Eye Movement Desensitization And Reprocessing Therapy Research Articles

Eye-movement desensitisation and reprocessing therapy (EMDR) to prevent transition to psychosis in people with an at-risk mental state (ARMS): mixed method feasibility study.

Trauma plays an important role in the development of psychosis, but no studies have investigated whether a trauma-focused therapy could prevent psychosis. This study aimed to establish whether it would be feasible to conduct a multicentre randomised controlled trial (RCT) to prevent psychosis in people with an at-risk mental state (ARMS), using eye-movement desensitisation and reprocessing therapy (EMDR). This started as a mixed-method randomised study comparing EMDR to treatment as usual but, as a result of low participant recruitment, was changed to a single-arm feasibility study. The proposed primary outcome for an RCT was transition to psychosis at 12-month follow-up. Data on secondary outcomes were also collected. Qualitative interviews were conducted with patients and therapists. Fourteen participants were recruited from the Early Intervention teams. Most people who expressed an interest in taking part attended an assessment to determine eligibility. All those eligible consented to take part. A total of 64% (7 of 11) of participants who were offered EMDR were followed up at 12 months. Of the 11 participants offered EMDR, one (11%, 95% CI: 0.2%, 48%) transitioned to psychosis. Nine patients and three therapists were interviewed. Participants who completed therapy (n = 4; mean 10.5 sessions) found EMDR helpful, but those who discontinued (n = 6; mean 5.2 sessions) said it had not benefitted them overall. Therapists said EMDR could be effective, although not for all patients. Future studies recruiting people with an ARMS to an RCT may need to extend recruitment beyond Early Intervention teams. Although some individuals found EMDR helpful, reasons for discontinuing need to be addressed in future studies.

The Effectiveness and Tolerability of an Intensive Outpatient Trauma Treatment Program for Adolescents With PTSD

Following the promising effects of an intensive trauma treatment for adults, the question arises whether adolescents suffering from posttraumatic stress disorder (PTSD) can also benefit from a similar treatment program. The objective of this study was to assess the effectiveness and tolerability of an intensive trauma treatment program combining two evidence-based, trauma-focused therapies—prolonged exposure (PE) and eye movement desensitization and reprocessing (EMDR)—with psychoeducation and physical activity for adolescents suffering from PTSD in an outpatient clinic. We used a multiple-baseline study design. Fifteen adolescents aged 12–18 years old with aDiagnostic and Statistical Manual of Mental Disorders(5th ed.) diagnosis of PTSD were included. Participants were randomized to wait 2, 3, or 4 weeks between the start of baseline and the start of the intervention. In the 2-week intervention period, participants received daily PE, EMDR, and physical activity. The social network of adolescents was involved for support. PTSD symptoms and treatment tolerability were assessed daily. PTSD diagnosis was assessed at baseline and at 1 month and 3 months after completion of treatment. In addition, semistructured interviews were conducted after treatment to determine the tolerability. After treatment, we found a diagnostic PTSD remission of 58%–62% and a decrease in PTSD severity compared with baseline. The effects were maintained at 1-month and 3-month follow-ups. The dropout rate was 13%. Participants reported good treatment tolerability. This study provides initial evidence that an intensive outpatient trauma treatment including PE, EMDR therapy, psychoeducation, and physical activity is effective and tolerable for adolescents with PTSD and is associated with low dropout rates.

Visual Schema Displacement Therapy versus Eye Movement Desensitization and Reprocessing therapy versus waitlist in the treatment of post-traumatic stress disorder: results of a randomized clinical trial.

