be involved in the therapeutic process. The effectiveness of cognitive behavioral therapy has received most scientific attention, especially for affective disorders. Posttraumatic stress disorders can be validly treated with eye movement desensitization and reprocessing (EMDR). There is also good evidence for exposure therapy with reinforcement in the treatment of anxiety disorders.
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Affiliation(s)
- Tanja Sappok
- Medizin für Menschen mit Behinderungen, Medizinische Fakultät, Universität Bielefeld, Bielefeld, Deutschland.
- Universitätsklinik für Inklusive Medizin, Krankenhaus Mara gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Maraweg 21, 33617, Bielefeld, Deutschland.
| | - Mareike Bayer
- Klinische Psychologie Sozialer Interaktion, Institut für Psychologie, Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Almut Helmes
- Arbeitsgruppe Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Universität Freiburg, Freiburg, Deutschland
| | - Anika Gabriel
- Arbeitsgruppe Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Universität Freiburg, Freiburg, Deutschland
| | - Jessica Wagner
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin Elisabeth Herzberge, Berlin, Deutschland
- MindDoc Berlin, Berlin, Deutschland
| | | | - Marlene Tergeist
- Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Ev. Krankenhaus Königin Elisabeth Herzberge, Berlin, Deutschland
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Oudman E, Baert JCM. Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report. Palliat Support Care 2023; 21:181-3. [PMID: 35543124 DOI: 10.1017/S1478951522000542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Eye movement desensitization and reprocessing (EMDR) is an established treatment for post-traumatic stress disorders (PTSD). Some patients diagnosed with amyotrophic lateral sclerosis (ALS) experience PTSD following choking or suffocation in the course of progressive loss of the ability to breathe. Although a loss of breathing functions in ALS is relatively common, there are currently no studies available on treatment for the fear of choking following advanced ALS. METHODS In this case study, we describe the positive effects of EMDR, an evidence-based form of trauma therapy, in a 48-year-old female, suffering from advanced ALS. As the consequence of ALS, she was not able to speak or breath independently, but could communicate through a speech-generating device. She experienced panic attacks, flashbacks, nightmares, and severe anxiety after her tracheostomy jammed, and she almost suffocated. RESULTS Mediative treatment was started by instructing the care staff to respond neutrally with step-by-step instructions following tracheostomy jam, resulting in significantly less panic attacks and flashbacks. EMDR was initiated two weeks later, and resulted in full remittance of the trauma symptomatology. SIGNIFICANCE OF THE RESULTS The present case study suggests that symptoms of PTSD, namely the strong fear of suffocation, can be successfully treated by means of mediative behavioral therapy combined with EMDR.
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Olivier E, de Roos C, Bexkens A. Eye Movement Desensitization and Reprocessing in Young Children (Ages 4-8) with Posttraumatic Stress Disorder: A Multiple-Baseline Evaluation. Child Psychiatry Hum Dev 2022; 53:1391-1404. [PMID: 34487289 DOI: 10.1007/s10578-021-01237-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
To reduce the acute and long-term effects of trauma, early and effective treatment is necessary. Eye movement desensitization and reprocessing (EMDR) therapy is a brief treatment for posttraumatic stress disorder (PTSD), with a substantial evidence base for children and adolescents aged 8 to 18 years. In the present study we aimed to provide preliminary evidence of EMDR as a trauma treatment for young children. We studied 9 children, aged 4 to 8 years old with a DSM-5 diagnosis of PTSD. A non-concurrent multiple baseline experimental design was used combined with standardized measures. Participants received six 1-h sessions of EMDR. Results post-treatment showed that EMDR was effective in reaching diagnostic remission of PTSD (85.7%), and decreasing severity of PTSD symptoms and emotional and behavioral problems. All gains were maintained at follow-up 3 months after treatment. EMDR appears an effective treatment for PTSD in young children aged 4 to 8 years. Further research is warranted.
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Affiliation(s)
- Eline Olivier
- GGZ Delfland, Delft, The Netherlands.
- Psymens, Korenmolenlaan 1D, 3447 GG, Woerden, The Netherlands.
| | - Carlijn de Roos
- Academic Centre for Child and Adolescent Psychiatry Levvel, Amsterdam University Medical Centre (Location AMC), Amsterdam, The Netherlands
| | - Anika Bexkens
- GGZ Delfland, Delft, The Netherlands
- Department of Psychology, Leiden University, Leiden, The Netherlands
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Wibbelink CJM, Lee CW, Bachrach N, Dominguez SK, Ehring T, van Es SM, Fassbinder E, Köhne S, Mascini M, Meewisse ML, Menninga S, Morina N, Rameckers SA, Thomaes K, Walton CJ, Wigard IG, Arntz A. The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial. Trials 2021; 22:848. [PMID: 34838102 PMCID: PMC8626728 DOI: 10.1186/s13063-021-05712-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05712-9.
