{
  "title": "Vision research",
  "introduction": {
    "paragraphs": [
      "Vision research includes eye movement desensitization and reprocessing (EMDR), alongside foundational research on retinal organisation, visual maps and spatial coding. Clinical intervention evidence and geometric mechanisms are assessed separately."
    ]
  },
  "chapters": [
    {
      "number": 1,
      "title": "EMDR: PTSD and mental health",
      "topics": [
        {
          "id": "i",
          "title": "EMDR for PTSD and related mental-health outcomes",
          "description": "Clinical studies of PTSD symptoms, depression, anxiety and emotional responses following EMDR.",
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            {
              "title": "Psychological and Brain Connectivity Changes Following Trauma-Focused CBT and EMDR Treatment in Single-Episode PTSD Patients.",
              "journal": "Frontiers in psychology",
              "year": 2019,
              "authors": "Santarnecchi E, Bossini L, Vatti G, Fagiolini A, La Porta P, Di Lorenzo G, Siracusano A, Rossi S, Rossi A.",
              "design": "Peer-reviewed research",
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                "https://pmc.ncbi.nlm.nih.gov/articles/PMC6397860/",
                "https://pubmed.ncbi.nlm.nih.gov/30858808/",
                "https://doi.org/10.3389/fpsyg.2019.00129"
              ],
              "doi": "10.3389/fpsyg.2019.00129",
              "pmid": "30858808",
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                  "https://doi.org/10.3389/fpsyg.2019.00129"
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                "reviewedAt": "2026-10-23"
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              "evidence": {
                "sample": "Single-episode PTSD patients; not a military-specific sample",
                "measurement": "Clinical outcomes and brain connectivity"
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
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                  "https://pubmed.ncbi.nlm.nih.gov/30858808/",
                  "https://doi.org/10.3389/fpsyg.2019.00129"
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
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            },
            {
              "title": "Eye Movement Desensitization and Reprocessing Versus Treatment as Usual in the Treatment of Depression: A Randomized-Controlled Trial.",
              "journal": "Frontiers in psychology",
              "year": 2018,
              "authors": "Hase M, Plagge J, Hase A, Braas R, Ostacoli L, Hofmann A, Huchzermeier C.",
              "design": "Randomized controlled trial",
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                "https://pmc.ncbi.nlm.nih.gov/articles/PMC6113947/",
                "https://pubmed.ncbi.nlm.nih.gov/30186192/",
                "https://doi.org/10.3389/fpsyg.2018.01384"
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              "doi": "10.3389/fpsyg.2018.01384",
              "pmid": "30186192",
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                  "https://pubmed.ncbi.nlm.nih.gov/30186192/",
                  "https://doi.org/10.3389/fpsyg.2018.01384"
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                "reviewedAt": "2026-10-23"
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              "evidence": {
                "sample": "People with depression; not a veteran-specific sample"
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              "recordId": "pmid-30186192",
              "quotes": [
                [
                  {
                    "text": "“Given the predicted worldwide increase of depression and the limited success of Treatment as Usual, it is important to develop adjunctive therapy strategies. The present randomized study examined whether EMDR therapy produces a positive effect in the treatment of depression beyond TAU.”",
                    "emphasis": false
                  }
                ],
                [
                  {
                    "text": "“the present study thus suggests that EMDR may improve treatment outcomes when added to Treatment as Usual”",
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              ],
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                  "https://doi.org/10.3389/fpsyg.2018.01384"
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            {
              "title": "How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action.",
              "journal": "Frontiers in psychology",
              "year": 2018,
              "authors": "Landin-Romero R, Moreno-Alcazar A, Pagani M, Amann BL.",
              "design": "Systematic review",
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                "https://pmc.ncbi.nlm.nih.gov/articles/PMC6106867/",
                "https://pubmed.ncbi.nlm.nih.gov/30166975/",
                "https://doi.org/10.3389/fpsyg.2018.01395"
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            {
              "title": "Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait-list in pediatric posttraumatic stress disorder following single-incident trauma: a multicenter randomized clinical trial.",
              "journal": "Journal of child psychology and psychiatry, and allied disciplines",
              "year": 2017,
              "authors": "de Roos C, van der Oord S, Zijlstra B, Lucassen S, Perrin S, Emmelkamp P, de Jongh A.",
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                "https://pubmed.ncbi.nlm.nih.gov/28660669/",
                "https://doi.org/10.1111/jcpp.12768"
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                "basis": "The primary article identifies a single-blind, three-arm randomized trial in 103 young people aged 8–18.",
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              "quotes": [
                [
                  {
                    "text": "“EMDR and CBWT are brief, trauma-focused treatments that yielded equally large remission rates for PTSD and reductions in the severity of PTSD and comorbid difficulties in children and adolescents seeking treatment for PTSD tied to a single event.”",
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            },
            {
              "title": "Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial.",
              "journal": "European child & adolescent psychiatry",
              "year": 2014,
              "authors": "Diehle J, Opmeer BC, Boer F, Mannarino AP, Lindauer RJ.",
              "design": "Randomized controlled trial · single-blind (assessor)",
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                "basis": "The methods describe a prospective randomized open-label blinded-endpoint trial. Psychologists assessing outcomes were blinded to treatment allocation.",
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              "quotes": [
                [
                  {
                    "text": "“Trauma focused CBT and EMDR are effective and efficient in reducing Post Traumatic Stress Symptoms in children.”",
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            },
            {
              "title": "Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: a meta-analysis of randomized controlled trials.",
              "journal": "PloS one",
              "year": 2014,
              "authors": "Chen YR, Hung KW, Tsai JC, Chu H, Chung MH, Chen SR, Liao YM, Ou KL, Chang YC, Chou KR.",
              "design": "Systematic review and meta-analysis",
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                "https://pmc.ncbi.nlm.nih.gov/articles/PMC4125321/",
                "https://pubmed.ncbi.nlm.nih.gov/25101684/",
                "https://doi.org/10.1371/journal.pone.0103676"
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                    "text": "“This study confirmed that EMDR therapy significantly reduces the symptoms of PTSD, depression, anxiety, and subjective distress in PTSD patients. The subgroup analysis indicated that a treatment duration of more than 60 min per session was a major contributing factor in the amelioration of anxiety and depression, and that a therapist with experience in conducting PTSD group therapy was a major contributing factor in the reduction of PTSD symptoms.”",
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            {
              "title": "The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences.",
              "journal": "The Permanente journal",
              "year": 2014,
              "authors": "Shapiro F.",
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              "title": "A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis.",
              "journal": "Trials",
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              "authors": "de Bont PA, van den Berg DP, van der Vleugel BM, de Roos C, Mulder CL, Becker ES, de Jongh A, van der Gaag M, van Minnen A.",
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              "title": "A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance.",
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            },
            {
              "title": "EMDR randomized trials: literature search",
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              "summary": "A research-search reference; it is not counted as an individual trial in the topic trust score.",
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                "basis": "This record is outside the paper-rating criteria or has unresolved publication identity.",
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                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial.",
              "journal": "JAMA psychiatry",
              "year": 2015,
              "authors": "van den Berg DP, de Bont PA, van der Vleugel BM, de Roos C, de Jongh A, Van Minnen A, van der Gaag M.",
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                "https://pubmed.ncbi.nlm.nih.gov/25607833/",
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              ],
              "doi": "10.1001/jamapsychiatry.2014.2637",
              "pmid": "25607833",
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                "Clinical & self-report"
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              },
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/25607833/",
                  "https://doi.org/10.1001/jamapsychiatry.2014.2637"
                ],
                "reviewedAt": "2026-10-23"
              },
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/25607833/",
                  "https://doi.org/10.1001/jamapsychiatry.2014.2637"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The immediate and follow-up effects of EMDR therapy for adults with post-traumatic stress disorder: a meta-analysis of randomized controlled trials.",
              "journal": "BMC psychology",
              "year": 2026,
              "authors": "Yang H, Xiong Z, Chen X, Wo Y, Tang H, Qiao M, Chen Y, Wang Z.",
              "design": "Systematic review and meta-analysis",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13599145/",
                "https://pubmed.ncbi.nlm.nih.gov/42773467/",
                "https://doi.org/10.1186/s40359-026-05349-w"
              ],
              "doi": "10.1186/s40359-026-05349-w",
              "pmid": "42773467",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
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                "count": 0,
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              },
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42773467/",
                  "https://doi.org/10.1186/s40359-026-05349-w"
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                "reviewedAt": "2026-10-23"
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              "recordId": "pmid-42773467",
              "quotes": [],
              "sourcePages": [],
              "summary": "Sixty-five studies with 3,342 participants include immediate and follow-up PTSD outcomes.",
              "limitation": "Comparator and trauma type influence results; overlapping trials in earlier reviews are not new independent evidence.",
              "id": "vision-i-pmid-42773467",
              "paperTrustAssessment": {
                "score": 1,
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42773467/",
                  "https://doi.org/10.1186/s40359-026-05349-w"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Efficacy of eye movement desensitization and reprocessing for anxiety: An umbrella review and meta-meta-analysis of randomized controlled trials.",
              "journal": "Journal of anxiety disorders",
              "year": 2026,
              "authors": "Antuña-Camblor C, Rabito-Alcón MF, Mathias-Fonseca TF.",
              "design": "Systematic review and meta-analysis",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/42880055/",
                "https://doi.org/10.1016/j.janxdis.2026.103243"
              ],
              "doi": "10.1016/j.janxdis.2026.103243",
              "pmid": "42880055",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
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                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42880055/",
