scholarly journals The Effects of the EMDR Group Traumatic Episode Protocol With Cancer Survivors

2018 ◽  
Vol 12 (3) ◽  
pp. 105-117
Author(s):  
Amanda Karen Patricia Roberts
Keyword(s):  
Treatment Group ◽  
Cancer Survivors ◽  
Posttraumatic Stress ◽  
Repeated Measures ◽  
Randomized Clinical Trials ◽  
Psychological Treatment ◽  
Delayed Treatment ◽  
Oncology Treatment ◽  
Traumatic Episode

The purpose of this pre-experimental case study was to explore the efficacy and safety of the Eye Movement Desensitization and Reprocessing (EMDR) Group Traumatic Episode Protocol (G-TEP) in the psychological treatment of cancer survivors and its potential effects on posttraumatic stress, anxiety, and depressive symptoms. Participants (N = 35) were patients with various types of cancer, in different stages, initial or recurring, with diagnosis or oncology treatment received within the past year. Following an individual psychoeducational intake session, participants received two 90-minute EMDR G-TEP sessions, administered on consecutive days. They were randomly assigned to a treatment group or a delayed treatment group. Assessments were administered at pre, post, and follow-up using the Short PostTraumatic Stress Disorder Interview (SPRINT), State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI-II). Repeated measures comparisons of PTSD symptoms, anxiety, and depression revealed significant differences between pretest and posttest, with most results maintained at follow-up. Pre-follow-up effect sizes showed medium effects. These promising results suggest the value in providing a lengthier course of treatment. They support the need for research with large sample, randomized clinical trials to examine the viability of providing EMDR G-TEP in the psychological treatment of cancer survivors. No serious adverse effects were reported and we conclude that the EMDR G-TEP may be effective and safe in the psychological treatment of an oncology population.

Early EMDR Intervention Following a Community Critical Incident: A Randomized Clinical Trial

2015 ◽  
Vol 9 (1) ◽  
pp. 17-27 ◽  
Author(s):  
Elan Shapiro ◽  
Brurit Laub
Keyword(s):  
Treatment Group ◽  
Critical Incident ◽  
Large Scale ◽  
Controlled Trial ◽  
Preliminary Evidence ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Delayed Treatment ◽  
Traumatic Episode

The aim of this study was to investigate the efficacy of early eye movement desensitization and reprocessing (EMDR) intervention using the EMDR recent traumatic episode protocol (R-TEP) after a traumatic community event whereby a missile hit a building in a crowded area of a town. In a waitlist/delayed treatment parallel-group randomized controlled trial, 17 survivors with posttraumatic distress were treated with EMDR therapy using the R-TEP protocol. Volunteer EMDR practitioners conducted treatment on 2 consecutive days. Participants were randomly allocated to either immediate or waitlist/delayed treatment conditions. Assessments with Impact of Event Scale-Revised (IES-R) and the Patient Health Questionnaire (PHQ-9) brief depression inventory took place at pre- and posttreatment and at 3 months follow-up. At 1 week posttreatment, the scores of the immediate treatment group were significantly improved on the IES-R compared to the waitlist/delayed treatment group, who showed no improvement prior to their treatment. At 3 months follow-up, results on the IES-R were maintained and there was a significant improvement on PHQ-9 scores. This pilot study provides preliminary evidence, supporting the efficacy of EMDR R-TEP for reducing posttrauma stress among civilian victims of hostility, and shows that this model of intervention briefly augmenting local mental health services following large-scale traumatic incidents, using an EMDR intervention on 2 consecutive days may be effective.

scholarly journals Quality of Life and Hemodynamic Effects of Switching From Hemodialysis to Hemodiafiltration: A Canadian Controlled Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110577
Author(s):  
Isabelle Ethier ◽  
Immaculate Nevis ◽  
Rita S. Suri
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Repeated Measures ◽  
Recovery Time ◽  
Randomized Clinical Trials ◽  
Analysis Of Covariance ◽  
Intradialytic Hypotension ◽  
Laboratory Values

