眼动脱敏（EMD）后创伤后应激障碍（PTSD）的应激和应激反应：一项随机对照试验

IF 2.2 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry Pub Date : 2025-07-16 DOI:10.1016/j.jbtep.2025.102052

Eka Susanty , Marit Sijbrandij , Denise J. van der Mee , Wilis Srisayekti , Yusep Suparman , Anja C. Huizink

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引用次数: 0

摘要

背景和目的创伤后应激障碍（PTSD）患者可能会经历高度的应激反应。眼动脱敏和再加工（EMDR）是一种基于证据的治疗方法，涉及在检索记忆时的眼动。我们评估了EMD参与者在个人创伤脚本后的应激反应是否低于仅提取的参与者。我们还研究了与治疗结果相关的每日皮质醇水平的变化。方法91名yptsd参与者随机分为EMD组（N = 47）和单纯检索组（N = 44）。收集基线和治疗后数据，并使用心率变异性（HRV）、心率（HR）、射血前期（PEP）和皮质醇水平(AUC；曲线下面积、CAR；皮质醇唤醒反应)。我们进行了一个线性混合模型来分析主要结果。结果随着时间的推移，EMD与提取法在降低应激反应性和加速恢复方面没有差异。两组患者治疗后HR和PEP对创伤脚本的反应性均显著降低。相比之下，只有EMD组在治疗后对创伤脚本的反应中经历了HR恢复的加速。皮质醇测量显示出不一致的模式，与EMD相比，治疗后仅恢复的CAR更高。然而，治疗后各组间的AUC水平无显著差异。限制测量和分析唾液样本的精度高度依赖于参与者对时间表的遵守。结论本研究未发现对眼球运动有明显的益处。EMDR和单纯的提取疗法都能降低PTSD患者的应激反应。临床试验注册[www.ClinicalTrials.gov]，标识符[ISRCTN55239132]。

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Stress and stress reactivity in posttraumatic stress disorder (PTSD) following eye movement desensitization (EMD): A randomized controlled trial

Background and objectives

People with posttraumatic stress disorder (PTSD) may experience heightened stress reactivity. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment involving eye movements while retrieving memories. We evaluated if EMD participants had less stress reactivity than retrieval-only participants after personal trauma scripts. We also investigated changes in daily cortisol levels related to treatment outcomes.

Methodology

PTSD participants (N = 91) were randomly assigned to EMD (N = 47) or retrieval-only conditions (N = 44). Baseline and post-treatment data were collected and measured using Heart rate variability (HRV), heart rate (HR), pre-ejection period (PEP), and cortisol levels (AUC; the area under the curve, and CAR; the cortisol awakening response). We conducted a linear mixed model to analyze the main outcomes.

Results

No difference between EMD and retrieval-only in the reduction of stress reactivity and acceleration of recovery over time. Both groups showed that HR and PEP reactivity to the trauma script decreased significantly after treatment. In contrast, only EMD group experienced an acceleration of HR recovery in response to trauma scripts following treatment. Cortisol measures showed an inconsistent pattern, with a higher CAR in retrieval-only after treatment compared to EMD. However, no significant difference was found between groups in terms of AUC levels after treatment.

Limitation

The precision of measuring and analyzing saliva samples is highly dependent on the participant's adherence to the schedule.

Conclusion

No specific benefits for eye movements was found in the current study. Both EMDR and retrieval-only can reduce stress reactivity in treating PTSD.

Clinical trial registration

[www.ClinicalTrials.gov], identifier [ISRCTN55239132].

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来源期刊

Journal of Behavior Therapy and Experimental Psychiatry Multiple-

CiteScore

3.60

自引率

5.60%

发文量

期刊介绍： The publication of the book Psychotherapy by Reciprocal Inhibition (1958) by the co-founding editor of this Journal, Joseph Wolpe, marked a major change in the understanding and treatment of mental disorders. The book used principles from empirical behavioral science to explain psychopathological phenomena and the resulting explanations were critically tested and used to derive effective treatments. The second half of the 20th century saw this rigorous scientific approach come to fruition. Experimental approaches to psychopathology, in particular those used to test conditioning theories and cognitive theories, have steadily expanded, and experimental analysis of processes characterising and maintaining mental disorders have become an established research area.