Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adolescent with Post-traumatic Stress Disorder: A Meta-Analysis of Randomized Controlled Trials.

Albert Sio-Eroles,Ana Moreno-Alcázar,Alicia Valiente-Gómez,Benedikt L Amann,Víctor Pérez,Joaquim Radua,Devi Treen

doi:10.3389/fpsyg.2017.01750

Abstract

Background: Post-traumatic stress disorder (PTSD) can occur in both adults and children/adolescents. Untreated PTSD can lead to negative long-term mental health conditions such as depression, anxiety, low self-concept, disruptive behaviors, and/or substance use disorders. To prevent these adverse effects, treatment of PTSD is essential, especially in young population due to their greater vulnerability. The principal aim of this meta-analysis was to examine the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for PTSD symptoms in children and adolescents. Secondary objectives were to assess whether EMDR therapy was effective to improve depressive or anxious comorbid symptoms.Methods: We conducted a thorough systematic search of studies published until January 2017, using PubMed, Medline, Scopus, and ScienceDirect as databases. All randomized controlled trials with an EMDR group condition compared to a control group, such as treatment as usual or another psychological treatment, were included. Meta-analysis was conducted with MetaNSUE to avoid biases related to missing information.Results: Eight studies (n = 295) met our inclusion criteria. EMDR therapy was superior to waitlist/placebo conditions and showed comparable efficacy to cognitive behavior therapy (CBT) in reducing post-traumatic and anxiety symptoms. A similar but non-statistically significant trend was observed for depressive symptoms. Exploratory subgroup analyses showed that effects might be smaller in studies that included more males and in more recent studies.Conclusion: Despite the small number of publications, the obtained results suggest that EMDR therapy could be a promising psychotherapeutic approach for the treatment of PTSD and comorbid symptoms in young individuals. However, further research with larger samples is needed to confirm these preliminary results as well as to analyze differences in the efficacy of EMDR therapy versus CBT.

Highlights

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA, 2013), posttraumatic stress disorder (PTSD) is an anxiety disorder that can appear after an encounter with an unexpected traumatic event and can affect adults, adolescents, and children
All studies but one (Scheck et al, 1998) included exclusively children and adolescents with PTSD or trauma caused symptoms and involved individually delivered face-toface eye movement desensitization and reprocessing (EMDR) sessions compared to no treatment (Soberman et al, 2002), pure waiting list (Chemtob et al, 2002; Ahmad et al, 2007; Kemp et al, 2010) active listening control (Scheck et al, 1998) or CBT (Jaberghaderi et al, 2004; de Roos et al, 2011; Diehle et al, 2015)
The main result of this meta-analysis is that patients treated with EMDR therapy present a reduction of their trauma-associated symptoms as compared to patients in the respective control conditions, this effect was observed for comorbid anxiety symptoms (d = −0.49 and −0.44, p < 0.013)

Summary

Introduction

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA, 2013), posttraumatic stress disorder (PTSD) is an anxiety disorder that can appear after an encounter with an unexpected traumatic event and can affect adults, adolescents, and children. In light of the foregoing, the exposure to early life stressful events can be considered as a major risk factor for mental disorders, a rapid trauma orientated intervention is essential to prevent these adverse long term effects. This is especially true in children and adolescents due to their greater vulnerability during brain maturation. Untreated PTSD can lead to negative long-term mental health conditions such as depression, anxiety, low self-concept, disruptive behaviors, and/or substance use disorders To prevent these adverse effects, treatment of PTSD is essential, especially in young population due to their greater vulnerability. Secondary objectives were to assess whether EMDR therapy was effective to improve depressive or anxious comorbid symptoms

Results

Discussion

Conclusion