Background: Recent randomized clinical trials have demonstrated beneficial effects of hemodiafiltration (HDF) compared with hemodialysis (HD) on mortality and hemodynamic stability. Data on quality of life in HDF compared with HD is limited. Objective: This study aimed to determine whether patients receiving HD experience improvements in quality of life, hemodynamic and laboratory parameters after switching to HDF. Design: Observational controlled cohort study. Setting & Patients: Adult patients receiving maintenance dialysis were followed for 3 months both before and after transfer to a new unit, where they received HDF. Prior to transfer, control patients were already treated by HDF. Methods: Quality of life at baseline and follow-up was measured using the validated minutes to recovery (MR) question. Dialysis data were collected for 3 consecutive sessions monthly; laboratory values were collected monthly. Wilcoxon signed rank test and repeated measures analysis of covariance were used to evaluate pre/post transfer changes and quantile regression to identify predictors of change in recovery time. Results: Of 227 patients, 82 died, were transplanted, were hospitalized or did not transfer, leaving 123 subjects and 22 controls for analysis. MR did not improve with switching to HDF, although patients with MR > 60 min before transfer experienced a significant decrease in their MR, compared with controls. There was no improvement in intradialytic hypotension with HDF. There were no differences in laboratory values before vs after switch. Limitations: Nonrandomized single-center study, including only small numbers of patients and covering a short follow-up period; hemodynamic values only evaluated over 1 week per month; residual kidney function not recorded. Conclusions: In this Canadian experience of HDF, patients remained stable with respect to several laboratory and dialysis related parameters. Switch to HDF was associated with substantially reduced recovery time in patients with MR > 60 minutes at baseline.

scholarly journals Treatment of Chronic Phantom Limb Pain Using a Trauma-Focused Psychological Approach

2010 ◽  
Vol 15 (2) ◽  
pp. 65-71 ◽  
Author(s):  
C de Roos ◽  
AC Veenstra ◽  
A de Jongh ◽  
ME den Hollander-Gijsman ◽  
NJA van der Wee ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Repeated Measures ◽  
Psychological Intervention ◽  
Psychological Treatment ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Before And After

BACKGROUND: Chronic phantom limb pain (PLP) is a disabling chronic pain syndrome for which regular pain treatment is seldom effective. Pain memories resulting from long-lasting preamputation pain or pain flashbacks, which are part of a traumatic memory, are reported to be powerful elicitors of PLP.OBJECTIVE: To investigate whether a psychological treatment directed at processing the emotional and somatosensory memories associated with amputation reduces PLP.METHODS: Ten consecutive participants (six men and four women) with chronic PLP after leg amputation were treated with eye movement desensitization and reprocessing (EMDR). Pain intensity was assessed during a two-week period before and after treatment (mean number of sessions = 5.9), and at short- (three months) and long-term (mean 2.8 years) follow-up.RESULTS: Multivariate ANOVA for repeated measures revealed an overall time effect (F[2, 8]=6.7; P<0.02) for pain intensity. Pairwise comparison showed a significant decrease in mean pain score before and after treatment (P=0.00), which was maintained three months later. All but two participants improved and four were considered to be completely pain free at three months follow-up. Of the six participants available at long-term follow-up (mean 2.8 years), three were pain free and two had reduced pain intensity.CONCLUSIONS: These preliminary results suggest that, following a psychological intervention focused on trauma or pain-related memories, substantial long-term reduction of chronic PLP can be achieved. However, larger outcome studies are required.