Visual Schema Displacement Therapy (VSDT) is a novel approach showing promise in mitigating distressing memories, akin to Eye Movement Desensitization and Reprocessing (EMDR). This study aimed to determine the safety, feasibility, and effectiveness of VSDT in individuals with post-traumatic stress disorder (PTSD), comparing it to EMDR therapy and a waitlist control condition (WLCC). It was hypothesized that the application of VSDT would be safe and PTSD symptoms significantly be reduced from both baseline to post-treatment and from baseline to follow-up in the VSDT and EMDR therapy conditions. Furthermore, we expected both treatments to be significantly more effective than the waitlist control. Moreover, we hypothesized that VSDT and EMDR therapy would be associated with significant improvements in symptoms of depression and general psychopathology. Forty-six adults with PTSD were randomly assigned to VSDT, EMDR therapy, or WLCC, receiving six 90-minute sessions. Assessments included the Clinician Administered PTSD Scale for the Diagnostic Statistical Manual (DSM)-5 (CAPS-5), PTSD Checklist for DSM-5 (PCL-5), Beck Depression Inventory-II (BDI-II) and Brief Symptom Inventory (BSI) before, during, and 3 months post-treatment. Bayesian analysis found no differences between VSDT and EMDR in PTSD symptom reduction but both outperformed WLCC. EMDR was superior to the WLCC in reducing symptoms of depression and general psychopathology. At 3-month follow-up, 58.3% of the participants in the VSDT condition no longer met the PTSD diagnostic criteria (41.2% EMDR therapy and 15.4% WLCC) with no difference between the two therapy conditions. Self-reported PTSD symptom reduction was significant in VSDT (d = 1.38) and EMDR (d = 1.40) but modest in WLCC (d = 0.39). Dropout rate was 19.3%, with no adverse events. This study supports VSDT's efficacy in treating PTSD, offering a valuable therapeutic option comparable to EMDR, with significant reductions in PTSD symptoms and no difference with EMDR or the control condition for depressive symptoms and general psychopathology, and no reported adverse events.

AIP-based Professional Intervention Program for Adversity for trauma and stress reduction in groups: a pilot study in Ethiopia.

Drawing from the principles of EMDR (Eye Movement Desensitization and Reprocessing) therapy and the AIP model, the Professional Intervention Program for Adversity (PIPA) was developed with the objective of amalgamating low-intensity group exercises into a unified framework, as a comprehensive intervention for group therapy. The PIPA Program integrates various aspects of EMDR therapy-such as stabilization, resourcing, desensitization, reprocessing, and forming beliefs about the self and future-into a cohesive program. The program's structure includes self-regulation exercises, the Pillars of Life, the Flash Technique, and the Quadrants exercise. The PIPA Program was administered to more than 220 individuals with a high probability of traumatization by the two-year civil war in Ethiopia (2020-2022). The results of this study show a statistically significant improvement in PTSD symptoms on PCL-5 scores (from M = 38.58 to M = 20.59) after completing the entire PIPA Program and statistically significant lower SUDS scores within the program segments of the Flash Technique and the Quadrants exercises. Future studies should explore the long-term effects of the PIPA Program and its broader application across different therapeutic contexts. The findings suggest that the PIPA Program is a promising group-based intervention for trauma treatment that is safe and effective, especially in non-clinical settings and for culturally diverse populations.

The Impact and Adaptation of EMDR Therapy on the Taiwanese Deaf University Students

Deaf adolescents from schools for the deaf face a difficult challenge adapting to hearing-dominated universities. They harbor stress or trauma from past interactions with the hearing. To understand the impact and adaptation of eye movement desensitization and reprocessing (EMDR) therapy on such students, a pilot study and a formal study were executed for this case study using Taiwanese sign language for all interactions. The client’s changes were documented through diverse sources, while adherence to the standard protocol was verified using the EMDR Fidelity Rating Scale. Results showed that EMDR therapy helped the client in the formal study to maintain calm with the hearing and become capable of overcoming communication barriers, stabilizing emotional arousal quickly, and finally appreciating his academic journey. This study examined the adaptation of EMDR’s various stages for the Deaf and the beneficial environmental support for Deaf university students.

State of the science: Eye movement desensitization and reprocessing (EMDR) therapy.

