The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy on Post-Traumatic Stress Disorder Symptoms and Diagnostic Status in Patients with a Personality Disorder: A Randomized Controlled Trial.

INTRODUCTION

Individuals with a personality disorder (PD) often report high exposure to adverse events. Given the strong link between negative life events and PD pathology, it is essential to evaluate trauma-focused treatments in this population. This study evaluated the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy versus waitlist in reducing post-traumatic stress disorder (PTSD) symptoms and diagnostic status, distinguishing between patients with and without PTSD. Second, it examined the impact of EMDR therapy on adverse event memories, both meeting and not meeting Criterion A for PTSD.

METHODS

Participants (n = 159) were randomly assigned to EMDR therapy or a waitlist. PDs were assessed using the Structured Clinical Interview for DSM-5. PTSD symptoms and diagnoses were evaluated using the Clinician-Administered PTSD Scale for DSM-5. Secondary analyses examined the effectiveness of EMDR on various types of memory.

RESULTS

Significant group-by-time interactions showed a greater reduction in PTSD symptoms in the EMDR therapy group, regardless of the baseline PTSD diagnosis. In patients with PTSD, large effects were found post-treatment (d = 1.26; control: d = 0.28) and at follow-up (d = 1.5; control: d = 0.69). In patients without PTSD, moderate to large effects emerged post-treatment (d = 0.77; control: d = 0.18) and at follow-up (d = 1.09; control: d = 0.46). EMDR therapy reduced symptoms associated with Criterion A trauma and other adverse events. Post-treatment, 65.5% of EMDR patients lost their PTSD diagnosis, increasing to 73.1% at the follow-up.

CONCLUSION

EMDR effectively reduced PTSD symptoms in individuals with a PD, regardless of PTSD diagnosis, and proved effective for memories that did not meet Criterion A.