Ellen M J Gielkens, Gina Rossi, Sebastiaan P J van Alphen, Sjacko Sobczak
{"title":"A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder?","authors":"Ellen M J Gielkens, Gina Rossi, Sebastiaan P J van Alphen, Sjacko Sobczak","doi":"10.1177/08919887231207639","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events).</p><p><strong>Design: </strong>Multicenter design with pre-post measurements.</p><p><strong>Setting: </strong>Psychiatric Dutch hospitals Mondriaan Mental Health Center and Altrecht.</p><p><strong>Participants: </strong>22 treatment-seeking PTSD-outpatients (60-84 years).</p><p><strong>Intervention: </strong>Weekly one-hour EMDR session during 3, 6, or 9 months.</p><p><strong>Measurements: </strong>PTSD was assessed with Clinician-Administered PTSD-scale for DSM-5 (CAPS-5). Verbal learning memory was measured with Auditory Verbal Learning Test (RAVLT), interference with Stroop Colour-Word Test (SCWT) and working memory with Wechsler Adult Intelligence Scale-Digit Span (WAIS-IV-DS).</p><p><strong>Results: </strong>A Linear mixed-model showed significant improvement on RAVLT immediate-recall (F (1, 21) = 15.928, <i>P</i> = .001, 95% CI -6.98-2.20), delayed-recall (F (1, 21) = 7.095, <i>P</i> = .015, 95% CI -2.43-.30), recognition (F (21) = 8.885, <i>P</i> = .007, 95% CI -1.70- -.30), and SCWT (F (1 ,21) = 5.504, <i>P</i> = .029, 95% CI 4.38-72.78) but not on WAIS-IV-DS (F (20) = -1.237, <i>P</i> = .230, 95% CI -3.07-.78). There was no significant influence of therapy duration and CAPS-5 pre-treatment scores. There were small-medium nonsignificant correlations between CAPS-5 and cognitive performance pre-post differences, and between most cognitive measures and sleep problems, depressive disorder, and physical inactivity.</p><p><strong>Conclusions: </strong>Cognitive functioning on memory and attention possible increased in older adults with PTSD after EMDR treatment. Further research is needed with a larger sample and a control condition to corroborate these findings and to identify the possible mediating role of modifiable risk factors.</p>","PeriodicalId":16028,"journal":{"name":"Journal of Geriatric Psychiatry and Neurology","volume":" ","pages":"206-221"},"PeriodicalIF":2.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Geriatric Psychiatry and Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08919887231207639","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events).
Design: Multicenter design with pre-post measurements.
Setting: Psychiatric Dutch hospitals Mondriaan Mental Health Center and Altrecht.
Intervention: Weekly one-hour EMDR session during 3, 6, or 9 months.
Measurements: PTSD was assessed with Clinician-Administered PTSD-scale for DSM-5 (CAPS-5). Verbal learning memory was measured with Auditory Verbal Learning Test (RAVLT), interference with Stroop Colour-Word Test (SCWT) and working memory with Wechsler Adult Intelligence Scale-Digit Span (WAIS-IV-DS).
Results: A Linear mixed-model showed significant improvement on RAVLT immediate-recall (F (1, 21) = 15.928, P = .001, 95% CI -6.98-2.20), delayed-recall (F (1, 21) = 7.095, P = .015, 95% CI -2.43-.30), recognition (F (21) = 8.885, P = .007, 95% CI -1.70- -.30), and SCWT (F (1 ,21) = 5.504, P = .029, 95% CI 4.38-72.78) but not on WAIS-IV-DS (F (20) = -1.237, P = .230, 95% CI -3.07-.78). There was no significant influence of therapy duration and CAPS-5 pre-treatment scores. There were small-medium nonsignificant correlations between CAPS-5 and cognitive performance pre-post differences, and between most cognitive measures and sleep problems, depressive disorder, and physical inactivity.
Conclusions: Cognitive functioning on memory and attention possible increased in older adults with PTSD after EMDR treatment. Further research is needed with a larger sample and a control condition to corroborate these findings and to identify the possible mediating role of modifiable risk factors.
期刊介绍：
Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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