El presente artículo reporta los resultados de seguimiento de nuestro estudio de campo (Jarero & Uribe, 2011), en el que se investigó la aplicación del Protocolo de Terapia de Reprocesamiento y Desensibilización a través del Movimiento Ocular para Incidentes Críticos Recientes (EMDR-PRECI) en una situación de masacre humana. Se aplicó una sola sesión de tratamiento a 32 empleados forenses de la Procuraduría General del Estado de Durango en México, quienes estaban trabajabando con 258 cuerpos recuperados de fosas clandestinas. Los resultados pre y post-tratamiento mostraron una mejoría significativa, tanto en el grupo de atención inmediata (GAI), como en el grupo de atención demorada (GAD), en los puntajes de la Impact of Events Scale (IES) y en el Short PTSD Rating Interview (SPRINT). En este estudio reportamos la evaluación de seguimiento, la cual se realizó después de 3 y 5 meses de la aplicación del tratamiento. Los puntajes obtenidos en el seguimiento muestran que los resultados del tratamiento original se mantuvieron, y que continuó presentándose una disminución significativa de los síntomas de estrés postraumático y de TEPT auto-reportados, entre el post-tratamiento y el seguimiento. Durante el período de seguimiento, los empleados continuaron su labor forense con los restos humanos recuperados y estuvieron permanentemente expuestos a estresores emocionales aterradores y a amenazas constantes relacionadas con su seguridad. Lo anterior sugiere que el EMDR-PRECI fue una intervención temprana efectiva al reducir el estrés postraumático en un grupo de adultos traumatizados que continuaron laborando bajo estresores extremos en una situación de masacre humana. Parece ser que el tratamiento ayudo a prevenir el desarrollo de TEPT crónico y a aumentar la resiliencia psicológica y emocional.

This article reports the follow-up results of our field study (Jarero & Uribe, 2011) that investigated the application of the eye movement desensitization and reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI) in a human massacre situation. A single individual session was provided to 32 forensic personnel of the State Attorney General in the Mexican state of Durango who were working with 258 bodies recovered from clandestine graves. Pre-post results showed significant improvement for both immediate treatment and waitlist/delayed treatment groups on the Impact of Event Scale (IES) and Short PTSD Rating Interview (SPRINT). In this study, we report the follow-up assessment, which was conducted, at 3 and 5 months posttreatment. Follow-up scores showed that the original treatment results were maintained, with a further significant reduction of self-reported symptoms of posttraumatic stress and PTSD between posttreatment and follow-up. During the follow-up period, the employees continued to work with the recovered corpses and were continually exposed to horrific emotional stressors, with ongoing threats to their own safety. This suggests that EMDR-PRECI was an effective early intervention, reducing traumatic stress for a group of traumatized adults continuing to work under extreme stressors in a human massacre situation. It appears that the treatment may have helped to prevent the development of chronic PTSD and to increase psychological and emotional resilience.

The purpose of this research is to evaluate the effectiveness of the eye movement desensitization and reprocessing (EMDR) Integrative Group Treatment Protocol (EMDR-IGTP) in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. EMDR-IGTP intensive therapy was administered for 3 consecutive days, twice daily, to 24 adult women diagnosed with different types of cancer (cervical, breast, colon, bladder, and skin) who had PTSD symptoms related to their diagnosis and treatment. The data was analyzed using factorial ANOVA with the effects of the EMDR-IGTP evaluated with the Short PTSD Rating Interview as dependent variable and group (two groups of patients: active phase and follow-up phase of cancer treatment) and time (four time points) as independent variables. Post hoc analyses were carried out. Results showed significant main effects for time and group. No significant interaction was found. Results also showed an overall subjective improvement in the participants. This pilot study suggests that intensive administration of the EMDR-IGTP can be a valuable support for cancer patients with PTSD symptoms related to their diagnosis and treatment. Further research with randomized controlled studies is needed to demonstrate the effectiveness of EMDR-IGTP in this population.

