Three- and 6-Month Follow-Up of EMDR Treatment of PTSD in an HMO Setting.

Eye movement desensitization and reprocessing (EMDR) treatment was found to maintain superiority to newly initiated standard Kaiser Care, which consisted of individual therapy plus variations of medication and group therapy. A 3- and 6-month follow-up of individuals randomly assigned to either EMDR treatment or standard care (SC) treatment for posttraumatlc stress disorder (PTSD) indicates that significantly greater improvements found with EMDR at posttreatment in an earlier article (S. Marcus, P. Marquis, & C. Sakai, 1997) were maintained on measures of PTSD, depression, anxiety, and general symptoms. Of the original 67 participants in this large HMO study, 44 were assessed at 3-month follow-up and 36 were assessed at 6-month follow-up by an independent assessor. The study indicates that a relatively small number of EMDR treatment sessions result in substantial benefits that are maintained over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A life review interview guide: a structured systems approach to information gathering

To study the efficacy of eye movement desensitization and reprocessing (EMDR) with traumatized young women, 60 women between the ages of 16 and 25 were randomly assigned to two sessions of either EMDR or an active listening (AL) control. Factorial ANOVA interaction effects and simple main effects for outcome measure (Beck Depression Inventory, State-Trait Anxiety Inventory, Penn Inventory for Posttraumatic Stress Disorder, Impact of Event Scale, Tennessee Self-Concept Scale) indicated significant improvement for both groups and significantly greater pre-post change for EMDR-treated participants. Pre-post effect sizes for the EMDR group averaged 1.56 compared to 0.65 for the AL group. Despite treatment brevity, the posttreatment outcome variable means of EMDR-treated participants compared favorably with nonpatient or successfully treated norm groups on all measures.     

Peer group training of pragmatic skills in adolescents with acquired brain injury

OBJECTIVE: To empirically evaluate a method of treating adolescents with cognitive communication disorders, including pragmatic deficits, secondary to acquired brain injury (ABI) in a group setting by objectively measuring outcomes before treatment and immediately after treatment and at 6 months posttreatment. DESIGN: A before-after trial with follow-up in a consecutive sample, with no control group. SETTING: Inpatient and outpatient pediatric rehabilitation center. SUBJECTS: Adolescents who demonstrated pragmatic deficits and scored a rating of 3 or less on each subdomain of the Rehabilitation Institute of Chicago Rating Scale of Pragmatic Communication Skills (RICE-RSPCS) were eligible for the study. Eight subjects were recruited into the study, and two subjects were lost to follow-up. Thus, six of the eight completed the study. MAIN OUTCOME MEASURES: RICE-RSPCS, Communication Performance Scale (CPS). Results: Clinically relevant and statistically significant (P <.01) changes occurred during the treatment and were maintained at follow-up for the four RICE-RSPCS subscales and the CPS. CONCLUSION: These results suggest that the potential and often typical long-term pragmatic and subsequent social difficulties associated with ABI can possibly be lessened through effective intervention.     

Culture-responsive one-session treatment for phobic Asian Americans: A pilot study.

In this pilot trial, 15 phobic Asian Americans were randomly assigned to standard one-session treatment (OSTS), culturally adapted one-session treatment (OST-CA), or manualized self-help. At posttreatment, OST (combined standard and culturally adapted) led to greater reductions in phobic avoidance and anxiety than self-help. Moreover, analyses comparing the two active treatments showed trends favoring OST-CA over OST-S. Results suggest that Asian Americans may benefit most from empirically supported treatments that consider Asian cultural values. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.

