Matthijssen Suzy J M A, Verhoeven Liselotte C M, van den Hout Marcel A, Heitland Ivo
Altrecht Academic Anxiety Center, Altrecht GGz, Utrecht, Netherlands.
Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.
Front Psychol. 2017 Nov 3;8:1937. doi: 10.3389/fpsyg.2017.01937. eCollection 2017.
Eye movement desensitization and reprocessing (EMDR) therapy is an evidence-based treatment for post-traumatic stress disorder (PTSD). A key element of this therapy is simultaneously recalling an emotionally disturbing memory and performing a dual task that loads working memory. Memories targeted with this therapy are mainly visual, though there is some evidence that auditory memories can also be targeted. The present study tested whether auditory memories can be targeted with EMDR in PTSD patients. A second objective was to test whether taxing the patient (performing a dual task while recalling a memory) in a modality specific way (auditory demanding for auditory memories and visually demanding for visual memories) was more effective in reducing the emotionality experienced than taxing in cross-modality. Thirty-six patients diagnosed with PTSD were asked to recall two disturbing memories, one mainly visual, the other one mainly auditory. They rated the emotionality of the memories before being exposed to any condition. Both memories were then recalled under three alternating conditions [visual taxation, auditory taxation, and a control condition (CC), which comprised staring a non-moving dot] - counterbalanced in order - and patients rerated emotionality after each condition. All three conditions were equally effective in reducing the emotionality of the auditory memory. Auditory loading was more effective in reducing the emotionality in the visual intrusion than the CC, but did not differ from the visual load. Auditory and visual aversive memories were less emotional after working memory taxation (WMT). This has some clinical implications for EMDR therapy, where mainly visual intrusions are targeted. In this study, there was no benefit of modality specificity. Further fundamental research should be conducted to specify the best protocol for WMT.
眼动脱敏再处理(EMDR)疗法是一种针对创伤后应激障碍(PTSD)的循证治疗方法。该疗法的一个关键要素是同时回忆一段情绪困扰记忆并执行一项会占用工作记忆的双重任务。尽管有一些证据表明听觉记忆也可作为该疗法的目标,但这种疗法所针对的记忆主要是视觉记忆。本研究测试了PTSD患者的听觉记忆是否可用EMDR疗法来针对处理。第二个目标是测试以特定模态方式(对听觉记忆进行听觉要求任务,对视觉记忆进行视觉要求任务)让患者承受负荷(在回忆记忆时执行双重任务)是否比跨模态负荷在减轻所体验到的情绪方面更有效。36名被诊断为PTSD的患者被要求回忆两段困扰记忆,一段主要是视觉记忆,另一段主要是听觉记忆。在接触任何条件之前,他们对这些记忆的情绪程度进行了评分。然后在三种交替条件下回忆这两段记忆[视觉负荷、听觉负荷和一种对照条件(CC),对照条件包括盯着一个静止的点]——按顺序进行平衡处理——并且患者在每种条件后重新对情绪程度进行评分。所有这三种条件在减轻听觉记忆的情绪程度方面同样有效。与对照条件相比,听觉负荷在减轻视觉侵入的情绪程度方面更有效,但与视觉负荷没有差异。在工作记忆负荷(WMT)后,听觉和视觉厌恶记忆的情绪性降低。这对主要针对视觉侵入的EMDR疗法具有一些临床意义。在本研究中,模态特异性没有优势。应该进行进一步的基础研究以确定WMT的最佳方案。