TY - JOUR
T1 - The working mechanisms of imagery rescripting and eye movement desensitization and reprocessing
T2 - Findings from a randomised controlled trial
AU - Rameckers, Sophie A.
AU - van Emmerik, Arnold A.P.
AU - Boterhoven de Haan, Katrina
AU - Kousemaker, Margriet
AU - Fassbinder, Eva
AU - Lee, Christopher W.
AU - Meewisse, Mariel
AU - Menninga, Simone
AU - Rijkeboer, Marleen
AU - Schaich, Anja
AU - Arntz, Arnoud
N1 - Funding Information:
We want to thank all students, patients, and therapists who contributed to the trial.
Publisher Copyright:
© 2024 The Authors
PY - 2024/4
Y1 - 2024/4
N2 - We studied the mechanisms of eye movement desensitization and reprocessing (EMDR) and imagery rescripting (ImRs). We hypothesized that EMDR works via changes in memory vividness, that ImRs works via changes in encapsulated beliefs (EB), and that both treatments work via changes in memory distress. Patients (N = 155) with childhood-related posttraumatic stress disorder (Ch-PTSD) received 12 sessions of EMDR or ImRs. The vividness, distress, and EB related to the index trauma were measured with the Imagery Interview. PTSD severity was assessed with the Impact of Events Scale-Revised and the Clinician-Administered PTSD Scale for DSM-5. We conducted mixed regressions and Granger causality analyses. EMDR led to initially stronger changes in all predictors, but only for distress this was retained until the last assessment. No evidence for vividness as a predictive variable was found. However, changes in distress and EB predicted changes in PTSD severity during ImRs. These findings partially support the hypothesized mechanisms of ImRs, while no support was found for the hypothesized mechanisms of EMDR. Differences in the timing of addressing the index trauma during treatment and the timing of assessments could have influenced the findings. This study provides insight into the relative effectiveness and working mechanisms of these treatments.
AB - We studied the mechanisms of eye movement desensitization and reprocessing (EMDR) and imagery rescripting (ImRs). We hypothesized that EMDR works via changes in memory vividness, that ImRs works via changes in encapsulated beliefs (EB), and that both treatments work via changes in memory distress. Patients (N = 155) with childhood-related posttraumatic stress disorder (Ch-PTSD) received 12 sessions of EMDR or ImRs. The vividness, distress, and EB related to the index trauma were measured with the Imagery Interview. PTSD severity was assessed with the Impact of Events Scale-Revised and the Clinician-Administered PTSD Scale for DSM-5. We conducted mixed regressions and Granger causality analyses. EMDR led to initially stronger changes in all predictors, but only for distress this was retained until the last assessment. No evidence for vividness as a predictive variable was found. However, changes in distress and EB predicted changes in PTSD severity during ImRs. These findings partially support the hypothesized mechanisms of ImRs, while no support was found for the hypothesized mechanisms of EMDR. Differences in the timing of addressing the index trauma during treatment and the timing of assessments could have influenced the findings. This study provides insight into the relative effectiveness and working mechanisms of these treatments.
KW - EMDR
KW - Imagery rescripting
KW - Posttraumatic stress disorder
KW - Treatment mechanisms
UR - http://www.scopus.com/inward/record.url?scp=85185712989&partnerID=8YFLogxK
U2 - 10.1016/j.brat.2024.104492
DO - 10.1016/j.brat.2024.104492
M3 - Article
C2 - 38359658
AN - SCOPUS:85185712989
SN - 0005-7967
VL - 175
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
M1 - 104492
ER -