The Effect of Dual Attention in an EMDR Intervention for Posttraumatic Symptomatology: a Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 100
- 试验地点
- 2
- 主要终点
- Change from posttraumatic symptoms at 10 weeks and 6 months
研究概览
简要总结
Research to date indicates that trauma-focused treatments are safe and effective for PTSD, even when higher-risk comorbidities (e.g., psychosis or substance use) are present. In particular, there are data pointing to the efficacy of prolonged exposure therapy and eye movement desensitization and reprocessing (EMDR) therapy. Clinical practice guidelines specifically recommend trauma-focused treatment with exposure and/or cognitive restructuring components. Regarding EMDR interventions, there are increasing results supporting its efficacy. Some interesting clinical advantages presented by EMDR as opposed to cognitive-behavioral therapies are 1) the efficacy found despite less exposure to the traumatic memory, 2) the exclusion of homework, 3) as well as the rapid reduction in subjective disturbance produced even after a single session of EMDR therapy. However, the mechanisms producing the improvement and, in particular, the effect of bilateral stimulation are not precisely known. More research is needed in this regard since bilateral stimulation is the most controversial part and with less evidence found. In addition to this, there are very few studies that have analyzed the differential efficacy of the presence or absence of bilateral stimulation or of the different types of stimulation possible. As for the comparison between types of stimulation (bilateral with eye movements, or focusing on a fixed point), greater treatment effects have been found for EMDR with fixation on an immobile hand compared to eye movements. The aim of this study is to examine the effectiveness of a comprehensive intervention protocol for people who have experienced traumatic events and present post-traumatic symptomatology. In addition, this study will compare the efficacy of traumatic memory processing with and without dual attention.
详细描述
The protocol will be developed following the three stages of recovery from trauma: first, focusing on establishing the therapeutic alliance and safety; second, focusing on recounting and re-processing the traumatic event; and third, focusing on reconnecting with others and with life despite the trauma experienced. This study will analyze the differences of type of traumatic processing; 1. using bilateral stimulation, 2. using fixed-point focusing and 3. closing the eyes (only exposure to the traumatic memory, without dual attention).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Those showing a high risk of PTSD (TSQ ≥6 or TSQ ≥4 with clinical criteria) will be further evaluated to determine whether they meet the inclusion criteria. Participants must:
- •Be between the ages of 18 and 65 fluent enough in Spanish language; 2.
排除标准
- •Present severe active suicidal ideation, or have made a self-injurious attempt during the last month.
- •Present a diagnosis of substance dependence, intellectual disability or severe cognitive dysfunction.
- •Participants with a score greater than or equal to 26 on the BDI-II, the inclusion of the person in the study will be assessed by clinical criteria.
- •Having received EMDR treatment in the last 6 months.
- •Also excluded from the program are those people who cannot guarantee continuity in the therapeutic process.
结局指标
主要结局
Change from posttraumatic symptoms at 10 weeks and 6 months
时间窗: Change baseline, 10 weeks, and 6 months
International Trauma Questionnaire (ITQ; Cloitre et al., 2018). Higher scores mean a worse outcome.
Change from Dissociative symptoms at 10 weeks and 6 months
时间窗: Change baseline, 10 weeks, and 6 months
Dissociative Experience Scale DES II (Carlson and Putnam, 1993). Higher scores mean a worse outcome.
Change from psychopathological symptoms at 10 weeks and 6 months
时间窗: Change baseline, 10 weeks, and 6 months
Symptom Checklist 45-SCL-90R brief (Davison et al., 1997).Higher scores mean a worse outcome.
次要结局
- Change from Satisfaction with life at 10 weeks and 6 months(Change baseline, 10 weeks, and 6 months)
- Change from Well-being at 10 weeks and 6 months(Change baseline, 10 weeks, and 6 months)
- Change from Attachment style at 10 weeks and 6 months(Change baseline, 10 weeks, and 6 months)
- Change from Emotion Regulation at 10 weeks and 6 months(Change baseline, 10 weeks, and 6 months)