                  "https://doi.org/10.1016/j.janxdis.2026.103243"
                ],
                "reviewedAt": "2026-10-23"
              },
              "recordId": "pmid-42880055",
              "quotes": [],
              "sourcePages": [],
              "summary": "Eleven meta-analyses report an average anxiety reduction, with a smaller advantage against active psychological treatments.",
              "limitation": "Most comparisons involve PTSD, nine reviews were rated low or critically low quality, and heterogeneity was substantial.",
              "id": "vision-i-pmid-42880055",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": false,
                "blinding": "not-applicable",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42880055/",
                  "https://doi.org/10.1016/j.janxdis.2026.103243"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The effect of eye movement desensitization on neurocognitive functioning compared to retrieval-only in PTSD patients: a randomized controlled trial.",
              "journal": "BMC psychiatry",
              "year": 2024,
              "authors": "Susanty E, Sijbrandij M, Srisayekti W, Suparman Y, Huizink AC.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC11673372/",
                "https://pubmed.ncbi.nlm.nih.gov/39731040/",
                "https://doi.org/10.1186/s12888-024-06420-9"
              ],
              "doi": "10.1186/s12888-024-06420-9",
              "pmid": "39731040",
              "targets": [],
              "categories": [
                "Clinical & self-report"
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39731040/",
                  "https://doi.org/10.1186/s12888-024-06420-9"
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                "reviewedAt": "2026-10-23"
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              "evidence": {
                "trialId": "ISRCTN55239132"
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              "recordId": "pmid-39731040",
              "quotes": [],
              "sourcePages": [],
              "summary": "Ninety-one patients received eye movement desensitisation or retrieval alone; no additional neurocognitive benefit from eye movements was found.",
              "limitation": "The tested neurocognitive endpoints and component intervention do not represent every outcome or the full clinical protocol.",
              "id": "vision-i-pmid-39731040",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39731040/",
                  "https://doi.org/10.1186/s12888-024-06420-9"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Treatment of traumatic birth experience with postpartum early eye movement desensitization and reprocessing therapy: a randomized clinical trial.",
              "journal": "American journal of obstetrics and gynecology",
              "year": 2025,
              "authors": "Hendrix YMGA, van Pampus MG, Hofman A, Henrichs J, van der Horst HE, de Jongh A.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/40769315/",
                "https://doi.org/10.1016/j.ajog.2025.07.051"
              ],
              "doi": "10.1016/j.ajog.2025.07.051",
              "pmid": "40769315",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 1,
              "citationSnapshot": {
                "count": 1,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/40769315"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40769315/",
                  "https://doi.org/10.1016/j.ajog.2025.07.051"
                ],
                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Two telephone contacts",
                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
                  "https://pubmed.ncbi.nlm.nih.gov/40769315/",
                  "https://doi.org/10.1016/j.ajog.2025.07.051"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
                  "https://daytab.com/study/d2wgsb9s",
                  "https://europepmc.org/article/MED/40769315"
                ],
                "selectionPolicy": "Success-focused discovery selection, with material limitations retained; not an exhaustive systematic review."
              },
              "id": "vision-i-pmid-40769315",
              "recordId": "pmid-40769315",
              "quotes": [],
              "sourcePages": [],
              "summary": "Of 151 women randomised after a traumatic birth, 143 entered the reported intention-to-treat analysis. Two early postpartum EMDR sessions reduced self-reported and clinician-rated PTSD symptom severity compared with two telephone contacts; the reported raw symptom differences were 8.7 and 3.8 points respectively.",
              "limitation": "Clinician-diagnosed PTSD rates did not differ significantly. The abstract contains an inconsistent confidence-interval entry, so that interval is not reproduced here; follow-up was nine weeks postpartum.",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40769315/",
                  "https://doi.org/10.1016/j.ajog.2025.07.051"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy on Post-Traumatic Stress Disorder Symptoms and Diagnostic Status in Patients with a Personality Disorder: A Randomized Controlled Trial.",
              "journal": "Psychotherapy and psychosomatics",
              "year": 2025,
              "authors": "Hafkemeijer L, Hofman S, de Jongh A, de Roos D, van Velzen M, Starrenburg A, Slotema K.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/40716437/",
                "https://doi.org/10.1159/000547622",
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC12503563/"
              ],
              "doi": "10.1159/000547622",
              "pmid": "40716437",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 2,
              "citationSnapshot": {
                "count": 2,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/40716437"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40716437/",
                  "https://doi.org/10.1159/000547622",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC12503563/"
                ],
                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Waitlist",
                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
                  "https://pubmed.ncbi.nlm.nih.gov/40716437/",
                  "https://doi.org/10.1159/000547622",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC12503563/"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
                  "https://daytab.com/study/h747ggnb",
                  "https://europepmc.org/article/MED/40716437"
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              },
              "id": "vision-i-pmid-40716437",
              "recordId": "pmid-40716437",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 159 people with personality disorders, EMDR reduced PTSD symptoms more than a waitlist. Among participants with PTSD receiving EMDR, 65.5% no longer met the diagnosis after treatment and 73.1% at follow-up.",
              "limitation": "A waitlist does not control for therapeutic attention. The remission percentages describe the treated subgroup; they are not an absolute treatment effect or a general remission guarantee.",
              "paperTrustAssessment": {
                "score": 2,
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40716437/",
                  "https://doi.org/10.1159/000547622",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC12503563/"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Eye movement desensitization and reprocessing (EMDR) therapy compared to usual treatment for posttraumatic stress disorder in adults with psychosis in forensic settings: Randomized controlled trial.",
              "journal": "Psychological trauma : theory, research, practice and policy",
              "year": 2024,
              "authors": "Every-Palmer S, Flewett T, Dean S, Hansby O, Freeland A, Weatherall M, Bell E.",
              "design": "Single-blind randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/38227442/",
                "https://doi.org/10.1037/tra0001643"
              ],
              "doi": "10.1037/tra0001643",
              "pmid": "38227442",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 12,
              "citationSnapshot": {
                "count": 12,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/38227442"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38227442/",
                  "https://doi.org/10.1037/tra0001643"
                ],
                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Routine-care waitlist",
                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
                  "https://pubmed.ncbi.nlm.nih.gov/38227442/",
                  "https://doi.org/10.1037/tra0001643"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
                  "https://daytab.com/study/n2bqk2h9",
                  "https://europepmc.org/article/MED/38227442"
                ],
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              },
              "id": "vision-i-pmid-38227442",
              "recordId": "pmid-38227442",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 24 forensic patients with psychosis and PTSD, blinded assessments favoured EMDR over routine-care waitlist for clinician-rated PTSD symptoms. The estimated difference averaged across follow-ups was 11.4 points, with a 95% confidence interval of 1.3 to 21.4.",
              "limitation": "Recruitment was curtailed by pandemic restrictions, leaving a small sample. Psychotic symptoms and adverse events did not differ significantly, so effectiveness claims remain specific to the measured PTSD outcomes.",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38227442/",
                  "https://doi.org/10.1037/tra0001643"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Eye Movement Desensitization and Reprocessing: Efficacy in Improving Clinical, Neuropsychological, and Quality of Life in Women Victims of Violence.",
              "journal": "Women's health reports (New Rochelle, N.Y.)",
              "year": 2024,
              "authors": "Meneses AYM, Fernández-Gonzalo S, Vicente MJ.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/39758524/",
                "https://doi.org/10.1089/whr.2023.0110",
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC11693959/"
              ],
              "doi": "10.1089/whr.2023.0110",
              "pmid": "39758524",
              "targets": [],
              "categories": [
                "Clinical & self-report"
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              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/39758524"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39758524/",
                  "https://doi.org/10.1089/whr.2023.0110",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC11693959/"
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                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
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                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
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                  "https://doi.org/10.1089/whr.2023.0110",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC11693959/"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
                  "https://daytab.com/study/fp9wt825",
                  "https://europepmc.org/article/MED/39758524"
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              "id": "vision-i-pmid-39758524",
              "recordId": "pmid-39758524",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 120 women exposed to violence, ten sessions of EMDR produced greater reported improvements in post-traumatic symptoms, anxiety, depression, quality of life and selected cognitive tests than narrative exposure therapy.",
              "limitation": "The abstract supplies significance levels without effect-size confidence intervals. Masking, multiple comparisons and durability require further appraisal before a high-confidence comparative claim.",
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                "score": 2,
                "scope": "Paper",
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
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                  "https://doi.org/10.1089/whr.2023.0110",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC11693959/"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Eye movement desensitisation and reprocessing for post-traumatic stress in survivors of critical illness (EMERALD): a mixed-methods, randomised, single-blind, parallel group-controlled, feasibility trial.",
              "journal": "EClinicalMedicine",
              "year": 2026,
              "authors": "Bates A, Cusack R, Golding H, Moyses H, Southam H, Rushbrook S, Highfield J, Pattison N, Baldwin DS, Grocott MPW.",
              "design": "Single-blind randomized feasibility trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/42518933/",
                "https://doi.org/10.1016/j.eclinm.2026.104082",
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13382324/"
              ],
              "doi": "10.1016/j.eclinm.2026.104082",
              "pmid": "42518933",
              "targets": [],
              "categories": [
                "Clinical & self-report"