Eye movement desensitization and reprocessing (EMDR) therapy is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), with support from more than 30 published randomized controlled trials (RCTs) demonstrating its effectiveness in both adults and children. Most international clinical practice guidelines recommend EMDR therapy as a first-line treatment for PTSD. This paper describes the current state of the evidence for EMDR therapy. We begin with a brief description of EMDR therapy and its theoretical framework. Next, we summarize the scientific support for its efficacy, effectiveness, and safety and discuss its applicability across cultures and with diverse populations. We conclude with suggestions for future directions to develop the research base and applications of EMDR therapy.

Neural Correlates of Symptom Remission Among Adults Receiving EMDR Therapy for PTSD: A Systematic Review and Meta-Analysis of 20 Years of Research

The present systematic review and meta-analysis provide an updated assessment of how eye movement desensitization and reprocessing (EMDR) therapy affects the human brain during treatment for posttraumatic stress disorder (PTSD). Brain region activity was assessed using resting-state functional magnetic resonance imaging, and trauma symptom severity was measured using the PTSD Checklist for the DSM-5 (PCL-5). We used PubMed, EMBASE, and ScienceDirect as our primary databases. Selected articles were subjected to seven eligibility criteria, and 22 articles remained for statistical analysis. Article quality was measured using the QUADAS-2 instrument, which showed that our review sample comprised high-quality articles. Statistical analyses implicated a forest plot meta-analysis of PCL-5 scores pretreatment and posttreatment, an activation likelihood estimation (ALE) meta-analysis of brain region activation after treatment, and a linear regression analysis that served as our method of statistical synthesis between forest plot and ALE results. Our forest plot showed that EMDR had a robust effect on decreasing PCL-5 scores during treatment (g= −2.92). Our ALE meta-analysis indicated the activation of different regions in the default mode and salience, limbic, and ventral attention networks. Statistical synthesis showed a robust correlation between PCL-5 score decrease and increased brain function (β = −.94). We also measured publication bias in our review sample with a funnel plot and Egger’s test of random effects (p= .280).

The AIP model as a theoretical framework for the treatment of personality disorders with EMDR therapy.

Research has shown that the impact of traumatic events and circumstances on individuals is cumulative and potentially has a wide range of harmful consequences, including negative consequences on mental health. One such consequence is the development of a personality disorder, a persistent mental condition characterized by a pronounced pattern of difficulties in impulse control, emotional regulation, cognitive functions, self-esteem, and interpersonal relationships. A wide array of studies indicates that the personal history of individuals with a personality disorder is often marked by exposure to traumatic events or other types of adverse childhood experiences (ACEs). Because existing treatments for personality disorders are usually long and costly, it is essential to continue exploring alternative and complementary interventions. Nowadays, knowledge and clinical experience in regard to personality disorders have been gained in addressing ACEs by processing memories of these events through eye movement desensitization and reprocessing (EMDR) therapy. In this paper, we present a theoretical framework for this treatment approach, based on Shapiro's Adaptive Information Processing (AIP) model, describe its current empirical basis, and provide guidance on how to formulate a useful case conceptualization that can serve as a basis for the treatment of personality disorders with EMDR therapy. This approach is illustrated with a case example.

Eye movement desensitization and reprocessing (EMDR) therapy compared to usual treatment for posttraumatic stress disorder in adults with psychosis in forensic settings: Randomized controlled trial.

