ABSTRACT
BACKGROUND: This study examined the feasibility, safety, and efficacy of addiction-focused eye movement desensitization and reprocessing (AF-EMDR) treatment, as an add-on intervention to treatment as usual (TAU). METHODS: Adult outpatients with alcohol use disorder (AUD) (N = 109) who already received or had just started with TAU (Community Reinforcement Approach) were recruited at 6 outpatient addiction care facilities. They were randomly assigned to either TAU + 7 weekly 90-minute sessions of AF-EMDR (N = 55) or TAU-only (N = 54). Assessments were made at baseline, after AF-EMDR therapy (+ 8 weeks in the TAU-only group), and at 1- and 6-month follow-up. The primary outcomes were changes in drinking behavior as reported by the participant and biomarker indices. RESULTS: Data were analyzed as intent-to-treat with linear mixed models. Additionally, sensitivity analyses were performed. No group or interaction effects were found for any of the outcome variables. Only limited change over time was seen with regard to indices of personal and societal recovery and in some secondary indices of clinical recovery (craving, desire thinking, and rumination). Reliable Change Index calculations showed that more TAU-only participants showed clinical improvement with regard to alcohol consumption while a somewhat higher proportion of participants in the TAU + AF-EMDR group experienced less craving. The acceptability, safety, and feasibility of the treatments received in both groups were comparable. CONCLUSIONS: There was no add-on effect of AF-EMDR on TAU with regard to drinking behavior in outpatients with an AUD. Possible explanations are discussed. Future studies should first establish proof of principle regarding the potential of AF-EMDR therapy to disrupt operant learning and habits relevant in addiction.
Subject(s)
Alcoholism/psychology , Alcoholism/therapy , Eye Movement Desensitization Reprocessing/methods , Outpatients/psychology , Substance Abuse Treatment Centers/methods , Adult , Alcoholism/diagnosis , Eye Movement Desensitization Reprocessing/trends , Female , Humans , Male , Middle Aged , Single-Blind Method , Substance Abuse Treatment Centers/trends , Treatment OutcomeABSTRACT
El tratamiento de desensibilización y reprocesamiento por movimiento ocular (EMDR de sus siglas en inglés: eye movement desensitization and reprocessing) es una terapia relativamente novedosa que de forma progresiva ha ido ganando popularidad en el tratamiento del trastorno por estrés postraumático. El objetivo de este trabajo es introducir el protocolo estándar EMDR, ofrecer una revisión de las hipótesis actuales sobre su mecanismo de acción y analizar la evidencia científica disponible sobre su eficacia clínica en pacientes adultos con diagnóstico de trastorno por estrés postraumático. Se realizó una revisión sistemática de la literatura publicada en las bases de datos PubMed y PsycINFO con los términos «eye movement desensitization and reprocessing» y «posttraumatic stress disorder» y sus contracciones en inglés «EMDR» y «PTSD». Se obtuvieron como resultado 15 ensayos controlados aleatorizados de elevada calidad metodológica que compararon EMDR con tratamientos no específicos, lista de espera y con tratamientos específicos. Los resultados de estos estudios permiten concluir que EMDR es una herramienta útil y basada en evidencia científica, tal y como refleja su reciente recomendación como tratamiento de elección en el trastorno por estrés postraumático por parte de distintas organizaciones internacionales de salud
Eye movement desensitization and reprocessing (EMDR) is a relatively new psychotherapy that has gradually gained popularity for the treatment of post-traumatic stress disorder. In the present work, the standardised EMDR protocol is introduced, along with current hypotheses of its mechanism of action, as well as a critical review of the available literature on its clinical effectiveness in adult post-traumatic stress disorder. A systematic review of the published literature was performed using PubMed and PsycINFO databases with the keywords «eye movement desensitization and reprocessing» and «post-traumatic stress disorder» and its abbreviations «EMDR» and «PTSD». Fifteen randomised controlled trials of good methodological quality were selected. These studies compared EMDR with unspecific interventions, waiting lists, or specific therapies. Overall, the results of these studies suggest that EMDR is a useful, evidence-based tool for the treatment of post-traumatic stress disorder, in line with recent recommendations from different international health organizations
Subject(s)
Humans , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Eye Movement Desensitization Reprocessing/trends , Psychotherapy/methods , Eye Movement Desensitization Reprocessing/methodsABSTRACT
La desensibilización y el reprocesamiento por medio de movimientos oculares (EMDR) ha suscitado un gran número de estudios desde su aparición en 1989. El objetivo principal de este artículo es describir su desarrollo y evolución hasta la actualidad. Para ello se realizó una búsqueda bibliográfica en MEDLINE y PsycINFO con la entrada «eye movement desensitizacion». Tras la revisión de los 795 artículos resultantes, se eligieron aquellos que por su relevancia e interés mostraban mejor el desarrollo y evolución de la técnica. Además, se configuró una línea de vida que representó gráficamente su historia. Aunque en los primeros años el foco de investigación fue la validación de la técnica para el trastorno de estrés postraumático (TEPT), ésta comenzó muy rápidamente a aplicarse a otras problemáticas. Solo un 14% de los trabajos encontrados son estudios experimentales controlados. Actualmente, si bien se ha demostrado su eficacia como tratamiento del TEPT, se siguen barajando diversas hipótesis explicativas de su eficacia
Eye movement desensitization and reprocessing (EMDR) has led to a great number of studies since its appearance in 1989. The aim of this article is to describe EMDR development and evolution to the present day. With this purpose a search was carried out on MEDLINE and PsycINFO with the entry «eye movement desensitization». After revising the resulting 797 articles, those that because of their relevance explained best the development and evolution of the technique were chosen and shaped into a lifeline graphically representing the history of EMDR. Despite the fact that during the first years the focus of research was on the validation of the technique for post-traumatic disorder (PTSD), it was soon applied to other areas. Only 14% of the articles found account for controlled studies. Up to date, in spite of the effectiveness of EMDR for the treatment of PTSD that has been proven, many different explanatory hypotheses are still up for discussion
