RESUMEN
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). Treaments 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.
Asunto(s)
Movimientos Oculares/fisiología , Psicoterapia/métodos , Relajación , Trastornos por Estrés Postraumático/terapia , Enseñanza/métodos , Adolescente , Adulto , Humanos , Distribución Aleatoria , Reproducibilidad de los Resultados , Factores de Tiempo , Resultado del TratamientoRESUMEN
Eye Movement Desensitization and Reprocessing (EMDR) is an efficacious and efficient treatment for posttraumatic stress disorder (PTSD). This article provides a brief overview of the findings of 20 controlled-outcome studies and describes Shapiro's Adaptive Information Processing model. This model posits that pathology results when distressing experiences are processed inadequately and hypothesizes that EMDR accelerates information processing, resulting in the adaptive resolution of traumatic memories. A detailed description of the eight phases of treatment highlights the procedures, assumptions, and clinical observations that currently guide EMDR clinical practice. A case study, with an in-session transcript, illustrates the application of EMDR to address the past events that have laid the groundwork for dysfunction, the present circumstances that elicit distress, and skills acquisition needed for adaptive functioning.
Asunto(s)
Cognición/fisiología , Desensibilización Psicológica/métodos , Movimientos Sacádicos/fisiología , Trastornos por Estrés Postraumático/terapia , Adulto , Femenino , HumanosRESUMEN
The controlled treatment outcome studies that examined the efficacy of EMDR in the treatment of posttraumatic stress disorder have yielded a range of results, with the efficacy of EMDR varying across studies. The current study sought to determine if differences in outcome were related to methodological differences. The research was reviewed to identify methodological strengths, weaknesses, and empirical findings. The relationships between effect size and methodology ratings were examined, using the Gold Standard (GS) Scale (adapted from Foa & Meadows, 1997). Results indicated a significant relationship between scores on the GS Scale and effect size, with more rigorous studies according to the GS Scale reporting larger effect sizes. There was also a significant correlation between effect size and treatment fidelity. Additional methodological components not detected by the GS Scale were identified, and suggestions were made for a Revised GS Scale. We conclude by noting that methodological rigor removes noise and thereby decreases error measurement, allowing for the more accurate detection of true treatment effects in EMDR studies.