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)     

Efficacy of self-examination therapy in the treatment of generalized anxiety disorder.

To determine the efficacy of self-examination therapy in the treatment of generalized anxiety disorder, 38 adults volunteered for a study in which they were randomly assigned to self-examination therapy or to a delayed-treatment group. Analyses indicated that participants in self-examination therapy had significantly fewer symptoms of anxiety than did participants in the delayed-treatment group on the outcome measures of this study, which included ratings by trained clinicians and participants. The reduction in anxiety for people receiving self-examination therapy was maintained 3 months after treatment ended. The delayed-treatment group also showed significant improvement in anxiety symptoms after receiving self-examination therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma.

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment. PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S. A. Wilson, L. A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed. (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.     

Behavioral and neurochemical methods in research on new psychotropic drugs

The present study is a 15-month follow-up of the effects of eye movement desensitization and reprocessing (EMDR) therapy on the functioning of 66 participants, 32 of whom were diagnosed with posttraumatic stress disorder (PTSD) prior to treatment, PTSD participants improved as much as those without the diagnosis, with both groups maintaining their gains at 15 months. At 15-month follow-up, the three 90-min sessions of EMDR previously administered (S.A. Wilson, L.A. Becker, & R. H. Tinker, 1995) produced an 84% reduction in PTSD diagnosis and a 68% reduction in PTSD symptoms. The average treatment effect size was 1.59; the average reliable change index was 3.37. Implications of the maintenance of EMDR treatment effects are discussed.     

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)     

Eye movement desensitization and reprocessing: Four case studies of a new tool for executive coaching and restoring employee performance after setbacks.

The effects of eye movement desensitization and reprocessing (EMDR) integrated into executive coaching are reported in 4 case studies illustrating varied job titles and industries. Participants received 1–10 hrs of coaching in which EMDR was used to desensitize an upsetting event that had impaired their performance at work. Outcomes indicated that EMDR desensitized the disturbing incident and that participants shifted their negative view to a more positive one. Work performance was restored or enhanced. In the 4th case EMDR appeared to decrease anxiety about job interviewing and the participant reported a satisfactory result. Findings suggest that EMDR is a promising adjunct to coaching for workplace performance enhancement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Impact of cognitive-behavioral treatment on quality of life in panic disorder patients.

Panic disorder (PD) is associated with significant social and health consequences. The present study examined the impact of treatment on PD patients' quality of life. Patients (N?=?156) meeting DSM-III—R (Diagnostic and Statistical Manual of Mental Disorders [3rd ed., rev.]; American Psychiatric Association, 1987) criteria for PD with agoraphobia were randomly assigned to group cognitive behavioral treatment (CBT) or a delayed-treatment control. An assessment battery measuring the major clinical features of PD as well as quality of life was administered at baseline (Week 0), post treatment (Week 9) and 6-month follow-up (Week 35). Consistent with previous studies, PD patients displayed significant impairment in quality of life at intake. Compared with delayed-treatment control participants, CBT-treated participants showed significant reductions in impairment that were maintained at follow-up. Consistent with prediction, anxiety and phobic avoidance were significantly associated with quality of life, whereas frequency of panic attacks was not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Eye movement desensitization and reprocessing (EMDR): A meta-analysis.

Eye movement desensitization and reprocessing (EMDR), a controversial treatment suggested for posttraumatic stress disorder (PTSD) and other conditions, was evaluated in a meta-analysis of 34 studies that examined EMDR with a variety of populations and measures. Process and outcome measures were examined separately, and EMDR showed an effect on both when compared with no treatment and with therapies not using exposure to anxiety-provoking stimuli and in pre–post EMDR comparisons. However, no significant effect was found when EMDR was compared with other exposure techniques. No incremental effect of eye movements was noted when EMDR was compared with the same procedure without them. R. J. DeRubeis and P. Crits-Christoph (1998) noted that EMDR is a potentially effective treatment for noncombat PTSD, but studies that examined such patient groups did not give clear support to this. In sum, EMDR appears to be no more effective than other exposure techniques, and evidence suggests that the eye movements integral to the treatment, and to its name, are unnecessary. (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)     

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.     

Comparative efficacy, speed, and adverse effects of three PTSD treatments: Exposure therapy, EMDR, and relaxation training.