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Affiliation(s)
- Carlijn J M Wibbelink
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands.
| | - Christopher W Lee
- Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Nathan Bachrach
- GGZ Oost Brabant, RINO Zuid and Tilburg University, Kluisstraat 2, 5427 EM, Boekel, the Netherlands
| | - Sarah K Dominguez
- School of Psychology and Exercise Science, Murdoch University and Sexual Assault Resource Centre, 90 South Street, Murdoch, Western Australia, 6150, Australia
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Leopoldstr. 13, 80802, Munich, Germany
| | - Saskia M van Es
- PsyQ Amsterdam, Parnassia Groep, Overschiestraat 57, 1062 HN, Amsterdam, the Netherlands
| | - Eva Fassbinder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Sandra Köhne
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Magda Mascini
- GGZ Noord-Holland-Noord, Stationsplein 138, 1703 WC, Heerhugowaard, the Netherlands
| | - Marie-Louise Meewisse
- Abate, Centre of Expertise in Anxiety and Trauma, Postweg 3, 1601 SX, Enkhuizen, the Netherlands
| | - Simone Menninga
- PsyQ Beverwijk, Parnassia Groep, Leeghwaterweg 1a, 1951 NA, Velsen-Noord, the Netherlands
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Muenster, Germany
| | - Sophie A Rameckers
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands
| | - Kathleen Thomaes
- Sinai Center, the Psychotrauma Expertise Center of Arkin and Amsterdam UMC, location VUmc, Department Psychiatry and Department of Anatomy and Neuroscience, Laan van de Helende Meesters 2, 1186 AM, Amstelveen, the Netherlands
| | - Carla J Walton
- Centre for Psychotherapy, Hunter New England Mental Health Service, NSW, Australia, PO Box 833, Newcastle, NSW, 2300, Australia
| | - Ingrid G Wigard
- PsyQ Amsterdam, Parnassia Groep, Overschiestraat 57, 1062 HN, Amsterdam, the Netherlands
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands
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Lortye SA, Will JP, Marquenie LA, Goudriaan AE, Arntz A, de Waal MM. Treating posttraumatic stress disorder in substance use disorder patients with co-occurring posttraumatic stress disorder: study protocol for a randomized controlled trial to compare the effectiveness of different types and timings of treatment. BMC Psychiatry 2021; 21:442. [PMID: 34493253 PMCID: PMC8423329 DOI: 10.1186/s12888-021-03366-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) have high comorbidity. Although prior research indicated that PTSD can effectively be treated with Prolonged Exposure (PE) in these patients, reported effects are small and treatment dropout rates high. Eye Movement Desensitization and Reprocessing (EMDR) and Imagery Rescripting (ImRs) are other promising treatment options for PTSD, that have not yet been examined in this patient group. Furthermore, it is unclear whether PTSD treatment is most effective when offered simultaneous to or after SUD treatment. METHODS In this article, the Treatment Of PTSD and Addiction (TOPA) study is described: a Dutch randomized controlled trial (RCT) that studies the effectiveness of PTSD treatment as an add-on to regular SUD treatment in patients with SUD and co-occurring PTSD. Effects of PE, EMDR, ImRs, and a 3-month SUD treatment only condition will be compared, as well as simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment. The primary outcome measure is PTSD symptoms. Secondary outcomes are: treatment completion, psychological distress, substance use, interpersonal problems, emotion dysregulation, and trauma-related emotions guilt, shame, and anger. DISCUSSION This study is the first to compare effects of PE, EMDR, and ImRs in one study and to compare simultaneous SUD/PTSD treatment to sequential SUD/PTSD treatment as well. This RCT will provide more knowledge about the effectiveness of different treatment strategies for PTSD in patients with co-occurring SUD and will ultimately improve treatment outcomes for patients with this common co-morbidity worldwide. TRIAL REGISTRATION Netherlands Trial Register (NTR), Identifier: NL7885 . Registered 22 July 2019.
