EMDR treatment in patients with personality disorders. Should we fear symptom exacerbation?
Bibliographic record
Abstract
Background: Clinicians are often hesitant to use trauma-focused therapy for patients with personality disorders (PDs) because of concerns that the pathology may worsen.Objective: Exploring trajectories of change and individual exacerbations in psychological distress and suicidal thoughts in patients with a PD without comorbid posttraumatic stress disorder (PTSD) during EMDR therapy or waiting time.Method: In a randomized controlled trial, the effectiveness of five sessions of EMDR therapy was compared with a waitlist in 97 outpatients. Acute suicidal patients were not included in this study. Psychological distress and suicidality scores were measured on a weekly basis during the EMDR and waiting list (WL) periods and at 3-month follow-up. Data were analysed in a descriptive manner for individual patients, and hierarchical cluster analysis was used to identify patterns of change among clusters of patients. Mann–Whitney U and chi-squared tests were used to explore differences in specific patient characteristics between the found clusters of patients.Results: Patients generally improved, and no clusters of patients deteriorated during the EMDR therapy. Session-to-session exacerbations occurred in both the EMDR (psychological distress: 10.0%; suicidal thoughts: 28.0%) and WL group (psychological distress: 28.0%; suicidal thoughts: 43.5%). Two percent of patients in the EMDR group and 8.7% of patients in the WL condition showed an increase in psychological distress, whereas 2.0% of patients in the EMDR group and 10.9% of patients in the WL condition showed an increase in suicidal thoughts posttreatment compared to baseline.Conclusions: These results show that although individual exacerbations in psychological distress and suicidal thoughts occur, these were less likely to occur in response to EMDR therapy compared with no therapy. Continuation of therapy following exacerbation led to a decrease in psychological distress and suicidal thoughts in most patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".