Important controlled study related to combat veterans

In the recent issue of the Journal of Traumatic Stress:

Carlson, J.G., Chemtob, C.M., Rusnak, K., Hedlund, N.L., & Muraoka, M.Y. (1998). Eye movement desensitization and reprocessing for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11, 3-24.

This controlled study tested the effect of EMDR on chronic combat veterans suffering from PTSD since the Vietnam War. Within 12 sessions subjects showed substantial clinical improvement, with 70% losing the PTSD diagnosis and with a number becoming completely symptom-free. EMDR proved superior to a biofeedback relaxation control group and to a group receiving routine VA clinical care. Results were independently evaluated on CAPS-1, Mississippi Scale for PTSD, IES, PTSD Symptom Scale, Beck Depression Inventory, and STAI.

A recent review of the PTSD literature (Shalev, Bonne & Eth, 1996) concluded that chronic PTSD appeared intractable to treatment and suggested that focus be placed upon rehabilitation instead. However, all treatments EXCEPT EMDR were evaluated. This study clearly has important implications for the treatment of combat veterans.

Further, it is extremely important that treatment outcome research incorporate appropriate clinical standards. The EMDR research with combat veterans that has shown negative and equivocal effects have used insufficient treatment time (e.g. only two sessions) and/or used global psychometrics when treating only one or two memories in this multiply-traumatized population. If appropriate clinical standards are not incorporated into controlled treatment research combat veterans will continue to needlessly suffer. It is vital that practicing clinicians become involved in the research process in order to appropriately guide clinical practice.

• Published Case of a 75-year old World War II veteran by Shapiro, 4/10/98