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Introduction: Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition. Methods: This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989). Results: Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group. Conclusion: Study results provide promising preliminary evidence that webbased EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results. [ABSTRACT FROM AUTHOR]

Introduction: 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. Aim: 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. Methods: A literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal. Results: 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). Discussion: 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. Practical implications: 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. [ABSTRACT FROM AUTHOR]

Objectives: This study reports on four similar studies intended to explore the acceptability, safety, and efficacy of the flash technique (FT), a method of rapidly reducing the intensity of a disturbing memory or image, with minimal subjective disturbance for subjects during the process. Of the four studies, two were conducted during FT trainings in the United States, one in Australia, and one in Uganda. Methods: The studies involve pre-, post-, and follow-up repeated-measures design to determine the effectiveness of a 15-min FT intervention. A total of 654 subjects were asked to think of a disturbing memory and then participate in a structured experience of an FT. The purpose of this investigation was to determine whether a brief application of an FT would be safe and effective in significantly reducing their disturbance. In each study, subjects rated their disturbing memories on a 0-to-10 scale, with zero representing no disturbance at all and 10 representing the worst they could imagine. Then, they took part in a 15-min group practicum where they were guided in a self-administering FT with no individual supervision or support. Results: In all four studies, the mean reduction in disturbance exceeded two-thirds, the results were significant (p < 0.001), and the effect size was very large. Of the 813 sessions (654 subjects) represented in these studies, only two subjects reported slight increases in disturbances, and both of these subjects reported reductions in disturbance in their second FT experiences 2 h later. At a 4-week follow-up, mean disturbance levels in all four studies indicated maintenance of benefit or slightly further reduction of mean disturbance levels. An 18-month follow-up study with a subgroup of subjects who initially reported a high level of memory-related distress found similar maintenance of gains as well as symptom reduction. Conclusion: These findings provide preliminary evidence of acceptability, safety, and efficacy of FT; therefore, further study is warranted. [ABSTRACT FROM AUTHOR]

IntroductionPromising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition.MethodsThis randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989).ResultsForty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group.ConclusionStudy results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047

ObjectivesThis study reports on four similar studies intended to explore the acceptability, safety, and efficacy of the flash technique (FT), a method of rapidly reducing the intensity of a disturbing memory or image, with minimal subjective disturbance for subjects during the process. Of the four studies, two were conducted during FT trainings in the United States, one in Australia, and one in Uganda.MethodsThe studies involve pre-, post-, and follow-up repeated-measures design to determine the effectiveness of a 15-min FT intervention. A total of 654 subjects were asked to think of a disturbing memory and then participate in a structured experience of an FT. The purpose of this investigation was to determine whether a brief application of an FT would be safe and effective in significantly reducing their disturbance. In each study, subjects rated their disturbing memories on a 0-to-10 scale, with zero representing no disturbance at all and 10 representing the worst they could imagine. Then, they took part in a 15-min group practicum where they were guided in a self-administering FT with no individual supervision or support.ResultsIn all four studies, the mean reduction in disturbance exceeded two-thirds, the results were significant (p

IntroductionPeople 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.AimThis 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.MethodsA literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal.ResultsAfter 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).DiscussionThe 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.Practical implicationsThe 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 practice-based evidence suggests that it is possible to use eye movement desensitization and reprocessing (EMDR) to treat major depressive disorder (MDD), but its specific efficacy is unknown. A systematic search was carried out for randomized controlled trials comparing EMDR with a control condition group in MDD patients. Two meta-analyses were conducted, with symptom reduction as primary outcome and remission as exploratory outcome. Eight studies with 320 participants were included in this meta-analysis. The first meta-analysis showed that EMDR outperformed “No Intervention” in decreasing depressive symptoms (standardized mean difference [SMD] = −0.81, 95% CI = −1.22 to −0.39, p < 0.001, low certainty), but statistically significant differences were not observed in improving remission (risk ratio = 1.20, 95% CI = 0.87–1.66, p = 0.25, very low certainty). The second showed the superiority of EMDR over CBT in reducing depressive symptoms (mean difference [MD] = −7.33, 95% CI = −8.26 to −6.39, p < 0.001, low certainty), and improving remission (risk ratio = 1.95, 95% CI = 1.24–3.06, p = 0.004, very low certainty). Besides, anxiety symptoms and level of functioning could not be included as secondary outcome due to the lack of data. The present meta-analysis suggests that EMDR is more effective in treating MDD than “No Intervention” and CBT, particularly in individuals who have traumatic experience. However, this result should be considered with caution due to small sample size and low quality of trails.

