Group eye movement desensitization and reprocessing interventions in adults and children: A systematic review of randomized and nonrandomized trials.

This review systematically synthesized existing literature on group protocols of eye movement desensitization and reprocessing (EMDR) therapy for treating a range of mental health difficulties in adults and children. We conducted database searches on PsychINFO, EMBASE, MEDLINE, Web of Science, The Cochrane Library and Francine Shapiro Library up to May 2020, using PRISMA guidelines. Studies were included if they used at least one standardized outcome measure, if they present a quantitative data on the effect of group EMDR protocols on mental health difficulties and if they were published in English. Twenty-two studies with 1739 participants were included. Thirteen studies examined EMDR Integrative Group Treatment Protocol (IGTP), four studies examined EMDR Group Traumatic Episode Protocol (G-TEP), four studies EMDR Integrative Group Treatment Protocol for Ongoing Traumatic Stress and one study considered EMDR Group Protocol with Children. Of the 22 studies included, 12 were one-arm trials and 10 were two-arm trials. We assessed risk of bias using a revised Tool to Assess Risk of Bias in Randomized Trials (ROB 2) and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I). Overall, the results suggested that Group EMDR protocols might be an effective tool in improving a wide range of mental health-related outcomes including posttraumatic stress disorder (PTSD), depression and anxiety. However, the included studies are limited to methodological challenges. The limitations and future directions are discussed.

A Systematic Review of Efficacy of the Attention Training Technique in Clinical and Nonclinical Samples.

OBJECTIVE: The Attention Training Technique (ATT; Wells, 1990) is a brief metacognitive treatment strategy aimed at remediating self-focused processing and increasing attention flexibility in psychological disorder. METHOD: We systematically reviewed and examined the efficacy of ATT in clinical and nonclinical samples. Scientific databases were searched from 1990 to 2014 and 10 studies (total N = 295) met inclusion criteria. Single-case data were meta-analyzed using the improvement rate difference, and standardized between and within-group effect sizes (ESs) were examined across 4 analogue randomized controlled trials (RCTs). RESULTS: Single-case outcomes indicated that ATT yields large ES estimates (pooled ES range: 0.74-1.00) for anxiety and depressive disorders. Standardized ESs across the RCTs indicated that ATT yields greater treatment gains than reference groups across majority outcomes (adjusted Cohen's d range: 0.40-1.23). CONCLUSIONS: These preliminary results suggest ATT may be effective in treating anxiety and depressive disorders and help remediate some symptoms of schizophrenia. Although a limited number of studies with small sample sizes warrants caution of interpretation, ATT appears promising and future studies will benefit from adequately powered RCTs.

Innovations in Practice: Adapting a specialized ADHD parenting programme for use with 'hard to reach' and 'difficult to treat' preschool children.

BACKGROUND: Effective implementation of parent training programmes for preschool Attention-Deficit/Hyperactivity Disorder type is constrained by barriers limiting take-up and effective engagement by 'hard to reach' and 'difficult to treat' families. METHOD: We describe an evidence-driven adaptation and piloting of an existing empirically supported preschool ADHD parenting programme to address these problems. RESULTS: The New Forest Parenting programme was changed substantially in terms of length; content and delivery on the basis of information gathered from the literature, from parents and practitioners, further modifications were made after the pilot study. CONCLUSIONS: The adapted-NFPP is currently being assessed for efficacy in a large multicentre randomized controlled trial.

Endothelial nitric oxide synthase polymorphisms are associated with hypertension and cardiovascular disease in renal transplantation.

AIM: Nitric oxide (NO), produced by the polymorphic endothelial nitric oxide synthase (NOS3), plays an important role in endothelial function. The aim was to determine the effect of NOS3 polymorphisms on hypertension and cardiovascular disease (CVD) in renal allograft recipients. METHODS: Three polymorphisms of NOS3 were examined in 168 renal allograft recipients. A 27 base pair repeat sequence in intron 4 (NOS3 a/b), a single G-->T substitution in exon 7 at nucleotide 894 and a T-786C substitution in the promoter region were studied. RESULTS: Significant differences in the frequencies of the 894T and -786C alleles between allograft recipients and controls (n = 141) were demonstrated (894T: 40.5% vs 30.1%, P < 0.01; -786C: 45.2% vs 34.4%, P < 0.01). There was a significant excess of both the 894T and -786C alleles in hypertensive allograft recipients compared with normotensive allograft recipients and controls (894T: 41.7%, 35.7% and 30.1%, respectively, P < 0.025; -786C: 47.4%, 37.1% and 34.4%, respectively, P < 0.01), and in allograft recipients with CVD compared with those without CVD and controls (894T: 47.2%, 38.6% and 30.1%, respectively, P < 0.025; -786C: 54.2%, 42.8% and 34.4%, respectively, P < 0.01). CONCLUSION: The 894T and -786C alleles of the NOS3 gene were significantly associated with both hypertension and CVD in renal allograft recipients.

