Eye Movement Desensitization And Reprocessing Research Articles

Eye movement intervention facilitates concurrent perception and memory processing.

A widely used psychotherapeutic treatment for post-traumatic stress disorder (PTSD) involves performing bilateral eye movement (EM) during trauma memory retrieval. However, how this treatment-described as eye movement desensitization and reprocessing (EMDR)-alleviates trauma-related symptoms is unclear. While conventional theories suggest that bilateral EM interferes with concurrently retrieved trauma memories by taxing the limited working memory resources, here, we propose that bilateral EM actually facilitates information processing. In two EEG experiments, we replicated the bilateral EM procedure of EMDR, having participants engaging in continuous bilateral EM or receiving bilateral sensory stimulation (BS) as a control while retrieving short- or long-term memory. During EM or BS, we presented bystander images or memory cues to probe neural representations of perceptual and memory information. Multivariate pattern analysis of the EEG signals revealed that bilateral EM enhanced neural representations of simultaneously processed perceptual and memory information. This enhancement was accompanied by heightened visual responses and increased neural excitability in the occipital region. Furthermore, bilateral EM increased information transmission from the occipital to the frontoparietal region, indicating facilitated information transition from low-level perceptual representation to high-level memory representation. These findings argue for theories that emphasize information facilitation rather than disruption in the EMDR treatment.

Feasibility of EMDR toward Personality Functioning in Older Adults with PTSD

ABSTRACT Objectives Severe posttraumatic stress disorder (PTSD) in older adults (≥60 years) has been found to be associated with maladaptive personality functioning and personality disorders (PD). Emerging evidence in adults supports that reprocessing adverse events with Eye Movement Desensitization and Reprocessing (EMDR) could improve personality functioning and reduce full PDdiagnosis. Methods A multicenterfeasibilitystudy in 24 older PTSD-patients receiving weekly EMDR-sessions for either 3, 6 or 9 months. A linear-mixed-model was used with personality functioning (SIPP-SF) as dependent variable and time, PTSD-severity (CAPS-5), and “othertreatment” as predictor variables. Secondary, pre- and posttreatment percentages were calculated for the PDspresence. Results Symptom changes over time showed a significant influence of CAPS-5 on SIPP-SF (b = −1.40, 95% CI=[−2.48 to −0.33], p = .012), no significant effect of time for total SIPP-SF, and a significant improvement of SIPP-SF “identityintegration”-scale over time (b = 9.20, 95% CI=[0.97–17.42], p = .029). There was a marginal significant effect of “othertreatment” (b = 8.42, 95% CI=[−0.30–17.13], p = .058). There was 31% full PDs-decrease. Conclusions Observed improvements in personality functioning from pre to post EMDRtreatment were explained by PTSD-severity. Identityintegration improved significantly over time. Results suggest that participants with “othertreatment” showed more severe baseline-pathology and thus lower personality functioning. Clinical implications EMDR, in addition to being a feasible treatment option for older adults with PTSD, improves personality functioning and reduces the presence of PDs over time.’

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.

EMDR Flash Technique in adolescents with depression: A twelve-week follow-up study.

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, 12-17years 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 12weeks, 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.

Eye Movement Desensitisation and Reprocessing (EMDR) therapy for prolonged grief: theory, research, and practice.

Prolonged Grief Disorder occurs within 7-10% of the bereaved population and is a more complicated and persistent form of grief which has been associated with suicidality, mental health disorders, sleep disturbance, poor health behaviors, and work and social impairment. EMDR is a fitting treatment option for those with Prolonged Grief, focusing on processing past memories, blocks, current triggers, future fears, and preparing the person for living life beyond the loss in line with the Adaptive Information Processing Model and grief frameworks. This paper discusses the theory, research regarding the application of EMDR with prolonged grief, and gives insight and guidance to clinicians working in this area including a case example.

