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Eye Movement Desensitization and Reprocessing

February 21, 2015 Written by JP       [Font too small?]

The majority of past events, even very painful ones, do not have to cause psychological distress in the present. On a rational level most of us understand this reality. However, sad and/or traumatic memories, whether fresh in history or dating back to childhood, still hold a great deal of power over many people. These hurtful, life-altering experiences often shape personalities and result in long term attempts at exorcising these mental images from the present mind. But, recent findings suggest that an unconventional form of treatment known as eye movement desensitization and reprocessing or EMDR may offer a brief, new alternative for shooing away hurtful recollections.

Although EMDR commonly takes place over an 8 phase process, the basic concept is really quite simple. During a 90 minute session, a therapist encourages patients to recall disturbing or traumatic experiences. The patient is urged to become acutely aware of the emotions and any physical sensations associated with the painful memories. During the process, the therapist will wave his finger or a wand back and forth in front of the patient’s eyes. The patient is asked to follow the therapist’s finger or wand while maintaining awareness of the recollections, associated emotions and physical sensations. So, why is this unusual approach helpful? Two exploratory studies from 2012 and 2014 report that employing EMDR inspired eye movements during recall reduces unpleasant emotionality and vividness of autobiographical memories.

It’s taken quite awhile for the medical establishment to seriously consider EMDR a legitimate treatment modality. But, these days you can find peer-reviewed studies about EMDR appearing in conventional journals, including the British Journal of Psychiatry, the International Journal of Clinical Practice and JAMA Psychiatry. Most of the research continues to focus on the positive effects of EMDR in patients struggling with post traumatic stress disorder (PTSD). Having said that, other trials have discovered promising outcomes in varied conditions such as dental phobia, negative body image in those with eating disorders and obsessive compulsive disorder.

While the future of EMDR looks promising, there’s still a lot to learned. For instance, can this combination of eye movements and reprocessing of memories positively influence bodily symptoms including pain? To answer that, a German study currently underway is investigating the impact of EMDR in patients with chronic back pain. The results of that trial may well open new avenues for this mind-body technology. Also of interest to scientists is how well EMDR performs in comparison to related therapies. In the June 2011 issue of the Journal of Nervous Mental Disease, a controlled comparison found that EMDR slightly outperformed another alternative treatment known as the emotional freedom technique (EFT). More studies of this kind are needed in order to clarify the relative merits of EMDR for those seeking to live more fully in the present.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Time-Course of Eye Movement-Related Decrease in Vividness and … (link)

Study 2 - How Eye Movements in EMDR Work: Changes in Memory Vividness (link)

Study 3 - Prolonged Exposure vs Eye Movement Desensitization and Reprocessing (link)

Study 4 - EMDR and Psychopharmacological Therapy in the Treatment of PTSD (link)

Study 5 – Brief Eclectic Psychotherapy v. Eye Movement Desensitisation and (link)

Study 6 - A Controlled Comparison of the Effectiveness and Efficiency of Two (link)

Study 7 - Efficacy of a Trauma-Focused Treatment Approach for Dental Phobia (link)

Study 8 – Comparison of Eye Movement Desensitization and Reprocessing with (link)

Study 9 - A Randomized Experimental Test of the Efficacy of EMDR Treatment (link)

Study 10 - Effects of Eye Movement Desensitization and Reprocessing on Non- (link)

EMDR Relieves PTSD Symptoms Effectively and Quickly

Source: Br J Psychiatry. 2012 Mar;200(3):224-31. (link)

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17 Comments & Updates to “Eye Movement Desensitization and Reprocessing”

  1. JP Says:

    Update: A comparison of EFT, a modified form of EMDR and cognitive behavioral therapy (CBT) …

    Explore (NY). 2009 Nov-Dec;5(6):338-40.

    Pilot study of emotional freedom techniques, wholistic hybrid derived from eye movement desensitization and reprocessing and emotional freedom technique, and cognitive behavioral therapy for treatment of test anxiety in university students.

    OBJECTIVE: This study explored test anxiety benefits of wholistic hybrid derived from eye movement desensitization and reprocessing and Emotional Freedom Techniques (WHEE), Emotional Freedom Techniques (EFTs), and cognitive behavioral therapy (CBT).

    PARTICIPANTS: Canadian university students with severe or moderate test anxiety participated.

    METHODS: A controlled trial of WHEE (n = 5), EFT (n = 5), and CBT (n = 5) was conducted. Standardized anxiety measures included the Test Anxiety Inventory and Hopkins Symptom Checklist-21.

