What is the Role of Eye Movements in Eye Movement Desensitization and Reprocessing (EMDR) for Post-Traumatic Stress Disorder (PTSD)? A Review

Jeffries, Fiona W.; Davis, Paul

doi:10.1017/s1352465812000793

Cited by 86 publications

(53 citation statements)

References 44 publications

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“…Due to their essential features e.g., persistent relieving of stress (Blackburn-Munro and Blackburn-Munro, 2001), responding with hopelessness (Beck et al, 1975, 1985; Joiner et al, 2001), catastrophizing (Quartana et al, 2009) or horror (Haugh, 2005) and avoidance of pain-related situations (Asmundson and Katz, 2009; Liedl and Knaevelsrud, 2008), chronic pain conditions may be viewed as a form of PTSD (Gibson, 2012; Liedl et al, 2010) suggesting additional rationale for the use of adrenergic antagonists. Evidently, various forms of psychotherapy is another critical modality for reversing aberrant learning and for emotional reconditioning (Harned et al, 2012; Jeffries and Davis, 2013). …”

Section: Therapeutic Considerationsmentioning

confidence: 99%

Pain and suicidality: Insights from reward and addiction neuroscience

Elman

Borsook

Volkow

2013

Progress in Neurobiology

184

147

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Suicidality is exceedingly prevalent in pain patients. Although the pathophysiology of this link remains unclear, it may be potentially related to the partial congruence of physical and emotional pain systems. The latter system’s role in suicide is also conspicuous during setbacks and losses sustained in the context of social attachments. Here we propose a model based on the neural pathways mediating reward and anti-reward (i.e., allostatic adjustment to recurrent activation of the reward circuitry); both are relevant etiologic factors in pain, suicide and social attachments. A comprehensive literature search on neurobiology of pain and suicidality was performed. The collected articles were critically reviewed and relevant data were extracted and summarized within four key areas: (1) physical and emotional pain, (2) emotional pain and social attachments, (3) pain-and suicide-related alterations of the reward and anti-reward circuits as compared to addiction, which is the premier probe for dysfunction of these circuits and (4) mechanistically informed treatments of co-occurring pain and suicidality. Pain-, stress- and analgesic drugs-induced opponent and proponent states of the mesolimbic dopaminergic pathways may render reward and anti-reward systems vulnerable to sensitization, cross-sensitization and aberrant learning of contents and contexts associated with suicidal acts and behaviors. These findings suggest that pain patients exhibit alterations in the brain circuits mediating reward (depressed function) and anti-reward (sensitized function) that may affect their proclivity for suicide and support pain and suicidality classification among other “reward deficiency syndromes” and a new proposal for “enhanced anti-reward syndromes”. We suggest that interventions aimed at restoring the balance between the reward and anti-reward networks in patients with chronic pain may help decreasing their suicide risk.

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Section: Therapeutic Considerationsmentioning

confidence: 99%

Pain and suicidality: Insights from reward and addiction neuroscience

Elman

Borsook

Volkow

2013

Progress in Neurobiology

184

147

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“…A literature review of studies on EMDR in PTSD found contradictory findings regarding the need for eye movements to achieve clinical improvements [29]. Some studies suggested that bilateral eye stimulation may increase access to episodic memories or make focusing on traumatic memories less unpleasant.…”

Section: Meditation and Mind-body Approaches Meditationmentioning

confidence: 99%

The integrative management of PTSD: A review of conventional and CAM approaches used to prevent and treat PTSD with emphasis on military personnel

Lake¹

2015

Advances in Integrative Medicine

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“…However, all the studies cited in past reviews suffer from either a small sample size or methodological problems. This exhibits the need for a randomized study with a sufficiently large sample size comparing the effects of eye movements to control treatment conditions in a realistic treatment setting with patients suffering from PTSD [20]. …”

Section: Introductionmentioning

confidence: 99%

A Comparison of Dual Attention, Eye Movements, and Exposure Only during Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder: Results from a Randomized Clinical Trial

Sack¹,

Zehl²,

Otti³

et al. 2016

Psychother Psychosom

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Background: Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). Methods: A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC). Except for the variation in stimulation, treatment strictly followed the standard EMDR manual. Symptom changes from pre- to posttreatment were measured with the Clinician-Administered PTSD Scale (CAPS) by an investigator blinded to treatment allocation. Results: In total, 116 patients completed the treatment, with an average of 4.6 sessions applied. Intention-to-treat analysis revealed a significant improvement in PTSD symptoms with a high overall effect size (Cohen's d = 1.96, 95% CI: 1.67-2.24) and a high remission rate of PTSD diagnosis (79.8%). In comparison to the control condition, EM and EF were associated with significantly larger pre-post symptom decrease (ΔCAPS: EM = 35.8, EF = 40.5, EC = 31.0) and significantly larger effect sizes (EM: d = 2.06, 95% CI: 1.55-2.57, EF: d = 2.58, 95% CI: 2.01-3.11, EC: d = 1.44, 95% CI: 0.97-1.91). No significant differences in symptom decrease and effect size were found between EM and EF. Conclusions: Exposure in combination with an explicit external focus of attention leads to larger PTSD symptom reduction than exposure alone. Eye movements have no advantage compared to visually fixating on a nonmoving hand.

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What is the Role of Eye Movements in Eye Movement Desensitization and Reprocessing (EMDR) for Post-Traumatic Stress Disorder (PTSD)? A Review

Cited by 86 publications

References 44 publications

Pain and suicidality: Insights from reward and addiction neuroscience

Pain and suicidality: Insights from reward and addiction neuroscience

The integrative management of PTSD: A review of conventional and CAM approaches used to prevent and treat PTSD with emphasis on military personnel

A Comparison of Dual Attention, Eye Movements, and Exposure Only during Eye Movement Desensitization and Reprocessing for Posttraumatic Stress Disorder: Results from a Randomized Clinical Trial

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