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Affiliation(s)
- Sera A. Lortye
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Joanne P. Will
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Loes A. Marquenie
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Anna E. Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands ,grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Arnoud Arntz
- grid.7177.60000000084992262Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Marleen M. de Waal
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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Carletto S, Malandrone F, Berchialla P, Oliva F, Colombi N, Hase M, Hofmann A, Ostacoli L. Eye movement desensitization and reprocessing for depression: a systematic review and meta-analysis. Eur J Psychotraumatol 2021; 12:1894736. [PMID: 33889310 PMCID: PMC8043524 DOI: 10.1080/20008198.2021.1894736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: In recent years, eye movement desensitization and reprocessing (EMDR) has been applied to different psychiatric conditions beyond post-traumatic stress disorder (PTSD), and an increasing number of studies have evaluated its effect on depression. To date, no quantitative synthesis of the efficacy of EMDR on depression has been conducted. Objective: To meta-analytically review the studies on EMDR for depression as the primary target for treatment. Method: Studies with a controlled design evaluating the effect of EMDR on depression were searched on six electronic databases (PubMed, Embase, CINAHL, PsycINFO, Cochrane database, and Francine Shapiro Library) and then selected by two independent reviewers. A systematic review and meta-analysis was conducted. Results: Eleven studies were included for qualitative synthesis. Nine studies were included in the meta-analysis, involving 373 participants. The overall effect size of EMDR for depressive symptoms is large (n = 9, Hedges' g = - 1.07; 95%CI [-1.66; - 0.48]), with high heterogeneity (I 2 = 84%), and corresponds to a 'number needed to treat' of 1.8. At follow-up (range 3-6 months), the effect remains significant but moderate (n = 3, Hedges' g = - 0.62; 95%CI [-0.97; - 0.28]; I 2 = 0%). The effect of EMDR compared with active controls is also moderate (n = 7, g = - 0.68; 95%CI [-0.92; - 0.43]; I 2 = 0%). No publication bias was found, although the results are limited by the small number and poor methodological quality of the included studies. Conclusions: Review findings suggest that EMDR may be considered an effective treatment for improving symptoms of depression, with effects comparable to other active treatments. However, findings need to be interpreted in light of the limited number of the studies and their quality. Further research is required to understand the longer-term of effects EMDR in treating depression and preventing depression relapse. Protocol registration: PROSPERO (CRD42018090086).
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Affiliation(s)
- Sara Carletto
- Department of Neurosciences, University of Turin, Turin, Italy
| | - Francesca Malandrone
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Nicoletta Colombi
- Biblioteca Federata di Medicina "Ferdinando Rossi", University of Turin, Turin, Italy
| | - Michael Hase
- Lüneburg Centre for Stress Medicine, Lüneburg, Germany
| | | | - Luca Ostacoli
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Gardoki-Souto I, Martín de la Torre O, Hogg B, Redolar-Ripoll D, Valiente-Gómez A, Martínez Sadurní L, Blanch JM, Lupo W, Pérez V, Radua J, Amann BL, Moreno-Alcázar A. Augmentation of EMDR with multifocal transcranial current stimulation (MtCS) in the treatment of fibromyalgia: study protocol of a double-blind randomized controlled exploratory and pragmatic trial. Trials 2021; 22:104. [PMID: 33514408 PMCID: PMC7844777 DOI: 10.1186/s13063-021-05042-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), combined with a non-invasive brain stimulation technique, such as multifocal transcranial current stimulation (MtCS), could be an innovative adjunctive treatment option. This double-blind randomized controlled trial (RCT) analyzes if EMDR therapy is effective in the reduction of pain symptoms in FM patients and if its potential is boosted with the addition of MtCS. METHODS Forty-five patients with FM and a history of traumatic events will be randomly allocated to Waiting List, EMDR + active-MtCS, or EMDR + sham-MtCS. Therapists and patients will be kept blind to MtCS conditions, and raters will be kept blind to both EMDR and MtCS. All patients will be evaluated at baseline, post-treatment, and follow-up at 6 months after post-treatment. Evaluations will assess the following variables: sociodemographic data, pain, psychological trauma, sleep disturbance, anxiety and affective symptoms, and wellbeing. DISCUSSION This study will provide evidence of whether EMDR therapy is effective in reducing pain symptoms in FM patients, and whether the effect of EMDR can be enhanced by MtCS. TRIAL REGISTRATION ClinicalTrials.gov NCT04084795 . Registered on 2 August 2019.