Dialectical Behavior Therapy in the Treatment of Trauma

The study aims to introduce Dialectical Behavior Therapy (DBT) as a viable approach to treating post-traumatic stress disorder (PTSD), as well as its comorbidity with borderline personality disorder (BPD). The paper refers to current studies conducted between 2017 and 2023 relating to DBT's efficacy in managing complex and relational early childhood trauma, including sexual abuse and violence. Analyses indicate that DBT helps to reduce PTSD symptoms in various age groups. An integrative approach, which combines DBT and methods such as Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), or Eye Movement Desensitization and Reprocessing (EMDR), appears to enhance therapeutic effects. Therefore, it is recommended to implement programs based on DBT and evaluate their effectiveness in a group of Polish patients who have co-occurring symptoms of PTSD and BPD or PTSD alone.

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.

Is a Personal Trauma History a Risk Factor for the Development of Secondary Traumatization in EMDR Therapists?

Symptoms severe enough to constitute a secondary traumatization (ST) can arise from providing eye movement desensitization and reprocessing (EMDR) treatment. However, little is known about specific risk factors such as a personal trauma history. EMDR therapists (n= 115) filled out a questionnaire battery to test whether the personal trauma history predicts symptom levels over and beyond vicarious exposure and whether vicarious exposure mediates the relationship between primary trauma history and current ST severity. Current exposure predicts ST symptom severity, while lifetime exposure is negatively associated. The number of primary traumata and the total severity of primary traumata do not explain additional variance in ST symptom severity. The mediation model suggests that primary trauma exposure instead is associated with treating more traumatized clients. The current results suggest that ST is a relevant topic to address in EMDR training, but the personal trauma history does not seem to constitute a relevant risk factor per se. It might, however, be associated with preferences for clientele composition, which in turn might act as a risk factor.

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.

EMDR in Three Adults With Severe Intellectual Disability and Posttraumatic Stress Disorder: A Multiple-Baseline Evaluation

Research on trauma treatment in people with severe intellectual disability (SID; IQ 20–35) is scarce, and controlled studies are lacking. This study examined the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy using the storytelling method in three adults with SID and posttraumatic stress disorder (PTSD). A multiple-baseline design was used to examine the effects of the EMDR storytelling method on PTSD classification, PTSD symptoms, challenging behaviors, and dysfunctional behaviors in three adults with SID and PTSD, EMDR resulted in a significant decrease in PTSD symptoms, challenging behaviors, and most dysfunctional behaviors. None of the participants had a PTSD classification after EMDR. Findings suggest EMDR to be effective in the treatment of PTSD in adults with SID. Follow-up research with a larger sample size is required.

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.

Group eye movement desensitization and reprocessing (EMDR) in chronic pain patients.

The prevalence of chronic pain is increasing, and conventional pain therapies often have limited efficacy in individuals with high levels of psychological distress and a history of trauma. In this context, the use of Eye Movement Desensitization and Reprocessing (EMDR), an evidence-based psychotherapy approach for the treatment of posttraumatic stress disorder, is becoming increasingly important. EMDR shows promising results, particularly for patients with pain and high levels of emotional distress. Although group therapy is becoming increasingly popular in pain management, EMDR has mainly been studied as an individual treatment. However, a systematic review suggests that group therapy can be an effective tool for improving mental health outcomes, especially when trauma is addressed together. Based on these findings, an outpatient EMDR group program was developed for patients with chronic pain. The program consists of a total of four treatment days with 5-5.5 h therapy sessions each day and provides patients with a supportive environment in which they can learn effective pain management strategies and interact with other patients with similar experiences. Initial pilot evaluations indicate high efficacy and adequate safety for patients with chronic pain.

