JMIR Publications

ABSTRACT

Background:

Exposures to ‘traumatic’ events are widespread, and can cause post-traumatic stress disorder (PTSD). Cognitive Behavioural Therapy (CBT), Exposure Based Therapies (EBTs), and Eye Movement and Desensitization (EMDR) are the best-validated behavioural PTSD treatments. Although EBTs have demonstrated effectiveness, they can evoke highly upsetting memories, resulting in extensive distress and treatment dropout. In recent years, several treatment approaches have eliminated the need for direct re-exposures to traumatic memories. One of these methods, the Flash Technique (FT), a modification of traditional EMDR, appears effective in distressing memory reduction. This RCT study examines FT efficacy delivered online via videos created by the FT treatment developers.

Objective:

To assess whether (online) FT - EMDR, is effective in reducing anxieties and PTSD symptoms associated with traumatic memories at post-intervention and 1-month follow up. Depression effects are also examined.

Methods:

This double-blinded, online 2-arm RCT employed self-report outcomes. N = 90 participants identified from the online CloudResearch platform were randomly allocated to the experimental or comparison group. Inclusion Criteria: (1) approved for engagement by the CloudResearch platform (www.cloudresearch.com); (2) 25 to 60 years; 3) US-Canada residence; (4) a recalled disturbing memory of an event > 2 years ago that has not repeated and was moderately or more upsetting when the event occurred; (5) memory moderately or more upsetting at baseline and not linked to an earlier memory (that is = or > = disturbing). Exclusion Criteria: bipolar disorder; borderline personality disorder; obsessive compulsive disorder; schizophrenia; and /or substance abuse/addiction in the past 3 months; suicidal ideation and/or suicide attempt in the past 6 months. Interventions: Guided video instruction of full FT versus guided video of EMDR. Measures: Primary outcome: Post Traumatic Stress Disorder symptoms (PTSD) measured by PCL-5 at 1 month follow-up and the State Anxiety subscale of the State Trait Anxiety Inventory (STAI) at baseline, post-intervention, and 1-month follow up; depression (PHQ9) and Positive-Negative Affect (PANAS) measured at 1 month follow up.

Results:

At 1 month follow-up, if the online EMDR interventions are effective in reducing Post Traumatic Stress Disorder symptoms (as measured by the PCL-5) these methods can be employed to reduce traumatic memory distress in multiple contexts.

Conclusions:

This RCT will advance current understandings of Post Traumatic Stress Disorder symptoms and interventions that target traumatic memory-related distress. Clinical Trial: ClinicalTrial.com (NCT05262127)