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Affiliation(s)
- I. Gardoki-Souto
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | - B. Hogg
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - D. Redolar-Ripoll
- Cognitive NeuroLab, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - A. Valiente-Gómez
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - L. Martínez Sadurní
- Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - J. M. Blanch
- Service of Rheumatology, Parc de Salut Mar, Barcelona, Spain
| | - W. Lupo
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
| | - V. Pérez
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - J. Radua
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Karolinska Institutet, Solna, Sweden
- King’s College, London, England
| | - B. L. Amann
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - A. Moreno-Alcázar
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, C/ Llull 410, 08019 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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13
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Rousseau PF, Boukezzi S, Garcia R, Chaminade T, Khalfa S. Cracking the EMDR code: Recruitment of sensory, memory and emotional networks during bilateral alternating auditory stimulation. Aust N Z J Psychiatry 2020; 54:818-831. [PMID: 32271126 DOI: 10.1177/0004867420913623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The inability to extinguish a conditioned fear is thought to be at the core of post-traumatic stress disorder. Eye movement desensitization and reprocessing therapy has been efficacious for post-traumatic stress disorder, but the brain mechanisms underlying the effect are still unknown. The core effect of eye movement desensitization and reprocessing therapy seems to rely on the simultaneous association of bilateral alternating stimulation and the recall of the traumatic memory. To shed light on how eye movement desensitization and reprocessing therapy functions, we aimed to highlight the structures activated by bilateral alternating stimulation during fear extinction and its recall. METHODS We included 38 healthy participants in this study. Participants were examined twice in functional magnetic resonance imaging, over 2 consecutive days. On the first day, they performed two fear conditioning and extinction procedures, one with and one without the bilateral alternating stimulation during the fear extinction learning phase in a counter-balanced order across the participants. On the second day, participants completed the fear extinction recall procedure, in the same order as the previous day. Statistical significance of maps was set at p < 0.05 after correction for family-wise error at the cluster level. RESULTS The analysis revealed significant activation with versus without bilateral alternating stimulation at the early extinction in the bilateral auditory areas, the right precuneus, and the left medial frontal gyrus. The same pattern was found in the early recall on the second day. The connectivity analysis found a significant increase in connectivity during bilateral alternating stimulation versus without bilateral alternating stimulation in the early extinction and recall between the two superior temporal gyri, the precuneus, the middle frontal gyrus and a set of structures involved in multisensory integration, executive control, emotional processing, salience and memory. CONCLUSION We show for the first time that in the eye movement desensitization and reprocessing therapy the bilateral alternating stimulation is not a simple sensory signal and can activate large emotional neural networks.
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Affiliation(s)
- Pierre-François Rousseau
- Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260, Aix-Marseille Université, CNRS, Marseille, France
| | - Sarah Boukezzi
- Connors Center for Women's Health & Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - René Garcia
- Institut de Neurosciences de la Timone, Aix-Marseille Université, CNRS, Marseille, France
| | - Thierry Chaminade
- Institut de Neurosciences de la Timone, Aix-Marseille Université, CNRS, Marseille, France
| | - Stéphanie Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, UMR 7260, Aix-Marseille Université, CNRS, Marseille, France
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Yunitri N, Kao CC, Chu H, Voss J, Chiu HL, Liu D, Shen STH, Chang PC, Kang XL, Chou KR. The effectiveness of eye movement desensitization and reprocessing toward anxiety disorder: A meta-analysis of randomized controlled trials. J Psychiatr Res 2020; 123:102-113. [PMID: 32058073 DOI: 10.1016/j.jpsychires.2020.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/02/2020] [Accepted: 01/20/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Eye Movement Desensitization and Reprocessing (EMDR) has been well established as an effective treatment for post-traumatic stress disorder (PTSD). However, PTSD has been re-categorized as part of trauma and stressor-related disorders instead of anxiety disorders. We conducted the first meta-analysis on Randomized Controlled Trials to evaluate the effectiveness of EMDR on reducing symptoms of anxiety disorders. METHODS A manual and systematic search using various databases and reference lists of systematic review articles published up to December 2018 was conducted. The symptoms of anxiety, phobia, panic, traumatic feelings and behaviors/somatic symptoms were examined. Hedges' g effect sizes were computed, and random effect models were used for all analyses. RESULTS A total of 17 trials with 647 participants were included in this meta-analysis. EMDR was associated with a significant reduction of anxiety (g = -0.71; 95% CI: -0.96 to -0.47), panic (g = -0.62; 95% CI: -1.10 to -0.14), phobia (g = -0.45; 95% CI: -0.81 to -0.08), behavioural/somatic symptoms (g = -0.40; 95% CI: -0.63 to -0.12), but not traumatic feelings (g = -0.48; 95% CI: -1.14 to -0.18). Subgroup analysis revealed greater effects of EMDR if compared to passive control. However, the effects were not significantly different based on the duration, number of therapy sessions, or the number of weekly sessions. CONCLUSIONS Our meta-analysis indicates that EMDR is efficacious for reducing symptoms of anxiety, panic, phobia, and behavioural/somatic symptoms. Further research is needed to explore EMDR's long term efficacy on anxiety disorders.
