Psychother Psychosom Med Psychol 2001; 51(9/10): 350-355
DOI: 10.1055/s-2001-16898
ORIGINALARBEIT
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Metaanalyse der Studien zur EMDR-Behandlung von Patienten mit posttraumatischen Belastungsstörungen

Der Einfluss der Studienqualität auf die EffektstärkenStudy Quality and Effect-Sizes - A Metaanalysis of EMDR-Treatment for Posttraumatic Stress DisorderMartin Sack, Wolfgang Lempa, Friedhelm Lamprecht
  • Abteilung Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover
Further Information

Publication History

Publication Date:
31 August 2001 (online)

Zusammenfassung

Die Wirksamkeit der EMDR-Behandlungstechnik in der Therapie von Patienten mit posttraumatischen Belastungsstörungen kann inzwischen als empirisch gut belegt gelten. Dennoch wird dieses neue Therapieverfahren in Fachkreisen teilweise sehr polemisch kritisiert. Ziel unserer Studie war es, den subjektiven Eindruck zu überprüfen, dass sich bei EMDR-Behandlungsstudien unterschiedliche methodische Qualitätsstandards in unterschiedlichen Ergebnissen niederschlagen. Unsere Metaanalyse der publizierten Therapiestudien zeigt, dass methodisch sorgfältig geplante Studien mit Behandlung durch gut ausgebildete und erfahrene Therapeuten und mit einer ausreichend hohen Zahl an Behandlungssitzungen deutlich bessere Behandlungsergebnisse erzielen, als Studien, die mit niedrigeren methodischen Standards durchgeführt werden.

Study Quality and Effect-Sizes - A Meta-Analysis of EMDR-Treatment for Posttraumatic Stress Disorder

Although the good efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of patients with PTSD is up to now documented by a number of studies, this new treatment technique is still the target of highly controversial critique. Our meta-analysis tries to answer the question of whether EMDR-therapy studies with higher quality standards achieve better results than others. Therefore, all published studies underwent a scoring procedure of study quality and effect sizes were computed. It can be shown that carefully planned studies, including treatment by well-trained therapists and with a sufficiently high number of treatment session achieve better results compared to studies with low methodological standards.

