Table_4_The Effectiveness of Eye Movement Desensitization for Post-traumatic Stress Disorder in Indonesia: A Randomized Controlled Trial.docx

ObjectivePost-traumatic stress disorder (PTSD) may affect individuals exposed to adversity. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based trauma-focused psychotherapy for PTSD. There is still some debate whether the eye movements (EMs) are an effective component of EMDR. The primary aim of this study was to investigate the effectiveness of Eye Movement Desensitization (EMD) treatment in reducing PTSD symptoms compared to a retrieval-only active control condition. We also investigated whether PTSD symptom reduction was associated with reductions in depression and anxiety, and improvements in quality of life.
MethodologyAdult PTSD patients (n = 91) were recruited at public psychological services in Jakarta, Bandung and Cimahi, Indonesia. PTSD was diagnosed with the Structured Clinical Interview for DSM-5 disorders (SCID-5). Participants were randomized into: EMD (n = 47) or retrieval-only (n = 44). EMD consisted of clinical history and treatment planning, preparation, assessment, EMs, closure, whereas retrieval-only consisted of the same elements except EMs. Data were collected at baseline (T0), 1-week post-treatment (T1), 1-month follow-up (T2), and 3-months follow-up (T3). Outcome measures included the PTSD Checklist for DSM-5 (PCL-5), Hopkins Symptoms Checklist-25 (HSCL-25), and the World Health Organization Quality of Life–BREF (WHOQoL–BREF). Data were analyzed with linear mixed model analysis in R Statistics.
ResultsAlthough there were main effects of time indicating reductions for both EMD and retrieval-only in PCL-5 and HSCL-25 scores, and improvements in WHOQoL-BREF scores at T1, T2, and T3, no significant differences in PCL-5, HSCL-25, and WHOQoL-BREF total scores between the EMD and retrieval-only groups at T1, T2, and T3 were found (all group x time interaction p’s > 0.005).
ConclusionWithin a clinical sample of PTSD patients in Indonesia, both EMD and retrieval-only was associated with reductions in symptoms of PTSD, anxiety and depression, and improvements in quality of life, although EMs did not add to the efficacy of the treatments. Further research to examine the underlying mechanisms of EMDR’s effective treatment elements in clinical samples is needed.
Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ISRCTN55239132].

研究目的
创伤后应激障碍（Post-traumatic stress disorder, PTSD）可能会对经历过逆境的个体造成影响。眼动脱敏与再加工（Eye Movement Desensitization and Reprocessing, EMDR）是一种基于实证的针对PTSD的创伤聚焦心理治疗方法。目前，关于眼动（Eye Movements, EMs）是否为EMDR的有效组成部分仍存在一定争议。本研究的主要目的为探讨眼动脱敏（Eye Movement Desensitization, EMD）治疗相较于仅提取记忆的主动对照条件，在缓解PTSD症状方面的有效性。此外，本研究还探讨了PTSD症状的缓解是否与抑郁、焦虑症状的减轻以及生活质量的改善相关。

研究方法
本研究于印度尼西亚雅加达、万隆和芝玛希的公立心理服务机构招募了成人PTSD患者（n=91）。采用《精神障碍诊断与统计手册第五版结构化临床访谈》（Structured Clinical Interview for DSM-5 disorders, SCID-5）对PTSD进行确诊。将参与者随机分为两组：EMD组（n=47）与仅提取记忆组（n=44）。EMD治疗流程包含病史采集与治疗计划制定、准备阶段、评估、眼动训练、结束环节；仅提取记忆组除无眼动训练外，其余流程与EMD组完全一致。数据分别在基线（T0）、治疗后1周（T1）、1个月随访（T2）及3个月随访（T3）四个时间点采集。结局指标包括《DSM-5创伤后应激障碍检查表》（PTSD Checklist for DSM-5, PCL-5）、霍普金斯症状量表25项版（Hopkins Symptoms Checklist-25, HSCL-25）以及世界卫生组织生活质量简表（World Health Organization Quality of Life–BREF, WHOQoL–BREF）。采用R统计软件中的线性混合模型进行数据分析。

研究结果
尽管时间主效应显示，EMD组与仅提取记忆组在T1、T2、T3时点的PCL-5与HSCL-25得分均有所降低，WHOQoL-BREF得分均有所改善，但两组在T1、T2、T3时点的PCL-5、HSCL-25及WHOQoL-BREF总分均无显著差异（所有组×时间交互作用的p值均>0.005）。

研究结论
在印度尼西亚的PTSD患者临床样本中，EMD与仅提取记忆治疗均能缓解PTSD、焦虑与抑郁症状，并改善生活质量，但眼动训练并未提升治疗的有效性。未来仍需开展进一步研究，以探讨EMDR有效治疗成分的潜在作用机制。

临床试验注册
临床试验注册平台：[www.ClinicalTrials.gov]，识别号：[ISRCTN55239132]。