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              "citationCount": 1,
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                "count": 1,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/42518933"
              },
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                "sources": [
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                  "https://doi.org/10.1016/j.eclinm.2026.104082",
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                  "https://doi.org/10.1016/j.eclinm.2026.104082",
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                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
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                  "https://europepmc.org/article/MED/42518933"
                ],
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              },
              "id": "vision-i-pmid-42518933",
              "recordId": "pmid-42518933",
              "quotes": [],
              "sourcePages": [],
              "summary": "The 40-person EMERALD trial in critical-illness survivors achieved 98% clinician-rated follow-up at 12 months. Exploratory PTSD symptom change favoured EMDR plus usual care by 14.1 points, with a 95% confidence interval of 6.2 to 22.0 points.",
              "limitation": "Feasibility, acceptability and safety were the primary objectives. The symptom estimate is hypothesis-generating and does not establish definitive treatment effectiveness.",
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                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC13382324/"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "A Pilot Randomized Controlled Trial of Eye Movement Desensitization and Reprocessing Therapy for Adults With Binge-Eating Disorder.",
              "journal": "The International journal of eating disorders",
              "year": 2026,
              "authors": "Hatoum AH, Richard K, Burton AL, Rieger E, Touyz S, Abbott MJ.",
              "design": "Single-blind randomized controlled pilot trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/41655996/",
                "https://doi.org/10.1002/eat.70056",
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13147140/"
              ],
              "doi": "10.1002/eat.70056",
              "pmid": "41655996",
              "targets": [],
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                "Clinical & self-report"
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                "source": "Europe PMC",
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                "url": "https://europepmc.org/article/MED/41655996"
              },
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                "sources": [
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                  "https://doi.org/10.1002/eat.70056",
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                "registeredMaskingBasis": false
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              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Waitlist",
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                  "https://doi.org/10.1002/eat.70056",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC13147140/"
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                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
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                  "https://europepmc.org/article/MED/41655996"
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              "summary": "A 38-person pilot found greater reductions in binge-eating symptoms, days and frequency with an adapted ten-session EMDR protocol than waitlist, alongside improvements in selected anxiety and sleep outcomes.",
              "limitation": "Treatment completion was 68.8%, and several other outcomes did not improve. The small pilot and immediate post-treatment assessment support a larger trial rather than a settled treatment recommendation.",
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/41655996/",
                  "https://doi.org/10.1002/eat.70056",
                  "https://pmc.ncbi.nlm.nih.gov/articles/PMC13147140/"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Trauma-focused therapy in early psychosis: results of a feasibility randomized controlled trial of EMDR for psychosis (EMDRp) in early intervention settings.",
              "journal": "Psychological medicine",
              "year": 2024,
              "authors": "Varese F, Sellwood W, Pulford D, Awenat Y, Bird L, Bhutani G, Carter LA, Davies L, Aseem S, Davis C, Hefferman-Clarke R, Hilton C, Horne G, Keane D, Logie R, Malkin D, Potter F, van den Berg D, Zia S, Bentall RP.",
              "design": "Single-blind randomized feasibility trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/37882058/",
                "https://doi.org/10.1017/s0033291723002532"
              ],
              "doi": "10.1017/s0033291723002532",
              "pmid": "37882058",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 17,
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                "count": 17,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/37882058"
              },
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                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/37882058/",
                  "https://doi.org/10.1017/s0033291723002532"
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                  "https://doi.org/10.1017/s0033291723002532"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
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                  "https://europepmc.org/article/MED/37882058"
                ],
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              },
              "id": "vision-i-pmid-37882058",
              "recordId": "pmid-37882058",
              "quotes": [],
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              "summary": "In 60 early-psychosis service users, a 16-session EMDR adaptation met trial feasibility targets and showed promising clinical signals at six months. PTSD symptoms and general-health signals remained evident at 12 months.",
              "limitation": "The study was designed to establish feasibility. Follow-up completion was 70% at 12 months, and the efficacy signals require confirmation in a larger trial.",
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/37882058/",
                  "https://doi.org/10.1017/s0033291723002532"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Clinical efficacy of trauma-focused psychotherapies in treatment-resistant depression (TRD) in-patients: A randomized, controlled pilot-study.",
              "journal": "Psychiatry research",
              "year": 2019,
              "authors": "Minelli A, Zampieri E, Sacco C, Bazzanella R, Mezzetti N, Tessari E, Barlati S, Bortolomasi M.",
              "design": "Single-blind randomized controlled pilot trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/30711853/",
                "https://doi.org/10.1016/j.psychres.2019.01.070"
              ],
              "doi": "10.1016/j.psychres.2019.01.070",
              "pmid": "30711853",
              "targets": [],
              "categories": [
                "Clinical & self-report"
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                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/30711853"
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                "category": "peer-reviewed",
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/30711853/",
                  "https://doi.org/10.1016/j.psychres.2019.01.070"
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                "registeredMaskingBasis": false
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                "intervention": "Therapist-delivered EMDR",
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                  "https://pubmed.ncbi.nlm.nih.gov/30711853/",
                  "https://doi.org/10.1016/j.psychres.2019.01.070"
                ],
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                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
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                  "https://europepmc.org/article/MED/30711853"
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              },
              "id": "vision-i-pmid-30711853",
              "recordId": "pmid-30711853",
              "quotes": [],
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              "summary": "In 22 treatment-resistant depression inpatients, both EMDR and trauma-focused CBT improved depressive symptoms; a post-hoc comparison favoured EMDR at the 12-week follow-up.",
              "limitation": "The small pilot and post-hoc nature of the comparison limit confidence in superiority. Benefits were only partly maintained at 24 weeks.",
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/30711853/",
                  "https://doi.org/10.1016/j.psychres.2019.01.070"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: a randomized, controlled pilot-study.",
              "journal": "Psychiatry research",
              "year": 2014,
              "authors": "Novo P, Landin-Romero R, Radua J, Vicens V, Fernandez I, Garcia F, Pomarol-Clotet E, McKenna PJ, Shapiro F, Amann BL.",
              "design": "Single-blind randomized controlled pilot trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/24880581/",
                "https://doi.org/10.1016/j.psychres.2014.05.012"
              ],
              "doi": "10.1016/j.psychres.2014.05.012",
              "pmid": "24880581",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 44,
              "citationSnapshot": {
                "count": 44,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/24880581"
              },
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                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/24880581/",
                  "https://doi.org/10.1016/j.psychres.2014.05.012"
                ],
                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Treatment as usual",
                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
                  "https://pubmed.ncbi.nlm.nih.gov/24880581/",
                  "https://doi.org/10.1016/j.psychres.2014.05.012"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
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                  "https://europepmc.org/article/MED/24880581"
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              },
              "id": "vision-i-pmid-24880581",
              "recordId": "pmid-24880581",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 20 people with bipolar disorder and trauma histories, EMDR improved depressive, hypomanic and trauma symptoms relative to usual care after treatment, using blinded outcome ratings.",
              "limitation": "The trial was small, with unequal dropout between groups. Most differences were not sustained at the 24-week assessment; this is an adjunctive pilot rather than evidence for replacing established bipolar treatment.",
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                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/24880581/",
                  "https://doi.org/10.1016/j.psychres.2014.05.012"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: randomised clinical trial.",
              "journal": "The British journal of psychiatry : the journal of mental science",
              "year": 2020,
              "authors": "Boterhoven de Haan KL, Lee CW, Fassbinder E, van Es SM, Menninga S, Meewisse ML, Rijkeboer M, Kousemaker M, Arntz A.",
              "design": "Single-blind randomized controlled trial (outcome assessors blinded)",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/32892758/",
                "https://doi.org/10.1192/bjp.2020.158"
              ],
              "doi": "10.1192/bjp.2020.158",
              "pmid": "32892758",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 70,
              "citationSnapshot": {
                "count": 70,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/32892758"
              },
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/32892758/",
                  "https://doi.org/10.1192/bjp.2020.158"
                ],
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                "registeredMaskingBasis": false
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              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Imagery rescripting",
                "evidenceType": "Clinical or experimental outcomes",
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                  "https://pubmed.ncbi.nlm.nih.gov/32892758/",
                  "https://doi.org/10.1192/bjp.2020.158"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
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                  "https://europepmc.org/article/MED/32892758"
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              },
              "id": "vision-i-pmid-32892758",
              "recordId": "pmid-32892758",
              "quotes": [],
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              "summary": "A 155-person international trial found substantial PTSD improvement after either EMDR or imagery rescripting for childhood-related trauma, with a 7.7% dropout rate.",
