Therapists' Experiences With the Effectiveness and Feasibility of Videoconference-Based Eye Movement Desensitization and Reprocessing.

Research on the effectiveness and applicability of eye movement desensitization and reprocessing (EMDR) via videoconference is sparse. Considering the emerging use of internet-based psychotherapy during the COVID-19 pandemic, information on videoconference-based EMDR (eEMDR) would be beneficial for many therapists. In this study, 23 therapists from the EMDR-Institute in Germany provided information about their experiences with eEMDR in a questionnaire-based survey. Information on the effectiveness and the course of 102 eEMDR sessions was recorded. Results showed the potential of eEMDR as an effective and viable method. The decrease in the subjective unit of disturbance (SUD), which is an important indicator of treatment outcome, was found to be at a similar level compared to that of previous EMDR studies that were not administered in eEMDR format. The most important predictor of the SUD decrease was the type of bilateral stimulation used in eEMDR sessions. Eye movements resulted in significantly greater SUD reductions than tapping. Perceived disadvantages and impediments for the implementation of eEMDR were mainly of bureaucratic and technical concerns. In addition, about one-third of the therapists stated that some patients were not willing to engage in eEMDR. In our study, eEMDR proved to be a practically applicable therapy method and therefore, therapists can consider using eEMDR. These findings will hopefully encourage EMDR therapists and their patients to use eEMDR due to its effectiveness and viability as an online treatment approach.

Comparison of Eye Movement Desensitization Reprocessing and Cognitive Behavioral Therapy as Adjunctive Treatments for Recurrent Depression: The European Depression EMDR Network (EDEN) Randomized Controlled Trial.

Background: Treatment of recurrent depressive disorders is currently only moderately successful. Increasing evidence suggests a significant relationship between adverse childhood experiences and recurrent depressive disorders, suggesting that trauma-based interventions could be useful for these patients. Objectives: To investigate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in addition to antidepressant medication (ADM) in treating recurrent depression. Design: A non-inferiority, single-blind, randomized clinical controlled trial comparing EMDR or CBT as adjunctive treatments to ADM. Randomization was carried out by a central computer system. Allocation was carried out by a study coordinator in each center. Setting: Two psychiatric services, one in Italy and one in Spain. Participants: Eighty-two patients were randomized with a 1:1 ratio to the EMDR group (n = 40) or CBT group (n = 42). Sixty-six patients, 31 in the EMDR group and 35 in the CBT group, were included in the completers analysis. Intervention: 15 ± 3 individual sessions of EMDR or CBT, both in addition to ADM. Participants were followed up at 6-months. Main outcome measure: Rate of depressive symptoms remission in both groups, as measured by a BDI-II score <13. Results: Sixty-six patients were analyzed as completers (31 EMDR vs. 35 CBT). No significant difference between the two groups was found either at the end of the interventions (71% EMDR vs. 48.7% CBT) or at the 6-month follow-up (54.8% EMDR vs. 42.9% CBT). A RM-ANOVA on BDI-II scores showed similar reductions over time in both groups [F(6,59) = 22.501, p < 0.001] and a significant interaction effect between time and group [F(6,59) = 3.357, p = 0.006], with lower BDI-II scores in the EMDR group at T1 [mean difference = -7.309 (95% CI [-12.811, -1.806]), p = 0.010]. The RM-ANOVA on secondary outcome measures showed similar improvement over time in both groups [F(14,51) = 8.202, p < 0.001], with no significant differences between groups [F(614,51) = 0.642, p = 0.817]. Conclusion: Although these results can be considered preliminary only, this study suggests that EMDR could be a viable and effective treatment for reducing depressive symptoms and improving the quality of life of patients with recurrent depression. TRIAL REGISTRATION: ISRCTN09958202.

Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting.

BACKGROUND: Depression is a severe mental disorder that challenges mental health systems worldwide as the success rates of all established treatments are limited. Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically acknowledged psychotherapeutic treatment for PTSD. Given the recent research indicating that trauma and other adverse life experiences can be the basis of depression, the aim of this study was to determine the effectiveness of EMDR therapy with this disorder. METHOD: In this study, we recruited a group of 16 patients with depressive episodes in an inpatient setting. These 16 patients were treated with EMDR therapy by reprocessing of memories related to stressful life events in addition to treatment as usual (TAU). They were compared to a group of 16 controls matched regarding diagnosis, degree of depression, sex, age and time of admission to hospital, which were receiving TAU only. RESULTS: Sixty-eight percent of the patients in the EMDR group showed full remission at end of treatment. The EMDR group showed a greater reduction in depressive symptoms as measured by the SCL-90-R depression subscale. This difference was significant even when adjusted for duration of treatment. In a follow-up period of more than 1 year the EMDR group reported less problems related to depression and less relapses than the control group. CONCLUSIONS: EMDR therapy shows promise as an effective treatment for depressive disorders. Larger controlled studies are necessary to replicate our findings.

Navigational place learning in children and young adults as assessed with a standardized locomotor search task.

Spatial behaviour was investigated using a spatial learning task based on the Radial Arm Maze, the Morris Water Maze, and open-field search-task procedures. Ninety-six healthy children from six age groups (3, 4, 5, 7, 10 and 12 years) with no history of CNS disorders were studied with respect to the emergence of position-, cue- and place responses. Participants were to detect x out of n hidden locations, frames of reference could be varied systematically, and three spatial memory errors and speed of navigation were recorded automatically. Task difficulties were equivalent for each age group. Results showed that navigational place learning was fully developed by the age of 10, whereas participants relied on cue orientation up to age 7. Even in the youngest group, the task could be achieved without relying on egocentric orientation, provided that proximal cues were presented. Most of the errors were of the reference memory type, whereas working memory errors were extremely rare. Speed of navigation markedly improved between age 5 and 7. An additional experiment showed that navigational place-learning behaviour was clearly dependent on distal cues. A third study showed that in young adults, learning of the spatial layout improved, but performance on the place task did not improve any further. No sex differences were observed.

Recovery of spatial memory and persistence of spatial orientation deficits after traumatic brain injury during childhood.

The present study set out to examine the recovery of spatial learning and cognitive mapping skills after severe TBI in childhood. A prospective investigation was carried out with repeated measures. Children with TBI (n = 18) and healthy matched controls (n = 18) were investigated while the children with TBI stayed in a rehabilitation facility (t0) and 4 years later (t1). Children were assessed with the Kiel Locomotor Maze, where they had to remember defined locations in an experimental chamber with completely controlled intra- and extra-maze cues until the learning criterion was reached. During probe trials, cognitive mapping strategies were assessed. Results showed (i) that spatial learning is functionally restituted 4 years post-trauma and (ii) that cognitive mapping skills are still impaired 4 years post-trauma. It was concluded that cognitive performance of children who survived a severe TBI may he overestimated, having far reaching consequences for the children.

The role of locomotion in the acquisition and transfer of spatial knowledge in children.

The role of locomotion in the acquisition and transfer of spatial knowledge was investigated in 144 five-, seven- and eleven-year-old children. Two experiments were conducted in the Kiel locomotor maze. In the first experiment, one group of children explored the spatial layout by walking through the maze, while another learned the maze by surveying the layout. In the second experiment, children were exposed to one of two orientation tests in the maze, one of which could be solved using "landmark orientation", the other only using a "relational place orientation". Children sitting by the side of the experimental chamber surveying the maze needed fewer trials to learn the spatial layout than children exploring the environment in the locomotion condition, but in the orientation test demanding the "relational place orientation" children who had explored the maze in the locomotion condition outperformed the children in the non-locomotion condition. Results are discussed in the context of cognitive mapping models.