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

A. B. P. Staring*, D. P. G. van den Berg, D. C. Cath, M. Schoorl, I. M. Engelhard, C. W. Korrelboom

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

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.
Methods
A Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models.
Results
COMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem.
Conclusions
COMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms.
Keywords
Self-esteem, Anxiety disorders, EMDR, COMET, Memory representations
Original languageEnglish
Pages (from-to)11-20
JournalBehaviour Research and Therapy
Volume82
DOIs
Publication statusPublished - 2016

Keywords

  • Self-esteem
  • Anxiety disorders
  • EMDR
  • COMET
  • Memory representations
  • POSTTRAUMATIC-STRESS-DISORDER
  • SOCIAL ANXIETY
  • CLINICAL-TRIAL
  • DSM-IV
  • DEPRESSION
  • SCALE
  • SCHIZOPHRENIA
  • ADOLESCENTS
  • SYMPTOMS
  • THERAPY

Cite this

@article{4c1f296a9ec449099f53951148065b61,
title = "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",
abstract = "Background and purposeLittle 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.MethodsA Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models.ResultsCOMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem.ConclusionsCOMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms.KeywordsSelf-esteem, Anxiety disorders, EMDR, COMET, Memory representations",
keywords = "Self-esteem, Anxiety disorders, EMDR, COMET, Memory representations, POSTTRAUMATIC-STRESS-DISORDER, SOCIAL ANXIETY, CLINICAL-TRIAL, DSM-IV, DEPRESSION, SCALE, SCHIZOPHRENIA, ADOLESCENTS, SYMPTOMS, THERAPY",
author = "Staring, {A. B. P.} and {van den Berg}, {D. P. G.} and Cath, {D. C.} and M. Schoorl and Engelhard, {I. M.} and Korrelboom, {C. W.}",
year = "2016",
doi = "10.1016/j.brat.2016.04.002",
language = "English",
volume = "82",
pages = "11--20",
journal = "Behaviour Research and Therapy",
issn = "0005-7967",
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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. / Staring, A. B. P.; van den Berg, D. P. G.; Cath, D. C.; Schoorl, M.; Engelhard, I. M.; Korrelboom, C. W.

In: Behaviour Research and Therapy, Vol. 82, 2016, p. 11-20.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Self-esteem treatment in anxiety

T2 - A randomized controlled crossover trial of Eye Movement Desensitization and Reprocessing (EMDR) versus Competitive Memory Training (COMET) in patients with anxiety disorders

AU - Staring, A. B. P.

AU - van den Berg, D. P. G.

AU - Cath, D. C.

AU - Schoorl, M.

AU - Engelhard, I. M.

AU - Korrelboom, C. W.

PY - 2016

Y1 - 2016

N2 - Background and purposeLittle 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.MethodsA Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models.ResultsCOMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem.ConclusionsCOMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms.KeywordsSelf-esteem, Anxiety disorders, EMDR, COMET, Memory representations

AB - Background and purposeLittle 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.MethodsA Randomized Controlled Trial (RCT) was used with a crossover design. Group 1 received six sessions EMDR first and then six sessions COMET; group 2 vice versa. Assessments were made at baseline (T0), end of first treatment (T1), and end of second treatment (T2). Main outcome was self-esteem. We included 47 patients and performed Linear Mixed Models.ResultsCOMET showed more improvements in self-esteem than EMDR: effect-sizes 1.25 versus 0.46 post-treatment. Unexpectedly, when EMDR was given first, subsequent effects of COMET were significantly reduced in comparison to COMET as the first intervention. For EMDR, sequence made no difference. Reductions in anxiety and depression were mediated by better self-esteem.ConclusionsCOMET was associated with significantly greater improvements in self-esteem than EMDR in patients with anxiety disorders. EMDR treatment reduced the effectiveness of subsequent COMET. Improved self-esteem mediated reductions in anxiety and depression symptoms.KeywordsSelf-esteem, Anxiety disorders, EMDR, COMET, Memory representations

KW - Self-esteem

KW - Anxiety disorders

KW - EMDR

KW - COMET

KW - Memory representations

KW - POSTTRAUMATIC-STRESS-DISORDER

KW - SOCIAL ANXIETY

KW - CLINICAL-TRIAL

KW - DSM-IV

KW - DEPRESSION

KW - SCALE

KW - SCHIZOPHRENIA

KW - ADOLESCENTS

KW - SYMPTOMS

KW - THERAPY

U2 - 10.1016/j.brat.2016.04.002

DO - 10.1016/j.brat.2016.04.002

M3 - Article

VL - 82

SP - 11

EP - 20

JO - Behaviour Research and Therapy

JF - Behaviour Research and Therapy

SN - 0005-7967

ER -