Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial
Open accessAbstract
Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL). Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and three months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-minute sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3. Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive. Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients. Trial Registration: Dutch Trial Register, Nr. 3134 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3134
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Preliminary research has shown promising results of clinical interventions that specifically focus on threat imagery in anxiety disorders, such as imagery rescripting or EMDR therapy.
“Preliminary research has also shown promising results of clinical interventions that specifically focus on threat imagery in anxiety disorders, such as imagery rescripting [34–37] or EMDR therapy [38–40].”
EMDR therapy focused on past aversive events reduces anxiety symptoms.
“Several randomized controlled trials found that EMDR therapy focused on past aversive events reduces anxiety symptoms [39, 40]”
EMDR has been applied to treat panic disorders and a variety of adverse life experiences.
“EMDR has also been applied to treat panic disorders18 and a variety of adverse life experiences.16”
From EMDR treatment for anxiety in MS patients: A pilot study (2020) · cites this paper as [18]
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- Authors
- Horst, F., Den Oudsten, B., Zijlstra, W., de Jongh, A., Lobbestael, J., & De Vries, J.
- Affiliations
- Elisabeth-TweeSteden Ziekenhuis (NL)
- Tilburg University (NL)
- Maastricht University (NL)
- Corresponding author
- Horst, Ferdinand
- ORCID
- Lobbestael, Jill
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2017-08-18
- Volume
- 8
- Pages
- 1409-1409
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC5563354
- OpenAlex
- W2748048619
- Cited by
- 38
- References
- 41
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 2 · 2018: 5
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- Worcester Research and Publications (University of Worcester) (acceptedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- VU Research Portal (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- panic disorder, cognitive behavioral therapy, EMDR, treatment comparison, non-inferiority, quality of life, panic attacks, bodily sensations, mobility (physical function)
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