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This study will examine the effects of Eye Movement Desensitization and Reprocessing (EMDR) group therapy on adults who experienced the April 2025 Silivri earthquake in Turkey. Participants will be randomly assigned to either an EMDR intervention group or a waitlist control group. Psychological symptoms will be measured using the PTSD Checklist for DSM-5 (PCL-5), the Depression, Anxiety, and Stress Scale (DASS-21), the Short Form Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Quantitative EEG (QEEG) recordings will also be collected before and after the intervention to assess changes in brain activity related to emotional regulation and trauma processing. The goal of the study is to evaluate whether EMDR produces both clinical and neurophysiological improvements in trauma-exposed individuals.
Traumatic experiences often lead to persistent psychological symptoms such as posttraumatic stress, depression, anxiety, and sleep disturbances, which significantly impair quality of life. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based intervention for trauma-related disorders, and growing evidence suggests that it may also produce measurable changes in brain activity. This randomized controlled trial will evaluate the effects of EMDR group therapy on both clinical outcomes and neurophysiological markers in adults exposed to the April 2025 Silivri earthquake in Turkey.
Forty participants meeting inclusion criteria will be randomly assigned to either an EMDR intervention group (20 participants) or a waitlist control group (20 participants). The intervention group will receive 5-7 sessions of standardized EMDR group therapy, delivered face-to-face by trained therapists. Quantitative EEG (QEEG) recordings will be collected at baseline and after the intervention to assess changes in spectral power, frontal alpha asymmetry, and coherence patterns. Clinical outcomes will be measured with validated self-report instruments assessing PTSD symptoms, depression, anxiety, stress, sleep quality, and overall health-related quality of life.
This study is designed to test the hypothesis that EMDR group therapy produces significant improvements in both psychological symptoms and EEG biomarkers compared to a waitlist control. By integrating subjective self-report and objective neurophysiological data, the trial aims to provide a comprehensive evaluation of EMDR's therapeutic effects in trauma-exposed populations.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EMDR Group | Experimental | Participants will receive 5-7 sessions of Eye Movement Desensitization and Reprocessing (EMDR) group therapy, delivered face-to-face by trained therapists, in line with the standard EMDR protocol. EEG measurements and psychological scales will be administered before and after the intervention. |
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| Waitlist Control | No Intervention | Participants in this arm will not receive any active psychotherapy intervention during the study period. They will undergo baseline and post-test EEG recordings and psychological assessments at the same time intervals as the experimental group. For ethical reasons, they will be offered EMDR therapy after the study is completed if requested. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eye Movement Desensitization and Reprocessing (EMDR) Group Therapy | Behavioral | Sessions conducted in groups with one therapist and one co-therapist; each session follows the EMDR standard protocol. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Posttraumatic Stress Symptoms (PCL-5) | The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report scale measuring the severity of posttraumatic stress disorder symptoms according to DSM-5 criteria. Scores range from 0 to 80, with higher scores indicating more severe PTSD symptoms. Change in total score from baseline (pre-intervention) to post-intervention will be assessed. | Baseline (Pre-intervention, T1; Week 0) and Post-intervention (T2; Week 6, after completion of EMDR intervention) |
| Change in Quantitative EEG (QEEG) Power Spectral Measures | EEG recordings will be collected using the Neuron-Spectrum-5 device according to the international 10-20 system. Power spectral analyses will be performed across frequency bands (delta, theta, alpha, beta, high beta). Changes in absolute and relative power from baseline to post-intervention will be examined. | Baseline (Pre-intervention, T1; Week 0) and Post-intervention (T2; Week 6, after completion of EMDR intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Quality of Life (SF-36) | The Short Form Health Survey (SF-36) is a 36-item measure of health-related quality of life, covering physical functioning, role limitations, pain, general health, vitality, social functioning, and emotional well-being. Scores range from 0 to 100, with higher scores reflecting better quality of life. Change in domain scores will be assessed from baseline to post-intervention. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Çiğdem Kınık, PhD | Contact | +905308777181 | psk.cigdem@gmail.com | |
| Önder Kavakçı, MD. Prof Dr | Contact | +90 530 419 91 92 | okavakci@yahoo.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28143760 | Background | Colvonen PJ, Glassman LH, Crocker LD, Buttner MM, Orff H, Schiehser DM, Norman SB, Afari N. Pretreatment biomarkers predicting PTSD psychotherapy outcomes: A systematic review. Neurosci Biobehav Rev. 2017 Apr;75:140-156. doi: 10.1016/j.neubiorev.2017.01.027. Epub 2017 Jan 28. | |
| 17284128 | Background | van der Kolk BA, Spinazzola J, Blaustein ME, Hopper JW, Hopper EK, Korn DL, Simpson WB. A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. J Clin Psychiatry. 2007 Jan;68(1):37-46. doi: 10.4088/jcp.v68n0105. |
| Label | URL |
|---|---|
| ORCID profile of Principal Investigator | View source |
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De-identified EEG data and questionnaire scores will be shared upon reasonable request after study completion, in compliance with ethical approval.
