Science and pseudoscience in the development of eye movement desensitization and reprocessing: implications for clinical psychology.

The enormous popularity recently achieved by Eye Movement Desensitization and Reprocessing (EMDR) as a treatment for anxiety disorders appears to have greatly outstripped the evidence for its efficacy from controlled research studies. The disparity raises disturbing questions concerning EMDR's aggressive commercial promotion and its rapid acceptance among practitioners. In this article, we: (1) summarize the evidence concerning EMDR's efficacy; (2) describe the dissemination and promotion of EMDR; (3) delineate the features of pseudoscience and explicate their relevance to EMDR; (4) describe the pseudoscientific marketing practices used to promote EMDR; (5) analyze factors contributing to the acceptance of EMDR by professional psychologists; and (6) discuss practical considerations for professional psychologists regarding the adoption of EMDR into professional practice. We argue that EMDR provides an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapeutic techniques. Such distinctions are of critical importance for clinical psychologists who intend to base their practice on the best available research.

Laser pointers and aviation safety.

Laser pointers have been used by teachers and lecturers for years to highlight key areas on charts and screens during visual presentations. When used in a responsible manner, laser pointers are not considered to be hazardous. However, as the availability of such devices has increased, so have reports of their misuse. The Food and Drug Administration (FDA) issued a warning in December 1997 on the possibility of eye injury to children from handheld laser pointers. In October 1998, the American Academy of Ophthalmology upgraded an earlier caution to a warning, stating that laser pointers can be hazardous and should be kept away from children, after two reports of eye injuries involving young girls (age 11 and 13 yr). Of particular concern was the promotion of laser products as children's toys, such as those that can project cartoon figures and line drawings. Additionally, there have been reports involving the misuse of laser pointers (e.g., arrests made after police interpreted the red beam to be a laser-sighted weapon, spectators aiming laser lights at athletes during sporting events, cars illuminated on highways, and numerous incidents involving the illumination of aircraft). This technical note discusses physiological effects of exposure from a laser pointer, the regulation and classification of commercial laser products, and how the misuse of these pointers is a possible threat to aviation safety.

Parametric analysis of overcorrection duration effects. Is longer really better than shorter?

Positive practice overcorrection (PPOC) has long played a significant role in the behavioral treatment of serious self-stimulatory behavior. Three experiments comparing the effectiveness of 30-second, 2-minute, and 8-minute PPOC on reduction of stereotypic hand behavior of adults with severe to profound developmental disabilities were conducted to resolve inconsistencies in previously reported findings concerning the role of PPOC duration in response suppression. Experiment 1, which used an alternating treatments--multiple baseline design, suggested that the different durations were equally effective in reducing the stereotypic behaviors to near-zero levels. Experiment 2, which used a reversal design, supported the findings of Experiment 1. Experiment 3, which used a reversal design to test the shortest and longest durations, generally confirmed the results of the first two experiments. This study therefore failed to support the oft-claimed superiority of long-duration PPOC. The possible factors underlying these findings and their implications for future research and practice are discussed.

Vision impairment and corrective considerations of civil airmen.

BACKGROUND: Civil aviation is a major commercial and technological industry in the United States. The Federal Aviation Administration (FAA) is responsible for the regulation and promotion of aviation safety in the National Airspace System. To guide FAA policy changes and educational programs for aviation personnel about vision impairment and the use of corrective ophthalmic devices, the demographics of the civil airman population were reviewed. METHODS: Demographic data from 1971-1991 were extracted from FAA publications and databases. RESULTS: Approximately 48 percent of the civil airman population is equal to or older than 40 years of age (average age = 39.8 years). Many of these aviators are becoming presbyopic and will need corrective devices for near and intermediate vision. In fact, there has been approximately a 12 percent increase in the number of aviators with near vision restrictions during the past decade. Ophthalmic considerations for prescribing and dispensing eyewear for civil aviators are discussed. CONCLUSIONS: The correction of near and intermediate vision conditions for older pilots will be a major challenge for eye care practitioners in the next decade. Knowledge of the unique vision and environmental requirements of the civilian airman can assist clinicians in suggesting alternative vision corrective devices better suited for a particular aviation activity.

Matching verbal repertoires: understanding the contingencies of practice in order to functionally communicate with clinicians.

The low utilization rate of empirically proven treatment techniques, the lack of adequate training being received by practitioners in such techniques, and the systemic resistance within the APA to changes designed to increase the dissemination of and support for empirically validated psychological service delivery lead to one conclusion: changes need to be made to increase the knowledge of and use of empirically supported treatment techniques. Such changes are unlikely to come from traditional psychology organizations. This article focuses on how scientist-practitioners can increase both the knowledge base and the utilization rate of empirically validated treatments by practitioners through understanding the contingencies under which practitioners must operate.

Rheoencephalographic and electroencephalographic measures of cognitive workload: analytical procedures.

