None listed
Conditions
Brief summary
Eye Movement Desensitisation and Reprogramming (EMDR) and exposure therapy are well established first line psychological treatments for Post-Traumatic Stress Disorder (PTSD)(Boudewyns et al., 1993; Boudewyns & Hyer, 1996; Edmond & Rubin, 2004; Lee et al., 2002; Montgomery & Ayllon, 1994; Power et al., 2002; Vaughan et al., 1994; Van Etten & Taylor, 1998). There have been few studies to date exploring changes in brain functioning following treatment in EMDR, which has left the underlying question of 'what is the mechanism by which the two therapies acheive their therapeutic effects' unresolved. Evidence as to what neurological changes occur as a result of treatment may help vindicate the efficacy of treatment modalities and aid understanding of treatment function. Positron Emission Tomography (PET) scanning enables research into changes in activation of different parts of the brain by measuring regional cerebral perfusion (blood flow), providing insight into this question by measuring brain activity. Magnetic Resonance Imaging (MRI) will enable accurate interpretation of the PET/CT scans and will aim to replicate or refute findings from a recent study that suggests effective treatment of PTSD is associated with an increase in hippocampal volume (Bossini et al., 2011). This project aims to also explore the therapeutic efficacy of EMDR and exposure therapy (in terms of symptom reduction), and the significance of the participant's experience of therapy; the impact of this experience on therapeutic efficacy and on the participant's quality of life and levels of functioning. Although there is an abundance of data evaluating the effectiveness of EMDR and prolonged exposure therapy in relation to symptom reduction (see refrences above), there are very few studies investigating participant's experience of therapy and the significance of this experience in their recovery both short and longer term; and only three major qualitative studies published on EMDR (Di Giorgio, Arnkoff, Glass, Lyhus & Walter, 2004; Edmond, Sloan & McCarty, 2004 and Ricci, Clayton and Shapiro, 2006). It was reported that due to the unusual nature of EMDR with the eye movements, exploration of participant's experiences of treatment was relevant, furthermore qualitative methods were felt to be the logical approach to gaining insight into these questions (Edmond, Sloan & McCarty, 2004).
Interventions
EMDR is a form of psychotherapy that was developed by Francine Shapiro to resolve the development of trauma-related disorders caused by exposure to distressing events. The theory suggests when distressing experiences occur they may overwhelm usual cognitive and neurological coping mechanisms. The memory and associated stimuli of the event are inadequately processed, and are dysfunction-ally stored in an isolated memory network. The goal of EMDR therapy is to process these distressing memories
EMDR is a form of psychotherapy that was developed by Francine Shapiro to resolve the development of trauma-related disorders caused by exposure to distressing events. The theory suggests when distressing experiences occur they may overwhelm usual cognitive and neurological coping mechanisms. The memory and associated stimuli of the event are inadequately processed, and are dysfunction-ally stored in an isolated memory network. The goal of EMDR therapy is to process these distressing memories, using dual attention stimuli (by way of bilateral stimulation (e.g. eye movements, tones or tapping) while triggering a physiological state that facilitates information processing, therefore reducing the distress and allowing the client to develop more adaptive coping mechanisms. Following a 6 week period, after the individual assessment, where participants receive MRI and PET scans and act as their own control group; participants in the EMDR intervention group will receive 2 x 90 minute sessions per week for 6 weeks, administered in one-on-one individualized sessions by trained therapists.
Sponsors
Murdoch University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Currently diagnosable with PTSD (via assessment interview and CAPS form 2); willing to engage in psychological treatment; consenting to neuroimaging and audio-taped interviews.
Exclusion criteria
Current drug or alcohol dependence; diabetes; currently pregnant or breast feeding; past history of psychotic illness; previously diagnosed organic brain disorder; evidence of diagnosable cluster B Personality Disorder (via SCID II); currently on Psychotropic based medications; unable to cope with confined spaces or needles; any metal implants.
Outcome results
None listed