Prolonged Exposure versus Eye Movement Desensitization and Reprocessing (EMDR) for PTSD rape victims

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 12/2005; 18(6):607-16. DOI: 10.1002/jts.20069
Source: PubMed


This controlled study evaluated the relative efficacy of Prolonged Exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR) compared to a no-treatment wait-list control (WAIT) in the treatment of PTSD in adult female rape victims (n = 74). Improvement in PTSD as assessed by blind independent assessors, depression, dissociation, and state anxiety was significantly greater in both the PE and EMDR group than the WAIT group (n = 20 completers per group). PE and EMDR did not differ significantly for change from baseline to either posttreatment or 6-month follow-up measurement for any quantitative scale.

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    • "Several studies have shown fewer dropouts in EMDR groups, leading to the proposition that EMDR is both better tolerated and a more efficient treatment model.59,61,67 EMDR has been shown to be effective without the prescription of several hours of homework which is most often required in exposure-based treatments, again contributing to the view that it is better tolerated and more efficient.59,67,68 Nevertheless, there is some difficulty in interpreting research on treatment efficiency due to the differences in the way efficiency has been operationalized (for example, number of sessions taken to reduce symptoms, reduction in Subjective Units of Distress Scale scores in the first session, attrition rates, and number of treatment hours required). "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.
    Psychology Research and Behavior Management 09/2014; 7:273-83. DOI:10.2147/PRBM.S52268
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    • "Two studies [5], [9] reported allocation concealment by an independent third party. Thirteen studies [6], [9], [14], [15], [16], [25], [26], [30], [32], [34], [35], [41], [42] involved the use of blinded outcome assessors, whereas 13 studies [5], [7], [8], [10], [12], [13], [27], [28], [31], [37], [38], [39], [40] did not report blinding. Data completeness was addressed in most of the studies. "
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    ABSTRACT: Background We performed the first meta-analysis of clinical studies by investigating the effects of eye-movement desensitization and reprocessing (EMDR) therapy on the symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and subjective distress in PTSD patients treated during the past 2 decades. Methods We performed a quantitative meta-analysis on the findings of 26 randomized controlled trials of EMDR therapy for PTSD published between 1991 and 2013, which were identified through the ISI Web of Science, Embase, Cochrane Library, MEDLINE, PubMed, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature electronic databases, among which 22, 20, 16, and 11 of the studies assessed the effects of EMDR on the symptoms of PTSD, depression, anxiety, and subjective distress, respectively, as the primary clinical outcome. Results The meta-analysis revealed that the EMDR treatments significantly reduced the symptoms of PTSD (g = −0.662; 95% confidence interval (CI): −0.887 to −0.436), depression (g = −0.643; 95% CI: −0.864 to −0.422), anxiety (g = −0.640; 95% CI: −0.890 to −0.390), and subjective distress (g = −0.956; 95% CI: −1.388 to −0.525) in PTSD patients. Conclusion This study confirmed that EMDR therapy significantly reduces the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients. The subgroup analysis indicated that a treatment duration of more than 60 min per session was a major contributing factor in the amelioration of anxiety and depression, and that a therapist with experience in conducting PTSD group therapy was a major contributing factor in the reduction of PTSD symptoms.
    PLoS ONE 08/2014; 9(8):e103676. DOI:10.1371/journal.pone.0103676
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    • "The severe consequences of rape emphasize the need for effective treatment. Various types of exposure-based cognitive behavior therapy (CBT; Vickerman & Margolin, 2009) and eye movement desensitization reprocessing (EMDR; Rothbaum, Astin, & Marsteller, 2005) have shown to be effective in reducing PTSD following sexual trauma. Typically, these studies involve adult women. "
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    ABSTRACT: BackgroundEfficacy studies on treatment in adolescent victims of single rape are lacking, even though sexual victimization is most likely to occur during adolescence and despite the fact that adolescents are at risk to develop subsequent posttraumatic stress disorder.AimThe aim of this prospective observational study was to evaluate the short- and long-term outcomes of a nine-session cognitive behavior group therapy (STEPS), including a parallel six-session parents’ group on rape-related symptomatology in female adolescents (13–18 years). STEPS includes psychoeducation, exposure in sensu as well as in vivo, cognitive restructuring, and relapse prevention.MethodsFifty-five female adolescents with mental health problems due to single rape, but without prior sexual trauma, received STEPS while their parents participated in a support group. Subjects were assessed on posttraumatic stress (PTS) and comorbid symptoms using self-report questionnaires prior to and directly after treatment, and at 6 and 12 months follow-up.ResultsRepeated measures analysis showed a significant and large decrease in symptoms of PTS, anxiety, depression, anger, dissociation, sexual concerns, and behavior problems directly after treatment, which maintained at 12 months follow-up. Time since trauma did not influence the results. Dropout during STEPS was 1.8%.ConclusionsThe results potentially suggest that the positive treatment outcomes at short- and long-term may be caused by STEPS. The encouraging findings need confirmation in future controlled studies on the effectiveness of STEPS because it may be possible that the treatment works especially well for more chronic symptoms, while the less chronic part of the sample showed considerable improvement on its own.
    European Journal of Psychotraumatology 06/2014; 5. DOI:10.3402/ejpt.v5.22969
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