Publications from unbiased EMDR research supported by donors
The following EMDR journal articles and scholarly presentations are from our grant recipients. This is the fruit of science and practice working together to change people's lives:
Schubert, S. J., Lee, C. W., Araujo, G., Butler, S. R., Taylor, G., & Drummond, P. D. (2016). The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.Journal of traumatic stress,29(2), 141-148.
Abstract: 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.
From the article: “To conclude, this research is significant as it appears to be the first study to examine the effectiveness of EMDR therapy for the treatment of PTSD symptoms in a postwar/conflict developing country. Findings demonstrated that EMDR therapy, as a structured trauma treatment, could be used effectively in Timor Leste. Our findings may be useful for future cross-cultural humanitarian efforts following war and large-scale disasters. Future research in this area is strongly encouraged, as it is vital to know that any intervention offered to treat trauma symptoms postwar/conflict or disaster in any context not only is harmless and effective, but that it complements survivors’ traditional coping strategies.” Free full text at: Full text: http://onlinelibrary.wiley.com/doi/10.1002/jts.22084/pdf
Pagani, M., Di Lorenzo, G., Monaco, L., Daverio, A., Giannoudas, I., La Porta, P., … Siracusano, A. (2015). Neurobiological response to EMDR therapy in clients with different psychological traumas. Frontiers in Psychology, 6, 1614. http://doi.org/10.3389/fpsyg.
2015.01614 FREE full-text at: http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC4621396/
We assessed cortical activation differences in real-time upon exposure to traumatic memory between two distinct groups of psychologically traumatized clients also in comparison with healthy controls. We used electroencephalography (EEG) to compare neuronal activation throughout the bilateral stimulation phase of Eye Movement Desensitization and Reprocessing (EMDR) sessions. We compared activation between the first (T0) and the last (T1) session, the latter performed after processing the index trauma. The group including all clients showed significantly higher cortical activity in orbito-frontal cortex at T0 shifting at T1 toward posterior associative regions. However, the subgroup of clients with chronic exposure to the traumatic event showed a cortical firing at both stages which was closer to that of controls. For the first time EEG monitoring enabled to disclose neurobiological differences between groups of clients with different trauma histories during the reliving of the traumatic event. Cortical activations in clients chronically exposed to traumatic memories were moderate, suggesting an association between social and environmental contexts with the neurobiological response to trauma exposure and psychotherapy.
To access a PDF of 114 slides from Dr. Pagani's plenary presentation, "Imaging EMDR Related Neurobiological Changes", given at the 2015 EMDRIA Conference in Philadelphia, PA click here.
- Hermans, E. L.D. De Voogd: None. J.W. Kanen: None. K. Roelofs: None. G. Fernández: None. E.J. Hermans: None.Neurobiological basis for EMDR: the medial temporal lobe suppression hypothesis. Preliminary results were presented as a poster in October 2015 at the annual meeting of the Society for Neuroscience, Chicago.
Poster Session at the Society for Neuroscience, 2015, Chicago, IL. October 2015.
Title: Investigating the effect of goal-directed eye movements during extinction on amygdala activity and long-term expression of fear memory.
Authors: L.D. De Voogd; J.W. Kane; K. Roelofs;G. Fernández;. E.J. Hermans.
Eye movement desensitization and reprocessing (EMDR) is seen as a promising treatment option for fear-related psychiatric diseases such as post-traumatic stress disorder (PTSD). Indeed, experimental studies have shown that performing goal-directed eye movements following recall of autobiographical episodic memories can reduce the vividness and emotionality of these memories. However, the effect of goal-directed eye movements on retention of fear memory has not been tested directly, and critically, the mechanisms by which eye movements may affect mnemonic processes remain poorly understood. Previous research suggests that performing tasks involving endogenous attention suppresses neural activity in the default mode network (DMN), a large-scale brain network which includes the ventromedial prefrontal cortex (vmPFC) and medial temporal lobe regions such as the amygdala and hippocampus. These regions are also critically implicated in fear and safety learning. We therefore hypothesized that deployment of endogenous attention during goal-directed eye movements suppresses activity in these regions and might thereby affect fear retention. To address this hypothesis, twenty-four healthy volunteers were tested in a Pavlovian fear conditioning paradigm, the most widely used experimental laboratory model of fear and safety learning, which is used in both animal and human research. Participants came to the lab on three consecutive days for an acquisition, an extinction, and a recall phase. During fear acquisition, two stimuli (CS+) were associated with a mild electrical shock, while two other stimuli (CS-) were never reinforced. During extinction, one CS+ and one CS- was always followed by a block of goal-directed eye movements. Blood Oxygenation Level-Dependent functional MRI data, pupil dilation, and skin conductance responses were recorded throughout all phases of the experiment. Preliminary results show that during eye movement blocks, there is suppression in the amygdala, hippocampus, and vmPFC relative to baseline compared to the fixation blocks. Further analyses will focus on whether this temporary suppression of brain regions supporting fear acquisition and extinction may affect retention of fear memories.