Little direct evidence supports any particular treatment for posttraumatic stress disorder (PTSD) in people with schizophrenia, forensic histories, and/or multiple comorbidities. This trial assesses the efficacy and risks of eye movement desensitization and reprocessing (EMDR) for people with PTSD and psychotic disorders receiving forensic care, including inpatients and prisoners. Single-blind randomized controlled trial comparing EMDR therapy to wait-list (routine care) in forensic-treated adults with psychotic disorders and PTSD. The primary outcome was clinician-rated PTSD symptoms. Secondary outcomes included participant-rated PTSD symptoms, psychotic symptoms, social functioning, disability level, self-esteem, depressive symptoms, posttraumatic cognitions, complex posttraumatic difficulties, and adverse events. Blinded investigators assessed outcomes at baseline, and after 10 weeks and 6 months. Analysis of the primary outcome was by a mixed linear model. Twenty-four participants were randomized, recruitment being hindered by COVID-19 restrictions. Clinician Administered PTSD Scale mean (SD) scores after 6 months were lower (better) in the EMDR group, 21.3 (13.3), compared with the control group, 31.5 (20.7). The point estimate [95% CI] difference, averaged over two measurement times, was 11.4 [1.3, 21.4], p = .028, favoring EMDR. Self-esteem increased in the EMDR group and depressive symptoms and disability reduced. There were no statistically significant differences in psychotic symptoms or adverse events, although point estimates favored EMDR. This is the first EMDR trial in mental health inpatient, forensic, or custodial settings, where PTSD is common. There were improvements in PTSD and other symptomatology consistent with EMDR being a safe and effective treatment for PTSD in these settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

EMDR treatment for people with intellectual disabilities: a systematic review about difficulties and adaptations.

People with intellectual disabilities (ID) are at increased risk for developing Post Traumatic Stress Disorder (PTSD). Emerging evidence indicates that Eye Movement Desensitization and Reprocessing (EMDR) therapy is feasible and potentially effective for this group. However, communication, cognition, stress regulation, and attachment difficulties may interfere with the EMDR process. Adaptation of the EMDR protocol seems therefore required for this population. This review aims to systematically identify and categorize the difficulties in applying EMDR to people with ID and the adaptations made by therapists to overcome these challenges. A literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal. After screening, 13 articles remained for further review. The identified difficulties and adaptations were categorized into the three domains of adaptive functioning (i.e., conceptual, social, and practical functioning). Considerable difficulties in applying the EMDR protocol for this group were reported. The adaptations made by therapists to overcome these difficulties were highly variable. They could be divided into three main categories: adaptions in EMDR delivery (e.g., tuning to the developmental level of the client, simplifying language, decreasing pace), involvement of others (e.g., involving family or support staff during or in between sessions), and the therapeutic relationship (e.g., taking more time, supportive attitude). The variability of the number of mentioned difficulties and adaptations per study seems to be partly related to the specific EMDR protocol that was used. In particular, when the Shapiro adult protocol was administered, relatively more detailed difficulties and adaptations were described than in publications based on derived existing versions of an EMDR protocol for children and adolescents. A probable explanation is that already embedded modifications in these protocols facilitate the needed attunement to the client's level of functioning. The authors of this review suggest that EMDR protocols for children and adolescents could be adapted for people with an intellectual disability. Further research should focus on the involvement of trusted others in EMDR therapy for people with ID and the therapeutic relationship from an attachment and relational-based perspective.

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)

BackgroundIrritable 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.MethodsThis 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.DiscussionThe 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 registrationHuman ethics committee MEC-U NL71740.100.20. International Clinical Trial Registry Platform: NL8894. Prospectively registered on 28 January 2020.

EMDR therapy vs. supportive therapy as adjunctive treatment in trauma-exposed bipolar patients: A randomised controlled trial

IntroductionPatients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates. Materials and methodsThis multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines. ResultsThere was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms. ConclusionsAlthough the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.

