Eye movement desensitization and reprocessing in the psychological treatment of combat -related guilt: A study of the effects of eye movements
The purpose of this study was to investigate the role of eye movements in Eye Movement Desensitization and Reprocessing (EMDR), and to test the efficacy of EMDR in the treatment of guilt associated with combat trauma. EMDR was compared to a non-eye movement (NEM) analog, which entailed the full EMDR procedure minus the eye movements.
A single-case multiple component cross-over design across seven participants was utilized. Participants were combat veterans who were receiving inpatient treatment for Posttraumatic Stress Disorder (PTSD) at the Coatesville Veterans Administration Medical Center. Four participants were introduced first to the EMDR condition and three participants were introduced first to the NEM analog condition. Each participant was exposed to both conditions. Dependent measures included: (1) pre- and post-treatment scores on the Clinician Administered PTSD Scale for DSM-IV - One Week Symptom Status Version (CAPS-SX), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and Trauma Related Guilt Inventory (TRGI), (2) self-monitoring data on the frequency and intensity of intrusive thoughts, disturbing dreams, and guilt, and (3) measures of participants' subjective level of distress within sessions and pre- and post-treatment using the Subjective Units of Distress Scale (SUDS).
As measured by SUDS ratings, EMDR resulted in a greater decrease in dyphoric affect within-session than the NEM analog. EMDR also resulted in a significant decrease in mean SUDS ratings from pre- to post-treatment. EMDR resulted in significant decreases in combat-related PTSD symptomatology, as measured by pre- and post-treatment scores on the CAPS-SX, BDI, and IES. EMDR also resulted in significant decreases in mean pre- and post-treatment frequency of self-reported intrusive thoughts and mean pre- and post-treatment intensity of intrusive thoughts, disturbing dreams, and guilt. Additionally, EMDR resulted in a significant decrease in pre- and post-treatment scores on one scale and two subscales of the TRGI. No differences in the mean frequency and intensity of self-reported intrusive thoughts, disturbing dreams, and guilt were detected between EMDR and the NEM analog.
Results of the present study support the role of eye movements in attaining treatment gains with EMDR. Additionally, this study supports the efficacy of EMDR in the treatment of combat-related guilt.