Effects of a Group EMDR Intervention on Narrative Complexity and Specificity of Autobiographical Memories: the Hug the Child Study (HTC)

Study Overview
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Brief Summary
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Background and study aims: The Eye Movement Desensitization and Reprocessing Group Protocol with Children (EMDR-GP/C) was first developed by Korkmazlar following the Marmara earthquake in Turkey in 1999 and can be adapted for different populations. The aim of this study is to assess if a EMDR-GP program may help primary school students in improving narrative complexity and specificity of autobiographical memories, as well as their subjective unit of distress (SUD) and validity of cognition (VoC). Who can participate? Students attending the fourth or fifth year of primary school What does the study involve? Participants will be randomly assigned to the experimental and control groups. Participants in the experimental group will undergo a 3-week EMDR-GP with weekly 60-minute group sessions (3 sessions), while the control group will follow routine daily school activities. Questionnaires will be used to assess narrative complexity, specificity of autobiographical memories, SUD and VoC before and after the intervention. What are the possible benefits and risks of participating? Benefits of participating in the study may include an improvement of narrative complexity, specificity of autobiographical memories, and their SUD and VoC.

Official Title
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Randomized Trial on the Effects of a Group EMDR Intervention on Narrative Complexity and Specificity of Autobiographical Memories: a Path Analytic and Supervised Machine Learning Approach

Conditions
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Child, Only, Narration, Memory Dysfunction, Distress, Emotional, Cognitive Change

Intervention / Treatment
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* Behavioral: Group EMDR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children aged 9 to 11 years Children have reasonable comprehension of spoken language and can follow simple instructions Children and their parents are willing to attend all intervention sessions Children and parents have an adequate understanding of Italian Exclusion Criteria: Concurrent enrollment in other intervention trials Child regularly practices EMDR intervention, or other therapeutical interventions, such as cognitive behavioral therapy or meditation.

Ages Eligible for Study
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Minimum Age: 9 Years
Maximum Age: 11 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group EMDR<br>Participants in the experimental group will undergo a 3-week group EMDR intervention with weekly 60-minute group sessions. | Behavioral: Group EMDR<br>* The eight phases of the adapted group EMDR protocol was administered during each session: 1. Meeting: Explaining the nature of trauma, group rules, name tags, filling in the scales. 2. Preparation: Exploring children's support system, explaining EMDR, safe place, resource exercise, and installation with bilateral stimulation (BLS, butterfly hug or knee tapping). 3. Assessment: Drawing the worst image on a small separate sheet of paper, SUD level, (negative cognition, emotions, body sensations - if possible). 4. Desensitization: It is done with drawing on 4 separate papers with BLS (butterfly hug or knee tapping). 5. Installation: With the healing story written according to the adaptive information processing (AIP) model, the installation is accompanied BLS. 6. Body scan: A positive body state is installed with the relaxation technique. 7. Closure & future template: Strong closure with artwork. 8. Re-evaluation: if possible.<br>|
| No Intervention: Control<br>The control group will follow routine daily school activities | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Event coding - Pre-intervention | Event coding is measured using Manual for Coding Events in Self Defining Memories. Relationship nominal score means a better outcome | Event coding is measured before the 3-week group EMDR intervention | 
| Memory specificity level - Pre-intervention | Memory specificity level is measured using Classification System and Scoring for Self-defining Autobiographical Memories. Specific nominal score means a better outcome | Memory specificity level is measured before the 3-week group EMDR intervention | 
| Narrative complexity level - Pre-intervention | Narrative complexity level is measured using Coding System for autobiographical Memory Narratives in Psychotherapy. Higher scores mean a better outcome. | Narrative complexity level is measured before the 3-week group EMDR intervention | 
| Subjective Unit of Distress - Pre-intervention | Subjective Unit of Distress is measured using a self-reporting scale with a 0- to 10-point rating scale. Higher scores mean a worse outcome | Subjective Unit of Distress is measured before the 3-week group EMDR intervention | 
| Validity of Cognition - Pre-intervention | Validity of Cognition is measured using a self-reporting scale with a 1- to 7-point rating scale. Higher scores mean a better outcome | Validity of Cognition is measured before the 3-week group EMDR intervention | 
| Event coding - Post-intervention | Event coding is measured using Manual for Coding Events in Self Defining Memories. Relationship nominal score means a better outcome | Event coding is measured after the 3-week group EMDR intervention | 
| Memory specificity level - Post-intervention | Memory specificity level is measured using Classification System and Scoring for Self-defining Autobiographical Memories. Specific nominal score means a better outcome | Memory specificity level is measured after the 3-week group EMDR intervention | 
| Narrative complexity level - Post-intervention | Narrative complexity level is measured using Coding System for autobiographical Memory Narratives in Psychotherapy. Higher scores mean a better outcome. | Narrative complexity level is measured after the 3-week group EMDR intervention | 
| Subjective Unit of Distress - Post-intervention | Subjective Unit of Distress is measured using a self-reporting scale with a 0- to 10-point rating scale. Higher scores mean a worse outcome | Subjective Unit of Distress is measured after the 3-week group EMDR intervention | 
| Validity of Cognition - Post-intervention | Validity of Cognition is measured using a self-reporting scale with a 1- to 7-point rating scale. Higher scores mean a better outcome | Validity of Cognition is measured after the 3-week group EMDR intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Autobiographical memory definition - Pre-intervention | Autobiographical memory definition is measured using Coding System for Autobiographical Memory Narratives in Psychotherapy. Autobiographic nominal score means a better outcome. | Autobiographical memory definition is measured before the 3-week group EMDR intervention | 
| Memory integration level - Pre-intervention | Memory integration level is measured using Classification System and Scoring for Self-defining Autobiographical Memories. Integrated nominal score means a better outcome | Memory integration level is measured before the 3-week group EMDR intervention | 
| Autobiographical memory definition - Post-intervention | Autobiographical memory definition is measured using Coding System for Autobiographical Memory Narratives in Psychotherapy. Autobiographic nominal score means a better outcome. | Autobiographical memory definition is measured after the 3-week group EMDR intervention | 
| Memory integration level - Post-intervention | Memory integration level is measured using Classification System and Scoring for Self-defining Autobiographical Memories. Integrated nominal score means a better outcome | Memory integration level is measured after the 3-week group EMDR intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Child, EMDR, Narrative complexity, Autobiographical memories, Distress, Cognition