Single Dose of the Attention Training Technique Increases Resting Alpha and Beta-Oscillations in Frontoparietal Brain Networks: A Randomized Controlled Comparison.

The Attention Training Technique (ATT) was developed with the aim of reducing self-focused attention and increasing executive control as part of metacognitive therapy. So far there is a paucity of data on the neurophysiological effects of ATT. In the present study we tested for specific effects to determine if attention control components of ATT elicit a specific signature that is different from passive listening. Thirty-six healthy volunteers were randomized to an active (follow instructions) or control (ignore instructions) condition. Resting state EEG was recorded for 3 min with eyes open and eyes closed before and after exposure to training, and the power of the theta, alpha, and beta-bands were analyzed in frontal, midline, and posterior electrodes. The active ATT condition enhanced alpha and beta-band activity during eyes-open, and frontal alpha during eyes-closed (p < 0.005). Frontoparietal changes in Alpha were generally accompanied by changes in Beta in the same brain regions of interest. However, these associations were largely significant in the active ATT rather than the control condition. No between-group differences were observed in the Theta-band. These results suggest a single dose of attention training increases alpha and beta-oscillations in frontoparietal networks. These networks are associated with top-down attentional or executive control.

Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder.

OBJECTIVE: This pilot study was a comparison of dimensional models assessing personality traits and personality pathology in a clinical sample of adults diagnosed with ADHD and adults diagnosed with borderline personality disorder (BPD), and a nonclinical control sample of healthy adults. METHOD: Personality traits were assessed using the NEO-Personality Inventory-Revised (NEO-PI-R) and dimensional personality pathology with the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). RESULTS: Adults with ADHD and BPD produced higher Emotional Dysregulation/Neuroticism and Dissocial Behavior scores than controls. For the Extraversion/Inhibitedness scale, adults with BPD produced significantly lower scores than adults with ADHD and controls. On the Conscientiousness/Compulsivity domains, Conscientiousness scores were lower for both disorders, whereas low Compulsivity values were specific to adult ADHD. CONCLUSION: Our results suggest that patients with adult ADHD and BPD have distinguishable profiles of personality traits and personality pathology.

The role of inner and outer face parts in holistic processing: a developmental study.

The effects of inner-outer feature interactions with unfamiliar faces were investigated in 6- and 10-year-old children and adults (20-30 years) to determine their contribution in holistic face vision. Participants completed a two-alternative forced-choice (2AFC) task under two conditions. The congruent condition used whole, inner-only, and outer-only stimuli. The incongruent condition used stimuli combining the inner features from one face with outer features from a novel face, or vice versa. Results yielded strong congruency effects which were moderated by pronounced feature-type asymmetries specific to developmental stage. Adults showed an inner-feature preference during congruent trials, but no asymmetry for incongruent trials. Children showed no asymmetry for congruent trials, but an outer-feature preference for incongruent trials. These findings concur with recent theoretical developments indicating that adults and children are likely to differ in the types of feature-specific information they preferentially encode in face perception, and that holistic effects are moderated differently in adults and children as a function of feature type.

When knowledge is not enough: the phenomenon of goal neglect in preschool children.

We argue that the concept of goal neglect can be fruitfully applied to understand children's potential problems in experimental tasks and real-world settings. We describe an assessment of goal neglect developed for administration to preschool children and report data on two measures derived from this task alongside the Dimensional Change Card Sort (DCCS) and an opposite color response inhibition task. The propensity to neglect initial task cues was uniquely linked to response inhibition, whereas neglect of a later cue was uniquely linked to the DCCS. Additional evidence suggests that recovery from neglect can occur and shows that goal neglect varies with the cognitive transparency of the signifying cue. Data demonstrate the importance of, and place constraints on, current theories of information regulation and foreground the notion of graded representations in working memory and executive functioning.