L'objectif de cette recherche est d'évaluer l'efficacité du protocole de traitement intégratif de groupe par la désensibilisation et le retraitement par les mouvements oculaires (PTIG-EMDR) dans la réduction des symptômes d'état de stress post-traumatique (ESPT) liés au diagnostic et au traitement de différents types de cancer chez des femmes adultes. La thérapie intensive PTIG-EMDR a été administrée pendant trois jours consécutifs, deux fois par jour, à 24 femmes adultes diagnostiquées avec différents types de cancer (cancer du col de l'utérus, du sein, du côlon, de la vessie et de la peau) et présentant des symptômes d'ESPT liés à leur diagnostic et à leur traitement. Les données ont été analysées à l'aide d'une ANOVA factorielle sur les effets du PTIG-EMDR, évalués avec le Short PTSD Rating Interview (entretien court d'évaluation de l'ESPT) comme variable dépendante, et le groupe (deux groupes de patientes : phase active et phase de suivi du traitement du cancer) et le temps (quatre intervalles de temps) comme variables indépendantes. Des analyses post hoc ont été effectuées. Les résultats ont montré des effets principaux significatifs pour le temps et le groupe. Aucune interaction importante n'a été observée. Les résultats ont également montré une amélioration subjective globale chez les participantes. Cette étude pilote suggère qu'une administration intensive du PTIG-EMDR peut être un apport valable pour des patients atteints du cancer et présentant des symptômes d'ESPT liés au diagnostic et au traitement. D'autres recherches comportant des études contrôlées randomisées seront nécessaires pour démontrer l'efficacité du PTIG-EMDR sur cette population.

This randomized controlled trial extended the investigation previously conducted by Jarero et al. (2015) which found that the eye movement desensitization and reprocessing Integrative Group Treatment Protocol adapted for ongoing traumatic stress (EMDR-IGTP-OTS) was effective in reducing posttraumatic stress disorder (PTSD) symptoms related to the diagnosis and treatment of different types of cancer in adult women. The current study sought to determine if the results could be replicated and if the treatment would also be effective in reducing symptoms of anxiety and depression. Participants in treatment (N = 35) and no-treatment control (N = 30) groups completed pre, post, and follow-up measurements using the Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (PCL-5) and the Hospital Anxiety and Depression Scale (HADS). Data analysis by repeated measures analysis of variance (ANOVA) showed that the EMDR-IGTP-OTS was effective in significantly reducing symptoms of PTSD, anxiety, and depression, with symptoms maintained at 90-day follow-up and with large effect sizes (e.g., d = 1.80). A comparison of the treatment and no-treatment control groups showed significantly greater decreases for the treatment group on symptoms of PTSD, anxiety, and depression. No significant correlation was found when exploring the relationship between scores on the Adverse Life Experiences scale and scores indicating pretreatment severity of PTSD, anxiety, and depression. This study suggests that EMDR-IGTP-OTS may be an efficient and effective way to address cancer-related posttraumatic, depressive, and anxious symptoms.

Experiencing cancer is a peculiar stressor within the infrastructure of posttraumatic stress disorder (PTSD) because this debilitating disease involves ongoing stressors and is both acute and potentially chronic. The experience can include a wide range of associated adverse events, such as tumor detection, diagnosis, severity of disease, and prognosis; aggressive treatment; disfigurement and bodily dysfunction; side effects of treatment; impaired physical, social, and occupational functioning; and sometimes, recurrence and diagnosis of terminal illness. This article provides a detailed description of the clinical application of the Eye Movement Desensitization and Reprocessing (EMDR) Integrative Group Treatment Protocol (EMDR-IGTP) Adapted for Adolescents and Adults Living with Ongoing Traumatic Stress for the patients with cancer. This protocol administers the eight phases of EMDR individual treatment to a group of patients using an art therapy format (i.e., drawings) and the butterfly hug (a self-administered bilateral stimulation method to process traumatic material). A previous study (Jarero et al., 2015) showed that after 6 sessions of EMDR-IGTP, there was a significant decrease in PTSD symptoms related to the diagnosis and treatment of different types of cancer in adult women. Effects were maintained at 90-day follow-up. In this article, we discuss how this protocol can be used to effectively provide intensive EMDR treatment to large groups of patients, and we provide detailed instructions for its provision to address one of the major psychological dimensions of cancer: the ongoing traumatic stress responses experienced by patients with cancer. A clinical example illustrates the treatment process.