The Effect of EMDR and CBT on Low Self-esteem in a General Psychiatric Population: A Randomized Controlled Trial

Although low self-esteem has been found to be an important factor in the development and maintenance of psychopathology, surprisingly little is known about its treatment. This study investigated the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy and Cognitive Behavioural Therapy (CBT), regarding their capacities in enhancing self-esteem in a general psychiatric secondary health care population. A randomized controlled trial with two parallel groups was used. Participants were randomly allocated to either 10 weekly sessions of EMDR (n = 15) or CBT (n = 15). They were assessed pre-treatment, after each session, post treatment and at 3 months follow-up on self-esteem (Rosenberg Self-esteem Scale and Credibility of Core Beliefs), psychological symptoms (Brief Symptom Inventory), social anxiety, and social interaction (Inventory of Interpersonal Situations) (IIS). The data were analyzed using repeated measures ANOVA for the complete cases (n = 19) and intention-to-treat (n = 30) to examine differences over time and between conditions. Both groups, EMDR as well as CBT, showed significant improvements on self-esteem, increasing two standard deviations on the main parameter (RSES). Furthermore, the results showed significant reductions in general psychiatric symptoms. The effects were maintained at 3 months follow-up. No between-group differences could be detected. Although the small sample requires to exercise caution in the interpretation of the findings, the results suggest that, when offering an adequate number of sessions, both EMDR and CBT have the potential to be effective treatments for patients with low self-esteem and a wide range of comorbid psychiatric conditions. This study was registered at www.trialregister.nl with identifier NTR4611.

Coping strategies and IQ in psychogenic movement disorders and paralysis

Inadequate coping strategies may cause some patients to develop psychogenic symptoms in periods of stress. This may be more prominent in patients with lower intelligence levels. Twenty-six patients with psychogenic neurological disorders (PND) were tested for coping abilities and intelligence and compared with 18 healthy controls and 26 patients with various nonpsychogenic disorders. Patients with PND have slightly lower IQ levels and active coping skills compared with healthy controls but not to nonpsychogenic patients. Low IQ was not associated with low active coping skills in either of the groups. Low active coping is not the result of low IQ and is not specific for psychogenic symptoms. At least part of the lower coping skills reported in patients with psychogenic symptoms may be the result of having an illness in general.