Meta-analyis by C-B researchers

• Cognitive-Behavioral Therapy and EMDR Research by Francine Shapiro, 8/4/97
  
  

What do you make of this? It is on the Anxiety forum of behavior.net.

Treatment of Post-Traumatic Stress Disorder (Highlights from a Poster Session)

Anxiety Disorders (Fleming) Report from AABT by Jim Pretzer, 11/30/96

Treatment of Post-Traumatic Stress Disorder (Highlights from a Poster Session) by Jim Pretzer, 11/30/96

One of the on-going controversies in the treatment of PTSD has been over Eye Movement Desensitization and Reprocessing (EMDR) and its efficacy as a treatment for PTSD. EMDR is an interesting treatment approach which combines repetitive eye movements while imagining a traumatic experience with cognitive restructuring. While the rationale for the repetitive eye movements is unconvincing to many, there have been clinical reports that this technique is remarkably effective. Unfortunately, well-controlled comparisons between this treatment approach and conventional treatments for PTSD have been lacking.

At previous AABT meetings, the results of studies of EMDR have been mixed. This year as well, there were studies with results which showed that EMDR was effective, studies which failed to find that it was effective, and studies which found that it was equally effective with and without the eye movements.

Michelle Van Etten (Johns Hopkins) and Steven Taylor (U. of British Columbia) presented the results of a meta-analysis of the results of 29 outcome studies of treatments for chronic PTSD which produced interesting results. In general, dropout was lower for psychotherapies than drug therapies. Overall, psychotherapies and drug therapies were both more effective than control groups and were equally effective on observer-rated measures. Pychotherapies were more effective than drug therapies on self-report measures. Psychotherapies and drug therapies were equally effective in treating intrusions while psychotherapies were more effective than drug therapies at redusive avoidance.

Behavior therapy was the most effective of the psychotherapies tested and SSRIs were the most effective of the medications tested. Studies of EMDR reported large effects on several self-report measures but the variance reported was quite large so that differences with other treatments were not statistically significant. Carbamazepine demonstrated large treatment effects on some measures but it had only been tested in one study.

The authors conclude that PTSD is a treatable disorder. They find that behavior therapy is the most effective and reliable psychotherapy for PTSD and that EMDR shows some promise but that further research is needed. They note that drug treatments have more trouble with clients dropping out of treatment prematurely and conclude that SSRIs are the most effective medications while carbamazepine shows promise.

• The finished Meta-analysis was reported one month ago by Francine Shapiro, 10/10/97