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Participants will be randomly assigned in parallel to either an EMDR intervention group or a waitlist control group. The EMDR group will receive 5-7 sessions of standardized group therapy, while the control group will not receive any intervention during the study period but will be offered EMDR after study completion
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| Baseline (Pre-intervention, T1; Week 0) and Post-intervention (T2; Week 6, after completion of EMDR intervention) |
| Change in Depression, Anxiety, and Stress (DASS-21) | The Depression, Anxiety, and Stress Scale-21 (DASS-21) is a 21-item self-report instrument measuring emotional distress across three subscales (depression, anxiety, stress). Scores range from 0 to 42 for each subscale, with higher scores indicating greater severity. Change in scores will be assessed from baseline to post-intervention. | Baseline (Pre-intervention, T1; Week 0) and Post-intervention (T2; Week 6, after completion of EMDR intervention) |
| Change in Sleep Quality (PSQI) | The Pittsburgh Sleep Quality Index (PSQI) is a 19-item self-report questionnaire assessing sleep quality and disturbances over the past month. Scores range from 0 to 21, with higher scores indicating poorer sleep quality. Change in total score will be assessed from baseline to post-intervention. | Baseline (Pre-intervention, T1; Week 0) and Post-intervention (T2; Week 6, after completion of EMDR intervention) |
| 14522608 | Background | Jokic-Begic N, Begic D. Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD). Nord J Psychiatry. 2003;57(5):351-5. doi: 10.1080/08039480310002688. |
| 31214058 | Background | Butt M, Espinal E, Aupperle RL, Nikulina V, Stewart JL. The Electrical Aftermath: Brain Signals of Posttraumatic Stress Disorder Filtered Through a Clinical Lens. Front Psychiatry. 2019 May 31;10:368. doi: 10.3389/fpsyt.2019.00368. eCollection 2019. |
| 23049852 | Background | Pagani M, Di Lorenzo G, Verardo AR, Nicolais G, Monaco L, Lauretti G, Russo R, Niolu C, Ammaniti M, Fernandez I, Siracusano A. Neurobiological correlates of EMDR monitoring - an EEG study. PLoS One. 2012;7(9):e45753. doi: 10.1371/journal.pone.0045753. Epub 2012 Sep 26. |
| 26579006 | Background | Pagani M, Di Lorenzo G, Monaco L, Daverio A, Giannoudas I, La Porta P, Verardo AR, Niolu C, Fernandez I, Siracusano A. Neurobiological response to EMDR therapy in clients with different psychological traumas. Front Psychol. 2015 Oct 27;6:1614. doi: 10.3389/fpsyg.2015.01614. eCollection 2015. |
| ID | Term |
|---|---|
| D003130 | Combat Disorders |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D007319 | Sleep Initiation and Maintenance Disorders |
| D013313 | Stress Disorders, Post-Traumatic |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D057169 | Eye Movement Desensitization Reprocessing |
| D011615 | Psychotherapy, Group |
| ID | Term |
|---|---|
| D003887 | Desensitization, Psychologic |
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D012960 | Socioenvironmental Therapy |
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