- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05419934
EMDR Therapy in Young Children, a Double-blinded Randomized Controlled Trial (EMDRJEER)
Is Eye-Movement Desensitization and Reprocessing (EMDR) Therapy Effective in Children Aged 3 to 6 Years With Trauma-related Disorders or Stressors and Anxiety? A Double-blinded Randomized Controlled Trial.
This project aims to answer to the question of EMDR effectiveness in young children and to determine whether or not the therapy effectiveness is related to the level of cognitive functioning in young children. The study requires a total of 60 children, girls and boys, aged 3 to 6 years and presenting disorders related to stressors, anxiety and/or trauma. Participants will be randomly distributed in two groups: "EMDR therapy" (N=30) group or "routine care" (N=30) group. The study will take place in four stages: 1/ Pre-treatment phase : An evaluation of child's various cognitive and executive functions, child's symptomatology and parental distress is planned in a pre-treatment phase. 2/ Treatment phase : An EMDR therapy or a routine care is administered to the child between 6 to 10 weeks. 3/ Post-treatment phase : A reassessment of child's and parent's symptoms is planned at the end of treatment. 4/ Continuation of treatment: Children who have received routine treatment and without symptomatic improvement will be proposed EMDR treatment. These children will receive the same symptomatic assessments at the end of EMDR treatment.
A significant reduction in disorders related to trauma or stress and anxiety factors and their symptomatology, as well as comorbid disorders and their symptomatology, is expected in children who received EMDR therapy compared to the group who received a routine care. These results are expected to be robust over a period of at least 3 months. The positive effects of EMDR on child symptomatology are also expected to be more pronounced in children showing higher levels of cognitive functioning
Study Overview
Status
Intervention / Treatment
Detailed Description
Eye-Movement Desensitization and Reprocessing (EMDR) therapy is now recommended to anyone suffering from emotional disturbance related to psychological trauma, including babies and very young children. Results of this therapy are promising in young children for PTSD and its comorbidities. However, no studies have documented yet the specific effects of individual EMDR therapy in the 3-6 years children.
The question of the EMDR effectiveness in this population should be investigated first to meet the therapeutic needs in the care management of childhood psychotrauma, and secondly because EMDR therapy involves memory and executive functions that are very immature in children under 6 years old.
Indeed, EMDR involves therapeutic methods such as cognitive restructuring which requires that certain executive functioning components to be functional, even those processes are still developing in young children. EMDR also involves an exposure in the imagination that solicits episodic memories, whereas the ability of young children to retrieve thoses memories is very limited compared to that of adults. Finally, the alternating bilateral stimuli used in EMDR would have an effect on autobiographical memory. However, an infantile amnesia is observed between the ages of 2 and 6, with an absence and then a poverty of autobiographical memories.
Therefore, the present project aims to answer to the question of EMDR effectiveness in young children suffering from stress related disorders, anxiety and/or trauma, but also to determine whether or not the therapy effectiveness is related to the level of cognitive functioning in young children. This study requires a total of 60 children, girls and boys, aged 3 to 6 years and presenting disorders related to stressors, anxiety and/or trauma. Participants will be randomly distributed in two groups: "EMDR therapy" (N=30) group or "routine care" (N=30) group. The study will take place in four stages: 1/ Pre-treatment phase : An evaluation of child's various cognitive and executive functions, child's symptomatology and parental distress is planned in a pre-treatment phase. 2/ Treatment phase : An EMDR therapy or a routine care is administered to the child between 6 to 10 weeks. 3/ Post-treatment phase : A reassessment of child's and parent's symptoms is planned at the end of treatment. 4/ Continuation of treatment: Children who have received routine treatment and without symptomatic improvement will be proposed EMDR treatment. These children will receive the same symptomatic assessments at the end of EMDR treatment.
In terms of results, a significant reduction in disorders related to trauma or stress and anxiety factors and their symptomatology, as well as comorbid disorders and their symptomatology, is expected in children who received EMDR therapy compared to the group who received a routine care. These results are expected to be robust over a period of at least 3 months. The positive effects of EMDR on child symptomatology are also expected to be more pronounced in children showing higher levels of cognitive functioning.
This protocol represents the first randomized controlled trial to investigate effects of an individual EMDR therapy conducted specifically in children aged 3 to 6 years.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Nina MONER
- Phone Number: 04 92 03 47 70
- Email: ninamoner@etu.univ-cotedazur.fr
Study Contact Backup
- Name: Andréa SOUBELET, MD
- Phone Number: 04.92.03.47.70
- Email: andrea.soubelet@univ-cotedazur.fr
Study Locations
-
-
-
Nice, France
- Recruiting
- Hôpitaux Pédiatriques de Nice CHU-Lenval
-
Contact:
- Nina MONER
- Phone Number: 0492034770
- Email: ninamoner@etu.univ-cotedazur.fr
-
Contact:
- Andréa SOUBELET, MD
- Phone Number: 0492034770
- Email: andrea.soubelet@univ-cotedazur.fr
-
Principal Investigator:
- Nina MONER
-
Sub-Investigator:
- Andréa SOUBELET, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Child aged 3 to 6 at the time of inclusion;
- Established diagnosis of one or more disorders related to a trauma or a stress factor, and/or an anxiety disorder, assessed by the Diagnostic Infant and Preschool Assessment (DIPA) diagnostic tool
- Typical language
Exclusion Criteria:
- Child taking a psychotropic treatment
- Suicidal intentions or ideation of the main caregivers, or of the child, and self-harming behavior;
- Parent(s) or care figure(s) with a substance use disorder;
- Presence or diagnosis of specific pathological conditions in the child (neurodevelopmental disorders based on Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria, brain trauma, or neurological pathology);
- Participation of the child in another biomedical research on the psychic care of disorders related to trauma or stress and anxiety factors
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: EMDR
Patient receiving " EMDR therapy " over 6 to 10 sessions.