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Affiliation(s)
- Ninik Yunitri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Mental Health and Psychiatric Nursing Department, Faculty of Nursing, Muhammadiyah University of Jakarta, Indonesia
| | - Ching-Chiu Kao
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Joachim Voss
- Sarah Cole Hirsh Center for Evidence-Based Practice, Frances Payne Bolton School of Nursing, Case Western Reserve University, USA
| | - Huei-Ling Chiu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shu-Tai H Shen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Xiao Linda Kang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, University of Pennsylvania, USA
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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15
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van Veen SC, Kang S, van Schie K. On EMDR: Measuring the working memory taxation of various types of eye (non-)movement conditions. J Behav Ther Exp Psychiatry 2019; 65:101494. [PMID: 31401457 DOI: 10.1016/j.jbtep.2019.101494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/05/2019] [Accepted: 06/09/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE A recent, large randomized controlled trial employing different forms of eye (non-)movements in eye movement desensitization and reprocessing (EMDR) showed that fixating the eyes either on a therapist's moving or non-moving hand led to equal reductions in symptoms of post-traumatic stress disorder (PTSD). However, numerous EMDR lab analogue studies found that eye movements produce larger memory effects than eyes stationary. These beneficial effects are typically explained by differences in working memory (WM) taxation. We tested the degree of WM taxation of several eye (non-)movement conditions used in the clinical trial. METHODS All participants (N = 40) performed: (1) eyes moving by following the experimenter's moving finger, (2) eyes fixed on the experimenter's stationary finger, (3) eyes closed, or (4) looking unfocused into the room. Simultaneously they performed a simple reaction time task. Reaction times are an objective index of the extent to which different dual attention tasks tax WM. RESULTS Eyes moving is more taxing than eyes fixed, while eyes fixed did not differ from eyes unfocused. All conditions were more taxing than eyes closed. LIMITATIONS We studied WM taxation in a laboratory setting; no clinical interventions were applied. CONCLUSIONS In line with previous lab studies, making eye movements was more taxing than eyes fixed. We discuss why this effect was not observed for reductions in PTSD symptoms in the clinical trial (e.g., differences in dependent variables, sample population, and intervention duration). For more comprehensive future insights, we recommend integration of mechanistically focused lab analogue studies and patient-oriented clinical studies.
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Affiliation(s)
| | - Sahaj Kang
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Kevin van Schie
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
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16
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Rousseau PF, Malbos E, Verger A, Nicolas F, Lançon C, Khalfa S, Guedj E. Increase of precuneus metabolism correlates with reduction of PTSD symptoms after EMDR therapy in military veterans: an 18F-FDG PET study during virtual reality exposure to war. Eur J Nucl Med Mol Imaging 2019; 46:1817-1821. [PMID: 31152209 DOI: 10.1007/s00259-019-04360-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/13/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE The prevalence of posttraumatic stress disorder (PTSD) is higher among veterans, and can lead to disastrous consequences such as suicide. Eye movement desensitization and reprocessing (EMDR) is recommended in first-line psychotherapies for PTSD. Virtual reality exposure (VRE) coupled with 18F-FDG PET imaging can highlight the activated brain regions during stress exposure. The objective of this study is to identify, after EMDR therapy, the regions of brain metabolism that evolve during the stress exposure of a war scene with symptomatic remission in a group of military veterans suffering from PTSD, and to secondarily search for predictive metabolic features. METHODS We recruited 15 military veterans suffering from PTSD who performed an 18F-FDG PET sensitized by the exposure to a virtual war scene, before (T0) and after (T1) EMDR therapy. Statistical parametric mapping was used to compare brain metabolism before and after treatment and to study correlations between metabolism and evolution scores on PTSD clinical scales (PTSD Checklist Scale, PCLS; Clinician-Administered PTSD Scale, CAPS). RESULTS The metabolic activity of the precuneus was increased after EMDR therapy (p < 0.005 uncorrected, k > 180) and correlated with clinical improvement with the CAPS scale (r = -0.73 and p < 0.001). Moreover, the precuneus metabolic value before therapy predicted the clinical improvement on the PCLS scale (T1-T0) after EMDR (r = -0.667 and p < 0.006). CONCLUSION The clinical improvement in military patients with PTSD after EMDR is related to increased precuneus metabolism upon VR stress exposure.
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Affiliation(s)
- P F Rousseau
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - E Malbos
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - A Verger
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France
- IADI, INSERM, UMR 1254, Lorraine University, Nancy, France
| | - F Nicolas
- Service de Psychiatrie, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - C Lançon
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - S Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - Eric Guedj
- CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Aix-Marseille Université, Marseille, France.
- Department of Nuclear Medicine, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France.
- CERIMED, Aix-Marseille University, Marseille, France.
