Authors' reply

Dr Halvorsen quite rightly draws attention to the various definitions of clinically significant change, which all have their advantages and disadvantages. We especially agree with the comment that the threshold for clinically significant change should at least coincide with the threshold for reliable change (18.66 in our sample).

Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria.

A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression.

Knowledge about early identification of, and preventive care for complex grief has increased.

Special issue : Trauma occurs in social contexts

With this special issue that presents highlights of the biennial psychotrauma conference in Europe with contributions from experts inside and outside Europe, we hope to boost future research on the role of the broader social context in which trauma occurs.

The effects of eye movements on emotional memories : using an objective measure of cognitive load

Background: Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. The working memory (WM) theory explains its efficacy: recall of an aversive memory and making eye movements (EM) both produce cognitive load, and competition for the limited WM resources reduces the memory’s vividness and emotionality. The present study tested several predictions from WM theory.

Blurring emotional memories using eye movements : individual differences and speed of eye movements

Background: In eye movement desensitization and reprocessing (EMDR), patients make eye movements (EM) while recalling traumatic memories. Making EM taxes working memory (WM), which leaves less resources available for imagery of the memory. This reduces memory vividness and emotionality during future recalls. WM theory predicts that individuals with small working memory capacities (WMCs) benefit more from low levels of taxing (i.e., slow EM) whereas individuals with large WMC benefit more from high levels of taxing (i.e., fast EM).

Erasing memory traces of trauma with eye movement desensitization and reprocessing therapy

With its open access character, the European Journal of Psychotraumatology aims to promote evidence-based treatments around the world, while at the same time welcoming new forms of treatment without losing its critical scientific eye. Eye movement desensitization and reprocessing therapy (EMDR) is by now a well-established treatment for posttraumatic stress disorder (PTSD).

The Effects of Mindfulness‐Based Cognitive Therapy and Cognitive Behavioral Analysis System of Psychotherapy added to Treatment as Usual on suicidal ideation in chronic depression : Results of a randomized-clinical trial

Suicidal ideation (SI) is common in chronic depression, but only limited evidence exists for the assumption that psychological treatments for depression are effective for reducing SI.

Self-esteem treatment in anxiety : A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders

Background and purpose

Little is known about treating low self-esteem in anxiety disorders. This study evaluated two treatments targeting different mechanisms: (1) Eye Movement Desensitization and Reprocessing (EMDR), which aims to desensitize negative memory representations that are proposed to maintain low self-esteem; and (2) Competitive Memory Training (COMET), which aims to activate positive representations for enhancing self-esteem.


Correcting Misconceptions About the Diagnostic Criteria for Posttraumatic Stress Disorder in DSM-5

This Special Communication argues for changing the definition of posttraumatic stress disorder in DSM-5. Are changes to the definition of posttraumatic stress disorder in DSM-5 a step forward?—Yes.

We take strong exception to many of the assertions, conclusions, and recommendations in the article by Hoge et al1 in this issue of JAMA Psychiatry. Although Hoge et al1 identify a number of reasons they do not support the DSM-52 workgroup’s revisions to the diagnosis of posttraumatic stress disorder (PTSD), we believe that their basic arguments are that