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      Imagery rescripting and eye movement desensitisation and reprocessing for treatment of adults with childhood trauma-related post-traumatic stress disorder: IREM study design

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          Post-traumatic stress disorder (PTSD) that originates from childhood trauma experiences can develop into a chronic condition that has lasting effects on an individual’s functioning and quality of life. While there are evidence-based guidelines for treating adult onset PTSD, treatments for adults with childhood trauma-related PTSD (Ch-PTSD) are varied and subject to ongoing debate. This study will test the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR) in participants with Ch-PTSD. Both have been found effective in treatment of adult PTSD or mixed onset PTSD and previous research indicates they are well-tolerated treatments. However, we know less about their effectiveness for treating Ch-PTSD or their underlying working mechanisms.


          IREM is an international multicentre randomised controlled trial involving seven sites across Australia, Germany and the Netherlands. We aim to recruit 142 participants (minimum of n = 20 per site), who will be randomly assigned to treatment condition. Assessments will be conducted before treatment until 1-year follow-up. Assessments before and after the waitlist will assess change in time only. The primary outcome measure is change in PTSD symptom severity from pre-treatment to 8-weeks post-treatment. Secondary outcome measures include change in severity of depression, anger, trauma-related cognitions, guilt, shame, dissociation and quality of life. Underlying mechanisms of treatment will be assessed on changes in vividness, valence and encapsulated belief of a worst trauma memory. Additional sub-studies will include qualitative investigation of treatment experiences from the participant and therapists’ perspective, changes in memory and the impact of treatment fidelity on outcome measures.


          The primary aims of this study are to compare the effectiveness of EMDR and ImRs in treating Ch-PTSD and to investigate the underlying working mechanisms of the two treatments. The large-scale international design will make a significant contribution to our understanding of how these treatments address the needs of individuals with Ch-PTSD and therefore, potentially improve their effectiveness.

          Trial registration

          Australian New Zealand Clinical Trials Registry ACTRN12614000750684. Registered 16 July 2014.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12888-017-1330-2) contains supplementary material, which is available to authorized users.

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                Author and article information

                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                4 May 2017
                4 May 2017
                : 17
                [1 ]ISNI 0000 0004 1936 7910, GRID grid.1012.2, , Division of Psychiatry, UWA Medical School, Faculty of Health & Medical Sciences, University of Western Australia, ; 35 Stirling Highway, Crawley, WA 6009 Australia
                [2 ]ISNI 0000 0001 0057 2672, GRID grid.4562.5, , Lübeck University, School of Psychiatry, ; Ratzeburger Allee 160, 23562 Lübeck, Germany
                [3 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, , Maastricht University, Faculty of Psychology and Neuroscience, Department Clinical Psychological Science, ; P.O. Box 616, 6200 MD Maastricht, The Netherlands
                [4 ]GGZ Noord-Holland Noord, Stationsplein 138, 1703 WC Heerhigowaard, Netherlands
                [5 ]PsyQ Amsterdam, George Westinghousestraat 2, 1097 BA Amsterdam, Netherlands
                [6 ]PsyQ Beverwijk, Leeghwaterweg 1A, 1951 NA Velsen-Noord, Netherlands
                [7 ]Sinai Centrum, Laan van de Helende Meesters 2, Postbus 2063, 1180 EB Amstelveen, Netherlands
                [8 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Clinical Psychology, , University of Amsterdam, ; Weesperplein 4, 1018 XA Amsterdam, Netherlands
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

                Funded by: FundRef, EMDR Research Foundation;
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