An investigation into EMDR and imagery rescripting for PTSD in adult survivors of childhood sexual abuse: A case series

In clinical settings, PTSD related to a history of childhood sexual abuse (CSA) is associated with more severe symptom complexity and worse prognosis, when compared to adult onset PTSD. Relatively little is known about how best to deal with this symptom profile. The current study reviewed three cases in which Imagery Rescripting (ImRs) or Eye Movement Desensitisation and Reprocessing (EMDR) was administered in survivors of CSA experiencing current PTSD symptoms. In the first case a survivor of prolonged CSA received 12 sessions of ImRs and demonstrated clinically significant improvement in PTSD symptoms at the conclusion of treatment, and by an eight week follow-up they no longer met criteria for a PTSD diagnosis. In the second case a survivor of a single incident of CSA received eight sessions (in full) of EMDR and at post-treatment assessment showed clinically significant improvement and an absence of a PTSD diagnosis was observed. The final case investigated the effect of 12 sessions of EMDR in a survivor of prolonged multiple CSA and multiple adult sexual assaults. In this case, clinically significant change was revealed at the conclusion of treatment, but was not maintained at follow-ups. All three cases revealed symptom improvement to some degree, as well as clinical observations and self-report of functional gains; however, finer analysis reveals these gains cannot yet be confidently attributed to ImRs and EMDR. Further investigation of EMDR and ImRs are needed in a RCT design before efficacy of treatment within this population can be determined. The current study's positive findings suggest it is feasible to conduct such a large scale investigation of these treatments. However, several design weaknesses were identified in this pilot including insufficient recruitment and retention rates and iatrogenic consequences of one of the measures. Recommendations are provided on how to address these issues.

Disseration/Thesis

English

Susannah Shields,

Shields, S. (2015). An investigation into EMDR and imagery rescripting for PTSD in adult survivors of childhood sexual abuse: A case series. (Master's thesis, Murdoch University)