ABSTRACT

Introduction: Individuals with intellectual disability (ID) are at significant risk of developing emotional trauma and post-traumatic stress disorder (PTSD) due to altered neuropsychological functioning, increased chance of experiencing adverse life events, difficulty expressing emotions, diagnostic overshadowing and institutional failures. Eye Movement Desensitization and Reprocessing Therapy (EMDR) is efficacious in the general population, but research lacks evidence to suggest EMDR remains effective in ID. This paper assesses the evidence available on the use of EMDR to treat PTSD in ID and provide direction for future research.

Methods: A scoping review using PRISMA guidance was conducted. PsychInfo, Embase and Medline were completed using the NICE Health Databases Advanced Search in March 2020. Supplementary searches of Joanna Briggs and ongoing randomized controlled trials were also conducted. The terms used related to Intellectual disability and EMDR therapy. Searches were conducted without the use of PTSD or trauma-related terms to increase the number of identified articles. Inclusion criteria involved the use of EMDR therapy as the primary intervention using a population of individuals with ID. Only articles available in English were included. There were no exclusions related to the study design. All study designs and publication types were included in this review to capture the breadth of information that might be available on the topic. Articles identified were summarized, appraised and collated into tables. Papers were assessed for quality using the GRADE criteria.

Results: Out of 16 identified publications, 13 demonstrated positive results and 3 less favorable. Heterogeneity among participants, variations in EMDR protocol/adaptations, and variation in trauma and PTSD assessment were prevalent.

Conclusions: It is not possible to conclude whether EMDR is efficacious in people with ID. Future studies need to use homogenized populations, standardized EMDR protocol and validated trauma and PTSD assessments.

摘要

简介：由于神经心理功能改变、经历不良生活事件的机会增加、情绪表达困难、诊断阴影和制度失败，智障 (ID) 个体处于发生情感创伤和创伤后应激障碍 (PTSD) 的重大风险。眼动脱敏和再加工疗法 (EMDR) 在一般人群中有效，但研究缺乏证据表明 EMDR 对 ID 仍然有效。本文评估了使用 EMDR 治疗 ID 中的 PTSD 的可用证据，并为未来的研究提供方向。

方法：使用 PRISMA 指南进行了范围界定审查。PsychInfo、Embase 和 Medline 于 2020 年 3 月使用 NICE 健康数据库高级搜索完成。还进行了 Joanna Briggs 的补充搜索和正在进行的随机对照试验。使用的术语与智力障碍和 EMDR 治疗有关。搜索是在不使用 PTSD 或与创伤相关的术语的情况下进行的，以增加已识别文章的数量。纳入标准涉及使用 EMDR 疗法作为主要干预措施，使用 ID 人群。仅包括英文文章。没有与研究设计相关的排除。本综述包括所有研究设计和出版物类型，以获取有关该主题的广泛信息。确定的文章被总结、评价并整理成表格。使用 GRADE 标准评估论文的质量。

结果：在 16 篇确定的出版物中，13 篇显示出积极的结果，3 篇不太有利。参与者之间的异质性、EMDR 协议/适应的变化以及创伤和 PTSD 评估的变化很普遍。

结论：无法得出 EMDR 对 ID 患者是否有效的结论。未来的研究需要使用同质化的人群、标准化的 EMDR 协议和经过验证的创伤和 PTSD 评估。