Objective: To follow distressed married couples for 5 years after their participation in a randomized clinical trial. Method: A total of 134 chronically and seriously distressed married couples were randomly assigned to approximately 8 months of either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Marital status and satisfaction were assessed approximately every 3 months during treatment and every 6 months for 5 years after treatment. Results: Pre- to posttreatment effect sizes on marital satisfaction were d = 0.90 for IBCT and d = 0.71 for TBCT, which were not significantly different. However, data through 2-year follow-ups revealed statistically significant superiority of IBCT over TBCT in relationship satisfaction, but subsequent data showed increasing similarity and nonsignificant differences in outcome. At 5-year follow-up for marital satisfaction relative to pretreatment, effect sizes were d = 1.03 for IBCT and d = 0.92 for TBCT; 50.0% of IBCT couples and 45.9% of TBCT couples showed clinically significant improvement. Relationship status, obtained on all 134 couples, revealed that 25.7% of IBCT couples and 27.9% of TBCT couples were separated or divorced. These follow-up data compared favorably to other, long-term results of couple therapy. Conclusion: TBCT and IBCT both produced substantial effect sizes in even seriously and chronically distressed couples. IBCT produced significantly but not dramatically superior outcomes through the first 2 years after treatment termination but without further intervention; outcomes for the 2 treatments converged over longer follow-up periods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learned tolerance to ethanol-induced c-Fos expression in rats

This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.     

Eye movement desensitization and reprocessing treatment for panic disorder: A controlled outcome and partial dismantling study.

Forty-three outpatients with DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed., revised; American Psychiatric Association, 1987) panic disorders were randomly assigned to receive 6 sessions of eye movement desensitization and reprocessing (EMDR), the same treatment but omitting the eye movement, or to a waiting list. Posttest comparisons showed EMDR to be more effective in alleviating panic and panic-related symptoms than the waiting-list procedure. Compared with the same treatment without the eye movement, EMDR led to greater improvement on 2 of 5 primary outcome measures at posttest. However, EMDR's advantages had dissipated 3 months after treatment, thereby failing to firmly support the usefulness of the eye movement component in EMDR treatment for panic disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMDR Therapy Following the 9/11 Terrorist Attacks: A Community-Based Intervention Project in New York City.

This article presents the results of a time-limited psychological relief effort using eye movement desensitization and reprocessing (EMDR) following the attacks on the World Trade Center on September 11, 2001. Clients made highly significant positive gains on a range of outcome variables, including validated psychometrics and self-report scales. Analyses of the data suggest 2 broad conclusions: EMDR is a useful treatment intervention both in the immediate aftermath of disaster as well as later; the longer treatment is delayed, the greater the level of disturbance experienced by clients. Also discussed are problems in conducting research during mass disaster response situations. A demonstration of an analog to a wait-list control group is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating phobic children: Effects of EMDR versus exposure.

This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n?=?9), (b) an exposure in vivo group (n?=?9), or (c) a computerized exposure (control) group (n?=?8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

One-session treatment of specific phobias in youth: A randomized clinical trial in the United States and Sweden.

One hundred and ninety-six youth, ages 7–16, who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for various specific phobias were randomized to a one-session exposure treatment, education support treatment, or a wait list control group. After the waiting period, the wait list participants were offered treatment and, if interested, rerandomized to 1 of the 2 active treatments. The phobias were assessed with semistructured diagnostic interviews, clinician severity ratings, and behavioral avoidance tests, whereas fears, general anxiety, depression, and behavior problems were assessed with self- and parent report measures. Assessments were completed pretreatment, posttreatment, and at 6 months following treatment. Results showed that both treatment conditions were superior to the wait list control condition and that 1-session exposure treatment was superior to education support treatment on clinician ratings of phobic severity, percentage of participants who were diagnosis free, child ratings of anxiety during the behavioral avoidance test, and treatment satisfaction as reported by the youth and their parents. There were no differences on self-report measures. Treatment effects were maintained at follow-up. Implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Progressive counting: Multi-site group and individual treatment open trials.

Progressive counting (PC), a variant of the counting method, is a recently developed trauma resolution procedure that appears to be efficient and well tolerated by clients. This paper reports on the posttreatment, 1 week, and 1 month posttreatment outcomes of 232 participants in 6 countries who experienced a brief Group PC treatment—average about 5 minutes of exposure—of a minor upsetting memory during the course of their participation in trauma treatment workshops. Additional posttreatment and follow-up data is reported on 128 of these participants who experienced a second (untimed) individual PC session focused on a more significant upsetting memory. The positive and sustained benefit realized from such a brief dose of PC indicates this treatment's potential value in individual and possibly group treatment of trauma and/or loss memories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of eye movement desensitization and reprocessing (EMDR) therapy on posttraumatic stress disorder in survivors of the 1999 Marmara, Turkey, earthquake.

