Géraldine Tapia

Treating Trauma in Addiction with EMDR: A Pilot Study

Abstract Objective: This study investigated the effects of standard eye movement desensitization and reprocessing (EMDR) protocol in chronically dependent patients. We propose that reprocessing traumatic memories with EMDR would lead to measurable changes of addiction symptoms. Method: Twelve patients with alcohol and/or drug dependency were randomly assigned to one of two treatment conditions: treatment as usual (TAU) or TAU plus eight sessions of EMDR (TAU+EMDR). Measures of PTSD symptoms, addiction symptoms, depression, anxiety, self-esteem, and alexithymia were included in this study. Results: The TAU+EMDR group showed a significant reduction in PTSD symptoms but not in addiction symptoms. EMDR treatment was also associated with a significant decrease in depressive symptoms, while patients receiving TAU showed no improvement in this area. The TAU+EMDR group also showed significant changes in self-esteem and alexithymia post-treatment. Conclusions: This study suggests that PTSD symptoms can be successfully treated with standard EMDR protocol in substance abuse patients.

Working memory processing of traumatic material in women with posttraumatic stress disorder

BACKGROUND Posttraumatic stress disorder (PTSD) is associated with medial frontal and amygdala functional alterations during the processing of traumatic material and frontoparietal dysfunctions during working memory tasks. This functional magnetic resonance imaging (fMRI) study investigated the effects of trauma-related words processing on working memory in patients with PTSD. METHODS We obtained fMRI scans during a 3-back task and an identity task on both neutral and trauma-related words in women with PTSD who had been sexually abused and in healthy, nonexposed pair-matched controls. RESULTS Seventeen women with PTSD and 17 controls participated in the study. We found no behavioural working memory deficit for the PTSD group. In both tasks, deactivation of posterior parietal midline regions was more pronounced in patients than controls. Additionally, patients with PTSD recruited the left dorsolateral frontal sites to a greater extent during the processing of trauma-related material than neutral material. LIMITATIONS This study included only women and did not include a trauma-exposed non-PTSD control group; the results may, therefore, have been influenced by sex or by effects specific to trauma exposure. CONCLUSION Our results broadly confirm frontal and parietal functional variations in women with PTSD and suggest a compensatory nature of these variations with regard to the retreival of traumatic memories and global attentional deficits, respectively, during cognitively challenging tasks.

Recollection of negative information in posttraumatic stress disorder

The purpose of the present study was to investigate the effects of posttraumatic stress disorder (PTSD) associated with the effects of emotional valence on recall processes in recognition memory. Patients suffering from PTSD (n = 15) were compared with 15 nontraumatized patients with anxious and depressive symptoms and with 15 nontraumatized controls on the remember/know paradigm using negative, positive, and neutral words. The PTSD group remembered more negative words than the nontraumatized controls, F(1, 42) = 7.20, p = .01, but there was no difference between those with PTSD and those with anxiety or depression, F(1, 42) = 2.93, p = .09, or between the latter and controls, F(1, 42) < 1. This study did not allow us to determine whether this recollection bias for negative information was specific to the PTSD status or was triggered by the greater level of anxiety displayed in this group.

Les troubles cognitifs dans le Post-Traumatic Stress Disorder (PTSD) : une revue de la littérature

The main goal of this paper is to review the existing literature on memory and executive non-trauma related functioning in Post-Traumatic Stress Disorder (PTSD), as well as the structural and functional brain substrates that might underlie the observed deficits. The second aim is to examine the reasons that may explain differences between studies. Studies were identified using general medical and psychology database. A lot of studies have shown an abnormal cognitive pattern among PTSD patients examining memory and executive impairments compared to non-PTSD and healthy participants. Neuroimaging studies have confirmed these behavioral differences between groups showing neuroanatomic abnormalities like hippocampal atrophy and deficit in subcortical-frontal circuitry. However, even if cognitive impairment is typically found in most of the studies, observed results frequently diverge from one study to another. Reasons for inconclusiveness of the results are discussed. Controlling for potential confounds could help to resolve some of the inconsistencies in the current literature.

Treating addiction with schema therapy and EMDR in women with co-occurring SUD and PTSD: A pilot study

ABSTRACT Background: This study aimed to examine whether the combined use of schema therapy (ST) and Eye Movement Desensitization and Reprocessing (EMDR) can improve substance use disorder (SUD) outcomes in a sample of women with co-occurring SUD and posttraumatic stress disorder (PTSD). To our knowledge, no research has examined this question in a SUD-PTSD clinical sample. Methods: We proposed to 15 women with SUD/PTSD comorbidity a two-phase-protocol therapy: eight ST sessions associated with EMDR focused on reprocessing traumatic memory (phase A) and eight ST sessions associated with EMDR focused on reprocessing addictive memory (phase B). We evaluated addiction severity, alcohol craving, cannabis craving, PTSD symptoms, early maladaptive schemas (EMS) intensity and depressive symptoms before and after treatment. Results: Findings indicated that eight sessions of ST combined with EMDR focused on traumatic memories (phase A) reduced PTSD symptoms and the number of EMS. Findings on phase B showed a statistically significant decrease for addiction severity and depressive symptoms. Conclusions. This study supports the importance of providing integrative therapies for improving SUD outcomes. Overall, this study indicates that ST plus EMDR is an effective, rapid, thorough and enduring treatment for SUD-PTSD women.

The mediating role of early maladaptive schemas on relations between post-traumatic stress disorder symptom severity and illicit substance use disorder

ABSTRACT Background: This study examines the role of Early Maladaptive Schemas (EMS) on relations between Post-traumatic stress disorder (PTSD) symptoms and illicit substance use. Objectives: We assumed that EMS play a mediating role in the pathways from PTSD symptom severity to illicit substance use. Method: We used the composite score from the Addiction Severity Index to assess illicit substance use severity, the PTSD Checklist Specific to determine PTSD symptom severity, and the Young Schema Questionnaire – Short Form, Second Edition to measure the number of hyperactivated EMS. The sample consisted of 35 patients receiving social and medical care for illicit substance use problems in three French drug centers. Results: The results showed that the number of hyperactivated EMS is an intermediate variable playing a mediating role between PTSD symptom severity and illicit substance use. Results indicating full mediation. Conclusion. Future research perspectives on this question are discussed as well as the clinical repercussions of these results on the current models of management of illicit drug users.

An exploratory study of students’ weekly stress levels and sources of stress during the semester

Studying at university can be a very stressful experience. Although the literature provides some information regarding different sources of stress among students, studies have not addressed the issue of changes over the course progression. This study aimed to obtain a deeper understanding of the sources of stress for first-year students and whether these stressors are more prevalent at different times during the semester. A mixed-method approach was used. Content analysis was undertaken on longitudinal electronic message data, and thematic analysis was used for focus group data. Results indicated an increasing trend of stress over the semester. The major stressors identified were academic, financial/work, personal, family-related, interpersonal, social support, university/life balance and starting university. A number of stressors were found to be more prevalent at different times during the semester, including some academic-related stressors plus starting university, family-related and financial/work-related stressors. This is one of the few studies to examine the influence of timing of the levels of stress. Importantly, this study suggests that the start and end of the first semester constitute the riskiest periods for negative stress-related consequences. These results could be used to assist universities in developing student support programmes.