    RESULTS: Despite small sample size, significant reductions in test anxiety were found for all three treatments. In only two sessions, WHEE and EFT achieved the same benefits as CBT did in five sessions. Participants reported high satisfaction with all treatments. Emotional freedom techniques and WHEE participants successfully transferred their self-treatment skills to other stressful areas of their lives.

    CONCLUSIONS: Both WHEE and EFT show promise as feasible treatments for test anxiety.

    Be well!

    JP

  2. JP Says:

    Update: An interesting study showing the potential and possible limitations of EMDR …

    http://www.tandfonline.com/doi/full/10.1080/02791072.2014.921744#abstract

    J Psychoactive Drugs. 2014 Sep-Oct;46(4):303-9.

    Objective: This study investigated the effects of standard eye movement desensitization and reprocessing (EMDR) protocol in chronically dependent patients. We propose that reprocessing traumatic memories with EMDR would lead to measurable changes of addiction symptoms.

    METHOD: Twelve patients with alcohol and/or drug dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus eight sessions of EMDR (TAU+EMDR). Measures of PTSD symptoms, addiction symptoms, depression, anxiety, self-esteem, and alexithymia were included in this study.

    RESULTS: The TAU+EMDR group showed a significant reduction in PTSD symptoms but not in addiction symptoms. EMDR treatment was also associated with a significant decrease in depressive symptoms, while patients receiving TAU showed no improvement in this area. The TAU+EMDR group also showed significant changes in self-esteem and alexithymia post-treatment.

    CONCLUSIONS: This study suggests that PTSD symptoms can be successfully treated with standard EMDR protocol in substance abuse patients.

    Be well!

    JP

  3. JP Says:

    Update: EMDR may have a place in the treatment of delusions and hallucinations …

    http://www.tijdschriftvoorpsychiatrie.nl/en/issues/481/articles/10367

    Tijdschr Psychiatr. 2014;56(9):568-76.

    Imagery in psychosis: EMDR as a new intervention in the treatment of delusions and auditory hallucinations.

    Croes CF, van Grunsven R, Staring AB, van den Berg DP, de Jongh A, van der Gaag M.

    BACKGROUND: Historically, psychotherapy has focused on the treatment of patients’ verbal representations (thoughts) and has proved particularly successful in the cognitive behavioural treatment of psychosis. However, there is mounting evidence that visual representations (imagery) play an important role in the onset and maintenance of psychiatric disorders, including psychotic symptoms. There are indications that heightened emotionality and vividness of visual representations are associated with severity of psychotic experiences. This may imply that a reduction in the vividness and emotionality of the psychosis-related imagery can lessen the suffering and stress, caused by the the psychotic symptoms.

    AIM: To introduce EMDR as a possible type of psychological treatment for patients suffering from psychosis-related imagery.

    METHOD: Three outpatients who had a psychotic disorder and suffered from auditory hallucinations and delusions were treated with EMDR in an average of six sessions. Treatment was performed by three therapists in different psychiatric institutions. All three were experienced in administrating CBT and EMDR.

    RESULTS: Treatment with EMDR reduced patients’ level of anxiety, depression and the severity of psychotic symptoms. In addition, patients reported less avoidant behaviour and greater cognitive insight.

    CONCLUSION: The results of the study suggest that EMDR reduces the vividness and emotionality of imagery in psychosis which in turn alleviates the patients’ psychotic symptoms. Further research into other possible types of interventions for the treatment of imagery in psychosis is recommended.

    Be well!

    JP

  4. JP Says:

    Update 04/28/15:

    Psychiatry Investig. 2014 Jul;11(3):340-1.

    Eye movement desensitization and reprocessing for posttraumatic stress disorder in bipolar disorder.

    There is evidence that posttraumatic stress disorder (PTSD) is more prevalent in patients with bipolar disorder. According to a review,1 the mean prevalence of PTSD in bipolar patients is 16.0%, which is double the lifetime prevalence of PTSD in the general population.2 Also bipolar patients with comorbid PTSD exhibit more severe bipolar illness and multiple Axis I disorders, and they disengage more frequently from treatment, suggesting poorer outcome and course of the disorder.3,4 Trauma-focused cognitive-behavior therapy and eye movement desensization and reprocessing (EMDR) are considered first-line treatments for PTSD.5 Nonetheless, evidence for the efficacy of PTSD treatment in bipolar disorder is lacking. This is an unsatisfactory situation given the fact that antidepressant pharmacotherapy, often suggested as a second-line treatment for PTSD, has limited application for for bipolar patients because of the possibility of manic switch and adverse long-term outcomes.6 We report here the successful administration of EMDR to two cases of PTSD in patients with bipolar disorder.