EMDR in older adults with PTSD and comorbid personality disorders

Objectives:Approximately one third of older adults (≥ 60 years) with a posttraumatic stress disorder (PTSD) also suffer from a comorbid personality disorder. Emerging evidence shows that in Eye Movement Desensitization and Reprocessing (EMDR) therapy can be beneficial for personality disorders. Since personality disorders are associated with several adverse events, the present study aims to investigate whether EMDR in older adults with PTSD will improve personality functioning.Methods:A multi-center feasibility study was conducted with 24 older PTSD-patients (60-83 years). PTSD was assessed with the Clinician-Administered PTSD Scale-5 (CAPS-5). All participants received weekly 1-hour sessions of EMDR therapy for PTSD up to a maximum of 9 months. The primary outcome was change in personality dysfunction, assessed by Severity Indices of Personality Problems–Short Form (SIPP-SF) at baseline and end of treatment. Secondary outcome was pre-post difference in the presence of (any) personality disorder according to DSM-IV criteria as measured with the Structured Clinical Interview for DSM-IV Axis-II PDs (SCID-II). All analyses were adjusted for PTSD severity, therapy duration, and other treatment (co-interventions) which was kept constant.Results:A linear mixed model approach showed an increase in SIPP-SF scores from pre- to posttreatment, a significant influence of pre-post CAPS-5 for the total sample (F(1,37.5)=6.95), p=.012) and a marginal significant effect of other treatment (F(1,21.9)=4.04), p=.057). No significant main effects of time, therapy duration (3, 6, or 9 months), CAPS-5 by time was found (all p>.05).Conclusions:EMDR treatment resulted in improved personality functioning. Other treatment next to EMDR had a negative impact on the increased of personality functioning.

Integrating Compassion into EMDR for PTSD

Post-traumatic stress disorder (PTSD) often involves feeling-states of shame and self-loathing. Traditional exposure-based treatments, which are effective for fear-based PTSD, are sometimes limited in effectiveness when working with these emotional experiences: clients with high levels of shame, guilt, or disgust may experience ‘blocks’ in processing when attempting eye movement desensitization and reprocessing (EMDR). Developed to help people who suffer from pervasive shame and self-attack, compassion focused therapy (CFT) is based upon an evolutionary framework, and draws on research from human neurobiology and attachment theory to understand how humans respond to different types of threat. This paper describes a protocol for integrating compassion focused techniques into EMDR therapy with the aim of facilitating adaptive information processing. Two case examples outline the use of the protocol and describe clients’ reflections on the process. We suggest that CFT approaches can be successfully integrated with EMDR when working with experiences of shame and self-blame.

“Without it, I am not sure I would still be here”: a mixed methods service evaluation for online EMDR trauma therapy in a primary care network in England

IntroductionPsychological services are typically offered via specialized mental health services, which are often overwhelmed with long waitlists. To address this need and provide patients with a service characterized by shorter waiting times and increased accessibility, online Eye Movement Desensitization and Reprocessing (EMDR) was established in the North Norfolk 4 Primary Care Network.MethodsThis article presents this service’s collaborative funding, development and outcomes within local GP surgeries. It constitutes a mixed-method service evaluation encompassing the future of EMDR in primary care services. Additionally, it includes the assessment of anxiety, depression, and PTSD symptoms as well as work and social adjustment in a cohort of 83 patients alongside a Thematic Analysis involving eighteen patients and six GPs.ResultsThe evaluation showed high completion and attendance among service users. Quantitative scores combined with qualitative feedback from patients and practitioners highlight the potential impact of EMDR therapy on General Practice and its broader provision of trauma-focused therapies. The most significant improvements were observed in anxiety and depression scores. Thematic Analysis indicated that the patients found the service helpful, labeling it as a “life-saver.” They also discussed why they found the service effective; some also wished the service had been available earlier.DiscussionFindings underscore the potential of EMDR and online EMDR as an accessible and effective approach within primary care settings. The assessments showed an elevated level of access and attendance among service users. Therefore, it is recommended that timely EMDR services be extended through primary care networks.