This investigation demonstrates the feasibility of mental workload assessment by rheoencephalographic (REG) and multichannel electroencephalographic (EEG) monitoring. During the performance of this research, unique testing, analytical and display procedures were developed for REG and EEG monitoring that extend the current state of the art and provide valuable tools for the study of cerebral circulatory and neural activity during cognition. REG records are analyzed to provide indices of the right and left hemisphere hemodynamic changes that take place during each test sequence. The EEG data are modeled using regression techniques and mathematically transformed to provide energy-density distributions of the scalp electrostatic field. These procedures permit concurrent REG/EEG cognitive testing not possible with current techniques. The introduction of a system for recording and analysis of cognitive REG/EEG test sequences facilitates the study of learning and memory disorders, dementia and other encephalopathies.

Eye movement desensitization across subjects: subjective and physiological measures of treatment efficacy.

Eye movement desensitization (EMD) was investigated in an experimental multiple baseline across subjects design. Six subjects who met the diagnostic criteria for Posttraumatic Stress Disorder (PTSD) were included in the study. While the EMD technique advanced by Shapiro has been reported to be clinically effective, major methodological issues have been raised which remain to be addressed. One issue raised is whether exposure to the traumatic image is sufficient to account for the reported clinical effects of EMD or whether the addition of saccadic eye movements is central to the treatment. This study attempted to address this concern by comparing two EMD-based procedures: a Non-saccade phase (without the saccadic eye movements) which functioned as a control and a second that included saccadic eye movements. Dependent variables included self-report information (SUDs, behavioral symptoms reports) and physiological data (heart rate and systolic blood pressure). The results showed no significant decreases in SUDs level with the EMD minus the saccadic eye movements procedure. However, five of the six subjects reported clinically significant decreases in their SUDs levels with the inclusion of the saccadic eye movements. This study appears to corroborate previous work employing single-case design as well as pre and postcomparisons.

Eye movement desensitization across images: a single case design.

The use of Eye Movement Desensitization (EMD) was investigated in a multiple baseline across two images. The subject was diagnosed as suffering from Post Traumatic Stress Disorder (PTSD) and had suffered from two distinct traumas which continued to generate intrusive disturbing images. Dependent variables included self-report information (Subjective Units of Distress, behavioral symptoms reports) and physiological data (heart rate and systolic blood pressure). Subjective and physiological data both demonstrated significant changes during the course of treatment which were maintained at a 2-month follow-up. This study represents the first investigation of EMD with multiple images within a single subject experimental design. Findings suggest that generalization across the images under investigation was not demonstrated. EMD treatment gains were clinically significant. However, the immediate and profound effects often cited in the literature were not demonstrated.

The effects of "do", "don't" and "wait" requests training on compliance behavior and stimulus generalization.

Previous implementation of compliance training has involved the use of aversive behaviors, as consequents, which bear neither a topographical nor a functional relationship to the behaviors under training. The present study explores compliance training in which training behaviors, used as consequents, are both topographically and functionally identical to the target behaviors. This study extends the compliance literature through: (1) an analysis of the effects of compliance training in long-term institutionalized mentally retarded adults, (2) the investigation of a third response class "Wait" requests, and (3) an assessment of stimulus generalization. Findings discussed include (a) the treatment effects of compliance training, across response classes, within treatment sessions; (b) the spontaneous generalization of treatment effects outside the treatment conditions; (c) the collateral effects of training upon aggressive outbursts; (d) the heightened potential for the utilization of these techniques in long-term care institutions.

Electroencephalographic scalp-energy analysis as a tool for investigation of cognitive performance.

In a new method of using electroencephalography (EEG) to monitor cognitive events, multichannel event-related potentials (ERPs) were used to estimate scalp distributions of surface energy densities of cortically generated electrical fields. Cross-subject regression analyses were then used to map sites and post-stimulus latencies, for which there is a high correlation of energy densities with subjects' performances. In a preliminary study, five right-handed young men were presented mental arithmetic tasks via a computer screen. A 21-channel ERP was computed for each subject and converted to show the scalp distribution of energy density at each sampling period (every 7.8 msec). Indices of subjects' task performances were regressed upon these estimates of potential energy at each electrode site and post-stimulus latency. High correlations were found at four distinct regions and latencies. These corresponded to the stages and sites of cortical localization for mental arithmetic inferred from studies of patients with localized cortical lesions. This correspondence suggests that the EEG procedure may offer an inexpensive, noninvasive method of investigating cortical localization of cognitive function in healthy subjects.

Cortical localization of cognitive function by regression of performance on event-related potentials.

This paper demonstrates a new method of mapping cortical localization of cognitive function, using electroencephalographic (EEG) data. Cross-subject regression analyses are used to identify cortical sites and post-stimulus latencies where there is a high correlation between subjects' performance and their cognitive event-related potential (ERP) amplitude. The procedure was tested using a mental arithmetic task and was found to identify essentially the same cortical regions that have been associated with such tasks on the basis of research with patients suffering localized cortical lesions. Thus, it appears to offer an inexpensive, noninvasive tool for exploring the dynamics of localization in neurologically normal subjects.