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随机分组眼动脱敏再处理干预对自传体记忆的叙述复杂性和特异性影响的试验研究:路径分析和有监督机器学习研究

Randomized Trial on the Effects of a Group EMDR Intervention on Narrative Complexity and Specificity of Autobiographical Memories: A Path Analytic and Supervised Machine-Learning Study.

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.

Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, 56126 Pisa, Italy.

出版信息

Int J Environ Res Public Health. 2022 Jun 23;19(13):7684. doi: 10.3390/ijerph19137684.

Abstract

Narratives of autobiographical memories may be impaired by adverse childhood experiences, generating narrative fragmentation and increased levels of perceived distress. Eye movement desensitization and reprocessing (EMDR) proved to be an effective treatment to overcome traumatic experiences and to promote coherent autobiographical narratives. However, the specific mechanisms by which EMDR promotes narrative coherence remains largely unknown. We conducted a randomized controlled pilot trial (ClinicalTrials.gov Identifier NCT05319002) in a non-clinical sample of 27 children recruited in a primary school. Participants were randomly assigned to the experimental and control groups. The experimental group underwent a three-week group EMDR intervention. Subjective unit of distress (SUD), validity of cognition (VoC), classification of autobiographical memories, narrative complexity and specificity were assessed before and after the group EMDR intervention. The group EMDR intervention was able to improve SUD and VoC scales, narrative complexity and specificity, and promoted the classification of autobiographical memories as relational. The path analysis showed that SUD was able to predict VoC and narrative specificity, which, in turn, was able to predict both narrative complexity and the classification of autobiographical memories as relational. Machine-learning analysis showed that random tree classifier outperformed all other models by achieving a 93.33% accuracy. Clinical implications are discussed.

摘要

自传体记忆的叙述可能会受到不良童年经历的影响,导致叙述碎片化和感知痛苦程度增加。眼动脱敏再处理(EMDR)已被证明是一种有效的治疗方法,可以克服创伤经历并促进连贯的自传体叙述。然而,EMDR 促进叙述连贯性的具体机制在很大程度上仍不清楚。我们在一所小学招募了 27 名非临床样本的儿童进行了一项随机对照试点试验(ClinicalTrials.gov 标识符 NCT05319002)。参与者被随机分配到实验组和对照组。实验组接受为期三周的小组 EMDR 干预。在小组 EMDR 干预前后评估主观不适单位 (SUD)、认知有效性 (VoC)、自传体记忆分类、叙述复杂性和特异性。小组 EMDR 干预能够改善 SUD 和 VoC 量表、叙述复杂性和特异性,并促进自传体记忆的分类为关系。路径分析表明,SUD 能够预测 VoC 和叙述特异性,而 VoC 和叙述特异性又能够预测叙述复杂性和自传体记忆的关系分类。机器学习分析表明,随机树分类器通过达到 93.33%的准确率超过了所有其他模型。讨论了临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c44/9265795/8f3b7533493d/ijerph-19-07684-g001.jpg

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