Eye movement desensitisation and reprocessing (EMDR) therapy in prison and forensic services: a qualitative study of lived experience

ABSTRACT Background: Posttraumatic stress disorder (PTSD) is common in people with serious mental illness who come into contact with the criminal justice system. Little evidence exists on EMDR treatment in forensic mental health, with no prior qualitative research exploring lived experience perspectives. Objective: This qualitative study recruited adult forensic mental health patients with PTSD and psychotic disorders, predominantly schizophrenia, who had received EMDR as part of a clinical trial, either in prison or in hospital. We sought to understand their experiences of EMDR therapy while receiving forensic care. Method: Ten in-depth, semi-structured qualitative interviews were undertaken and analysed using thematic analysis. We used an inductive, realist approach, reporting the experiences, meanings, and reality of the participants. Results: Five overarching themes were identified. First, severe trauma was ubiquitous and participants felt Seriously Messed Up by their traumatic experiences, with debilitating and enduring PTSD symptoms contributing to offending and psychosis (‘giving the voices something to feed on’). Second, EMDR was regarded with Early Scepticism. Third, the therapy itself was initially emotionally taxing and Not Easy but participants generally felt safe and persevered. Fourth, they were often surprised and delighted by results (And it Worked!), describing significant symptom reduction and personal transformation. Lastly, EMDR Fits the Forensic Setting, bringing empowerment in a place perceived as disempowering. People reported changes that increased their hope in a violence-free future. Conclusions: The limited research on EMDR in forensic mental health is unfortunate given how common PTSD is in mentally unwell offenders and its potential to impede recovery and contribute to further offending. This first qualitative study found participants experienced positive transformative change, extending beyond symptom reduction. Themes support previously published quantitative outcomes showing EMDR to be safe and effective in this cohort. EMDR was well suited to a forensic setting and was seen as an empowering therapy. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618000683235. Study registration: The study was registered on the Australia and New Zealand Clinical Trials Network, registration number ACTRN12618000683235 (registered prospectively, 24 April 2018), https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 374682

The effectiveness, efficiency, and acceptability of EMDR vs. EMDR 2.0 vs. the Flash technique in the treatment of patients with PTSD: study protocol for the ENHANCE randomized controlled trial.

Several widely studied therapies have proven to be effective in the treatment of post-traumatic stress disorder (PTSD). However, there is still room for improvement because not all patients benefit from trauma-focused treatments. Improvements in the treatment of PTSD can be achieved by investigating ways to enhance existing therapies, such as eye movement desensitization and reprocessing (EMDR) therapy, as well as exploring novel treatments. The purpose of the current study is to determine the differential effectiveness, efficiency, and acceptability of EMDR therapy, an adaptation of EMDR therapy, referred to as EMDR 2.0, and a novel intervention for PTSD, the so-called Flash technique. The second aim is to identify the moderators of effectiveness for these interventions. This study will be conducted among individuals diagnosed with PTSD using a randomized controlled trial design. A total of 130 patients diagnosed with (complex) PTSD will be randomly allocated to either six sessions of EMDR therapy, EMDR 2.0, or the Flash technique. The primary outcomes used to determine treatment effectiveness include the presence of a PTSD diagnosis and the severity of PTSD symptoms. The secondary outcomes of effectiveness include symptoms of depression, symptoms of dissociation, general psychiatric symptoms, and experiential avoidance. All patients will be assessed at baseline, at 4-week post-treatment, and at 12-week follow-up. Questionnaires indexing symptoms of PTSD, depression, general psychopathology, and experiential avoidance will also be assessed weekly during treatment and bi-weekly after treatment, until the 12-week follow-up. Efficiency will be assessed by investigating the time it takes both to lose the diagnostic status of PTSD, and to achieve reliable change in PTSD symptoms. Treatment acceptability will be assessed after the first treatment session and after treatment termination. This study is the first to investigate EMDR 2.0 therapy and the Flash technique in a sample of participants officially diagnosed with PTSD using a randomized controlled trial design. This study is expected to improve the available treatment options for PTSD and provide therapists with alternative ways to choose a therapy beyond its effectiveness by considering moderators, efficiency, and acceptability. The trial was retrospectively registered in the ISRCTN registry at 10th November 2022 under registration number ISRCTN13100019.

