眼动脱敏再处理疗法（EMDR）治疗边缘型人格障碍的有效性：一项随机对照试验
Effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in Treating Borderline Personality Disorder: A Randomized Controlled Trial.
作者信息
Nvo-Fernandez Marcelo, Salas Fabiola, Miño-Reyes Valentina, Ahumada-Méndez Francisco, Medina Pablo, Avello Daniela, Landim Síbila Floriano, Via Marc, Napolitano Nicholas, Leiva-Bianchi Marcelo
机构信息
Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, 3460000 Talca, Chile.
Departamento de Terapia Ocupacional, Escuela de Ciencias de la Salud, Facultad de Medicina. Pontificia Universidad Católica de Chile, 8940000 Santiago, Chile.
出版信息
Alpha Psychiatry. 2025 Apr 28;26(2):40031. doi: 10.31083/AP40031. eCollection 2025 Apr.
BACKGROUND
Eye movement desensitization and reprocessing (EMDR) is recommended by major health organizations for trauma treatment, but its efficacy for borderline personality disorder (BPD) remains unestablished. This study aims to evaluate EMDR's effectiveness in treating BPD through a randomized controlled trial (RCT) and compare its outcomes with cognitive behavioral therapy (CBT).
METHODS
A total of 76 individuals participated in the RCT, with 18 patients (78% female) completing the study. Participants were randomly assigned to receive either EMDR (n = 8) or CBT (n = 10) via teletherapy sessions. Trauma symptoms were assessed using the international trauma questionnaire (ITQ), BPD symptoms were assessed using the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR), and post-traumatic growth (PTG) was assessed using the post-traumatic growth inventory (PTGI). Additionally, attentional evaluations were conducted at behavioral and electroencephalographic levels through an oddball paradigm. A final comparison was made between a participant who did not complete the therapeutic process and a participant who did.
RESULTS
Both EMDR and CBT treatments significantly improved trauma and BPD symptoms, as well as post-traumatic growth. The effect size was moderate for ITQ (η = 0.615) and PTGI (η = 0.610), and low for PAI-BOR (η = 0.147). Symptomatic participants showed a decrease in ITQ ( = 0.006) and PAI-BOR ( = 0.047) scores, and an increase in PTGI scores ( = 0.028).
CONCLUSIONS
Both EMDR and CBT significantly improved trauma and BPD symptoms, as well as post-traumatic growth. Additionally, EMDR showed benefits in response accuracy and speed, with a correct response rate of 97% when comparing two participants (with and without therapy). However, completely clean electroencephalography (EEG) data were not obtained from both participants for a deeper comparison.
CLINICAL TRIAL REGISTRATION
The study was registered at https://doi.org/10.1186/ISRCTN91146045, registration number: ISRCTN91146045, registration date: 21 May 2021.
背景
主要健康组织推荐眼动脱敏再处理疗法（EMDR）用于创伤治疗，但其对边缘性人格障碍（BPD）的疗效尚未明确。本研究旨在通过随机对照试验（RCT）评估EMDR治疗BPD的有效性，并将其结果与认知行为疗法（CBT）进行比较。
方法
共有76人参与了该RCT，18名患者（78%为女性）完成了研究。参与者通过远程治疗课程被随机分配接受EMDR（n = 8）或CBT（n = 10）。使用国际创伤问卷（ITQ）评估创伤症状，使用人格评估量表边缘特征量表（PAI - BOR）评估BPD症状，使用创伤后成长问卷（PTGI）评估创伤后成长（PTG）。此外，通过奇偶数范式在行为和脑电图水平进行注意力评估。最后对未完成治疗过程的参与者和完成治疗过程的参与者进行了比较。
结果
EMDR和CBT治疗均显著改善了创伤和BPD症状以及创伤后成长。ITQ（η = 0.615）和PTGI（η = 0.610）的效应量为中等，PAI - BOR（η = 0.147）的效应量为低。有症状的参与者ITQ（ = 0.006）和PAI - BOR（ = 0.047）得分降低，PTGI得分升高（ = 0.028）。
结论
EMDR和CBT均显著改善了创伤和BPD症状以及创伤后成长。此外，EMDR在反应准确性和速度方面显示出优势，比较两名参与者（接受治疗和未接受治疗）时正确反应率为97%。然而，未从两名参与者处均获得完全清晰的脑电图（EEG）数据以进行更深入的比较。
临床试验注册
该研究在https://doi.org/10.1186/ISRCTN91146045注册，注册号：ISRCTN91146045，注册日期：2021年5月21日。
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