Decreased Emotional Dysregulation Following Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation Therapy (3MDR): Identifying Possible Driving Factors in Remediation of Treatment-Resistant PTSD

Tang, Emily; Jones, Chelsea; Smith-MacDonald, Lorraine; Brown, Matthew; Vermetten, Eric; Brémault‐Phillips, Suzette

doi:10.3390/ijerph182212243

Cited by 11 publications

(13 citation statements)

References 41 publications

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“…Our findings complement the growing body of evidence suggesting 3MDR may effectively address emotional regulation by providing a healthy way for participants to remain grounded and connected while processing distressing emotions ( 28 , 29 , 35 ). Difficulties with emotional regulation are common in PTSD, with emotional dysregulation being positively associated with PTSD severity ( 36 ) and maintenance of PTSD symptoms ( 37 , 38 ).…”

Section: Discussionsupporting

confidence: 77%

“…Addressing emotion may be as important as addressing the fear-based stimuli (39). Study results add to preliminary quantitative results from a 3MDR randomized control trial showing an increase in emotional regulation following 3MDR (35,40). Within the current study, participants felt that "breaking through" and reconsolidating traumatic memories allowed them to reconnect with their "lost selves" and provided hope for recovery.…”

Section: Discussionmentioning

confidence: 61%

“…The increasing emotional intensity of sequential images within 3MDR appears to minimize avoidance. Participants noted that viewing the images allowed them to process distressing emotions and facilitate improvements in their emotional regulation during the treatment by enabling participants to adaptively respond to negative emotions arising from threatening or aversive stimuli ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

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Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

et al. 2021

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Introduction: Military members and Veterans are at risk of developing combat-related, treatment-resistant posttraumatic stress disorder (TR-PTSD) and moral injury (MI). Conventional trauma-focused therapies (TFTs) have shown limited success. Novel interventions including Multi-modal Motion-assisted Memory Desensitization and Reconsolidation therapy (3MDR) may prove successful in treating TR-PTSD.Objective: To qualitatively study the experiences of Canadian military members and Veterans with TR-PTSD who received the 3MDR intervention.Methods: This study explored qualitative data from a larger mixed-method waitlist control trial testing the efficacy of 3MDR in military members and veterans. Qualitative data were recorded and collected from 3MDR sessions, session debriefings and follow-up interviews up to 6 months post-intervention; the data were then thematically analyzed.Results: Three themes emerged from the data: (1) the participants' experiences with 3MDR; (2) perceived outcomes of 3MDR; and (3) keys to successful 3MDR treatment. Participants expressed that 3MDR provided an immersive environment, active engagement and empowerment. The role of the therapist as a coach and “fireteam partner” supports the participants' control over their therapy. The multi-modal nature of 3MDR, combining treadmill-walking toward self-selected trauma imagery with components of multiple conventional TFTs, was key to helping participants engage with and attribute new meaning to the memory of the traumatic experience.Discussion: Preliminary thematic analysis of participant experiences of 3MDR indicate that 3MDR has potential as an effective intervention for combat-related TR-PTSD, with significant functional, well-being and relational improvements reported post-intervention.Conclusion: Military members and Veterans are at risk of developing TR-PTSD, with worse outcomes than in civilians. Further research is needed into 3MDR and its use with other trauma-affected populations.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

et al. 2021

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“…Cortisol elevations have also been associated with 3MDR response, which may be key to successful treatment outcomes [ 618 , 765 ]. Improvement in MI symptoms, emotional regulation [ 769 ], resilience [ 762 ], function, well-being and relationships, sustained up to 6 months post-intervention, have also been reported Findings align with studies combining exposure with exercise to promote extinction retention (possibly via increased release of BDNF) [ 770 , 771 ], showing that exercise both improves PTSD, depressive and anxiety symptoms [ 772 , 773 ] and increases divergent thinking [ 764 ]. Ongoing studies in the Netherlands, United Kingdom, United States, and Canada aim to further explore the underlying mechanisms of 3MDR and its application with various populations.…”

Section: Emerging and Novel Approaches To The Treatment Of Ptsdmentioning

confidence: 59%

Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

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Brémault‐Phillips

Nijdam

et al. 2024

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This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of treatment yields a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.

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“…First is the advancement of our model per se , in the anticipation that it has generalisable value in underpinning and structuring detailed, empirical, exploration of the full range of factors associated with the success (or otherwise) of psychological interventions [ 33 , 34 ]. Second is the use of this model in an exemplifying way to support the granular analysis of factors associated specifically with the provision and receipt of 3MDR, this being a new and novel trauma-focused psychological intervention for people living with PTSD about which relatively little is known of its mechanism of effect [ 35 ]. Taken together, our paper advances understanding of what happens when complex interventions are delivered in complex systems to people living with complex difficulties.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the outcomes of a novel virtual reality therapy for military veterans with PTSD: Theory development using a mixed methods analysis

et al. 2023

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Background Multi-modular motion-assisted memory desensitization and reconsolidation therapy (3MDR) is a new psychological intervention for people with post-traumatic stress disorder (PTSD). 3MDR is immersive, delivered in a virtual reality environment, and emphasises engagement, recollection and reprocessing. Objective Through a theory-driven examination of data relating to 10 out of 42 UK military veterans taking part in a trial of 3MDR, the principal objective was to explore the complex interrelationships between people, interventions and context and to investigate how factors within these domains interacted in specific outcome typologies. Method Quantitative and qualitative data relating to 10 trial participants were derived from: researcher-assessed and self-report clinical measures; interviews; physiological recordings; words describing thoughts and feelings during therapy; and subjective unit of distress scores. Using a convergent mixed methods approach, data were tabulated using a person, intervention and context model. Participant summaries were grouped into outcome typologies, followed by an analysis of data convergence and divergence within each and an interpretation of identified patterns. Results Three outcome response typologies were identified: dramatic improvement, moderate improvement and minimal improvement. Within the person domain, factors associated with outcomes included walking capacity, commitment and ability to complete therapy, and levels of subjective distress. Within the intervention domain, factors associated with outcomes related to image selection and use, therapeutic alliance and orientations towards the tailoring of sessions. Within the context domain, factors associated with outcomes included reactions to the therapy environment. The patterning of secondary outcomes broadly corresponded with primary outcomes within each typology. Alongside patterned data differentiating aspects of the person, intervention and context domains, within the three response typologies data also existed where no obvious patterning was detected. Conclusions The model developed here may have novel value in evaluating a range of personalised interventions, but further work is needed before confident assertions can be made of who is likely to benefit from 3MDR specifically.

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Decreased Emotional Dysregulation Following Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation Therapy (3MDR): Identifying Possible Driving Factors in Remediation of Treatment-Resistant PTSD

Cited by 11 publications

References 41 publications

Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Factors associated with the outcomes of a novel virtual reality therapy for military veterans with PTSD: Theory development using a mixed methods analysis

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