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Cuperus AA, Laken M, van Schie K, Engelhard IM, van den Hout MA. Dual-tasking during recall of negative memories or during visual perception of images: Effects on vividness and emotionality. J Behav Ther Exp Psychiatry 2019; 62:112-116. [PMID: 30316043 DOI: 10.1016/j.jbtep.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/29/2018] [Accepted: 10/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Several treatments are effective in reducing symptoms of post-traumatic stress disorder. We tested the effectiveness of an experimental intervention that consists of elements from two of these: virtual reality (VR) exposure therapy and eye movement desensitization and reprocessing. The latter is characterized by a dual-task approach: the patient holds a traumatic memory in mind while simultaneously making voluntary eye movements, resulting in reduced vividness and emotionality of the traumatic memory. If the experimental intervention is effective, it could provide a useful approach for highly avoidant individuals. METHODS Participants recalled negative memories induced by a VR paradigm. The experimental group viewed VR screenshots that represented these negative memories while carrying out a dual-task. One control group recalled negative memories while carrying out the same dual-task (a standard dual-task condition) and another merely viewed the VR screenshots. Pre-to-post changes in self-rated memory vividness/emotionality were measured. RESULTS The results indicate that viewing a screenshot only was outperformed by both dual-task interventions in terms of reductions in vividness/emotionality. Furthermore, the dual-task interventions had a comparable impact on vividness, but the screenshot variant led to greater decreases in emotionality. LIMITATIONS Changes in memory vividness/emotionality were only assessed shortly after the interventions and no measures of avoidance behavior were included in the study. CONCLUSIONS Looking at an image in VR that represents a memory while carrying out a dual-task may be at least as effective as recalling the memory during the dual-task. Interestingly, visually supporting a negative memory does not seem to prevent memory degrading by dual-tasking.
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Affiliation(s)
- Anne A Cuperus
- Department of Health, Medical and Neuropsychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands; Triple, Keesomstraat 10e, 1821 BS, Alkmaar, the Netherlands.
| | - Maarten Laken
- Servicehouse B.V., Utrechtseweg 31c, 3811 NA, Amersfoort, the Netherlands.
| | - Kevin van Schie
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, the Netherlands.
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, the Netherlands.
| | - Marcel A van den Hout
- Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC, Utrecht, the Netherlands.
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Gil-Jardiné C, Al Joboory S, Jammes JTS, Durand G, Ribéreau-Gayon R, Galinski M, Salmi LR, Revel P, Régis CA, Valdenaire G, Poulet E, Tazarourte K, Lagarde E. Prevention of post-concussion-like symptoms in patients presenting at the emergency room, early single eye movement desensitization, and reprocessing intervention versus usual care: study protocol for a two-center randomized controlled trial. Trials 2018; 19:555. [PMID: 30314512 PMCID: PMC6186089 DOI: 10.1186/s13063-018-2902-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/04/2018] [Indexed: 01/04/2023] Open
Abstract
Background Recent data suggest that 10–20% of injury patients will suffer for several months after the event from diverse symptoms, generally referred to as post-concussion-like symptoms (PCLS), which will lead to a decline in quality of life. A preliminary randomized control trial suggested that this condition may be induced by the stress experienced during the event or emergency room (ER) stay and can be prevented in up to 75% of patients with a single, early, short eye movement desensitization and reprocessing (EMDR) psychotherapeutic session delivered in the ER. The protocol of the SOFTER 3 study was designed to compare the impact on 3-month PCLS of early EMDR intervention and usual care in patients presenting at the ER. Secondary outcomes included 3-month post-traumatic stress disorder, 12-month PCLS, self-reported stress at the ER, self-assessed recovery expectation at discharge and 3 months, and self-reported chronic pain at discharge and 3 months. Methods This is a two-group, open-label, multicenter, comparative, randomized controlled trial with 3- and 12-month phone follow-up for reports of persisting symptoms (PCLS and post-traumatic stress disorder). Those eligible for inclusion were adults (≥18 years old) presenting at the ER departments of the University Hospital of Bordeaux and University Hospital of Lyon, assessed as being at high risk of PCLS using a three-item scoring rule. The intervention groups were a (1) EMDR Recent Traumatic Episode Protocol intervention performed by a trained psychologist during ER stay or (2) usual care. The number of patients to be enrolled in each group was 223 to evidence a 15% decrease in PCLS prevalence in the EMDR group. Discussion In 2012, the year of the last national survey in France, 10.6 million people attended the ER, some of whom did so several times since 18 million visits were recorded in the same year. The SOFTER 3 study therefore addresses a major public health challenge. Trial registration Clinical Trials. NCT03400813. Registered 17 January 2018 – retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s13063-018-2902-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cédric Gil-Jardiné
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France. .,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France. .,Emergency Department, University Hospital of Bordeaux, Pellegrin Hospital, Place Amélie Raba-Léon, 33000, Bordeaux, France. .,Bordeaux University Hospital, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33400, Talence, France.