              "limitation": "The active treatments did not differ significantly. This supports EMDR as a promising structured treatment in this population, without establishing superiority to imagery rescripting.",
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                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/32892758/",
                  "https://doi.org/10.1192/bjp.2020.158"
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial.",
              "journal": "The British journal of psychiatry : the journal of mental science",
              "year": 2012,
              "authors": "Nijdam MJ, Gersons BP, Reitsma JB, de Jongh A, Olff M.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/22322458/",
                "https://doi.org/10.1192/bjp.bp.111.099234"
              ],
              "doi": "10.1192/bjp.bp.111.099234",
              "pmid": "22322458",
              "targets": [],
              "categories": [
                "Clinical & self-report"
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              "citationSnapshot": {
                "count": 76,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-26",
                "url": "https://europepmc.org/article/MED/22322458"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Reported design checked against the primary publication abstract. Blinding terminology reflects the source report, not an independent risk-of-bias rating.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/22322458/",
                  "https://doi.org/10.1192/bjp.bp.111.099234"
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                "assessedAt": "2026-10-26",
                "registeredMaskingBasis": false
              },
              "evidence": {
                "intervention": "Therapist-delivered EMDR",
                "comparator": "Brief eclectic psychotherapy",
                "evidenceType": "Clinical or experimental outcomes",
                "sourceURLs": [
                  "https://pubmed.ncbi.nlm.nih.gov/22322458/",
                  "https://doi.org/10.1192/bjp.bp.111.099234"
                ],
                "checkedAt": "2026-10-26",
                "reviewScope": "Primary publication abstract and bibliographic identity checked; comprehensive full-text risk-of-bias and Jadad assessment pending.",
                "discoverySources": [
                  "https://europepmc.org/article/MED/22322458"
                ],
                "selectionPolicy": "Success-focused discovery selection, with material limitations retained; not an exhaustive systematic review.",
                "trialId": "ISRCTN64872147"
              },
              "id": "vision-i-pmid-22322458",
              "recordId": "pmid-22322458",
              "quotes": [],
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              "summary": "In 140 people with PTSD, EMDR and brief eclectic psychotherapy produced similar final improvements; EMDR achieved improvement more rapidly during treatment.",
              "limitation": "Dropout was substantial in both groups, approximately 29% and 36%. Faster improvement does not establish superior final outcomes or effectiveness of an automated EMDR-derived intervention.",
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                  "https://doi.org/10.1192/bjp.bp.111.099234"
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
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            {
              "title": "Imagery Rescripting (ImRs) and Eye Movement Desensitization and Reprocessing (EMDR) as treatment of childhood-trauma related post-traumatic stress disorder (Ch-PTSD) in adults: effects on Schema Modes.",
              "journal": "European journal of psychotraumatology",
              "year": 2025,
              "authors": "Daniëls M, Meewisse ML, Nugter A, Rameckers SA, Fassbinder E, Arntz A.",
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            {
              "title": "Outcomes from eye movement desensitization and reprocessing in active-duty service members with posttraumatic stress disorder.",
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            {
              "title": "Eye movement desensitization and reprocessing (EDMR) treatment for combat-related posttraumatic stress disorder.",
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              "authors": "Carlson JG, Chemtob CM, Rusnak K, Hedlund NL, Muraoka MY.",
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            {
              "title": "Responding to an identified need: A joint department of defense/department of veterans affairs training program in eye movement desensitization and reprocessing (EMDR) for clinicians providing trauma services.",
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              "title": "A multisite retrospective review exploring the delivery of eye movement desensitization and reprocessing (EMDR) therapy to veterans via telehealth (TH) versus in person (IP).",
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              "title": "An Eye Movement Desensitization and Reprocessing (EMDR) Group Intervention for Syrian Refugees With Post-traumatic Stress Symptoms: Results of a Randomized Controlled Trial.",
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              "title": "The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: results of a randomized controlled trial.",
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              "authors": "Acarturk C, Konuk E, Cetinkaya M, Senay I, Sijbrandij M, Gulen B, Cuijpers P.",
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                "blinding": "not-applicable",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/41340540/",
                  "https://doi.org/10.1002/cpp.70186"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Psychological Interventions for Pediatric Posttraumatic Stress Disorder: A Systematic Review and Network Meta-Analysis.",
              "journal": "JAMA psychiatry",
              "year": 2025,
              "authors": "Hoppen TH, Wessarges L, Jehn M, Mutz J, Kip A, Schlechter P, Meiser-Stedman R, Morina N.",
              "design": "Systematic review and network meta-analysis",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC11618582/",
                "https://pubmed.ncbi.nlm.nih.gov/39630422/",
                "https://doi.org/10.1001/jamapsychiatry.2024.3908"
              ],
              "doi": "10.1001/jamapsychiatry.2024.3908",
              "pmid": "39630422",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 18,
              "citationSnapshot": {
                "count": 18,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39630422/",
                  "https://doi.org/10.1001/jamapsychiatry.2024.3908"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "The 70 trials cover several therapies, not EMDR alone. Longer-term EMDR data remain limited; included ages extend to 19."
              },
              "recordId": "pmid-39630422",
              "quotes": [],
              "sourcePages": [],
              "summary": "Across 70 pediatric PTSD trials involving 5,528 participants, EMDR reduced symptoms relative to passive controls at treatment end (g = 0.86). Trauma-focused CBT had the most consistent evidence across time points.",
              "limitation": "The 70 trials cover several therapies, not EMDR alone. Longer-term EMDR data remain limited; included ages extend to 19.",
              "id": "vision-children-pmid-39630422",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": false,
                "blinding": "not-applicable",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39630422/",
                  "https://doi.org/10.1001/jamapsychiatry.2024.3908"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Trauma-focused treatments for refugee children and adolescents with PTSD: a three-arm randomized controlled trial comparing the efficacy of EMDR and KIDNET versus a waitlist control group (the KIEM study).",
              "journal": "Child and adolescent psychiatry and mental health",
              "year": 2026,
              "authors": "Velu ME, de Roos C, van der Aa N, Jongedijk R, Lindauer R, Mooren T.",
              "design": "Randomized controlled trial · single-blind (assessor)",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13576352/",
                "https://pubmed.ncbi.nlm.nih.gov/42324567/",
                "https://doi.org/10.1186/s13034-026-01118-0"
              ],
              "doi": "10.1186/s13034-026-01118-0",
              "pmid": "42324567",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Europe PMC",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "single-blind-rct",
                "peerReviewed": true,
                "basis": "Independent assessors were blinded to EMDR versus KIDNET, but knew active-treatment versus waitlist status. The single-blind designation applies to the active-treatment comparison; masking was incomplete across all three arms.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42324567/",
                  "https://doi.org/10.1186/s13034-026-01118-0"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "trialId": "NL-OMON22679"
              },
              "recordId": "pmid-42324567",
              "quotes": [],
              "sourcePages": [],
              "summary": "Ninety-six refugee children aged 8–18 were allocated to EMDR, KIDNET or waitlist; both active treatments improved PTSD outcomes.",
              "limitation": "Small arms and different dropout rates limit comparative claims. Outcomes do not establish treatment equivalence.",
              "id": "vision-children-pmid-42324567",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
                "blinding": "single",
                "peerReviewed": true,
                "basis": "Independent assessors were blinded to EMDR versus KIDNET, but knew active-treatment versus waitlist status. The single-blind designation applies to the active-treatment comparison; masking was incomplete across all three arms.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42324567/",
                  "https://doi.org/10.1186/s13034-026-01118-0"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Long-term effectiveness of eye movement desensitization and reprocessing in children and adolescents with medically related subthreshold post-traumatic stress disorder: a randomized controlled trial.",
              "journal": "European journal of cardiovascular nursing",
              "year": 2021,
              "authors": "Meentken MG, van der Mheen M, van Beynum IM, Aendekerk EWC, Legerstee JS, van der Ende J, Del Canho R, Lindauer RJL, Hillegers MHJ, Helbing WA, Moll HA, Utens EMWJ.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/33709117/",
                "https://doi.org/10.1093/eurjcn/zvaa006"
              ],
              "doi": "10.1093/eurjcn/zvaa006",
              "pmid": "33709117",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 12,
              "citationSnapshot": {
                "count": 12,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/33709117/",
                  "https://doi.org/10.1093/eurjcn/zvaa006"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "Subthreshold medically related PTSD differs from diagnosed PTSD after other trauma. Keep this neutral primary result alongside positive trials."
              },
              "recordId": "pmid-33709117",
              "quotes": [],
              "sourcePages": [],
              "summary": "Among 74 previously hospitalized children aged 4–15 with subthreshold PTSD, EMDR did not outperform care as usual on the primary PTSD outcome through eight months. Parent-reported blood-injection-injury phobia improved more with EMDR.",
              "limitation": "Subthreshold medically related PTSD differs from diagnosed PTSD after other trauma. Keep this neutral primary result alongside positive trials.",
              "id": "vision-children-pmid-33709117",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/33709117/",
                  "https://doi.org/10.1093/eurjcn/zvaa006"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Effects of eye movement desensitisation and reprocessing on depressive symptoms, stress and rumination in adolescents with depression: a randomised controlled trial.",
              "journal": "European journal of psychotraumatology",
              "year": 2025,
              "authors": "Zheng S, Shen Y, Geng F, Ye M, Song S, Wang R, Zhang S, Ou Y, Zhou X.",
              "design": "Randomized controlled trial",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC12006939/",
                "https://pubmed.ncbi.nlm.nih.gov/40243164/",
                "https://doi.org/10.1080/20008066.2025.2488558"
              ],
              "doi": "10.1080/20008066.2025.2488558",
              "pmid": "40243164",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 7,
              "citationSnapshot": {
                "count": 7,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40243164/",
                  "https://doi.org/10.1080/20008066.2025.2488558"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "Small trial with brief follow-up. This is adjunctive treatment alongside medication; it does not test an entertainment intervention."
