Gonzalez-Vazquez Ana I, Rodriguez-Lago Lucía, Seoane-Pillado Maria T, Fernández Isabel, García-Guerrero Francisca, Santed-Germán Miguel A
Department of Psychiatry, University Hospital Coruña, A Coruña, Spain.
Assistens Clinic, A Coruña, Spain.
Front Psychol. 2018 Feb 13;8:2377. doi: 10.3389/fpsyg.2017.02377. eCollection 2017.
Eye Movement Desensitization and Reprocessing is a psychotherapeutic approach with recognized efficiency in treating post-traumatic stress disorder (PTSD), which is being used and studied in other psychiatric diagnoses partially based on adverse and traumatic life experiences. Nevertheless, there is not enough empirical evidence at the moment to support its usefulness in a diagnosis other than PTSD. It is commonly accepted that the use of EMDR in severely traumatized patients requires an extended stabilization phase. Some authors have proposed integrating both the theory of structural dissociation of the personality and the adaptive information processing model guiding EMDR therapy. One of these proposals is the Progressive Approach. Some of these EMDR procedures will be evaluated in a group therapy format, integrating them along with emotional regulation, dissociation, and trauma-oriented psychoeducational interventions. Patients presenting a history of severe traumatization, mostly early severe and interpersonal trauma, combined with additional significant traumatizing events in adulthood were included. In order to discriminate the specific effect of EMDR procedures, two types of groups were compared: TAU (treatment as usual: psychoeducational intervention only) vs. TAU+EMDR (the same psychoeducational intervention plus EMDR specific procedures). In pre-post comparison, more variables presented positive changes in the group including EMDR procedures. In the TAU+EMDR group, 4 of the 5 measured variables presented significant and positive changes: general health (GHQ), general satisfaction (Schwartz), subjective well-being, and therapy session usefulness assessment. On the contrary, only 2 of the 5 variables in the TAU group showed statistically significant changes: general health (GHQ), and general satisfaction (Schwartz). Regarding post-test inter-group comparison, improvement in subjective well-being was related to belonging to the group that included EMDR procedures, with differences between TAU and TAU+EMDR groups being statistically significant [χ(1) = 14.226; < 0.0001]. In the TAU+EMDR group there was not one patient who got worse or did not improve; 100% experienced some improvement. In the TAU group, 70.6% referred some improvement, and 29.4% said to have gotten worse or not improved.
眼动脱敏再处理疗法是一种心理治疗方法，在治疗创伤后应激障碍（PTSD）方面具有公认的疗效，目前该疗法正在其他部分基于不良和创伤性生活经历的精神疾病诊断中被应用和研究。然而，目前尚无足够的实证证据支持其在PTSD以外的诊断中的有效性。普遍认为，在严重受创伤的患者中使用眼动脱敏再处理疗法需要延长稳定期。一些作者提议将人格结构解离理论和指导眼动脱敏再处理疗法的适应性信息处理模型相结合。其中一个提议是渐进式方法。这些眼动脱敏再处理程序中的一些将以团体治疗的形式进行评估，并将其与情绪调节、解离和以创伤为导向的心理教育干预措施相结合。纳入了有严重创伤史的患者，这些创伤大多为早期严重的人际创伤，并伴有成年期其他重大创伤事件。为了区分眼动脱敏再处理程序的具体效果，比较了两种类型的组：常规治疗组（TAU：仅进行心理教育干预）与TAU+眼动脱敏再处理组（相同的心理教育干预加上眼动脱敏再处理特定程序）。在前后比较中，包括眼动脱敏再处理程序的组中有更多变量呈现出积极变化。在TAU+眼动脱敏再处理组中，所测量的5个变量中有4个呈现出显著的积极变化：总体健康状况（GHQ）、总体满意度（施瓦茨量表）、主观幸福感和治疗会话有用性评估。相反，在常规治疗组的5个变量中，只有2个显示出统计学上显著的变化：总体健康状况（GHQ）和总体满意度（施瓦茨量表）。关于测试后组间比较，主观幸福感的改善与属于包括眼动脱敏再处理程序的组有关，常规治疗组和TAU+眼动脱敏再处理组之间的差异具有统计学意义[χ(1)=14.226；P<0.0001]。在TAU+眼动脱敏再处理组中，没有一名患者病情恶化或没有改善；100%的患者有一定程度的改善。在常规治疗组中，70.6%的患者表示有一定改善，29.4%的患者表示病情恶化或没有改善。
