Efficacy of Eye-Movement Desensitization and Reprocessing for Patients with Posttraumatic-Stress Disorder: A Meta-Analysis of Randomized Controlled Trials

Background We performed the first meta-analysis of clinical studies by investigating the effects of eye-movement desensitization and reprocessing (EMDR) therapy on the symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and subjective distress in PTSD patients treated during the past 2 decades. Methods We performed a quantitative meta-analysis on the findings of 26 randomized controlled trials of EMDR therapy for PTSD published between 1991 and 2013, which were identified through the ISI Web of Science, Embase, Cochrane Library, MEDLINE, PubMed, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature electronic databases, among which 22, 20, 16, and 11 of the studies assessed the effects of EMDR on the symptoms of PTSD, depression, anxiety, and subjective distress, respectively, as the primary clinical outcome. Results The meta-analysis revealed that the EMDR treatments significantly reduced the symptoms of PTSD (g = −0.662; 95% confidence interval (CI): −0.887 to −0.436), depression (g = −0.643; 95% CI: −0.864 to −0.422), anxiety (g = −0.640; 95% CI: −0.890 to −0.390), and subjective distress (g = −0.956; 95% CI: −1.388 to −0.525) in PTSD patients. Conclusion This study confirmed that EMDR therapy significantly reduces the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients. The subgroup analysis indicated that a treatment duration of more than 60 min per session was a major contributing factor in the amelioration of anxiety and depression, and that a therapist with experience in conducting PTSD group therapy was a major contributing factor in the reduction of PTSD symptoms.

[1]  G. A. Flint,et al.  Emotional Freedom Techniques , 2006 .

[2]  James A. Jensen.  An investigation of eye movement desensitization and reprocessing (EMD/R) as a treatment for posttraumatic stress disorder (PTSD) symptoms of Vietnam combat veterans , 1994 .

[3]  R. DeRubeis,et al.  Cognitive therapy vs medications in the treatment of moderate to severe depression. , 2005, Archives of general psychiatry.

[4]  David B. Pillemer,et al.  Summing Up: The Science of Reviewing Research , 1984 .

[5]  M. Kemp,et al.  A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents , 2010, Clinical child psychology and psychiatry.

[6]  G. Högberg,et al.  On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers – A randomized controlled trial , 2007, Nordic journal of psychiatry.

[7]  G. Stams,et al.  Efficacy of EMDR in children: a meta-analysis. , 2009, Clinical psychology review.

[8]  J. Higgins,et al.  Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. The Cochrane Collaboration , 2013 .

[9]  Steven Taylor,et al.  Comparative efficacy, speed, and adverse effects of three PTSD treatments: exposure therapy, EMDR, and relaxation training. , 2003, Journal of consulting and clinical psychology.

[10]  M. Schwartz,et al.  Measuring effectiveness of eye movement desensitization and reprocessing (EMDR) in non-clinical anxiety: a multi-subject, yoked-control design. , 1996, Journal of behavior therapy and experimental psychiatry.

[11]  J. G. Carlson,et al.  Eye Movement Desensitization and Reprocessing (EDMR) Treatment for Combat-Related Posttraumatic Stress Disorder , 1998, Journal of traumatic stress.

[12]  K. Parker,et al.  Eye movement desensitization and reprocessing (EMDR): a meta-analysis. , 2001, Journal of consulting and clinical psychology.

[13]  T. Karatzias,et al.  A Controlled Comparison of the Effectiveness and Efficiency of Two Psychological Therapies for Posttraumatic Stress Disorder: Eye Movement Desensitization and Reprocessing vs. Emotional Freedom Techniques , 2011, The Journal of nervous and mental disease.

[14]  Steven V. Marcus,et al.  Controlled study of treatment of PTSD using EMDR in an HMO setting. , 1997 .

[15]  T. Borkovec,et al.  Efficacy of Eye Movement Desensitization in the treatment of cognitive intrusions related to a past stressful event. , 2002, Journal of anxiety disorders.