Literatur

  • 1 Shapiro F. EMDR - Grundlagen und Praxis. Handbuch zur Behandlung traumatisierter Menschen. Paderborn; Junfermann 1998
  • 2 Hofmann A. EMDR in der Therapie psychotraumatischer Belastungssymptome. Stuttgart; Thieme 1999
  • 3 Foa E B. Psychosocial treatment of posttraumatic stress disorder.  J Clin Psychiatry. 2000;  61, Suppl 5 43-48
  • 4 Bergmann U. Further thoughts on the neurophysiology of EMDR. EMDRIA Newsletter 1996 June 1996
  • 5 Stickgold R, Scott L, Rittenhouse C, Hobson J A. Sleep-induced changes in associative memory.  J Cogn Neurosci. 1999;  11 182-193
  • 6 Foa E B, Keane T M, Friedman M J. Effective treatments for PTSD. New York; Guilford Press 2000
  • 7 van Etten M, Taylor S. Comparative efficacy of treatments for posttraumatic stress disorder: a meta-analysis.  Clin Psychol Psychother. 1998;  5 126-145
  • 8 Wilson D L, Silver S M, Covi W G, Foster S. Eye movement desensitization and reprocessing: effectiveness and autonomic correlates.  J Behav Ther Exp Psychiat. 1996;  27 219-229
  • 9 Montgomery R W, Ayllon T. Eye movement desensitization across subjects: subjective and physiological measures of treatment efficacy.  J Behav Ther Exp Psychiat. 1994;  25 217-230
  • 10 Shapiro F. Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories.  J Trauma Stress. 1989;  2 199-223
  • 11 Wilson S A, Becker L A, Tinker R H. Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals.  J Consult Clin Psychol. 1995;  63 928-937
  • 12 Wilson S A, Becker L A, Tinker R H. Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma.  J Consult Clin Psychol. 1997;  65 1047-1056
  • 13 Pitman R K, Orr S P, Altman B. et al . Emotional processing during eye movement desensitization and reprocessing therapy of Vietnam veterans with chronic posttraumatic stress disorder.  Compr Psychiatry. 1996;  37 419-429
  • 14 Macklin M L, Metzger L J, Lasko N B. et al . Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related posttraumatic stress disorder.  Compr Psychiatry. 2000;  41 24-27
  • 15 Hartmann A, Herzog T, Drinkmann A. Psychotherapy of Bulimia Nervosa: what is effective? A meta-analysis.  Journal of Psychosomatic Research. 1992;  36 159-167
  • 16 Schilter B, Jäger B, Heemann R, Lamprecht F. Medikamentöse und psychologische Therapien bei chronischem subjektivem Tinnitus - Metaanalyse zur Therapieeffektivität.  HNO. 2000;  48 589-597
  • 17 Petrak F, Hardt J, Nickel R, Egle U T. Checkliste zur Bewertung der wissenschaftlichen Qualität kontrollierter psychotherapeutischer Interventionsstudien (CPI).  Psychotherapeut. 1999;  44 390-393
  • 18 Hartmann A, Herzog T. Varianten der Effektstärkenberechnung in Meta-Analysen: Kommt es zu variablen Ergebnissen?.  Z klin Psychol. 1995;  24 337-343
  • 19 Forbes D, Creamer M, Rycroft P. Eye movement desensitization and reprocessing in posttraumatic stress disorder: a pilot study using assessment measures.  J Behav Ther Exp Psychiat. 1994;  25 113-120
  • 20 Jensen J A. An investigation of eye movement desensitization and reprocessing (EMDR) as a treatment for posttraumatic stress disorder (PTSD) symptoms of Vietnam combat veterans.  Behavior Therapy. 1994;  25 311-326
  • 21 Lazrove S, Triffleman E, Kite L. et al . An open trial of EMDR as treatment for chronic PTSD.  Am J Orthopsychiatry. 1998;  68 601-608
  • 22 Rogers S, Silver S M, Goss J. et al . A single session, group study of exposure and Eye Movement Desensitization and Reprocessing in treating Posttraumatic Stress Disorder among Vietnam War veterans: preliminary data.  J Anxiet Disord. 1999;  13 119-130
  • 23 Devilly G J, Spence S H. The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder.  J Anxiet Disord. 1999;  13 131-157
  • 24 Carlson J G, Chemtob C M, Rusnak K. et al . Eye movement desensitization and reprocessing (EMDR) treatment for combat-related posttraumatic stress disorder.  J Trauma Stress. 1998;  11 3-24
  • 25 Rothbaum B O. A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims.  Bulletin of the Menninger Clinic. 1997;  61 317-334
  • 26 Scheck M M, Schaeffer J A, Gillette C. Brief psychological intervention with traumatized young women: the efficacy of eye movement desensitization and reprocessing.  J Trauma Stress. 1998;  11 25-44
  • 27 Lohr J M, Tolin D F, Lilienfeld S O. Efficacy of eye movement desensitization and reprocessing: implications for behavior therapy.  Behavior Therapy. 1998;  29 123-156
  • 28 Shapiro F. Eye Movement Desensitization and Reprocessing (EMDR) and the anxiety disorders: clinical and research implications of an integrated psychotherapy treatment.  J Anxiet Disord. 1999;  13 35-67
  • 29 Boudewyns P A, Stwertka S A, Albrecht S A, Sperr E V. Eye movement desensitization and reprocessing: a pilot study.  The Behavior Therapist. 1993;  16 30-33
  • 30 Renfrey G, Spates C R. Eye movement desensitization: a partial dismantling study.  J Behav Ther Exp Psychiat. 1994;  25 231-239
  • 31 Silver S M, Brooks A, Obenchain J. Treatment of Vietnam War veterans with PTSD: a comparison of eye movement desensitization and reprocessing, biofeedback, and relaxation training.  J Trauma Stress. 1995;  8 337-342
  • 32 Cusack K, Spates C R. The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD).  J Anxiet Disord. 1999;  13 87-99
  • 33 Marcus S V, Marquis P, Sakai C. Controlled study of treatment of PTSD using EMDR in an HMO setting.  Psychotherapy. 1997;  34 307-315
  • 34 Vaughan K, Armstrong M S, Gold R. et al . A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder.  J Behav Ther Exp Psychiat. 1994;  25 283-291
  • 35 Vaughan K, Wiese M, Gold R, Tarrier N. Eye-movement desensitization. Symptom change in post-traumatic stress disorder.  Br J Psychiatry. 1994;  164 533-541

Dr. med. Martin Sack

Abteilung Psychosomatik und Psychotherapie
Medizinische Hochschule Hannover

30625 Hannover

Email: sack.martin@mh-hannover.de