Factors Related to Underuse of Surveillance Mammography Among Breast Cancer Survivors

2006 ◽  
Vol 24 (1) ◽  
pp. 85-94 ◽  
Author(s):  
Nancy L. Keating ◽  
Mary Beth Landrum ◽  
Edward Guadagnoli ◽  
Eric P. Winer ◽  
John Z. Ayanian
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Repeated Measures ◽  
Breast Cancer Survivors ◽  
Geographic Region ◽  
Fee For Service ◽  
Factors Associated ◽  
Follow Up Care ◽  
Surveillance Mammography

Purpose Many older breast cancer survivors do not undergo annual mammography despite guideline recommendations. We identified factors associated with underuse of surveillance mammography and examined whether variation was explained by differences in follow-up care. Patients and Methods We used Surveillance, Epidemiology, and End Results-Medicare data to identify a population-based sample of 44,511 women fee-for-service Medicare enrollees aged ≥ 65 years who were diagnosed with stage I or II breast cancer in 1992 to 1999 who underwent primary surgical therapy. We assessed factors associated with mammography during months 7 to 18, 19 to 30, and 31 to 42 after breast cancer diagnosis using repeated-measures logistic regression; and we examined whether follow-up care with providers of various specialties explained variation in mammography use. Results Only three quarters of women (77.6%) underwent mammography during months 7 to 18 after diagnosis, and only 56.7% had mammography yearly over 3 years. In multivariable analyses, women who were older, black, unmarried, and living in certain regions were less likely than other women to undergo surveillance mammography (all P < .05). Patients with more visits and patients who continued to see a medical oncologist, radiation oncologist, or surgeon were most likely to have mammograms (P < .001); however, adjusting for visits with providers did not explain the lower mammography rates based on age, race, marital status, and geographic region. Conclusion Many elderly breast cancer survivors do not undergo annual surveillance mammography, particularly women who are older, black, and unmarried, and this underuse was not explained by access to follow-up care. New strategies are needed to increase use of surveillance mammography and decrease variations based on nonclinical factors that are likely unrelated to appropriateness of medical care.

Randomized Controlled Trial: Self-Care Traumatic Episode Protocol (STEP), Computerized EMDR Treatment of COVID-19 Related Stress

2021 ◽  
pp. EMDR-D-20-00047
Author(s):  
Judy Moench ◽  
Olivia Billsten
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Mental Health Clinicians ◽  
Delayed Treatment ◽  
Randomized Controlled ◽  
Traumatic Episode ◽  
General Self Efficacy

Healthcare workers and Mental Health clinicians are at heightened risk for mental health issues while they support their communities during the COVID-19 pandemic, and early psychological intervention is crucial to protect them. The Self-Care Traumatic Episode Protocol (STEP) is a computerized intervention adapted from the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP). This study evaluated the effectiveness of STEP for Mental Health clinicians in the context of COVID-19. Thirty-four Mental Health clinicians were randomly allocated to treatment (n = 17) or waitlist (n = 17). The Generalized Self-Efficacy Scale (GSE) and Depression and Anxiety Stress Scale (DASS- 21) were completed by the treatment group at baseline and 1-week follow-up postintervention and by the waitlist group at baseline, preintervention, and 1-week follow-up postwaitlist. Pre–post comparisons showed a significant decrease in depression, anxiety, and stress for Immediate Treatment, t(15) = −3.64, p < .01, d = .73, and for Delayed Treatment, t(15) = −3.53, p < .01, d = .68, There was also a significant increase in general self-efficacy for Immediate Treatment, t(15) = 2.87, p < .05, d = .46, and Delayed Treatment, t(15) = 3.72, p < .01, d = .56. The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among Mental Health clinicians in the context of COVID-19. Further research investigating the potential of utilizing the STEP intervention on a larger scale and with other populations is needed.

Exposure in vivo of agoraphobics: contributions of diazepam, group exposure, and anxiety evocation

1976 ◽  
Vol 6 (1) ◽  
pp. 71-88 ◽  
Author(s):  
Julian Hafner ◽  
Isaac Marks
Keyword(s):  
Treatment Group ◽  
Psychological Treatment ◽  
Group Versus ◽  
Parallel Design ◽  
Individual Exposure ◽  
Treatment Conditions ◽  
Exposure In Vivo ◽  
Anxiety Arousal