              },
              "recordId": "pmid-40243164",
              "quotes": [],
              "sourcePages": [],
              "summary": "Thirty adolescents aged 12–18 completed a comparison of EMDR plus an SSRI with an SSRI alone. Six sessions over two weeks were associated with larger improvements in depression, event-related stress and rumination.",
              "limitation": "Small trial with brief follow-up. This is adjunctive treatment alongside medication; it does not test an entertainment intervention.",
              "id": "vision-children-pmid-40243164",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40243164/",
                  "https://doi.org/10.1080/20008066.2025.2488558"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Efficacy of the Adapted Integrative Group EMDR Therapy Protocol for Ongoing Traumatic Stress in Adolescents after a Traumatic Event.",
              "journal": "Journal of child & adolescent trauma",
              "year": 2026,
              "authors": "Almarcha GS, Peinado AI, de Álvaro JI, López-Morales JL, Reyes-Bossio M, Delgado-Campusano M.",
              "design": "Uncontrolled before-and-after study",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/42703195/",
                "https://doi.org/10.1007/s40653-025-00808-9"
              ],
              "doi": "10.1007/s40653-025-00808-9",
              "pmid": "42703195",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42703195/",
                  "https://doi.org/10.1007/s40653-025-00808-9"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "Only 11 of 235 screened students entered treatment. No control group isolates treatment effects."
              },
              "recordId": "pmid-42703195",
              "quotes": [],
              "sourcePages": [],
              "summary": "Eleven school students meeting PTSD criteria received psychoeducation and psychologist-led group EMDR. PTSD symptoms fell following the programme.",
              "limitation": "Only 11 of 235 screened students entered treatment. No control group isolates treatment effects.",
              "id": "vision-children-pmid-42703195",
              "paperTrustAssessment": {
                "score": null,
                "scope": "Paper",
                "status": "not-applicable",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "This record is outside the paper-rating criteria or has unresolved publication identity.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42703195/",
                  "https://doi.org/10.1007/s40653-025-00808-9"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            }
          ],
          "number": "1.5",
          "trustAssessment": {
            "score": 2,
            "scope": "Subchapter",
            "minimumQualifyingStudies": 3,
            "status": "assessed",
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              "rct": [
                "pmid-28660669",
                "pmid-24965797",
                "pmid-42324567",
                "pmid-33709117",
                "pmid-40243164"
              ],
              "single-blind-rct": [
                "pmid-28660669",
                "pmid-24965797",
                "pmid-42324567"
              ],
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                "pmid-28660669",
                "pmid-24965797",
                "pmid-41340540",
                "pmid-39630422",
                "pmid-42324567",
                "pmid-33709117",
                "pmid-40243164"
              ]
            },
            "counts": {
              "double-blind-rct": 0,
              "rct": 5,
              "single-blind-rct": 3,
              "peer-reviewed": 7
            },
            "assessedAt": "2026-10-27",
            "basis": "Highest threshold supported by the recorded paper assessments; repeated reports of an identified trial count once."
          },
          "trustScore": 2,
          "sourceTrustScore": 2
        },
        {
          "id": "young-adults",
          "title": "EMDR and related interventions for young adults",
          "description": "Research including young adults aged 18–24. Several studies span adolescence or extend to age 25; these broader samples are identified explicitly.",
          "papers": [
            {
              "title": "Coronavirus Disease 2019 Emergency and Remote Eye Movement Desensitization and Reprocessing Group Therapy With Adolescents and Young Adults: Overcoming Lockdown With the Butterfly Hug.",
              "journal": "Frontiers in psychology",
              "year": 2021,
              "authors": "Lazzaroni E, Invernizzi R, Fogliato E, Pagani M, Maslovaric G.",
              "design": "Uncontrolled clinical cohort",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC8424043/",
                "https://pubmed.ncbi.nlm.nih.gov/34512458/",
                "https://doi.org/10.3389/fpsyg.2021.701381"
              ],
              "doi": "10.3389/fpsyg.2021.701381",
              "pmid": "34512458",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 21,
              "citationSnapshot": {
                "count": 21,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/34512458/",
                  "https://doi.org/10.3389/fpsyg.2021.701381"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "Mixed adolescent and young-adult sample with no randomized control. Findings do not isolate an 18–24 subgroup or unguided use."
              },
              "recordId": "pmid-34512458",
              "quotes": [],
              "sourcePages": [],
              "summary": "A remote clinician-led EMDR group intervention during COVID-19 was associated with reduced traumatic stress and anxiety in participants aged 13–24 who were already receiving mental-health care.",
              "limitation": "Mixed adolescent and young-adult sample with no randomized control. Findings do not isolate an 18–24 subgroup or unguided use.",
              "id": "vision-young-adults-pmid-34512458",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/34512458/",
                  "https://doi.org/10.3389/fpsyg.2021.701381"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Effectiveness of an intensive outpatient treatment programme combining prolonged exposure and EMDR therapy for adolescents and young adults with PTSD in a naturalistic setting.",
              "journal": "European journal of psychotraumatology",
              "year": 2025,
              "authors": "Rentinck EM, van Mourik R, de Jongh A, Matthijssen SJMA.",
              "design": "Naturalistic treatment cohort",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC11753006/",
                "https://pubmed.ncbi.nlm.nih.gov/39835632/",
                "https://doi.org/10.1080/20008066.2025.2451478"
              ],
              "doi": "10.1080/20008066.2025.2451478",
              "pmid": "39835632",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 9,
              "citationSnapshot": {
                "count": 9,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39835632/",
                  "https://doi.org/10.1080/20008066.2025.2451478"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "Intensive clinician-delivered, multimodal treatment with no randomized comparator. The sample included 36 people aged 12–17 and 38 aged 18–25; it does not establish a gentle entertainment effect."
              },
              "recordId": "pmid-39835632",
              "quotes": [],
              "sourcePages": [],
              "summary": "A six-day programme combining prolonged exposure, EMDR, physical activity and support from relatives or friends included 74 people aged 12–25. At one month, 65% no longer met PTSD criteria; dropout was 4%.",
              "limitation": "Intensive clinician-delivered, multimodal treatment with no randomized comparator. The sample included 36 people aged 12–17 and 38 aged 18–25; it does not establish a gentle entertainment effect.",
              "id": "vision-young-adults-pmid-39835632",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39835632/",
                  "https://doi.org/10.1080/20008066.2025.2451478"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The effect of eye movement desensitization and reprocessing-based online group counseling for university students: Psychological need satisfaction, psychological resilience, psychological well-being, and small 't' trauma.",
              "journal": "Psychological trauma : theory, research, practice and policy",
              "year": 2023,
              "authors": "Yilmaz Dinç S, Sapmaz F.",
              "design": "Controlled experimental study",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/38032626/",
                "https://doi.org/10.1037/tra0001629"
              ],
              "doi": "10.1037/tra0001629",
              "pmid": "38032626",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 6,
              "citationSnapshot": {
                "count": 6,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38032626/",
                  "https://doi.org/10.1037/tra0001629"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
                "measuredGenes": [],
                "relationshipNote": "University enrolment does not establish an exclusively 18–24 sample. The abstract does not provide sufficient age or masking detail; body-sense effects were not significant."
              },
              "recordId": "pmid-38032626",
              "quotes": [],
              "sourcePages": [],
              "summary": "EMDR-based online group counselling for university students reported improvements in psychological need satisfaction, resilience, wellbeing and several small-t trauma measures across repeated assessments.",
              "limitation": "University enrolment does not establish an exclusively 18–24 sample. The abstract does not provide sufficient age or masking detail; body-sense effects were not significant.",
              "id": "vision-young-adults-pmid-38032626",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38032626/",
                  "https://doi.org/10.1037/tra0001629"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Peer-delivered combined EMD and imagery rescripting for traumatized Chinese university students: a RCT.",
              "journal": "European journal of psychotraumatology",
              "year": 2026,
              "authors": "Fan H, Zhang J, Wang Y, Yang K, Wang Y, Yang X.",
              "design": "Randomized controlled trial · open-label",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13347840/",
                "https://pubmed.ncbi.nlm.nih.gov/42411718/",
                "https://doi.org/10.1080/20008066.2026.2686577"
              ],
              "doi": "10.1080/20008066.2026.2686577",
              "pmid": "42411718",
              "targets": [],
              "categories": [
                "Clinical & self-report"
              ],
              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "rct-open-label",
                "peerReviewed": true,
                "basis": "The study describes an open-label randomized design. Participants reported their own outcomes; hypothesis masking and blinded analysis do not establish masked outcome collection.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42411718/",
                  "https://doi.org/10.1080/20008066.2026.2686577"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Clinical & self-report",
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              "title": "Addressing mental health need after COVID-19: a systematic review of remote EMDR therapy studies as an emerging option.",
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              "summary": "Eighty-five participants completed a remotely delivered intensive group protocol; PTSD, anxiety and depression measures improved through six-month follow-up.",
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40424141/",
                  "https://doi.org/10.1037/tra0001917"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "sample": "VA clinician update: 256 veterans (130 telehealth, 126 in person). Current article abstract: 279 eligible veterans (140 telehealth, 139 in person).",
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              "summary": "Across 256 veterans, both delivery groups improved. Completion, reliable change and clinically significant change did not differ, although the in-person symptom reduction was larger.",
              "limitation": "Treatment format was chosen rather than randomised. This supports individual telehealth delivery; it does not test online group EMDR.",
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40424141/",
                  "https://doi.org/10.1037/tra0001917"
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              "title": "Coronavirus Disease 2019 Emergency and Remote Eye Movement Desensitization and Reprocessing Group Therapy With Adolescents and Young Adults: Overcoming Lockdown With the Butterfly Hug.",
              "journal": "Frontiers in psychology",
              "year": 2021,
              "authors": "Lazzaroni E, Invernizzi R, Fogliato E, Pagani M, Maslovaric G.",
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                "https://pmc.ncbi.nlm.nih.gov/articles/PMC8424043/",
                "https://pubmed.ncbi.nlm.nih.gov/34512458/",
                "https://doi.org/10.3389/fpsyg.2021.701381"
              ],
              "doi": "10.3389/fpsyg.2021.701381",
              "pmid": "34512458",
              "targets": [],
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                "Clinical & self-report"
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              "citationCount": 21,
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                "retrievedAt": "2026-10-23"
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/34512458/",
                  "https://doi.org/10.3389/fpsyg.2021.701381"
                ],
                "reviewedAt": "2026-10-23"
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                "evidenceType": "Clinical & self-report",
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                "relationshipNote": "Mixed adolescent and young-adult sample with no randomized control. Findings do not isolate an 18–24 subgroup or unguided use."
