Master of Science / School of Family Studies and Human Services / Joyce Baptist / This study examined the efficacy of EMDR therapy as a treatment for unipolar depression. Results provide preliminary evidence for the efficacy of EMDR therapy. Of the 12 participants that received 10 sessions of EMDR therapy, four met the criteria for “Recovered,” six “Improved” and two reported no change in severity of depressive symptoms. Results further indicated that participants who experienced decline in depressive symptoms within the first six sessions of treatment had a higher probability to be meet the criteria for “Recovered.” A small sample comparison between EMDR therapy (n = 4) and CBT (n = 4) did not find any significant difference in terms of treatment outcome. In phase 2, participants in both groups either improved or recovered after 10 sessions of treatment. Sudden gains analysis indicated that 5 out of 12 EMDR therapy participants had sudden gains. Participants in sudden gains group were more likely to meet “Recovered” criteria than participants in no-gains group. Examination of attention bias found that depression was positively related to negative affect fixation duration and negatively related to positive affect fixation duration when only using female affect images. These findings support previous research that used attention bias to differentiate depressed and non-depressed persons. Clinical implication and further research are discussed.

This research focuses on the integration of Eye Movement Desensitization and Reprocessing therapy (EMDR) and Virtual Reality (VR). EMDR is a therapeutic approach using bilateral stimulation to process distressing memories, emotions, and experiences. It is widely employed for conditions like PTSD, anxiety, and depression. The study involves the development of a proof-of-concept virtual reality tool tailored for EMDR therapy sessions. The tool comprises a bilaterally moving sphere within the user's VR environment, controllable by the therapist through a graphical interface on a computer. The therapist can dynamically adjust the sphere's color, speed, and sound to enhance the therapeutic process. The study's findings affirm the feasibility of creating a VR tool that supports therapists in conducting effective EMDR therapy sessions.

Child sexual abuse is prevalent worldwide and can result in adverse psychological effects that persist into adulthood. Therapists must identify therapeutic treatments for adult survivors of child sexual abuse who continue to experience psychological difficulties, such as anxiety, depression, and PTSD. The purpose of this phenomenological qualitative study was to explore the perceptions of therapists about eye movement desensitization and reprocessing (EMDR) as a tool to assist adult women survivors of child sexual abuse through the healing process and to regain their abilities to function and behave appropriately. Data were collected through the Moustakas Theory (1994) with 10 therapists who provided therapeutic or counseling services (or both) through EMDR to women with a history of repeated sexual abuse as children. The therapists perceived EMDR as more effective in treating child sexual abuse trauma than other treatment options because it involved the body and worked rapidly, although the treatment may involve a danger of dysregulating the patient. Results indicated the perceived role of EMDR in a treatment program is to allow patients to remember traumatic events without reliving them and to free patients from shame and prepare them to learn more effective coping skills. The therapists implemented EMDR by building rapport, conducting a thorough assessment, focusing treatment on the most distressing elements of past traumas and present triggers, and teaching the client skills for coping with distress. This study contributes to social change by adding more knowledge and awareness about women survivors of child sexual abuse and the various available treatments, thereby helping the long-term impact of women's health with histories of childhood sexual abuse.

L’objectif de cette thèse a été de comprendre les mécanismes cérébraux associés aux symptômes du trouble de stress post-traumatique (TSPT), ainsi que les mécanismes cérébraux modulés par la disparition des symptômes, en utilisant la thérapie de désensibilisation et de retraitement de l’information par les mouvements oculaires (Thérapie EMDR). Cette thérapie associe rappel du traumatisme et stimulations bilatérales alternées (SBA). Premièrement, en utilisant l’IRM fonctionnelle (IRMf), nous avons mis en évidence une altération de l’activité fonctionnelle du système de récompense dans le TSPT, correspondant à une mobilisation déséquilibrée des processus motivationnels cognitifs et hédoniques (étude 1). Deuxièmement, par l’intermédiaire d’une étude en IRMf au repos, nous avons montré que les patients présentent des altérations de connectivité fonctionnelle entre un réseau neuronal impliqué dans les processus mnésiques et émotionnels, et un réseau neuronal impliqué dans les processus attentionnels (étude 2). Troisièmement, nous avons montré que les structures initialement altérées par la pathologie évoluent après rémission symptomatique, suggérant un rétablissement des altérations neuronales induites par le stress chronique (étude 3). Enfin, nous avons montré que les SBA employées dans la thérapie EMDR facilitent l’extinction de la peur ainsi que la récupération de cette extinction au sein d’un groupe de volontaires sains (étude 4). Ainsi, ces travaux offrent de nouvelles perspectives en termes de modélisation de la pathologie, et offre de nouvelles pistes de réflexion quant à la prise en charge thérapeutique de ce trouble. / Posttraumatic Stress Disorder (PTSD) is a debilitating psychiatric disorder that arises in the aftermath of a traumatic event. To date, the Eye Movement Desensitization and Reprocessing therapy (EMDR) therapy has shown to be the most efficient therapy for the treatment of PTSD. The aim of this thesis was therefore to understand neural mechanisms underlying PTSD and its recovery. To do so, we conducted four studies. In a first study, we showed alterations in the reward circuit activity in PTSD patients, which may underlie an imbalance mobilization of cognitive and hedonic motivational processes, possibly contributing to emotional numbing in PTSD (study 1). Following this, an altered resting state functional connectivity between a network associated with attentional processes and another associated with emotional and memory processes was also found, suggesting an atypical emotional regulation and attention processing (study 2). A third study showed changes of grey matter density in regions involved in emotional regulation after symptoms remission by EMDR therapy. Finally, we were also able to replicate, in PTSD patients, the fear extinction and fear extinction recall facilitation by bilateral alternating stimulations (BAS) a major component of EMDR therapy, previously demonstrated in animal studies. Taken together, the present findings of these studies contribute to enlarge our knowledge, opening new ways of thinking the actual model of explaining the PTSD. More importantly, we believe that our findings may contribute to improve therapeutic strategies to significantly ameliorate the life of these patients.