Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: randomised clinical trial

Abstract

Background Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population. Aims The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD. Method We conducted an international, multicentre, randomised clinical trial, recruiting adults with Ch-PTSD from childhood trauma before 16 years of age. Participants were randomised to treatment condition and assessed by blind raters at multiple time points. Participants received up to 12 90-min sessions of either ImRs or EMDR, biweekly. Results A total of 155 participants were included in the final intent-to-treat analysis. Drop-out rates were low, at 7.7%. A generalised linear mixed model of repeated measures showed that observer-rated post-traumatic stress disorder (PTSD) symptoms significantly decreased for both ImRs (d = 1.72) and EMDR (d = 1.73) at the 8-week post-treatment assessment. Similar results were seen with secondary outcome measures and self-reported PTSD symptoms. There were no significant differences between the two treatments on any standardised measure at post-treatment and follow-up. Conclusions ImRs and EMDR treatments were found to be effective in treating PTSD symptoms arising from childhood trauma, and in reducing other symptoms such as depression, dissociation and trauma-related cognitions. The low drop-out rates suggest that the treatments were well tolerated by participants. The results from this study provide evidence for the use of trauma-focused treatments for Ch-PTSD.

How do adults with post‐traumatic stress disorder from childhood trauma talk about single versus repeated traumas?

“…The Beck depression inventory (Beck et al, 1961) score did not differ between groups (SE: M = 30.6, SD = 11.3; RE: M = 30.9, SD = 10.9). All participants were screened for psychiatric disorders using the structured clinical interview or mini international neuropsychiatric interview, as well as trauma history (see Boterhoven de Haan et al, 2020 for details and exclusion criteria).…”

“…We focus exclusively on differences in consistency between SE and RE, because the small case numbers do not permit an analysis of interaction effects with treatment type. The treatments and outcomes are reported elsewhere (see Boterhoven de Haan et al, 2020).…”

“…For details of the methodology of the clinical trial see Boterhoven de Haan et al (2017). The complete results of the clinical trial are presented in a separate paper (Boterhoven de Haan et al, 2020 ) and will not be discussed further here.…”

“…the clinical trial are presented in a separate paper (Boterhoven de Haan et al, 2020) and will not be discussed further here.…”

Clinical Efficacy and Cost-Effectiveness of Imagery Rescripting Only Compared to Imagery Rescripting and Schema Therapy in Adult Patients With PTSD and Comorbid Cluster C Personality Disorder: Study Design of a Randomized Controlled Trial

“…In a meta-analysis, Morina et al (16) conclude that ImRs holds promise as an effective and efficient intervention reducing psychological complaints associated with aversive memories. Furthermore, a recent study comparing ImRs and eye movement desensitization and reprocessing, a well-established evidencebased treatment for PTSD, showed that the two approaches were equally safe and effective in a population of patients with PTSD from childhood trauma (17).…”