Gerald M. Rosen

Psychology Should List Empirically Supported Principles of Change (ESPs) and Not Credential Trademarked Therapies or Other Treatment Packages

Current systems for listing empirically supported therapies (ESTs) provide recognition to treatment packages, many of them proprietary and trademarked, without regard to the principles of change believed to account for their effectiveness. Our position is that any authoritative body representing the science and profession of psychology should work solely toward the identification of empirically supported principles of change (ESPs). As challenging as it is to take this approach, a system that lists ESPs will keep a focus on issues central to the science and practice of psychology while also insulating the profession from undue entrepreneurial influences.

Posttraumatic stress disorder: An empirical evaluation of core assumptions

The diagnosis of posttraumatic stress disorder (PTSD) rests on several core assumptions, particularly the premise that a distinct class of traumatic events is linked to a distinct clinical syndrome. This core assumption of specific etiology ostensibly distinguishes the PTSD diagnosis from virtually all other psychiatric disorders. Additional attempts to distinguish PTSD from extant conditions have included searches for distinctive markers (e.g., biological and laboratory findings) and hypothesized underlying mechanisms (e.g., fragmentation of traumatic memory). We review the literature on PTSDs core assumptions and various attempts to validate the construct within a nomological network of distinctive correlates. We find that virtually all core assumptions and hypothesized mechanisms lack compelling or consistent empirical support. We consider the implications of these findings for conceptualizing PTSD in the forthcoming edition of the American Psychiatric Associations diagnostic manual.

Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology

The enormous popularity recently achieved by Eye Movement Desensitization and Reprocessing (EMDR) as a treatment for anxiety disorders appears to have greatly outstripped the evidence for its efficacy from controlled research studies. The disparity raises disturbing questions concerning EMDRs aggressive commercial promotion and its rapid acceptance among practitioners. In this article, we: (1) summarize the evidence concerning EMDRs efficacy; (2) describe the dissemination and promotion of EMDR; (3) delineate the features of pseudoscience and explicate their relevance to EMDR; (4) describe the pseudoscientific marketing practices used to promote EMDR; (5) analyze factors contributing to the acceptance of EMDR by professional psychologists; and (6) discuss practical considerations for professional psychologists regarding the adoption of EMDR into professional practice. We argue that EMDR provides an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapeutic techniques. Such distinctions are of critical importance for clinical psychologists who intend to base their practice on the best available research.

Problems with the post-traumatic stress disorder diagnosis and its future in DSM–V

Significant issues challenge the diagnosis of post-traumatic stress disorder (PTSD). Yet, applications of the PTSD model have been extended to an increasing array of events and human reactions across diverse cultures. These issues have implications for clinical practice and for those who revise criteria in the DSM-V.

Duration of Exposure and the Dose-Response Model of PTSD

A dose-response model underlies posttraumatic stress disorder (PTSD) and posits a relationship between event magnitude and clinical outcome. The present study examines whether one index of event magnitude—duration of exposure—contributes to risk of PTSD among female victims of sexual assault. Findings support a small but significant contribution of event duration to clinical status in the immediate aftermath of trauma but not at 3-month follow-up. The opposite pattern is obtained for subjective appraisals of threat. These findings add to a growing literature that suggests that a simple application of the dose-response model to objective event characteristics may be insufficient to explain the risk of PTSD.

Self-Help or Hype? Comments on Psychology's Failure to Advance Self-Care

This article demonstrates that self-help programs are experiencing explosive growth; that psychologists are to be credited with a substantial body of research dating back to the 1970s; that this research demonstrates the potential of self-help programs; that some psychologists have failed to heed the results of studies by rushing to market with exaggerated product claims; and that the American Psychological Association has itself set a poor example and failed to advance clear standards. These points are not intended as a criticism of self-help. Rather, they serve as an observation of psychologys failure to advance self-care. Psychologists are encouraged to meet the challenge that self-care presents.

Treatment fidelity and research on Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing was introduced by Frances Shapiro (1989) as a treatment for posttraumatic stress disorder. When controlled studies failed to support the extraordinarily positive findings and claims made by Shapiro, proponents of EMDR raised the issue of treatment fidelity and criticized researchers for being inadequately trained. This paper considers the issues raised by EMDR proponents. It is concluded that treatment fidelity has been used as a specious, distracting issue that permits the continued promotion of EMDR in the face of negative empirical findings. Clinical psychologists are urged to remember the basic tenets of science when evaluating extraordinary claims made for novel techniques.

Reflections on PTSD’s future in DSM–V

Research findings have fuelled debate on the construct validity of post-traumatic stress disorder (PTSD). Accompanying these issues are competing suggestions to redefine PTSDs criteria, including a recent proposal by DSM-V committee members. We review various approaches to revising the PTSD diagnosis and conclude that proposed changes should be placed in the appendix that the DSM has used for experimental criteria sets.

Use of a Symptom Validity Test in the forensic assessment of Posttraumatic Stress Disorder

Symptom Validity Tests (SVTs) employ a two-alternative, forced-choice method to assess an individuals motivation to perform. The strategy is routinely used by neuropsychologist with plaintiffs who allege brain injury, but heretofore has not been applied to the forensic assessment of posttrauma claims. The present case report applied an accepted SVT, the Portland Digit Recognition Test, to the forensic assessment of Posttraumatic Stress Disorder. Findings illustrate how SVTs can be useful in any forensic or disability case that presents with memory complaints.

On the origin of eye movement desensitization

Francine Shapiro, the founder of eye movement desensitization therapy (EMD) claims to have serendipitously discovered this technique by experiencing spontaneous saccadic eye movements in response to disturbing thoughts during a walk in the woods. This explanation is difficult to accept because normal saccadic eye movements appear to be physiologically undetectable and are typically triggered by external stimuli. In the present limited study, all subjects failed to elicit any experience of eye movements, thus calling into question how best to interpret Dr. Shapiros experience and the origin of EMD.