The authors examined the efficacy, speed, and incidence of symptom worsening for 3 treatments of posttraumatic stress disorder (PTSD): prolonged exposure, relaxation training, or eye movement desensitization and reprocessing (EMDR; N=60). Treatments did not differ in attrition, in the incidence of symptom worsening, or in their effects on numbing and hyperarousal symptoms. Compared with EMDR and relaxation training, exposure therapy (a) produced significantly larger reductions in avoidance and reexperiencing symptoms, (b) tended to be faster at reducing avoidance, and (c) tended to yield a greater proportion of participants who no longer met criteria for PTSD after treatment. EMDR and relaxation did not differ from one another in speed or efficacy. (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)     

Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet.

Online therapy offers many advantages over face-to-face therapy. Interapy includes psychoeducation, screening, effect measures, and a protocol-driven treatment via the Internet for people suffering from posttraumatic stress. The present article reports the results of a controlled trial on the Internet-driven treatment of posttraumatic stress and grief in a group of people who manifested mild to relatively severe trauma symptoms. Participants in the treatment condition (n=69) improved significantly more than participants in the waiting-list control condition (n=32) on trauma-related symptoms and general psychopathology. The effect sizes were large. On most subscales, more than 50% of the treated participants showed reliable change and clinically significant improvement, with the highest percentages being found for depression and avoidance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of motivational enhancement therapy with nontreatment-seeking adolescent cannabis users: A further test of the teen marijuana check-up.

Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Comparative efficacy of a DA2/alpha2 agonist and a beta-blocker in reducing adrenergic drive and cardiac fibrosis in an experimental model of left ventricular dysfunction after coronary artery occlusion

In a prepilot study, eight adults with chronic PTSD underwent three 90-minute sessions of eye movement desensitization and reprocessing (EMDR) at one-week intervals in an open trial. None of the seven who completed treatment met criteria for current PTSD two months later. Significant decreases in measures of pathology and disturbance were recorded. A controlled trial of EMDR is under way.     

Can group interventions facilitate forgiveness of an ex-spouse? A randomized clinical trial.

This study evaluated the effectiveness of 2 versions of an 8-session forgiveness group intervention for divorced individuals. Participants (randomized, n = 192; analyzed, n = 149) were randomly assigned to a secular forgiveness condition, a religious forgiveness condition, or a no-intervention comparison condition. Measures of forgiveness and mental health were obtained at pretest, posttest, and 6-week follow-up. Participants in both intervention conditions increased significantly more than comparison participants on self-reported forgiveness of an ex-spouse and understanding of forgiveness. Participants in the secular condition showed a greater decrease in depressive symptoms than comparison participants. Intrinsic religiousness did not moderate intervention effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of group- versus home-based exercise in the treatment of obesity.

This study examined the effects of 2 aerobic exercise regimens on exercise participation, fitness, eating patterns, treatment adherence, and weight changes in 49 obese women undergoing a year-long behavioral weight loss program. Participants were assigned randomly to weight loss treatment plus either group- or home-based exercise. All participants were instructed to complete a moderate-intensity walking program (30 min/day, 5 days/week). Group exercise participants were provided with 3 supervised group exercise sessions per week for the 1st 26 weeks and with 2 sessions per week thereafter. Home exercise participants were instructed to complete all exercise in their home environment. After 6 months, both conditions displayed significant improvements in exercise participation, fitness, eating patterns, and weight loss. At 12 months, the home-based program showed superior performance to the group condition in exercise participation and treatment adherence; at 15 months, participants in the home program demonstrated significantly greater weight losses than those in the group program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of generalized anxiety disorder in older adults.

Older adults with generalized anxiety disorder (GAD; N=75; M age=67.1 years) were randomly assigned to cognitive-behavioral therapy (CBT), a discussion group (DG) organized around worry provoking topics, or a waiting period. Participants in both active conditions improved relative to the waiting list. Although CBT participants improved on more measures than DG participants, the authors found only 1 significant difference immediately after treatment and no differences at 6-month follow-up. Effect sizes were smaller than in younger samples, but CBT showed large effects and DG showed medium-sized effects. Overall, results indicate that brief treatment of late-life GAD is beneficial, but they provide only limited support for the superiority of CBT to a credible comparison intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)