|
Children will receive an EMDR psychotherapy comprising 8 treatment phases. As the treatment progresses, the child will proceed to desensitize the events of adversity experienced. Phase 1 and 2, before the desensitization phases:
|
Sham Comparator: Routine Care
Patient receiving the " routine care " over 6 to 10 sessions
|
Children in the routine care group receive psychological monitoring administered by the Lenval Foundation (CHU de Nice - France) within the Pediatric Psychotrauma Assessment Center (Centre d'évaluation du psychotraumatisme pédiatrique - CE2P).
The proposed treatment is a psychological follow-up associated with relational support psychotherapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline of Diagnostic Infant and Preschool Assessment at 3months
Time Frame: at 3 months from inclusion
|
diagnostic of 13 pathologies, such as post Traumatic stress disorder (PTSD) or others stress related disorders, Anxiety related disorders, and associated disorders.
This tool as 517 items.
This scale doesn't work on numerical values (there is no min, max or cut scores), this scale makes it possible to confirm or invalidate the presence of symptoms necessary for establishing diagnoses on Diagnosis and Statistical Manual of Mental Disorders (DSMV) criteria.
|
at 3 months from inclusion
|
Diagnostic Infant and Preschool Assessment at 6 months
Time Frame: at 6 months from inclusion
|
diagnostic of 13 pathologies, such as post Traumatic stress disorder (PTSD) or others stress related disorders, Anxiety related disorders, and associated disorders.
This tool as 517 items.
This scale doesn't work on numerical values (there is no min, max or cut scores), this scale makes it possible to confirm or invalidate the presence of symptoms necessary for establishing diagnoses on Diagnosis and Statistical Manual of Mental Disorders (DSMV) criteria.
|
at 6 months from inclusion
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Preschool Anxiety Assessment
Time Frame: at inclusion, at 3 and 6 months from inclusion
|
symptoms of anxiety is measure by Preschool Anxiety Scale (PAS) The PAS is a heteroevaluation (for parents or the main care figure) to assess symptomatology of anxiety in children aged 3 to 6 years.
This tool has 34 items, based on a 5-points Likert scale, each item is scored from 0 to 4, the PAS has a score ranging from 0 to 112.
To interpret this questionnaire, T-scores must be used.
T-Scores enable the comparison of a child scores against norms from an equivalent age and gender group from a representative normative sample.
|
at inclusion, at 3 and 6 months from inclusion
|
Parental Stress
Time Frame: at inclusion, at 3 and 6 months from inclusion
|
symptoms of parental distress and parent-child dysfunctional interaction is performed by Parental Stress Index Screening Form (PSI-SF). The "Parental Stress Index Short Form" is a self-assessment intended for the child's parent The PSI-SF has 36 items from the original 120-item PSI and based on a 5-points Likert scale, each item is scored from 1 to 5, the PSI-SF has a score ranging from 36 to 180. Percentile scores are used to interpret the scores. Scores at or above the 85th percentile are considered high (normal range : 15th-80th percentile) |
at inclusion, at 3 and 6 months from inclusion
|
symptoms of Post Traumatic Stress Disorder
Time Frame: at inclusion, at 3 and 6 months from inclusion
|
measure of symptoms of PTSD by Young Child Post-traumatic Stress Disorder Checklist. This scale aims to screen for post-traumatic stress disorder symptoms in children aged 1 to 6 years old, by evaluating traumatic exposures (13 items), symptoms presented by the child (23 items) and his level of impairment or functional impairment (6 items). Items 14 to 36 relate to symptoms of PTSD and are based on a 5-points Likert scale, each item is scored from 0 to 4, the YCPC has a score ranging from 0 to 92. The diagnosis Cutoff is at 26 or more for items 14-36, it indicates a "probable diagnosis" of PTSD. Items 37 to 42 study functional impairment. These items scores can be added together to form a disability score, but they are not used in the PTSD symptom score |
at inclusion, at 3 and 6 months from inclusion
|
Child Behavior
Time Frame: at inclusion, at 3 and 6 months from inclusion
|
pathologic behaviors are measured by Child Behavior Checklist " (CBCL) ; The Child Behavior Checklist assesses anxiety, depression, emotional dysregulation, sleep disorders, attention problems, withdrawal behavior, and aggressive behavior. This list of items initially used with children aged 6 to 18 has been adapted for preschoolers. The study plans to use the preschool form (CBCL/ 1.5-5) for children aged 3 years to 5 years and 11 months, and the original CBCL for children aged 6 years to 6 years and 11 months. The Checklist is based on a 3-points Likert scale, each item is scored from 0 to 2, the CBCL has a score ranging from 0 to 230. To interpret this questionnaire, T-scores must be used. |