    Be well!

    JP

  5. JP Says:

    Update 05/25/15:

    http://www.ncbi.nlm.nih.gov/pubmed/25989952

    Eur J Psychotraumatol. 2015 May 18;6:27414.

    EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial.

    BACKGROUND: The most common mental health problems among refugees are depression and posttraumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) is an effective treatment for PTSD. However, no previous randomized controlled trial (RCT) has been published on treating PTSD symptoms in a refugee camp population.

    OBJECTIVE: Examining the effect of EMDR to reduce the PTSD and depression symptoms compared to a wait-list condition among Syrian refugees.

    METHOD: Twenty-nine adult participants with PTSD symptoms were randomly allocated to either EMDR sessions (n=15) or wait-list control (n=14). The main outcome measures were Impact of Event Scale-Revised (IES-R) and Beck Depression Inventory (BDI-II) at posttreatment and 4-week follow-up.

    RESULTS: Analysis of covariance showed that the EMDR group had significantly lower trauma scores at posttreatment as compared with the wait-list group (d=1.78, 95% CI: 0.92-2.64). The EMDR group also had a lower depression score after treatment as compared with the wait-list group (d=1.14, 95% CI: 0.35-1.92).

    CONCLUSION: The pilot RCT indicated that EMDR may be effective in reducing PTSD and depression symptoms.

    Be well!

    JP

  6. JP Says:

    Update 05/19/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26085967

    Brain Behav. 2015 Jun;5(6):e00342.

    Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting.

    BACKGROUND: Depression is a severe mental disorder that challenges mental health systems worldwide as the success rates of all established treatments are limited. Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically acknowledged psychotherapeutic treatment for PTSD. Given the recent research indicating that trauma and other adverse life experiences can be the basis of depression, the aim of this study was to determine the effectiveness of EMDR therapy with this disorder.

    METHOD: In this study, we recruited a group of 16 patients with depressive episodes in an inpatient setting. These 16 patients were treated with EMDR therapy by reprocessing of memories related to stressful life events in addition to treatment as usual (TAU). They were compared to a group of 16 controls matched regarding diagnosis, degree of depression, sex, age and time of admission to hospital, which were receiving TAU only.

    RESULTS: Sixty-eight percent of the patients in the EMDR group showed full remission at end of treatment. The EMDR group showed a greater reduction in depressive symptoms as measured by the SCL-90-R depression subscale. This difference was significant even when adjusted for duration of treatment. In a follow-up period of more than 1 year the EMDR group reported less problems related to depression and less relapses than the control group.

    CONCLUSIONS: EMDR therapy shows promise as an effective treatment for depressive disorders. Larger controlled studies are necessary to replicate our findings.

    Be well!

    JP

  7. JP Says:

    Update 07/14/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26153191

    Glob J Health Sci. 2015 Apr 19;7(6):47723.

    Effect of Eye Movement Desensitization and Reprocessing (EMDR) on Depression in Patients With Myocardial Infarction (MI).

    BACKGROUND: Coronary heart disease is the most important cause of death and inability in all communities. Depressive symptoms are frequent among post-myocardial infarction (MI) patients and may cause negative effects on cardiac prognosis. This study was conducted to identify efficacy of EMDR on depression of patients with MI.

    METHODS: This study is a clinical trial. Sixty patients with MI were selected by simple sampling, and were separated randomly into experimental and control groups. To collect data, demographic questionnaire and Beck Depression Questionnaire were used. In experimental group, EMDR therapy were performed in three sessions alternate days for 45-90 minutes, during four months after their MI. Depression level of patients was measured before, and a week after EMDR therapy. Data were analyzed using paired -t- test, t-test, and Chi-square.

    RESULTS: The mean depression level in experimental group 27.26± 6.41 before intervention, and it was 11.76 ± 3.71 after intervention. Hence, it showed a statistically significant difference (P<0.001). The mean depression level in control group was 24.53 ± 5.81 before intervention, and it was 31.66± 6.09 after intervention, so it showed statistically significant difference (P<0.001). The comparison of mean depression level at post treatment, in both groups showed statistically significant difference (P<0.001).

    CONCLUSION: EMDR is an effective, useful, efficient, and non-invasive method for treatment and reducing depression in patients with MI.

    Be well!

    JP

  8. JP Says:

    Updated 2/2/16:

    http://journal.frontiersin.org/article/10.3389/fpsyg.2015.01662/full

    Front Psychol. 2015 Nov 5;6:1662.

    Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: a hdEEG study.

    Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults’ emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children’s traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time.

    Be well!

    JP

  9. JP Says:

    Updated 02/17/16:

    http://www.ncbi.nlm.nih.gov/pubmed/26877093

    Full Text in Spanish: http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=0&pident_usuario=0&pcontactid=&pident_revista=286&ty=0&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=es&fichero=S1888-9891%2816%2900019-7.pdf&eop=1&early=si

    Rev Psiquiatr Salud Ment. 2016 Feb 11.

    25 years of Eye Movement Desensitization and Reprocessing (EMDR): The EMDR therapy protocol, hypotheses of its mechanism of action and a systematic review of its efficacy in the treatment of post-traumatic stress disorder.

    Eye movement desensitization and reprocessing (EMDR) is a relatively new psychotherapy that has gradually gained popularity for the treatment of post-traumatic stress disorder. In the present work, the standardised EMDR protocol is introduced, along with current hypotheses of its mechanism of action, as well as a critical review of the available literature on its clinical effectiveness in adult post-traumatic stress disorder. A systematic review of the published literature was performed using PubMed and PsycINFO databases with the keywords «eye movement desensitization and reprocessing» and «post-traumatic stress disorder» and its abbreviations «EMDR» and «PTSD». Fifteen randomised controlled trials of good methodological quality were selected. These studies compared EMDR with unspecific interventions, waiting lists, or specific therapies. Overall, the results of these studies suggest that EMDR is a useful, evidence-based tool for the treatment of post-traumatic stress disorder, in line with recent recommendations from different international health organisations.

    Be well!

    JP

  10. JP Says:

    Updated 03/11/16:

    http://www.ncbi.nlm.nih.gov/pubmed/26963955

    Psychol Trauma. 2016 Mar 10.

    Outcomes From Eye Movement Desensitization and Reprocessing in Active-Duty Service Members With Posttraumatic Stress Disorder.

    OBJECTIVE: Eye movement desensitization and reprocessing (EMDR) is one of the therapy interventions recommended by the Veterans Affairs and Department of Defense Clinical Practice Guidelines. However, the literature concerning the effectiveness of this treatment modality in military service members is sparse. This study investigated the efficacy of EMDR in active-duty service members.

    METHOD: We conducted an effectiveness study with a record review from active-duty military mental health clinics where clinical outcomes had been monitored over a 10-week period using self-report measures of posttraumatic stress and disability. Symptom scores were examined over time in 331 service members who met presumptive criteria for the disorder on the PTSD Checklist-Military Version (PCL-M), who were in psychotherapy, and who received (n = 46) or didn’t receive (n = 285) EMDR.

    RESULTS: Results indicated that patients receiving EMDR had significantly fewer therapy sessions over 10 weeks but had significantly greater gains in their PCL-M scores than did individuals not receiving EMDR.

    CONCLUSIONS: Randomized, controlled trials are still needed, but these findings provide further support for the use of EMDR in service members with PTSD.

    Be well!

    JP

  11. JP Says:

    Updated 03/19/16:

    http://www.ncbi.nlm.nih.gov/pubmed/26934487

    J Trauma Stress. 2016 Mar 2.

    The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.

    The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored ≥2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen’s d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste.

    Be well!

    JP

  12. JP Says:

    Updated 05/06/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27148134

    Front Psychol. 2016 Apr 21;7:526.

    Treating Post-traumatic Stress Disorder in Patients with Multiple Sclerosis: A Randomized Controlled Trial Comparing the Efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy.

    OBJECTIVE: Multiple Sclerosis (MS) is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD). This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS.

    METHODS: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20) and Relaxation Therapy (RT; n = 22). The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale 6-months after the treatment.

    RESULTS: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety and depression symptoms, and to improve Quality of Life.

    CONCLUSION: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition.

    Be well!

    JP

  13. JP Says:

    Updated 06/16/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27302452

    Glob J Health Sci. 2016 Feb 24;8(10):56100.

    Efficacy of Eye Movements Desensitization and Reprocessing on the Quality of Life of the Patients with Myocardial Infarction.

