Preliminary efficacy of eye movement desensitization and reprocessing for children aged 1.5-8 years with PTSD: a multiple baseline experimental design (N = 19).

Abstract

Background: Trauma exposure is common in (pre) school-aged children and around one-fifth of exposed children meet the criteria for post-traumatic stress disorder (PTSD). These symptoms can cause severe impairment to a child's functioning and, if left untreated, have negative long-term consequences. Therefore, there is an urgent need for effective treatment to reduce the acute and long-term effects of trauma. However, currently, there are no established empirically validated treatments for PTSD in young children.Objective: To assess the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for improving PTSD symptoms, behavioural and emotional problems in young children aged 1.5-8 years, and parenting stress in their parents.Method: A non-concurrent, multiple baseline experimental design was combined with standardized measures across 19 mostly chronically trauma-exposed children fulfilling DSM-5 PTSD diagnosis. Primary outcomes included effects on the severity of PTSD symptoms and the rate of diagnostic remission from PTSD. Secondary outcomes included emotional and behavioural problems and parenting stress at each assessment point (baseline, pre-treatment, post-treatment, and three-month follow-up). Participants received six 1-hour EMDR sessions.Results: At post-treatment 79% of the children no longer met the diagnostic criteria for PTSD. Further, a significant decline in the severity of PTSD symptoms, emotional and behavioural problems in children was found post-treatment (all effect sizes > 1.20), as well as a significant reduction of parenting stress in their parents (Cohen's d effect size 0.45). All gains were maintained at the three-month follow-up, including a 79% loss of PTSD diagnosis. There was no dropout (0%) and no adverse events were reported.Conclusions: The findings provide preliminary evidence of the safety, feasibility, and efficacy of six sessions of EMDR therapy for reducing paediatric PTSD and comorbidity in young children aged 1.5-8 years and, at the same time, decreasing parenting stress. Further trials are warranted.Trial Registration: International Clinical Trial Registry Platform (before National Trial Register, trial search/who/int: identifier: NL8426, EMDR for young children with PTSD).