Dissociation predicts treatment response in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder

Using clinical data at a specialized trauma clinic, this study investigated pre-treatment clinical factors predicting response to eye movement desensitization and reprocessing (EMDR) among adult patients diagnosed with posttraumatic stress disorder (PTSD). Participants were evaluated on the Clinician-administered PTSD Scale (CAPS), the Symptom Checklist-90-Revised, the Beck Depression Inventory, and the Dissociative Experiences Scale before treatment, and were reassessed on the CAPS after treatment and at 6-month follow-up. A total of 69 patients underwent an average of four sessions of EMDR and 60 (87%) completed the post-treatment evaluation, including eight participants who terminated treatment prematurely. Intent-to-treat analysis revealed that 39 (65%) of the 60 patients were classified as responders and 21 (35%) as non-responders when response was defined as a more than 30% decrease in total CAPS score. The non-responders had higher levels of dissociation (depersonalization and derealization) and numbing symptoms, but other PTSD symptoms such as avoidance, hyperarousal and intrusion were not significantly different. The number of psychiatric comorbidities was also associated with treatment non-response. The final logistic regression model yielded two significant variables: dissociation (p < .001) and more than two comorbidities compared to none (p<.05). These results indicate that complex symptom patterns in PTSD may predict treatment response, and support the inclusion of the dissociative subtype of PTSD in the DSM-5.

Journal

English

Hwallip Bae
Daeho Kim
Yong Chon Park

Bae, H., Kim, D., & Park, Y. C. (2015, July). Dissociation predicts treatment response in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder. Journal of Trauma & Dissociation.  doi:10.1080/15299732.2015.1037039