Examination of Initial Evidence for Eye Movement Desensitization and Reprocessing as a Treatment for Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a debilitating psychological condition that impacts millions of people globally. The front-line psychological intervention for OCD is exposure/response prevention (ERP), however, many individuals do not respond to this treatment approach. Eye movement desensitization and reprocessing (EMDR) is a new therapeutic option which could be effective in treating OCD. This review examined the initial evidence for the effectiveness of EMDR in reducing OCD symptoms. Nine studies were included in the review, including six case studies and three group studies. Results indicate that EMDR is a promising candidate for treating OCD, with all studies showing EMDR therapy resulted in reduced symptoms from baseline. Results also indicated that EMDR may be as effective as ERP, and more effective than selective serotonin reuptake inhibitors (SSRIs) in treating OCD.

Effectiveness of Exposure/Response Prevention plus Eye Movement Desensitization and Reprocessing in Reducing Anxiety and Obsessive-Compulsive Symptoms Associated with Stressful Life Experiences: A Randomized Controlled Trial

Background: Obsessive-compulsive disorder (OCD) is known as a non-psychotic mental disorder resistant to treatment. It has been found that eye movement desensitization and reprocessing (EMDR) can increase the effectiveness of its standard treatments. Objectives: The current study aimed at evaluating the impact of exposure/response prevention (ERP) combined with EMDR as a treatment method on patients with OCD who had experienced stressful life events by comparison to ERP alone. Methods: The present randomized controlled trial was conducted among 60 OCD patients who experienced stressful life events and were resistant to medication treatment. The participants were randomly assigned to the ERP plus EMDR (n = 30) and ERP (n = 30) groups. The Yale-Brown Obsessive-Compulsive scale (Y-BOCS) and Beck Anxiety Inventory (BAI) were completed before and after the intervention, as well as, after a follow-up period of three months. The scores were compared using the chi‐squared test, analysis of covariance (ANCOVA), and repeated measures analysis of variance (ANOVA). Results: ANOVA results demonstrated that both treatment protocols had a significant effect on the reduction of anxiety and severity of OCD symptoms, while the results of ANCOVA showed a significantly higher effect of ERP plus EMDR compared to the ERP protocol (P = 0.001), and sample attrition was significantly higher in the ERP group (P < 0.05). Conclusions: The ERP plus EMDR protocol compared to the ERP protocol showed a higher rate of completion and efficacy in OCD treatment.

Measuring Within-Session and Between-Session Compliance in Hoarding Disorder: A Preliminary Investigation of the Psychometric Properties of the CBT Compliance Measure (CCM) and Patient Exposure/Response Prevention Adherence Scale for Hoarding (PEAS-H)

Hoarding disorder (HD) is a new psychiatric diagnosis in Diagnostic and Statistical Manual of Mental Disorders–Fifth edition and preliminary evidence suggests that cognitive-behavioral treatments are effective in treating this condition. However, it has been demonstrated that individuals with HD generally display poor compliance during treatment, which may lead to poor outcomes. Treatment compliance can be conceptualized as either within-session or between-session compliance, but currently there are no validated measures of within-session or between-session compliance specifically for HD. The aim of this study was to provide an initial validation of the CBT Compliance Measure and the Patient Exposure/Response Prevention Adherence Scale for Hoarding in a sample of participants with HD who were undergoing group cognitive behavioral therapy (CBT) for HD ( N = 70). Both measures, which were administered at each relevant treatment session, demonstrated a unidimensional structure, good reliability, as well as predictive validity, and are thus promising in the measurement of within-session and between-session compliance with CBT for HD.

Comparative Study on Efficacy of Various Types of Exposure Response Prevention Therapies on OCD

Objective: The heterogeneity of OCD has various mixed findings related to the treatment procedures, psychological and pharmacological treatment. Consistent research has shown mixed findings regarding which form of ERP, ERP as Habituation tool or ERP as restructuring tool, is more efficacious. Hence this study is done to examine efficacies of various treatment procedures but importantly to propose a possible treatment choices based on efficacy and acceptability in Indian settings for OCD management. Method: Participants were adult outpatients (N=22) with primary OCD selected from OPD level and randomly assessed to two treatment groups; a) ERP(Habituation only) with SSRI b) ERP (ERP as restructuring tool) with SSRI. Participants received 12-14 exposure sessions, Result and Conclusions: ERP when used as a process of “habituation” is more efficacious in terms of treatment outcomes but when ERP used as both habituation and cognitive restructuring tool is more tolerable and acceptable by patients and also not prone to dropouts.

Modified Exposure and Response Prevention to Treat the Repetitive Behaviors of a Child with Autism: A Case Report

We report the case study of a school-aged child with autism whose repetitive behaviors were treated with a modified version of a technique routinely used in cognitive behavior therapy (i.e., exposure response prevention) to treat obsessive-compulsive disorder. A trained behavioral therapist administered the modified ERP treatment over the course of an intensive two-week treatment period with two therapy sessions occurring daily. The treatment was successful at decreasing the amount of child distress and cooccurring problem behavior displayed; however, the child's interest in the repetitive behavior eliciting stimulus (i.e., puzzles) remained. The case study demonstrates specific ways that exposure response prevention strategies can be adapted to the unique kinds of repetitive behaviors that present clinically in autism. A larger clinical trial is needed to substantiate these findings.