              },
              "recordId": "pmid-34512458",
              "quotes": [],
              "sourcePages": [],
              "summary": "A remote clinician-led EMDR group intervention during COVID-19 was associated with reduced traumatic stress and anxiety in participants aged 13–24 who were already receiving mental-health care.",
              "limitation": "Mixed adolescent and young-adult sample with no randomized control. Findings do not isolate an 18–24 subgroup or unguided use.",
              "id": "vision-online-pmid-34512458",
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                "score": 1,
                "scope": "Paper",
                "status": "assessed",
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                  "https://doi.org/10.3389/fpsyg.2021.701381"
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The effect of eye movement desensitization and reprocessing-based online group counseling for university students: Psychological need satisfaction, psychological resilience, psychological well-being, and small 't' trauma.",
              "journal": "Psychological trauma : theory, research, practice and policy",
              "year": 2023,
              "authors": "Yilmaz Dinç S, Sapmaz F.",
              "design": "Controlled experimental study",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/38032626/",
                "https://doi.org/10.1037/tra0001629"
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              "doi": "10.1037/tra0001629",
              "pmid": "38032626",
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                "Clinical & self-report"
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              "citationCount": 6,
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                "category": "peer-reviewed",
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38032626/",
                  "https://doi.org/10.1037/tra0001629"
                ],
                "reviewedAt": "2026-10-23"
              },
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                "evidenceType": "Clinical & self-report",
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                "relationshipNote": "University enrolment does not establish an exclusively 18–24 sample. The abstract does not provide sufficient age or masking detail; body-sense effects were not significant."
              },
              "recordId": "pmid-38032626",
              "quotes": [],
              "sourcePages": [],
              "summary": "EMDR-based online group counselling for university students reported improvements in psychological need satisfaction, resilience, wellbeing and several small-t trauma measures across repeated assessments.",
              "limitation": "University enrolment does not establish an exclusively 18–24 sample. The abstract does not provide sufficient age or masking detail; body-sense effects were not significant.",
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                "sources": [
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                  "https://doi.org/10.1037/tra0001629"
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                "assessedAt": "2026-10-27"
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          "id": "self-help",
          "title": "EMDR-derived self-help interventions",
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              "title": "Low-Intensity Interventions and EMDR Therapy",
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              "authors": "Louise Maxfield",
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                "reviewedAt": "2026-10-23"
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              "recordId": "doi-b4b0af603557eafe",
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                  {
                    "text": "“it offers an excellent template for the future development of efficacious low-intensity EMDR interventions. Developing safe, easy-to-use, affordable, and readily available low-intensity interventions will make effective EMDR treatment available to many millions of people around the world.”",
                    "emphasis": false
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              "sourcePages": [
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                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Randomized Controlled Trial: Self-Care Traumatic Episode Protocol, Computerized EMDR Treatment of COVID-19-Related Stress",
              "journal": "Journal of EMDR Practice and Research",
              "year": 2021,
              "authors": "Judy Moench; Olivia Billsten",
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              "urls": [
                "https://doi.org/10.1891/emdr-d-20-00047"
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              "doi": "10.1891/emdr-d-20-00047",
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                "sources": [
                  "https://doi.org/10.1891/emdr-d-20-00047"
                ],
                "reviewedAt": "2026-10-23"
              },
              "recordId": "doi-37bd65a31f48ce93",
              "quotes": [
                [
                  {
                    "text": "“The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among Mental Health clinicians in the context of COVID-19.”",
                    "emphasis": false
                  }
                ]
              ],
              "sourcePages": [
                15
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              "limitation": "STEP tested 34 mental-health clinicians using a recorded session with worksheets, clinical screening and access to support. This population and protocol differ from general unguided entertainment use.",
              "id": "vision-self-help-doi-37bd65a31f48ce93",
              "paperTrustAssessment": {
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                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
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            {
              "title": "Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study",
              "journal": "Journal of EMDR Practice and Research",
              "year": 2021,
              "authors": "Mehmet Karadag; Zehra Topal; Ravza Nur Ezer; Cem Gokcen",
              "design": "Randomized controlled trial",
              "urls": [
                "https://doi.org/10.1891/emdr-d-20-00054"
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              "doi": "10.1891/emdr-d-20-00054",
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                "sources": [
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                ],
                "reviewedAt": "2026-10-23"
              },
              "recordId": "src-796cb6656464",
              "quotes": [
                [
                  {
                    "text": "“The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.”",
                    "emphasis": false
                  }
                ]
              ],
              "sourcePages": [
                15
              ],
              "limitation": "Parent-supported story-based intervention during COVID-19. This is not a test of unsupervised trauma processing or a complete clinical EMDR protocol.",
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                "basis": "This record is outside the paper-rating criteria or has unresolved publication identity.",
                "sources": [
                  "https://doi.org/10.1891/emdr-d-20-00054"
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                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Self-administered EMDR therapy: potential solution for expanding the availability of psychotherapy for PTSD or unregulated recipe for disaster?",
              "journal": "BJPsych Open",
              "year": 2020,
              "authors": "Lauren Z. Waterman; Maxwell Cooper",
              "design": "Review",
              "urls": [
                "https://doi.org/10.1192/bjo.2020.92"
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              "doi": "10.1192/bjo.2020.92",
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                "reviewedAt": "2026-10-23"
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              "recordId": "src-4981a8e87964",
              "quotes": [
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                    "text": "“The results indicated significantly reduced symptoms of PTSD, depression, anxiety, distress and disability between pre-treatment and 3 month follow-up.”",
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                  }
                ]
              ],
              "sourcePages": [
                19
              ],
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                "sources": [
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          },
          "trustScore": 1,
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      ]
    },
    {
      "number": 4,
      "title": "EMDR and molecular research",
      "topics": [
        {
          "id": "rna",
          "title": "EMDR and trauma-focused psychotherapy: gene expression",
          "description": "Direct measurements of messenger RNA and microRNA. The studies combine EMDR with trauma-focused CBT cohorts; they do not establish a molecular effect caused specifically by eye movements.",
          "papers": [
            {
              "title": "Transcriptional Modulation of Stress-Related Genes in Association with Early Life Stress Exposure and Trauma-Focused Psychotherapy in Treatment-Resistant Depression Patients",
              "journal": "Journal of EMDR Practice and Research",
              "year": 2023,
              "authors": "Rosana Carvalho Silva; Vincenzo Dattilo; Giulia Perusi; Monica Mazzelli; Elisabetta Maffioletti; Roberta Bazzanella; Marco Bortolomasi; Annamaria Cattaneo; Massimo Gennarelli; Alessandra Minelli",
              "design": "Longitudinal gene-expression study",
              "urls": [
                "https://doi.org/10.1891/emdr-2023-0019"
              ],
              "doi": "10.1891/emdr-2023-0019",
              "pmid": null,
              "targets": [
                "NR3C1",
                "FKBP5",
                "SGK1"
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              "categories": [
                "Genomics & gene expression"
              ],
              "citationCount": 4,
              "citationSnapshot": {
                "count": 4,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Longitudinal observational molecular analysis of a combined EMDR/TF-CBT cohort. No randomized masked molecular comparison.",
                "sources": [
                  "https://spj.science.org/doi/10.1891/EMDR-2023-0019"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Direct RNA expression",
                "intervention": "24 sessions of EMDR or trauma-focused CBT alongside usual medication",
                "sample": "41 baseline; 21 longitudinal (12 EMDR, 9 TF-CBT)",
                "measurement": "Whole-blood mRNA using RT-qPCR",
                "timing": "Baseline, weeks 4, 8 and 12",
                "measuredGenes": [
                  "NR3C1",
                  "FKBP5",
                  "SGK1"
                ],
                "trialId": "Brescia-TRD-21",
                "relationshipNote": "Combined therapy cohort; no untreated molecular comparator."