DNA methylation changes in association with trauma-focused psychotherapy efficacy in treatment-resistant depression patients: a prospective longitudinal study

ABSTRACT Background: Stressful events increase the risk for treatment-resistant depression (TRD), and trauma-focused psychotherapy can be useful for TRD patients exposed to early life stress (ELS). Epigenetic processes are known to be related to depression and ELS, but there is no evidence of the effects of trauma-focused psychotherapy on methylation alterations. Objective: We performed the first epigenome-wide association study to investigate methylation changes related to trauma-focused psychotherapies effects in TRD patients. Method: Thirty TRD patients assessed for ELS underwent trauma-focused psychotherapy, of those, 12 received trauma-focused cognitive behavioural therapy, and 18 Eye Movement Desensitization and Reprocessing (EMDR). DNA methylation was profiled with Illumina Infinium EPIC array at T0 (baseline), after 8 weeks (T8, end of psychotherapy) and after 12 weeks (T12 – follow-up). We examined differentially methylated CpG sites and regions, as well as pathways analysis in association with the treatment. Results: Main results obtained have shown 110 differentially methylated regions (DMRs) with a significant adjusted p-value area associated with the effects of trauma-focused psychotherapies in the entire cohort. Several annotated genes are related to inflammatory processes and psychiatric disorders, such as LTA, GFI1, ARID5B, TNFSF13, and LST1. Gene enrichment analyses revealed statistically significant processes related to tumour necrosis factor (TNF) receptor and TNF signalling pathway. Stratified analyses by type of trauma-focused psychotherapy showed statistically significant adjusted p-value area in 141 DMRs only for the group of patients receiving EMDR, with annotated genes related to inflammation and psychiatric disorders, including LTA, GFI1, and S100A8. Gene set enrichment analyses in the EMDR group indicated biological processes related to inflammatory response, particularly the TNF signalling pathway. Conclusion: We provide preliminary valuable insights into global DNA methylation changes associated with trauma-focused psychotherapies effects, in particular with EMDR treatment.

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.

Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder

BackgroundThe psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes. MethodsWe enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment. ResultsWe found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment. ConclusionsTF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.

The Potential for Computerized Eye Tracking Technology to Improve Bilateral Stimulation Methodology and Assessment

Bilateral stimulation is also called Eye Movement Desensitization and Reprocessing (EMDR) and is a psychotherapeutic technique for treating PTSD and other mental health issues. Trauma affects brain activity, and EMDR may help rewire that activity through use of bilateral stimulation (BLS) during memory processing. BLS typically involves eye movements; tracking a stimulus back and forth. However, the effectiveness of EMDR is debated due to limited research on its neurological mechanisms and methodological inconsistencies in the literature. Inconsistencies include lack of concrete methodology and inconclusive meta-analyses. The traditional EMDR eight-phase protocol involves history, assessment, desensitization, and more. A major appeal of EMDR for clients includes the low requirement for verbalizing traumatic memories in session, but effectiveness assessment relies on self-report. Eye tracking technology could address the standardization issues with EMDR while also enhancing protocols and research. Standardized EMDR, online or in-person, could improve outcomes and expand its applications.

The Distancing Approach: A Comprehensive Eye Movement Desensitization and Reprocessing Psychotherapy for Obsessive-Compulsive Disorder

The Distancing Approach is a comprehensive psychotherapy, rooted in the principles and practices of eye movement desensitization and reprocessing (EMDR) therapy. It aims to address the complex symptoms of obsessive-compulsive disorder (OCD), through insight enhancement, skill development, desensitization of triggers, and reprocessing of related memories. Building on prior OCD research with cognitive behavioral therapy (CBT) and with EMDR, it combines EMDR’s Phobia Protocol with two new EMDR-derived techniques: the Distancing Technique and Future Rehearsal. The Distancing Technique is designed to develop insight through the creation of adaptive coping statements. It identifies and strengthens these adaptive statements in EMDR’s preparation phase so that they can be available as resources during EMDR’s reprocessing phases and in daily life. Future Rehearsal is a technique that combines EMDR methods with CBT’s exposure response prevention to desensitize OCD triggers. EMDR’s Phobia Protocol is applied according to standard procedures. Consistent with the psychotherapy approach, the therapeutic relationship is optimized, and treatment is individualized, to best meet the needs of the client. A case example illustrates the application of the approach.

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).