| | | | | | - Guillaume Durand
- Department of Emergency Medicine, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France.,University Hospital, Claude Bernard University, Lyon, France
| | - Régis Ribéreau-Gayon
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France.,University Hospital of Bordeaux, Pole of Medicine, Bordeaux, France
| | - Michel Galinski
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | - Louis-Rachid Salmi
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France.,University Hospital of Bordeaux, Pole of Public Health, Bordeaux, France
| | - Philippe Revel
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | | | - Guillaume Valdenaire
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | - Emmanuel Poulet
- University Hospital, Claude Bernard University, Lyon, France.,Department of Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France
| | - Karim Tazarourte
- Department of Emergency Medicine, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France.,EA 7425 Hesper University Hospital, Claude Bernard University, Lyon, France
| | - Emmanuel Lagarde
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
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Dibbets P, Lemmens A, Voncken M. Turning negative memories around: Contingency versus devaluation techniques. J Behav Ther Exp Psychiatry 2018; 60:5-12. [PMID: 29477486 DOI: 10.1016/j.jbtep.2018.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/11/2017] [Accepted: 02/05/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES It is assumed that fear responses can be altered by changing the contingency between a conditioned stimulus (CS) and an unconditioned stimulus (US), or by devaluing the present mental representation of the US. The aim of the present study was to compare the efficacy of contingency- and devaluation-based intervention techniques on the diminishment in - and return of fear. We hypothesized that extinction (EXT, contingency-based) would outperform devaluation-based techniques regarding contingency measures, but that devaluation-based techniques would be most effective in reducing the mental representation of the US. Additionally, we expected that incorporations of the US during devaluation would result in less reinstatement of the US averseness. METHODS Healthy participants received a fear conditioning paradigm followed by one of three interventions: extinction (EXT, contingency-based), imagery rescripting (ImRs, devaluation-based) or eye movement desensitization and reprocessing (EMDR, devaluation-based). A reinstatement procedure and test followed the next day. RESULTS EXT was indeed most successful in diminishing contingency-based US expectancies and skin conductance responses (SCRs), but all interventions were equally successful in reducing the averseness of the mental US representation. After reinstatement EXT showed lowest expectancies and SCRs; no differences were observed between the conditions concerning the mental US representation. LIMITATIONS A partial reinforcement schedule was used, resulting in a vast amount of contingency unaware participants. Additionally, a non-clinical sample was used, which may limit the generalizability to clinical populations. CONCLUSION EXT is most effective in reducing conditioned fear responses.
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Schäfer I, Chuey-Ferrer L, Hofmann A, Lieberman P, Mainusch G, Lotzin A. Effectiveness of EMDR in patients with substance use disorder and comorbid PTSD: study protocol for a randomized controlled trial. BMC Psychiatry 2017; 17:95. [PMID: 28302084 PMCID: PMC5356401 DOI: 10.1186/s12888-017-1255-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD. METHODS/DESIGN We conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD. Patients are randomized to receive either EMDR, added to SUD rehabilitation and non-trauma-focused PTSD treatment (TAU), or TAU alone. The primary outcome is change from baseline in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale at 6-month follow-up. Secondary outcomes are change from baseline in substance use, addiction-related problems, depressive symptoms, dissociative symptoms, emotion dysregulation and quality of life. Assessments are carried out by blinded raters at admission, at end of treatment, and at 3- and 6-month follow-up. We expect that EMDR plus TAU will be more effective in reducing PTSD symptoms than TAU alone. Mixed models will be conducted using an intention-to-treat and per-protocol approach. DISCUSSION This study aims to expand the knowledge about the effectiveness of EMDR in patients with SUD and comorbid PTSD. The expected finding of the superiority of EMDR in reducing PTSD symptoms compared to non-trauma-focused PTSD treatment may enhance the use of trauma-focused treatment approaches for patients with SUD and co-morbid PTSD. TRIAL REGISTRATION German Clinical Trials Register: DRKS00009007 ; U1111-1172-9213. Retrospectively registered 01 Juni 2016.
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Affiliation(s)
- Ingo Schäfer
- 0000 0001 2180 3484grid.13648.38Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistr. 52, Hamburg, D-20246 Germany
| | | | - Arne Hofmann
- EMDR-Institute Germany, Bergisch Gladbach, Germany
| | | | | | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. .,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistr. 52, Hamburg, D-20246, Germany.