[16]  G. Ironson,et al.  Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure. , 2002, Journal of clinical psychology.

[17]  P. Drummond,et al.  Treatment of PTSD: stress inoculation training with prolonged exposure compared to EMDR. , 2002, Journal of clinical psychology.

[18]  J. G. Carlson,et al.  Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: a field study. , 2002, Journal of clinical psychology.

[19]  Jacob Cohen.  A Coefficient of Agreement for Nominal Scales , 1960 .

[20]  Bo Larsson,et al.  EMDR treatment for children with PTSD: Results of a randomized controlled trial , 2007, Nordic journal of psychiatry.

[21]  S. Spence,et al.  The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder. , 1999, Journal of anxiety disorders.

[22]  Nasrin Jaberghaderi,et al.  A comparison of CBT and EMDR for sexually‐abused Iranian girls , 2004 .

[23]  R. Jorge,et al.  Posttraumatic Stress Disorder , 2015, Continuum.

[24]  Craig S. Gillette,et al.  Brief Psychological Intervention with Traumatized Young Women: The Efficacy of Eye Movement Desensitization and Reprocessing , 1998, Journal of traumatic stress.

[25]  L. A. Becker,et al.  Stress Management with Law Enforcement Personnel: A Controlled Outcome Study of EMDR Versus a Traditional Stress Management Program , 2001 .

[26]  B. Rothbaum,et al.  Prolonged Exposure versus Eye Movement Desensitization and Reprocessing (EMDR) for PTSD rape victims. , 2005, Journal of traumatic stress.

[27]  I. Wilkinson.  Summing Up: The Science of Reviewing Research [Book Review]. , 1987 .

[28]  J. Goss,et al.  A single session, group study of exposure and Eye Movement Desensitization and Reprocessing in treating Posttraumatic Stress Disorder among Vietnam War veterans: preliminary data. , 1999, Journal of anxiety disorders.

[29]  H. Merckelbach,et al.  Eye Movement Desensitization and Reprocessing , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[30]  F. Shapiro,et al.  Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols, and Procedures , 1995 .

[31]  D. L. Korn,et al.  A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. , 2007, The Journal of clinical psychiatry.

[32]  T. Vos,et al.  Cognitive Behavioural Therapy for Depression, Panic Disorder and Generalized Anxiety Disorder: A Meta-Regression of Factors that May Predict Outcome , 2006, The Australian and New Zealand journal of psychiatry.

[33]  M. S. Patel,et al.  An introduction to meta-analysis. , 1989, Health Policy.

[34]  K. N. Mahani,et al.  Efficacy of "eye movement desensitization and reprocessing" in reducing anxiety and unpleasant feelings due to earthquake experience. , 2007 .

[35]  E. González-Fraile,et al.  Interventions for caregivers of patients with dementia. , 2014, Actas espanolas de psiquiatria.

[36]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[37]  N. Tarrier,et al.  A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. , 1994, Journal of behavior therapy and experimental psychiatry.

[38]  B. Rothbaum.  A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims. , 1997, Bulletin of the Menninger Clinic.

[39]  Michele Tarsilla.  Cochrane Handbook for Systematic Reviews of Interventions , 2010, Journal of MultiDisciplinary Evaluation.

[40]  F. Shapiro.  Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd ed.). , 2001 .

[41]  K. Power,et al.  A controlled comparison of eye movement desensitization and reprocessing versus exposure plus cognitive restructuring versus waiting list in the treatment of post-traumatic stress disorder , 2002 .

[42]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[43]  R. D. Grainger,et al.  An empirical evaluation of eye movement desensitization and reprocessing (EMDR) with survivors of a natural disaster. , 1997, Journal of traumatic stress.

[44]  L A Becker,et al.  Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. , 1995, Journal of consulting and clinical psychology.

[45]  Henry Brodaty,et al.  Meta‐Analysis of Psychosocial Interventions for Caregivers of People with Dementia , 2003, Journal of the American Geriatrics Society.