Download complete citation/abstract: http://www.abstractsonline.com/Plan/AbstractPrintView.aspx?mID=3744&sKey=ef80f778-67f7-4251-889b-e1b2732deeb5&cKey=c90786d0-2893-4682-a409-cf102a2f147a
- Bira, L., Stuetzle, R., & Ironson, G. (2014, November). Determining person-treatment fit for brief treatment of trauma in a community setting: Which interventions are best for whom? Presentation at the International Society for Traumatic Stress Studies 30th Annual Meeting, Miami, FL. https://www.istss.org/ISTSS_Main/media/Documents/ISTSS14FPE.pdf
This study (part of a larger NIH-funded study) compares 3 brief interventions (Psychological First Aid – PFA; Stress Management Therapy – SMT; and Eye Movement Desensitization and Reprocessing – EMDR) to determine whether certain interventions are better for certain types of people (considering gender, PTSD severity, substance abuse, childhood trauma, and borderline personality disorder) and trauma (considering time since trauma and trauma type). 87 participants were randomized to 4 active sessions of either PFA, SMT or EMDR. Follow-up assessments were conducted at 1, 3 and 6 months post-intervention and HLM analyses were used to test the hypotheses. Outcomes examined included PTSD symptoms, depression, and physical symptoms. Examination of individual and trauma factors showed that EMDR worked best for those high in baseline PTSD and for those endorsing borderline personality characteristics. SMT worked best for those who reported using marijuana and for those with a trauma of bereavement. PFA worked best for those with a history of childhood sexual abuse and those endorsing a violent trauma. Limitations and future directions are discussed. Results indicate that treatment type may be selected based on individual and trauma factors after a traumatic event, and brief treatments may have great utility, particularly when the need for treatment is high and time/resources are low.
- Markus, W., de Weer - van Oene, G. H., Becker, E. S., & DeJong C. A. J. (2015). A multi-site randomized study to compare the effects of eye movement desensitization and reprocessing (EMDR) added to TAU versus TAU to reduce craving and drinking behavior in alcohol dependent outpatients: Study protocol. BMC Psychiatry, 15(51). doi:10.1186/s12888-015-0431-z. For full-text pdf, go to: http://www.biomedcentral.com/content/pdf/s12888-015-0431-z.pdf
Background: Addiction constitutes a major public health problem, and despite treatment, relapse rates remain very high. Preliminary findings suggest that Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based treatment for PTSD, may also reduce craving and relapse rates when applied in substance abuse. This study aims to determine the feasibility, efficacy and effectiveness of EMDR when added to treatment as usual (TAU) for addiction in alcohol dependent outpatients, compared to TAU only.
Methods/Design: A single blinded study in which 100 adult patients with a primary DSM-IV-TR diagnosis of alcohol dependence or abuse receiving treatment in one of six Dutch outpatient addiction care facility sites, will be enrolled. After baseline assessment participants will be allocated to one of two treatment conditions (allocation ratio of 1:1) using a stratified (per site, per care pathway), blocked randomization procedure. The intervention consists of EMDR (seven weekly 90 minute sessions) + TAU or TAU only. Assessments are scheduled pre-treatment (t0), post-treatment (t0 + eight weeks), and one and six months post treatment. The effects of both treatment arms are compared on indices of (a) drinking behavior, (b) mediators, moderators and predictors of treatment outcome, (c) quality of life and d) safety, acceptability and feasibility of treatment. Repeated measures ANOVA’s will be conducted using an intention-to-treat and per-protocol approach. Multiple imputation will be used to deal with missing values when possible.
Discussion: This study adapts and extends the standard EMDR treatment for traumatized patients for use with patients with alcohol use disorders without psychological trauma. [ClinicalTrial.gov: NCT01828866]