SynopsisFifty-seven chronic agoraphobic outpatients were treated by 12 hours of exposure in vivo on four days over two weeks to check the effects of oral diazepam versus placebo during group exposure, group versus individual exposure, and high versus medium anxiety arousal during individual exposure. The controlled parallel design allowed comparative evaluation of each treatment condition to six months follow-up. Assessment was blind with respect to drug and psychological treatment. Patients in all treatment conditions improved significantly in phobias and in related life areas.Outcome to group exposure on phobias and other measures was similar in all three drug conditions (placebo, waning diazepam, peak diazepam) with no significant differences between them. Diazepam patients had significantly less discomfort than placebo patients during group exposure treatment. Group exposure patients improved slightly but significantly more than individual exposure patients on non-phobic measures, though group exposure was accompanied by more panics during treatment yet was easier to run by the therapist. Individual exposure under high anxiety arousal was no more therapeutic than with lower anxiety. Diazepam is a mild palliative during group exposure but does not facilitate outcome to treatment. Group exposure in vivo is mildly facilitatory for outcome compared with individual exposure. Anxiety evocation during treatment was not therapeutically helpful.

scholarly journals Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review

Salud Mental ◽  
2018 ◽  
Vol 41 (2) ◽  
pp. 81-90
Author(s):  
Carmen Fernández Fillol ◽  
◽  
Elena Rocío Serrano-Ibáñez ◽  
Gema Teresa Ruiz-Párraga ◽  
Carmen Ramírez Maestre ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Randomized Clinical Trials ◽  
Stress Disorder ◽  
Psychological Treatment ◽  
Quality Criteria ◽  
Control Group ◽  
Complex Posttraumatic Stress Disorder ◽  
Psychological Treatments ◽  
Two Phases

Background. Current literature shows that posttraumatic stress disorder and complex posttraumatic stress disorder symptoms differ. Although the psychological treatments available for posttraumatic disorder are well established, little is known about the effectiveness of those aimed at the treatment of complex posttraumatic stress. Objective. To evaluate the efficacy of psychological treatments for complex posttraumatic stress disorder. Method. A systematic qualitative search was conducted according to PRISMA guidelines, searching four psychological and health electronic databases: Medline, Pilots, PsycINFO, and Pubmed. Three reviewers independently selected the studies in two phases: preselection (criteria for complex posttraumatic stress disorder, replicable psychological treatment, and treatment effect) and selection (additional criteria: type of study, participants, and treatment). Results. Of the 615 studies reviewed, 25 were preselected, eight of which met the inclusion and methodological quality criteria. Five studies explored adult populations (with one exception, all were randomized clinical trials) and three child populations (clinical studies with pre- post-treatment design, with and without control group). Most studies with adult populations included psychoeducation, cognitive restructuration, and exposure therapy. The studies with child samples included EMDR and mindfulness as the most frequent treatment components. Discussion and conclusion. The evidence was insufficient to determine the most effective treatment. More research on this issue is required.

scholarly journals A Spiderless Arachnophobia Therapy: Comparison between Placebo and Treatment Groups and Six-Month Follow-Up Study

2007 ◽  
Vol 2007 ◽  
pp. 1-11 ◽  
Author(s):  
Laura Carmilo Granado ◽  
Ronald Ranvaud ◽  
Javier Ropero Peláez
Keyword(s):  
Placebo Group ◽  
Treatment Group ◽  
Repeated Measures ◽  
Clustering Algorithm ◽  
Group Interaction ◽  
Recovery Process ◽  
Treatment Groups ◽  
Follow Up Study

We describe a new arachnophobia therapy that is specially suited for those individuals with severe arachnophobia who are reluctant to undergo direct or even virtual exposure treatments. In this therapy, patients attend a computer presentation of images that, while not being spiders, have a subset of the characteristics of spiders. The Atomium of Brussels is an example of such an image. The treatment group (n=13) exhibited a significant improvement (time×group interaction:P=.0026) when compared to the placebo group (n=12) in a repeated measures multivariate ANOVA. Ak-means clustering algorithm revealed that, after 4 weeks of treatment, 42% of the patients moved from the arachnophobic to the nonarachnophobic cluster. Six months after concluding the treatment, a follow-up study showed a substantial consolidation of the recovery process where 92% of the arachnophobic patients moved to the nonarachnophobic cluster.

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