              },
              "recordId": "doi-14a5c17359f1dfcb",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 21 people receiving EMDR or trauma-focused CBT for treatment-resistant depression, whole-blood NR3C1, FKBP5 and SGK1 expression varied over time. FKBP5 and SGK1 fell significantly at eight weeks; transcript levels rebounded during follow-up.",
              "limitation": "EMDR and CBT participants were analysed together, alongside medication. The 2021 microRNA paper uses the same underlying cohort; this is not an independent replication or evidence of an isolated eye-movement effect.",
              "id": "vision-rna-doi-14a5c17359f1dfcb",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Longitudinal observational molecular analysis of a combined EMDR/TF-CBT cohort. No randomized masked molecular comparison.",
                "sources": [
                  "https://spj.science.org/doi/10.1891/EMDR-2023-0019"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Inflammation-related microRNAs are involved in stressful life events exposure and in trauma-focused psychotherapy in treatment-resistant depressed patients.",
              "journal": "European journal of psychotraumatology",
              "year": 2021,
              "authors": "Maffioletti E, Bocchio-Chiavetto L, Perusi G, Carvalho Silva R, Sacco C, Bazzanella R, Zampieri E, Bortolomasi M, Gennarelli M, Minelli A.",
              "design": "Longitudinal molecular study",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC8772504/",
                "https://pubmed.ncbi.nlm.nih.gov/35070159/",
                "https://doi.org/10.1080/20008198.2021.1987655"
              ],
              "doi": "10.1080/20008198.2021.1987655",
              "pmid": "35070159",
              "targets": [
                "MIR15A",
                "MIR29A",
                "MIR126",
                "MIR195",
                "MIRLET7F",
                "MIR146A"
              ],
              "categories": [
                "Genomics & gene expression",
                "Clinical & self-report"
              ],
              "citationCount": 36,
              "citationSnapshot": {
                "count": 36,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/35070159/",
                  "https://doi.org/10.1080/20008198.2021.1987655"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Genomics & gene expression",
                "measuredGenes": [
                  "MIR15A",
                  "MIR29A",
                  "MIR126",
                  "MIR195",
                  "MIRLET7F",
                  "MIR146A"
                ],
                "relationshipNote": "The longitudinal group combined 12 EMDR and nine CBT participants. This cohort also informs the 2023 stress-gene paper, so the two publications are not independent replications.",
                "sample": "41 baseline; 21 longitudinal (12 EMDR, 9 TF-CBT)",
                "measurement": "Whole-blood microRNA expression",
                "trialId": "Brescia-TRD-21"
              },
              "recordId": "pmid-35070159",
              "quotes": [],
              "sourcePages": [],
              "summary": "Blood microRNA was measured in 41 people with treatment-resistant depression; 21 received EMDR or trauma-focused CBT. miR-15a, miR-29a, miR-126, miR-195 and let-7f changed during treatment; baseline miR-29a was associated with response.",
              "limitation": "The longitudinal group combined 12 EMDR and nine CBT participants. This cohort also informs the 2023 stress-gene paper, so the two publications are not independent replications.",
              "id": "vision-rna-pmid-35070159",
              "paperTrustAssessment": {
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                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/35070159/",
                  "https://doi.org/10.1080/20008198.2021.1987655"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "MicroRNAs expression changes associated with trauma-focused psychotherapy efficacy in treatment-resistant depression: An exploratory study.",
              "journal": "Neuroscience applied",
              "year": 2026,
              "authors": "Buson L, Carvalho Silva R, Galbiati C, Bortolomasi M, Scaglia M, Perusi G, Abate M, Maffioletti E, Gennarelli M, Lorenzon N, Dierssen M, European College of Neuropsychopharmacology (ECNP) Pharmacogenomics & Transcriptomics Network, Minelli A.",
              "design": "Exploratory longitudinal microRNA study",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC13383946/",
                "https://pubmed.ncbi.nlm.nih.gov/42519422/",
                "https://doi.org/10.1016/j.nsa.2026.107020"
              ],
              "doi": "10.1016/j.nsa.2026.107020",
              "pmid": "42519422",
              "targets": [
                "MIR132"
              ],
              "categories": [
                "Genomics & gene expression",
                "Clinical & self-report"
              ],
              "citationCount": 0,
              "citationSnapshot": {
                "count": 0,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42519422/",
                  "https://doi.org/10.1016/j.nsa.2026.107020"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Genomics & gene expression",
                "measuredGenes": [
                  "MIR132"
                ],
                "relationshipNote": "EMDR-only subgroup changes did not survive multiple-testing correction. The result does not establish an EMDR-specific microRNA effect."
              },
              "recordId": "pmid-42519422",
              "quotes": [],
              "sourcePages": [],
              "summary": "In 24 people receiving EMDR or trauma-focused CBT for treatment-resistant depression, 148 microRNAs passed quality control. The combined sample’s miR-132-3p change survived correction for multiple testing.",
              "limitation": "EMDR-only subgroup changes did not survive multiple-testing correction. The result does not establish an EMDR-specific microRNA effect.",
              "id": "vision-rna-pmid-42519422",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/42519422/",
                  "https://doi.org/10.1016/j.nsa.2026.107020"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            }
          ],
          "number": "4.1",
          "trustAssessment": {
            "score": null,
            "scope": "Subchapter",
            "minimumQualifyingStudies": 3,
            "status": "below-minimum",
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              "single-blind-rct": 0,
              "peer-reviewed": 2
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            "basis": "Highest threshold supported by the recorded paper assessments; repeated reports of an identified trial count once."
          },
          "trustScore": null,
          "sourceTrustScore": 1
        },
        {
          "id": "epigenetics",
          "title": "EMDR and trauma-focused psychotherapy: DNA methylation",
          "description": "Blood and saliva methylation studies, including youth and combined treatment programmes. DNA methylation and RNA expression are different measurements.",
          "papers": [
            {
              "title": "DNA methylation changes in association with trauma-focused psychotherapy efficacy in treatment-resistant depression patients: a prospective longitudinal study.",
              "journal": "European journal of psychotraumatology",
              "year": 2024,
              "authors": "Carvalho Silva R, Martini P, Hohoff C, Mattevi S, Bortolomasi M, Menesello V, Gennarelli M, Baune BT, Minelli A.",
              "design": "Exploratory DNA-methylation study",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC10878335/",
                "https://pubmed.ncbi.nlm.nih.gov/38362742/",
                "https://doi.org/10.1080/20008066.2024.2314913"
              ],
              "doi": "10.1080/20008066.2024.2314913",
              "pmid": "38362742",
              "targets": [
                "LTA",
                "GFI1",
                "S100A8",
                "TNF"
              ],
              "categories": [
                "Epigenetics",
                "Clinical & self-report"
              ],
              "citationCount": 26,
              "citationSnapshot": {
                "count": 26,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38362742/",
                  "https://doi.org/10.1080/20008066.2024.2314913"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Epigenetics",
                "measuredGenes": [
                  "LTA",
                  "GFI1",
                  "S100A8",
                  "TNF"
                ],
                "relationshipNote": "Small treatment groups and concurrent usual care limit attribution. DNA methylation is a separate measurement from RNA expression."
              },
              "recordId": "pmid-38362742",
              "quotes": [],
              "sourcePages": [],
              "summary": "Blood DNA methylation was studied in 30 people with treatment-resistant depression receiving EMDR (18) or trauma-focused CBT (12). Differentially methylated regions included inflammation-related genes and pathways.",
              "limitation": "Small treatment groups and concurrent usual care limit attribution. DNA methylation is a separate measurement from RNA expression.",
              "id": "vision-epigenetics-pmid-38362742",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/38362742/",
                  "https://doi.org/10.1080/20008066.2024.2314913"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Distinct saliva DNA methylation profiles in relation to treatment outcome in youth with posttraumatic stress disorder.",
              "journal": "Translational psychiatry",
              "year": 2024,
              "authors": "Ensink JBM, Henneman P, Venema A, Zantvoord JB, den Kelder RO, Mannens MMAM, Lindauer RJL.",
              "design": "Longitudinal DNA-methylation study",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC11282249/",
                "https://pubmed.ncbi.nlm.nih.gov/39060246/",
                "https://doi.org/10.1038/s41398-024-02892-1"
              ],
              "doi": "10.1038/s41398-024-02892-1",
              "pmid": "39060246",
              "targets": [
                "C18orf63",
                "CRHR2",
                "NUP35"
              ],
              "categories": [
                "Epigenetics",
                "Clinical & self-report"
              ],
              "citationCount": 7,
              "citationSnapshot": {
                "count": 7,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39060246/",
                  "https://doi.org/10.1038/s41398-024-02892-1"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Epigenetics",
                "measuredGenes": [
                  "C18orf63",
                  "CRHR2",
                  "NUP35"
                ],
                "relationshipNote": "Treatment combined evidence from EMDR and trauma-focused CBT. Saliva findings do not establish a brain-tissue effect or isolate eye movements."