As part of a program of response to the 1999 Marmara, Turkey, earthquake, an estimated 1,500 trauma victims with posttraumatic stress disorder (PTSD) symptoms were treated in tent cities with eye movement desensitization and reprocessing (EMDR). A field study evaluating a representative group of 41 participants with diagnosed PTSD indicated that a mean of five 90-minute sessions was sufficient to eliminate symptoms in 92.7% of those treated, with reduction in symptoms in the remaining participants. Significant reductions occurred between the pre and posttreatment PTSD Symptom Scale Self-Report version (PSS-SR) total scores and all subscales. These gains were maintained at 6-month follow-up. The same pattern of recovery was observed regardless of the use or nonuse of psychotropic medication at the time of intake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Controlled study of treatment of PTSD using EMDR in an HMO setting.

67 individuals (aged 18–73 yrs) diagnosed with posttraumatic stress disorder (PTSD) were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) treatment or Standard Care (SC) treatment. Participants were assessed pretreatment, after 3 sessions, and at the completion of treatment using the SCL-90, Beck Depression Inventory, Impact of Event Scale (M. Horowitz et al, 1979), modified PTSD Symptom Scale (S. A. Falsetti et al, 1993), State Trait Anxiety Inventory, and other measures. In addition, an independent evaluator assessed participants using Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria for PTSD including Global Assessment of Functioning at the 3 data points. Ss in the EMDR treatment group showed significantly greater improvement with greater rapidity than those in the SC treatment group on measures of PTSD, depression, anxiety, and general symptoms. Ss who received EMDR treatment used fewer medication appointments for their psychological symptoms and needed fewer psychotherapy appointments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EMDR for panic disorder with agoraphobia: Comparison with waiting list and credible attention-placebo control conditions.

In a randomized controlled trial, eye movement desensitization and reprocessing (EMDR) for panic disorder with agoraphobia (PDA) was compared with both waiting list and credible attention-placebo control groups. EMDR was significantly better than waiting list for some outcome measure, (questionnaire, diary, and interview measures of severity of anxiety, panic disorder, and agoraphobia) but not for others (panic attack frequency and anxious cognitions). However, low power and, for panic frequency, floor effects may account for these negative results. Differences between EMDR and the attention placebo control condition were not statistically significant on any measure, and, in this case, the effect sizes were generally small (η?=?.00–.06), suggesting the poor results for EMDR were not due to lack of power. Because there are established effective treatments such as cognitive–behavior therapy for PDA, these data, unless contradicted by future research, indicate EMDR should not be the first-line treatment for this disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responding to an identified need: A joint department of defense/department of veterans affairs training program in eye movement desensitization and reprocessing (EMDR) for clinicians providing trauma services.

An earlier study of federal Department of Defense mental health professionals found relatively few trained in the psychotherapies for posttraumatic stress disorder previously identified as effective by both this department and the federal Department of Veterans Affairs. In response to that need, a training program for one of the psychotherapies, eye movement desensitization and reprocessing (EMDR), was implemented utilizing personnel from these federal departments with assistance from a nonprofit agency. This article presents an evaluation of that program with rating data gathered from participants as well as treatment outcome data from the application of the training to patients. The program was highly rated by the participants and the impact of EMDR treatment was significant. Suggestions for similar programs and for further research are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders

Changes in calorie intake and weight gain were evaluated in five children with cystic fibrosis (CF) who received behavioral intervention and four children with CF who served as wait list controls. The behavioral intervention was a 6-week group treatment that provided nutritional education plus management strategies aimed at mealtime behaviors that parents find most problematic. The control group was identified prospectively and was evaluated on all dependent measures at the same points in time pre- and posttreatment as the intervention group. Difference scores on calorie intake and weight gain from pre- to posttreatment were compared between groups using t tests for independent samples. The behavioral intervention group increased their calorie intake by 1,032 calories per day, while the control group's intake increased only 244 calories per day from pre- to posttreatment [t(6) = 2.826, p = 0.03]. The intervention group also gained significantly more weight (1.7 kg) than the control group (0 kg) over the 6 weeks of treatment [t(7) = 2.588, p = 0.03] and demonstrated catchup growth for weight, as indicated by improved weight Z scores (-1.18 to -0.738). The control group showed a decline in weight Z scores over this same time period (-1.715 to -1.76). One month posttreatment, the intervention was replicated with two of the four children from the control group. Improved calorie intake and weight gain pre- to posttreatment were again found in these children. At 3- and 6-month follow-up study of children receiving intervention, maintenance of calorie intake and weight gain was confirmed. No changes were found on pulmonary functioning, resting energy expenditure, or activity level pre- to posttreatment. This form of early intervention appears to be promising in improving nutritional status and needs to be investigated over a longer period of time to evaluate the effects of treatment gains on the disease process.     

Treating adult marijuana dependence: A test of the relapse prevention model.

161 men and 51 women seeking treatment for marijuana use were randomly assigned to either a relapse prevention (RP; G. A. Marlatt & J. R. Gordon, 1985) or a social support (SSP) group discussion intervention. Data collected for 12 mo posttreatment revealed substantial reductions in frequency of marijuana use and associated problems. There were no significant differences between the cognitive-behavioral RP intervention and the SSP group discussion conditions on measures of days of marijuana use, related problems, or abstinence rates. Men in the RP condition were more likely than men in the SSP condition to report reduced use without problems at 3-mo follow-up. Posttreatment increases in problems associated with alcohol did not appear to relate to reduced marijuana use. Results are discussed in terms of the need for further research with marijuana-dependent adults and the efficacy of RP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pressure pain thresholds in patients with craniomandibular disorders before and after treatment with acupuncture and occlusal splint therapy: a controlled clinical study

Fifty-five patients (46 women and 9 men) with craniomandibular disorders and a history of pain of at least 6 months' duration participated in this trial. The patients were randomly assigned to three groups: one group to receive acupuncture; one group to receive occlusal splint therapy; and one group to act as controls. Pressure pain threshold, clinical dysfunction score, and visual analog scale measures were used to evaluate patients before, immediately after, and 6 months after treatment. A moderate, but statistically significant, correlation was found between pressure pain threshold and the number of tender spots in the masticatory muscles (tau = -.43; P < .001), degree of tenderness in the masticatory muscles (tau = -.43; P < .001), clinical dysfunction score (tau = .32; P < .001), and the visual analog scale (tau = -.25; P < .01). The short-term results showed a statistically significant improvement in all evaluations for both treatment groups. No significant differences were found in the control group. The improvements resulted in significant differences between the control and each treatment group immediately after treatment. At the 6-month follow-up, no significant differences in pressure pain threshold or clinical dysfunction score were found in the two treatment groups compared with the short-term results.     

Allergen-avoidance measures in homes of house-dust-mite-allergic asthmatic patients: effects of acaricides and mattress encasings

This double-blind, placebo-controlled study investigated whether the application of an acaricide (Acarosan) on mattresses and on textile floor coverings in living rooms and bedrooms can contribute to improvement in lung function and airway hyperresponsiveness in 40 adult asthmatic patients sensitized to house-dust mite. In a second group of 19 patients who refused chemical intervention, the clinical effects of application of allergen-impermeable mattress encasings were studied. In all three treatment groups, Der p 1 levels in mattress dust were statistically significantly decreased after 12 months. However, this decrease was much greater in the group who received mattress encasings (final mean level 430 ng/g) than in groups with acaricide- or placebo-treated mattresses (final mean levels 1730 and 2100 ng/g, respectively). Treatment of textile floors with either Acarosan or placebo chemical caused a statistically significant decrease in the level of the house-dust-mite allergen Der p1 in floor dust. In the group with mattress encasings, no significant changes of floor dust Der p 1 were found. Airway hyperresponsiveness (as measured by the PC20 histamine) improved significantly in the mattress cover group after 6 months. The Acarosan group also showed a small but statistically significant improvement after 12 months.