Dismantling Eye Movement Desensitization (EMD) in Post-traumatic Stress Disorder

We aimed to investigate the effects of EMs in the eye movement desensitization (EMD) process, as important part of EMDR, in reducing stress reactivity, PTSD symptoms, anxiety-depression symptoms, and improving quality of life and neurocognitive function, as compared to a retrieval-only condition, which involved the same procedures as EMD but excluded EMs, in Indonesian PTSD patients. Our research was a dismantling study that specifically examined the essential EMs component of EMDR. We followed the EMDR protocol when carrying out the EMD procedure. EMD is the initial stage of EMDR that does not involve the installation phase. We omitted the installation phase to achieve precise EMs effects during retrieval of traumatic memories. The results of our systematic review indicated that psychological treatment for PTSD did not affect most neurocognitive functions, except memory outcomes. The RCT, as presented in Chapters 4, 5, and 6, investigated the effect of EMD on the reduction of stress reactivity, PTSD symptoms, anxiety or depression symptoms, and the improvement of neurocognitive function in PTSD patients in comparison with retrieval-only conditions. We conducted a comparison of EMD with a retrieval-only control condition, which involved the same procedures as EMD but excluded EMs. Data collection occurred at baseline (T0), one week post-treatment (T1), one month (T2), and three months post-treatment (T3), with the exception of psychophysiological measures obtained at T0 and T1. In Chapter 4, it was described that no significant differences in stress reactivity between EMD and retrieval-only participants were found, as both groups showed a decreased HRV reactivity and accelerated HRV recovery at post- treatment in response to trauma scripts compared to neutral scripts. The study also did not find significant differences between EMD and retrieval-only in other physiological variables, such as HR, PEP, and circadian cortisol levels (area under the curve; AUC), and the cortisol awakening response (CAR) after treatment. In general, the physiological data indicated that EMs did not have an additive beneficial effect on the reduction of stress responses or the acceleration of recovery responses to traumatic memories in PTSD when compared to retrieval-only. There was one exception: a significant acceleration in HR recovery in response to the trauma script after treatment was found in the EMD condition, but not in the retrieval-only condition. Furthermore, in chapter 5, we reported no significant differences between the two groups in symptoms of PTSD, anxiety and depression and in quality of life. Finally, in chapter 6, the findings of our study indicated that there was no significant difference between the EMD and the retrieval-only conditions in terms of neurocognitive function. Our study findings did not support the hypothesis that EMs were more effective than retrieval-only in improving stress reactivity and stress response in PTSD patients, nor were EMs more effective in reducing PTSD symptoms, anxiety and depression symptoms, or in improving quality of life and neurocognitive functioning. Against expectations, the study's findings did not provide evidence to support the theory thatEMs have additional effects on the effectiveness of EMDR. Therefore, this studyconcludes that both EMD and retrieval-only interventions can be used to reduce stress reactivity, PTSD symptoms, and improve neurocognitive function in PTSD patients.