EMDR Therapy in Specific Phobia of Vomiting (SPOV)

Specific phobia of vomiting (SPOV), commonly known as emetophobia, is a subtype of “Specific Phobia” (other type) in theDSM-5(American Psychiatric Association, 2013). Individuals with this condition have a persistent and disproportionate fear of vomiting that runs a chronic course limiting their social, occupational, and leisure-based functioning. There are several case reports of SPOV demonstrating positive therapeutic outcomes and a single randomized controlled trial (RCT) demonstrating the efficacy of cognitive behavioral therapy (CBT) incorporating exposure work and imagery rescripting. However, a large internet survey also suggests that most SPOV individuals would not try exposure treatments. This article provides the readers with an overview of SPOV followed by the application of the standard eye movement desensitization and reprocessing (EMDR) protocol supplemented with the flash-forward technique as a treatment for SPOV using a single-case example. Client outcomes were monitored for 20 months with a self-rating tool, the SPOV inventory, and associated comorbidity assessed using a patient health questionnaire (PHQ-9) and generalized anxiety disorder rating scales.

Effectiveness of Eye Movement Desensitization and Reprocessing Therapy in Response Inhibition and Cognitive Flexibility of Veterans with Posttraumatic Stress Disorder

Background: People traumatized by wars develop posttraumatic stress disorder (PTSD) and have low distress tolerance or emotional perception. Objectives: The present study aimed to investigate the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy in response inhibition and cognitive flexibility of veterans with PTSD. Methods: This quasi-experimental research adopted a pretest-posttest follow-up control group design. The statistical population included all the veterans supported by the Foundation of Martyrs and Veterans Affairs (FMVA) in Ahvaz, Khuzestan Province (Iran) in 2021. The purposive sampling method was employed to select 30 veterans who visited the psychological service centers affiliated with the FMVA of Ahvaz. They were then randomly assigned to the experimental (n = 15) and control (n = 15) groups. The participants in the experimental group received ten 60-minute EMDR therapy sessions held by the researcher, who underwent specialized training at the FMVA Counseling Center in Boustan Hospital. The participants in the control group received no intervention. The cognitive flexibility questionnaire and response inhibition scale were used to collect data. The analysis of covariance (ANCOVA) was used for data analysis in SPSS 24. Results: In the experimental group, the posttest and follow-up scores of response inhibition (response time) and cognitive flexibility showed significant improvements compared to pretest scores (P < 0.001). Conclusions: Hence, EMDR therapy improved cognitive flexibility and response inhibition in veterans with PTSD. As a result, EMDR therapy can be employed to enhance the psychological characteristics of veterans with stress.

Effectiveness of Eye Movement Desensitization and Reprocessing Therapy and Computer-Based Cognitive Rehabilitation on the Cognitive Bias of Veterans with Post-traumatic Stress Disorder

Background: People with post-traumatic stress disorder (PTSD) from war have more severe symptoms when combined with other chronic disorders, worsening their condition. Objectives: The present study aimed to investigate the effects of eye movement desensitization and reprocessing (EMDR) therapy and computer-based cognitive rehabilitation on the cognitive bias of veterans with PTSD. Methods: This was a quasi-experimental study with pretest, posttest, follow-up, and a control group. The statistical population included all the veterans under the Foundation of Martyrs and Veterans Affairs coverage of Ahvaz, Iran, in 2021. After the necessary examinations, 45 eligible participants were randomly assigned to two experimental groups and one control group (15 participants per group) after the necessary coordination. The experimental groups separately received EMDR therapy and computer-based cognitive rehabilitation, whereas the control group received no intervention. Repeated measures ANOVA in SPSS-24 was used for data analysis. Results: The results showed that compared to the control group, EMDR and computer-based cognitive rehabilitation interventions significantly influenced the cognitive bias of veterans with PTSD (P < 0.001). Moreover, cognitive bias scores from the posttest and follow-up significantly differed from those from the pretest (P < 0.001). Conclusions: Since EMDR and computer-based cognitive rehabilitation improved cognitive bias in veterans with PTSD, these methods are recommended for improving their psychological characteristics.