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van den Berg DPG, van der Vleugel BM, de Bont PAJM, Staring ABP, Kraan T, Ising H, de Roos C, de Jongh A, van Minnen A, van der Gaag M. Predicting trauma-focused treatment outcome in psychosis. Schizophr Res 2016; 176:239-244. [PMID: 27449253 DOI: 10.1016/j.schres.2016.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/08/2016] [Accepted: 07/17/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Although TF treatments are effective in patients with psychosis, it is unknown whether specific psychosis-related obstacles limit the effects, and what determines good outcome. METHODS Baseline posttraumatic stress disorder (PTSD) symptom severity and seven psychosis-specific variables were tested as predictors in patients with a psychotic disorder and PTSD (n=108), who received eight sessions of TF treatment (Prolonged Exposure, or Eye Movement Desensitization and Reprocessing therapy) in a single-blind randomized controlled trial. Multiple regression analyses were performed. RESULTS Baseline PTSD symptom severity was significantly associated with posttreatment PTSD symptom severity, explaining 11.4% of the variance. Additionally, more severe PTSD at baseline was also significantly associated with greater PTSD symptom improvement during treatment. After correction for baseline PTSD symptom severity, the model with the seven baseline variables did not significantly explain the variance in posttreatment PTSD outcome. Within this non-significant model, the presence of auditory verbal hallucinations contributed uniquely to posttreatment outcome but explained little variance (5.4%). Treatment completers and dropouts showed no significant difference on any of the psychosis-related variables. CONCLUSIONS Given the low predictive utility of baseline psychosis-related factors, we conclude that there is no evidence-based reason to exclude patients with psychotic disorders from TF treatments. Also, we speculate that patients with psychosis and severe baseline PTSD might derive more benefit if given more than eight sessions. Trial registration current controlled-trials.com | Identifier: ISRCTN79584912 | http://www.isrctn.com/ISRCTN79584912.
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Affiliation(s)
| | - Berber M van der Vleugel
- Community Mental Health Service GGZ Noord-Holland Noord, Oude Hoeverweg 10, 1816 BT Alkmaar, The Netherlands.
| | - Paul A J M de Bont
- Mental Health Organization (MHO) GGZ Oost Brabant Land van Cuijk en Noord Limburg, Bilderbeekstraat 44, 5831 CX Boxmeer, The Netherlands.
| | - Anton B P Staring
- Altrecht Psychiatric Institute, ABC straat 8, 3512 PX Utrecht, The Netherlands.
| | - Tamar Kraan
- Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, The Netherlands.
| | - Helga Ising
- Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, The Netherlands.
| | - Carlijn de Roos
- MHO Rivierduinen, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands.
| | - Ad de Jongh
- Dept of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; School of Health Sciences, Salford University, Manchester, United Kingdom.
| | - Agnes van Minnen
- Radboud University Nijmegen, Behavioural Science Institute, NijCare, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; MHO Pro Persona, Centre for Anxiety Disorders Overwaal, Nijmegen, The Netherlands.
| | - Mark van der Gaag
- Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, The Netherlands; VU University Amsterdam and EMGO Institute for Health and Care Research, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
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Tang TC, Yang P, Yen CF, Liu TL. Eye movement desensitization and reprocessing for treating psychological disturbances in Taiwanese adolescents who experienced Typhoon Morakot. Kaohsiung J Med Sci 2015; 31:363-9. [PMID: 26162817 DOI: 10.1016/j.kjms.2015.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 03/04/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022] Open
Abstract
In this case-control study, we aimed to assess the intervention effects of four-session eye movement desensitization and reprocessing (EMDR) on reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in Taiwanese adolescents who experienced Typhoon Morakot. A total of 83 adolescents with posttraumatic stress disorder related to Typhoon Morakot, major depressive disorder, or current moderate or high suicide risk after experiencing Typhoon Morakot were allocated to a four-session course of EMDR (N = 41) or to treatment as usual (TAU; N = 42). A multivariate analysis of covariance was performed to examine the effects of EMDR in reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in adolescents by using preintervention severity values as covariates. The multivariate analysis of covariance results indicated that the EMDR group exhibited significantly lower preintervention severity values of general anxiety and depression than did the TAU group. In addition, the preintervention severity value of disaster-related anxiety in the EMDR group was lower than that in the TAU group (p = 0.05). The results of this study support that EMDR could alleviate general anxiety and depressive symptoms and reduce disaster-related anxiety in adolescents experiencing major traumatic disasters.
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Affiliation(s)
- Tze-Chun Tang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Pinchen Yang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan; Department of Psychiatry, Faculty of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
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Abstract
While cognitive behavior therapy is considered to be the first-line therapy for adolescent depression, there are limited data on whether other psychotherapeutic techniques are also effective in treating adolescents with depression. This report suggests the potential application of eye movement desensitization and reprocessing (EMDR) for treatment of depressive disorder related, not to trauma, but to stressful life events. At present, EMDR has only been empirically validated for only trauma-related disorders such as posttraumatic stress disorder. Two teenagers with major depressive disorder (MDD) underwent three and seven sessions of EMDR aimed at memories of stressful life events. After treatment, their depressive symptoms decreased to the level of full remission, and the therapeutic gains were maintained after two and three months of follow up. The effectiveness of EMDR for depression is explained by the model of adaptive information processing. Given the powerful effects observed within a brief period of time, the authors suggest that further investigation of EMDR for depressive disorders is warranted.
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Affiliation(s)
- Hwallip Bae
- Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Korea
| | - Daeho Kim
- Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Korea
| | - Yong Chon Park
- Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, Korea
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