The practice-based evidence suggests that it is possible to use eye movement desensitization and reprocessing (EMDR) to treat major depressive disorder (MDD), but its specific efficacy is unknown. A systematic search was carried out for randomized controlled trials comparing EMDR with a control condition group in MDD patients. Two meta-analyses were conducted, with symptom reduction as primary outcome and remission as exploratory outcome. Eight studies with 320 participants were included in this meta-analysis. The first meta-analysis showed that EMDR outperformed "No Intervention" in decreasing depressive symptoms (standardized mean difference [SMD] = −0.81, 95% CI = −1.22 to −0.39, p < 0.001, low certainty), but statistically significant differences were not observed in improving remission (risk ratio = 1.20, 95% CI = 0.87–1.66, p = 0.25, very low certainty). The second showed the superiority of EMDR over CBT in reducing depressive symptoms (mean difference [MD] = −7.33, 95% CI = −8.26 to −6.39, p < 0.001, low certainty), and improving remission (risk ratio = 1.95, 95% CI = 1.24–3.06, p = 0.004, very low certainty). Besides, anxiety symptoms and level of functioning could not be included as secondary outcome due to the lack of data. The present meta-analysis suggests that EMDR is more effective in treating MDD than "No Intervention" and CBT, particularly in individuals who have traumatic experience. However, this result should be considered with caution due to small sample size and low quality of trails. [ABSTRACT FROM AUTHOR]

Eye movement desensitization and reprocessing (EMDR) therapy targets emotionally disturbing visual memories of traumatic life events, and may be deployed as an efficacious treatment for posttraumatic stress disorder. A key element of EMDR therapy is recalling an emotionally disturbing visual memory while simultaneously performing a dual task. Previous studies have shown that auditory emotional memories may also become less emotional as a consequence of dual tasking. This is potentially beneficial for psychotic patients suffering from disturbing emotional auditory memories of auditory hallucinations. The present study examined whether and to what extent emotionality of auditory hallucination memories could be reduced by dual tasking. The study also assessed whether a modality matching dual task (recall + auditory taxation) could be more effective than a cross modal dual task (recall + visual taxation). Thirty-six patients suffering from auditory hallucinations were asked to recall an emotionally disturbing auditory memory related to an auditory hallucination, to rate emotionality of the memory, and to recall it under three conditions: two active conditions, i.e., visual taxation (making eye-movements) or auditory taxation (counting aloud), and one control condition (staring at a non-moving dot) counterbalanced in order. Patients re-rated emotionality of the memory after each condition. Results show the memory emotionality of auditory hallucinations was reduced and the active conditions showed stronger effects than the control condition. No modality-specific effect was found: the active conditions had an equal effect.

Eye movement desensitization and reprocessing (EMDR) therapy targets emotionally disturbing visual memories of traumatic life events, and may be deployed as an efficacious treatment for posttraumatic stress disorder. A key element of EMDR therapy is recalling an emotionally disturbing visual memory while simultaneously performing a dual task. Previous studies have shown that auditory emotional memories may also become less emotional as a consequence of dual tasking. This is potentially beneficial for psychotic patients suffering from disturbing emotional auditory memories of auditory hallucinations. The present study examined whether and to what extent emotionality of auditory hallucination memories could be reduced by dual tasking. The study also assessed whether a modality matching dual task (recall + auditory taxation) could be more effective than a cross modal dual task (recall + visual taxation). Thirty-six patients suffering from auditory hallucinations were asked to recall an emotionally disturbing auditory memory related to an auditory hallucination, to rate emotionality of the memory, and to recall it under three conditions: two active conditions, i.e., visual taxation (making eye-movements) or auditory taxation (counting aloud), and one control condition (staring at a non-moving dot) counterbalanced in order. Patients re-rated emotionality of the memory after each condition. Results show the memory emotionality of auditory hallucinations was reduced and the active conditions showed stronger effects than the control condition. No modality-specific effect was found: the active conditions had an equal effect. [ABSTRACT FROM AUTHOR]

Objective: Eye movement desensitization and reprocessing (EMDR)—an evidence-based approach to eliminate emotional distress from traumatic experiences—was recently suggested for the treatment of chronic pain. The aim of this study was to estimate preliminary efficacy of a pain-focused EMDR intervention for the treatment of non-specific chronic back pain (CBP). Design: Randomized controlled pilot study. Methods: 40 non-specific CBP (nsCBP) patients reporting previous experiences of psychological trauma were consecutively recruited from outpatient tertiary care pain centers. After baseline assessment, patients were randomized to intervention or control group (1:1). The intervention group received 10 sessions standardized pain-focused EMDR in addition to treatment-as-usual (TAU). The control group received TAU alone. The primary outcome was preliminary efficacy, measured by pain intensity, disability, and treatment satisfaction from the patients’ perspective. Clinical relevance of changes was determined according to the established recommendations. Assessments were conducted at the baseline, posttreatment, and at a 6-month follow-up. Intention-to-treat analysis with last observation carried forward method was used. Registered with http://ClinicalTrials.gov (NCT01850875). Results: Estimated effect sizes (between-group, pooled SD) for pain intensity and disability were d = 0.79 (CI95%: 0.13, 1.42) and d = 0.39 (CI95%: −0.24, 1.01) posttreatment, and d = 0.50 (CI95%: 0.14, 1.12) and d = 0.14 (CI95%: −0.48, 0.76) at 6-month follow-up. Evaluation on individual patient basis showed that about 50% of the patients in the intervention group improved clinically relevant and also rated their situation as clinically satisfactory improved, compared to 0 patients in the control group. Conclusion: There is preliminary evidence that pain-focused EMDR might be useful for nsCBP patients with previous experiences of psychological trauma, with benefits for pain intensity maintained over 6 months. [ABSTRACT FROM AUTHOR]