    Myocardial infarction causes limitations in the physical activity and perturbation of quality of life.The aim of this study was to evaluate the effect of eye movements desensitization and reprocessing (EMDR) on the quality of life of these patients. This study was conducted in two groups as the before and after while the effect of eye movements desensitization and reprocessing on the quality of life of the patients with Myocardial infarction. Sampling was done based on the purposive sampling. Patients were randomly divided into two experimental and control groups (30 patients in each group). Samples were assigned through randomized allocation. In the experimental group, the EMDR method was carried out on the patients in five 90-minute sessions over a two week period. In the control group no intervention was received. Data of Quality of life, pre-treatment, post-treatment were analyzed using SPSS. The results showed that the quality of life increase in all its dimensions of the experimental group, after performing the EMDR therapy significantly (P=0.001). Treatment what has already been stated, was effective on the quality of life in patients. Treatment team members can use this method as an effective intervention in order to improve the quality of life of their patients.

    Be well!

    JP

  14. JP Says:

    Update 06/17/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745337/

    Front Psychiatry. 2016 Feb 8;7:14.

    Desensitizing Addiction: Using Eye Movements to Reduce the Intensity of Substance-Related Mental Imagery and Craving.

    Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. During this treatment, patients recall traumatic memories while making horizontal eye movements (EM). Studies have shown that EM not only desensitize negative memories but also positive memories and imagined events. Substance use behavior and craving are maintained by maladaptive memory associations and visual imagery. Preliminary findings have indicated that these mental images can be desensitized by EMDR techniques. We conducted two proof-of-principle studies to investigate whether EM can reduce the sensory richness of substance-related mental representations and accompanying craving levels. We investigated the effects of EM on (1) vividness of food-related mental imagery and food craving in dieting and non-dieting students and (2) vividness of recent smoking-related memories and cigarette craving in daily smokers. In both experiments, participants recalled the images while making EM or keeping eyes stationary. Image vividness and emotionality, image-specific craving and general craving were measured before and after the intervention. As a behavioral outcome measure, participants in study 1 were offered a snack choice at the end of the experiment. Results of both experiments showed that image vividness and craving increased in the control condition but remained stable or decreased after the EM intervention. EM additionally reduced image emotionality (experiment 2) and affected behavior (experiment 1): participants in the EM condition were more inclined to choose healthy over unhealthy snack options. In conclusion, these data suggest that EM can be used to reduce intensity of substance-related imagery and craving. Although long-term effects are yet to be demonstrated, the current studies suggest that EM might be a useful technique in addiction treatment.

    Be well!

    JP

  15. JP Says:

    Updated 07/29/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28752580

    Clin Psychol Psychother. 2017 Jul 28.

    A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder.

    BACKGROUND: This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention.

    METHOD: This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive-compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen’s d and multilevel modelling.

    RESULTS: Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive-compulsive scale severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90).

    CONCLUSIONS: EMDR and CBT had comparable completion rates and clinical outcomes.

    Be well!

    JP

  16. JP Says:

    Updated 09/05/17:

    Front Psychol. 2017 Aug 18;8:1409.

    https://www.ncbi.nlm.nih.gov/pubmed/28868042

    Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial.

    Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL).

    Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and 3 months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-min sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3.

    Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive.

    Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients.

    Be well!

    JP

  17. JP Says:

    Updated 11/02/17:

    https://www.ncbi.nlm.nih.gov/pubmed/29087910

    Mil Med. 2017 May;182(5):e1672-e1680.

    Effectiveness of Eye Movement Desensitization and Reprocessing in German Armed Forces Soldiers With Post-Traumatic Stress Disorder Under Routine Inpatient Care Conditions.

    BACKGROUND: Post-traumatic stress disorder (PTSD) is one of the more commonly occurring mental disorders following potentially traumatizing events soldiers may encounter when deployed abroad. One of the first-line recommended treatment options is eye movement desensitization and reprocessing (EMDR). The number of studies assessing the effectiveness of EMDR in German soldiers under routine conditions is currently almost nil.

    METHODS: A retrospective, quasi-experimental effectiveness study on EMDR in an inpatient setting is presented using a prepost design. The study compares symptom reduction in soldiers (N = 78) with a wait-list (N = 18). Effect sizes of EMDR were measured for PTSD, symptoms of depression, and general mental health.

    RESULTS: Effect size for EMDR treatment of PTSD was d = 0.77; 95% confidence interval (CI): 0.51 to 1.36, for symptoms of depression d = 0.99; 95% CI: 0.31 to 1.36, and for general psychiatric symptoms d = 0.53; 95% CI: 0.17 to 1.21. The effects resulting from EMDR treatment were somewhat weaker than those reported in comparable studies in civilians.

    CONCLUSION: EMDR therapy is an effective treatment to reduce symptoms of PTSD and depression. However, in the military context it needs to be complemented by treatment options that specifically address further conditions perpetuating the disorders.

    Be well!

    JP

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