Hotspots in trauma memories in post-traumatic stress disorder: An exploratory investigation using EMDR
Rachel King, Hotspots in Trauma Memories in PosttraumatiStress Disorder - An Exploratory Investigation Using EMDR, 2014.pdf (2.422Mb)
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The current study examined hotspots - worst memories of trauma - in patients with post-traumatic stress disorder (PTSD) or trauma who underwent EMDR therapy. Emotional, cognitive and physical themes corresponding to hotspots were examined in relation to diagnostic criteria for PTSD. The warning signal hypothesis (Ehlers et al., 2002) was also tested by examining the timing of hotspots relative to the traumatic event. EMDR (Eye Movement Desensitisation and Reprocessing) is a controversial, but NICE (National Institute for Clinical Excellence) recommended, treatment for PTSD. The current study is the first to examine hotspots within this context, despite EMDR’s relevance to hotspots. This study is also the first to examine hotspots in relation to the most recent diagnostic criteria for PTSD (DSM-5; APA, 2013). Data was taken from closed case files of 42 patients who had received EMDR therapy for PTSD in a private psychology practice. Previous research using different therapies found that reported emotions and cognitions in PTSD did not correspond well with DSM-IV criteria (APA, 2000). The current study found that the most common emotion was fear, although others were also identified. Both sets of DSM criteria were found to account for the same proportion of emotional themes, although helplessness, an emotion omitted in DSM-5, was commonly found, suggesting that this should not have been omitted. As in previous studies cognitions corresponded more frequently to threat to one’s psychological (as opposed to physical) integrity. This is consistent with the concept of a sense of current threat in PTSD (Ehlers & Clark, 2000). Results supported the warning signal hypothesis, as most hotspots occurred either before or after the traumatic event. A significant overall reduction in SUD (Subjective Units of Distress) scores supported the efficacy of EMDR for dealing with hotspots in the current sample. Implications regarding treatment of PTSD are discussed.