Editing Post-traumatic stress disorder (section)

==== Eye movement desensitization and reprocessing ====
{{Main|Eye movement desensitization and reprocessing}}
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed and studied by [[Francine Shapiro]].<ref name="Shapiro F 1989 199–223">{{cite journal |vauthors=Shapiro F |title=Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories |journal=[[Journal of Traumatic Stress]] |date=April 1989 |volume=2 |issue=2 |pages=199–223 |doi=10.1002/jts.2490020207}}</ref> She had noticed that, when she was thinking about disturbing memories herself, her eyes were moving rapidly. When she brought her eye movements under control while thinking, the thoughts were less distressing.<ref name="Shapiro F 1989 199–223" />

In 2002, Shapiro and Maxfield published a theory of why this might work, called adaptive information processing.<ref>{{cite journal |vauthors=Shapiro F, Maxfield L |title=Eye Movement Desensitization and Reprocessing (EMDR): information processing in the treatment of trauma |journal=[[Journal of Clinical Psychology]] |volume=58 |issue=8 |pages=933–46 |date=August 2002 |pmid=12115716 |doi=10.1002/jclp.10068}}</ref> This theory proposes that eye movement can be used to facilitate emotional processing of memories, changing the person's memory to attend to more adaptive information.<ref name=VAguideline>{{cite web |last=The Management of Post-Traumatic Stress Working Group |title=VA/DoD clinical practice guideline for management of post-traumatic stress |url=http://www.healthquality.va.gov/Post_Traumatic_Stress_Disorder_PTSD.asp |access-date=2 June 2013 |publisher=Department of Veterans Affairs, Department of Defense |page=Version 2.0 |year=2010 |url-status=live |archive-url=https://web.archive.org/web/20130530234757/http://www.healthquality.va.gov/Post_Traumatic_Stress_Disorder_PTSD.asp |archive-date=30 May 2013}}</ref> The therapist initiates voluntary rapid eye movements while the person focuses on memories, feelings or thoughts about a particular trauma.<ref name=UK2005/><ref name=CochraneGilliesKids>{{cite journal |vauthors=Gillies D, Taylor F, Gray C, O'Brien L, D'Abrew N |title=Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents |journal=[[Cochrane Library|The Cochrane Database of Systematic Reviews]] |volume=12 |pages=CD006726 |date=December 2012 |pmid=23235632 |doi=10.1002/14651858.CD006726.pub2 |hdl=1959.13/1311467 |hdl-access=free}}</ref> The therapist uses hand movements to get the person to move their eyes backward and forward, but hand-tapping or tones can also be used.<ref name=UK2005/> EMDR closely resembles [[cognitive behavior therapy]] as it combines exposure (re-visiting the traumatic event), working on cognitive processes and relaxation/self-monitoring.<ref name=UK2005/> However, exposure by way of being asked to think about the experience rather than talk about it has been highlighted as one of the more important distinguishing elements of EMDR.<ref name="Jeffries/Davis">{{cite journal |vauthors=Jeffries FW, Davis P |title=What is the role of eye movements in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD)? a review |journal=[[Behavioural and Cognitive Psychotherapy]] |volume=41 |issue=3 |pages=290–300 |date=May 2013 |pmid=23102050 |doi=10.1017/S1352465812000793 |s2cid=33309479}}</ref>

Several scientific studies have evaluated the efficacy of EMDR in adults<ref name="AHRQtreat92">{{Cite book |vauthors=Jonas DE, Cusack K, Forneris CA |title=Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD) |publisher=Agency for Healthcare Research and Quality |url=https://www.ncbi.nlm.nih.gov/books/NBK137702/ |series=Comparative Effectiveness Reviews No. 92 |date=April 2013 |location=Rockville, MD |pmid=23658937 |url-status=live |archive-url=https://web.archive.org/web/20170118124526/https://www.ncbi.nlm.nih.gov/books/NBK137702/ |archive-date=2017-01-18}}</ref> as well as children and adolescents.<ref name="CochraneGilliesKids" /> There is moderate strength of evidence to support the efficacy of EMDR "for reduction in PTSD symptoms, loss of diagnosis, and reduction in depressive symptoms" according to a 2018 systematic review update.<ref name="Forman-Hoffman_2018" /> 

In children and adolescents, a recent meta-analysis of [[randomized controlled trials]] found that EMDR was at least as efficacious as CBT, and superior to waitlist or placebo.<ref name=MetaNSUE/> There was some evidence that EMDR might prevent depression.<ref name="AHRQtreat92" /> Adverse effects were largely unstudied.<ref name="AHRQtreat92" /> The benefits were greater for women with a history of sexual assault compared with people who had experienced other types of traumatizing events (such as accidents, physical assaults and war).

The eye movement component of the therapy may not be critical for benefit.<ref name="UK2005" /><ref name="VAguideline" />