at inclusion, at 3 and 6 months from inclusion
|
cognitive function
Time Frame: at inclusion
|
use of French version of the Wechsler Preschool and Primary Scale of Intelligence ; only the subtests: Picture naming - for children ages 3 to 6 years ; Matrix - for children ages 4 to 6 years; Pictures Memory - for children ages 3 to 3 years and 11 months; Spatial Memory (Zoo location)- for children ages 3 to 6 years; The Wechsler Preschool and Primary Scale of Intelligence (WPPSI) is a cognitive assessment of children aged 2 years and 6 months to 7 years and 7 months. The 4th revision makes it possible to take into account the major stages of the child's cognitive and neurological development. Only subtests that show how the child develops certain major cognitive functions will be administered |
at inclusion
|
executive functioning
Time Frame: at inclusion
|
cognitive functioning (executive functioning) measure by french test of Executive Function Assessment Battery for Preschoolers named " La batterie d'évaluation des fonctions exécutives pour enfants d'âge préscolaire " (BEFEX-P) version 4.0 - (Monette & Bigras, 2017) This evaluation includes two independent tests: a Stroop test adapted to the child, and a tracing tracks. The Stroop fruit is an evaluation of inhibition and flexibility functions in preschool children which is practiced in verbal condition. Trace tracing is a cognitive task that allow the evaluation of executive functions (inhibition and flexibility) in preschool children. |
at inclusion
|
autobiographical memory
Time Frame: at inclusion
|
cognitive functioning (autobiographical memory) measure with french test of Autobiographical Memory Evaluation Task named " Tâche d'Evaluation de la Mémoire Autobiographique " (TEMA ; Deplus, de Romree, & Van Broeck, 2013) The TEMA assessment evaluates the functioning of autobiographical memory in preschool children (children from 3 years to 5 years and 11 months). This test makes the child do exercises to produce autobiographical memories. |
at inclusion
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 21-HPNCL-09
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Anxiety Disorders
-
Prisma Health-UpstateCompletedAnxiety | Anxiety, Separation | Separation Anxiety | Anxiety Generalized
-
Ann & Robert H Lurie Children's Hospital of ChicagoUniversity of California, Los Angeles; University of CincinnatiRecruitingAnxiety, Separation | Anxiety, Social | Anxiety, GeneralizedUnited States
-
AstraZenecaCompletedAnxiety Disorders | Anxiety | Anxiety Neuroses | Anxiety StatesUnited States
-
Nazife Begüm KARANCompletedDental Anxiety | Sedative; Anxiety DisorderTurkey
-
Loyola UniversityCompletedAnxiety | Anxiety State | Procedural AnxietyUnited States
-
Eli Lilly and CompanyCompletedAnxiety Neuroses | Anxiety States, Neurotic | Neuroses, AnxietyUnited States, Mexico, South Africa
-
West University of TimisoaraUnknownAnxiety Disorder/Anxiety StateRomania
-
Dr. Nazanin AlaviActive, not recruitingGeneralized Anxiety Disorder | AnxietyCanada
-
ProofPilotFisher WallaceActive, not recruitingGeneralized Anxiety Disorder | Anxiety | Generalized AnxietyUnited States
-
Loma Linda UniversityCompletedParental/Caregiver Anxiety | Child's AnxietyUnited States
Clinical Trials on EMDR therapy
-
Khushal Khan Khattak Univeristy, Karak, PakistanUnknown
-
FIDMAG Germanes HospitalàriesHospital Clinic of Barcelona; Hospital del Mar; Hospital Universitari de Bellvitge and other collaboratorsCompletedBipolar DisorderSpain
-
Hospital de Clinicas de Porto AlegreUnknown
-
Center of Integrative Addiction Research, AustriaMedical University of GrazUnknownSubstance Use Disorders | PsychotherapyAustria
-
Norwegian University of Science and TechnologyCompletedPosttraumatic Stress DisorderNorway
-
Parc de Salut MarFundacion IMIM; EMDR EuropeCompletedPsychological Trauma | Severe Mental DisorderSpain
-
Fundació Institut de Recerca de l'Hospital de la...EMDR EuropeRecruiting
-
Norwegian University of Science and TechnologySt. Olavs HospitalWithdrawnSpecific Phobia
-
Erasmus Medical CenterNot yet recruitingAnxiety and Fear
-
Khushal Khan Khattak Univeristy, Karak, PakistanNot yet recruitingGeneralized Anxiety Disorder | Major Depressive Disorder | Social Anxiety Disorder | Panic Attacks | Somatic Symptom | Obsessive-Compulsive Disorder and SymptomsPakistan