The efficacy of EMDR for survivors of a natural disaster: Intervention after Hurricane Floyd

Eye movement desensitization and reprocessing (EMDR) is considered effective for civilian PTSD, but no controlled evaluation of EMDR, or any other treatment for PTSD, has been conducted with adults in a natural disaster context. Following Hurricane Floyd, 8 individuals from disaster-torn North Carolina communities were randomly assigned to 6 sessions of EMDR or a 1-month waiting list followed by treatment. All of the predominantly Caucasian, female participants met DSM-IV criteria for PTSD, and half reported moderate to severe levels of depression. Participants completed standardized self-report measures of PTSD, depression, and anxiety before and after the waiting period, or before, during (Session 4), and after the 6-week intervention. The principal investigator (PI) and blind assistants conducted a PTSD symptom interview before and after treatment and waiting period. Weekly progress was monitored with additional PTSD and depression self-report measures. The PI, a Level II-trained EMDR therapist, provided treatment. Treatment integrity, assessed by undergraduate assistants following an established checklist, was good.Compared to the untreated control condition, EMDR produced significantly larger decreases in self-reported PTSD and depression symptoms, and tended to promote greater improvement in observer-rated PTSD. However, random effects regression analyses of the secondary PTSD measure failed to detect a significant difference between the two groups. In contrast, random regression analyses confirmed a significant decrease in depression during treatment compared to the control condition. Controlled effect sizes for PTSD symptoms were large and compared favorably to research with other trauma populations. Nevertheless, despite sizeable reductions in symptoms, many clients continued to report elevated levels of PTSD even after treatment. In addition, despite random assignment, the average age of the two groups differed, and age was non-significantly but negatively associated with change in PTSD symptoms. This association, and the small size of this sample, limit the interpretation and generalizability of these findings. Thus, while results tentatively support extending EMDR to disaster survivors with depression and PTSD, this work is best considered as preliminary data. Research with a larger sample remains necessary to better evaluate both the impact of treatment and the potentially more complex treatment needs of this population.

Dissertation/Thesis

English

Ursula Mary Swiney

Swiney, U. M. (2004). The efficacy of EMDR for survivors of a natural disaster: Intervention after Hurricane Floyd. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65(4-B), 2116