              },
              "recordId": "pmid-39060246",
              "quotes": [],
              "sourcePages": [],
              "summary": "The study included 46 young people with PTSD and 41 trauma-exposed controls, aged 8–18. Saliva DNA-methylation differences associated with treatment response included C18orf63 and the stress-related CRHR2 locus.",
              "limitation": "Treatment combined evidence from EMDR and trauma-focused CBT. Saliva findings do not establish a brain-tissue effect or isolate eye movements.",
              "id": "vision-epigenetics-pmid-39060246",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/39060246/",
                  "https://doi.org/10.1038/s41398-024-02892-1"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Epigenetic impact of a 1-week intensive multimodal group program for adolescents with multiple adverse childhood experiences.",
              "journal": "Scientific reports",
              "year": 2022,
              "authors": "Kaliman P, Cosín-Tomás M, Madrid A, Roque López S, Llanez-Anaya E, Papale LA, Alisch RS, Davidson RJ.",
              "design": "Randomized trial · molecular analysis",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC9585146/",
                "https://pubmed.ncbi.nlm.nih.gov/36266402/",
                "https://doi.org/10.1038/s41598-022-21246-9"
              ],
              "doi": "10.1038/s41598-022-21246-9",
              "pmid": "36266402",
              "targets": [
                "SIRT5",
                "TRAPPC2L"
              ],
              "categories": [
                "Epigenetics",
                "Clinical & self-report"
              ],
              "citationCount": 24,
              "citationSnapshot": {
                "count": 24,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "rct-masking-unclear",
                "peerReviewed": true,
                "basis": "The methods report random-number allocation for 44 girls. Post-allocation participant or assessor masking is not established. The intervention combines mindfulness, art and group EMDR.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/36266402/",
                  "https://doi.org/10.1038/s41598-022-21246-9"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Epigenetics",
                "measuredGenes": [
                  "SIRT5",
                  "TRAPPC2L"
                ],
                "relationshipNote": "The programme has several components. Saliva methylation findings do not isolate EMDR; the study detected no intervention effect on intrinsic epigenetic age acceleration."
              },
              "recordId": "pmid-36266402",
              "quotes": [],
              "sourcePages": [],
              "summary": "A one-week programme combining mindfulness, artistic expression and EMDR group therapy studied 44 adolescent girls with multiple adverse experiences. Forty-nine DNA-methylation loci differed with intervention; SIRT5 and TRAPPC2L changes correlated with trauma measures.",
              "limitation": "The programme has several components. Saliva methylation findings do not isolate EMDR; the study detected no intervention effect on intrinsic epigenetic age acceleration.",
              "id": "vision-epigenetics-pmid-36266402",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "The methods report random-number allocation for 44 girls. Post-allocation participant or assessor masking is not established. The intervention combines mindfulness, art and group EMDR.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/36266402/",
                  "https://doi.org/10.1038/s41598-022-21246-9"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Successful treatment of post-traumatic stress disorder reverses DNA methylation marks.",
              "journal": "Molecular psychiatry",
              "year": 2019,
              "authors": "Vinkers CH, Geuze E, van Rooij SJH, Kennis M, Schür RR, Nispeling DM, Smith AK, Nievergelt CM, Uddin M, Rutten BPF, Vermetten E, Boks MP.",
              "design": "Longitudinal molecular cohort",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/31645664/",
                "https://doi.org/10.1038/s41380-019-0549-3"
              ],
              "doi": "10.1038/s41380-019-0549-3",
              "pmid": "31645664",
              "targets": [
                "ZFP57",
                "APOB",
                "MUC4",
                "EDN2",
                "GPX6",
                "AFF3",
                "TP73"
              ],
              "categories": [
                "Epigenetics",
                "Clinical & self-report"
              ],
              "citationCount": 103,
              "citationSnapshot": {
                "count": 103,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/31645664/",
                  "https://doi.org/10.1038/s41380-019-0549-3"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Epigenetics",
                "measuredGenes": [
                  "ZFP57",
                  "APOB",
                  "MUC4",
                  "EDN2",
                  "GPX6",
                  "AFF3",
                  "TP73"
                ],
                "relationshipNote": "Treatment included trauma-focused CBT and/or EMDR. This observational analysis does not isolate EMDR or establish altered gene expression from methylation alone."
              },
              "recordId": "pmid-31645664",
              "quotes": [],
              "sourcePages": [],
              "summary": "In veterans receiving trauma-focused psychotherapy, remission was associated with changes in 12 blood DNA-methylation regions. ZFP57 also showed evidence in an independent prospective deployment cohort.",
              "limitation": "Treatment included trauma-focused CBT and/or EMDR. This observational analysis does not isolate EMDR or establish altered gene expression from methylation alone.",
              "id": "vision-epigenetics-pmid-31645664",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/31645664/",
                  "https://doi.org/10.1038/s41380-019-0549-3"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            }
          ],
          "number": "4.2",
          "trustAssessment": {
            "score": 1,
            "scope": "Subchapter",
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            "status": "assessed",
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                "pmid-36266402",
                "pmid-31645664"
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              "double-blind-rct": 0,
              "rct": 1,
              "single-blind-rct": 0,
              "peer-reviewed": 4
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            "basis": "Highest threshold supported by the recorded paper assessments; repeated reports of an identified trial count once."
          },
          "trustScore": 1,
          "sourceTrustScore": 1
        },
        {
          "id": "biomarkers",
          "title": "EMDR, cortisol and molecular biomarkers",
          "description": "Cortisol and endocannabinoid measurements alongside clinical or physiological outcomes. These are distinct from gene-expression findings.",
          "papers": [
            {
              "title": "Pretreatment cortisol predicts trauma-focused psychotherapy response in youth with (partial) posttraumatic stress disorder.",
              "journal": "Psychoneuroendocrinology",
              "year": 2019,
              "authors": "Zantvoord JB, Ensink JBM, Op den Kelder R, Wessel AMA, Lok A, Lindauer RJL.",
              "design": "Prospective biomarker study",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/31352130/",
                "https://doi.org/10.1016/j.psyneuen.2019.104380"
              ],
              "doi": "10.1016/j.psyneuen.2019.104380",
              "pmid": "31352130",
              "targets": [],
              "categories": [
                "Molecular biomarkers",
                "Clinical & self-report"
              ],
              "citationCount": 23,
              "citationSnapshot": {
                "count": 23,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/31352130/",
                  "https://doi.org/10.1016/j.psyneuen.2019.104380"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Molecular biomarkers",
                "measuredGenes": [],
                "relationshipNote": "The trauma script rarely produced a cortisol stress response. The predictive contribution was limited and insufficient for clinical application; this is not a gene-expression measurement."
              },
              "recordId": "pmid-31352130",
              "quotes": [],
              "sourcePages": [],
              "summary": "Among 53 young people aged 8–18 treated with EMDR or trauma-focused CBT, higher pretreatment basal salivary cortisol was associated with greater subsequent symptom improvement.",
              "limitation": "The trauma script rarely produced a cortisol stress response. The predictive contribution was limited and insufficient for clinical application; this is not a gene-expression measurement.",
              "id": "vision-biomarkers-pmid-31352130",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/31352130/",
                  "https://doi.org/10.1016/j.psyneuen.2019.104380"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "The Role of the Endocannabinoids 2-AG and Anandamide in Clinical Symptoms and Treatment Outcome in Veterans with PTSD.",
              "journal": "Chronic stress (Thousand Oaks, Calif.)",
              "year": 2022,
              "authors": "Leen NA, de Weijer AD, van Rooij SJH, Kennis M, Baas JMP, Geuze E.",
              "design": "Longitudinal biomarker cohort",
              "urls": [
                "https://pmc.ncbi.nlm.nih.gov/articles/PMC9190205/",
                "https://pubmed.ncbi.nlm.nih.gov/35707677/",
                "https://doi.org/10.1177/24705470221107290"
              ],
              "doi": "10.1177/24705470221107290",
              "pmid": "35707677",
              "targets": [],
              "categories": [
                "Molecular biomarkers",
                "Clinical & self-report"
              ],
              "citationCount": 17,
              "citationSnapshot": {
                "count": 17,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "observational",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/35707677/",
                  "https://doi.org/10.1177/24705470221107290"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Molecular biomarkers",
                "measuredGenes": [],
                "relationshipNote": "Treatments included CBT with exposure or EMDR. Exploratory correlations require replication; endocannabinoid concentrations are distinct from gene expression."
              },
              "recordId": "pmid-35707677",
              "quotes": [],
              "sourcePages": [],
              "summary": "Plasma anandamide and 2-AG were measured in 54 veterans with PTSD and 26 combat controls. Pretreatment levels did not predict symptom reduction following trauma-focused therapy; cortisol decreased over time.",
              "limitation": "Treatments included CBT with exposure or EMDR. Exploratory correlations require replication; endocannabinoid concentrations are distinct from gene expression.",
              "id": "vision-biomarkers-pmid-35707677",
              "paperTrustAssessment": {
                "score": 1,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": null,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Molecular or biomarker analysis with combined trauma-focused treatment exposure. No independently verified single- or double-blind randomized molecular comparison is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/35707677/",
                  "https://doi.org/10.1177/24705470221107290"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            },
            {
              "title": "Stress and stress reactivity in posttraumatic stress disorder (PTSD) following eye movement desensitization (EMD): A randomized controlled trial.",
              "journal": "Journal of behavior therapy and experimental psychiatry",
              "year": 2025,
              "authors": "Susanty E, Sijbrandij M, van der Mee DJ, Srisayekti W, Suparman Y, Huizink AC.",
              "design": "Randomized controlled component trial",
              "urls": [
                "https://pubmed.ncbi.nlm.nih.gov/40706348/",
                "https://doi.org/10.1016/j.jbtep.2025.102052"
              ],
              "doi": "10.1016/j.jbtep.2025.102052",
              "pmid": "40706348",
              "targets": [],
              "categories": [
                "Molecular biomarkers",
                "Clinical & self-report"
              ],
              "citationCount": 1,
              "citationSnapshot": {
                "count": 1,
                "source": "Crossref",
                "retrievedAt": "2026-10-23"
              },
              "studyDesignAssessment": {
                "category": "peer-reviewed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40706348/",
                  "https://doi.org/10.1016/j.jbtep.2025.102052"
                ],
                "reviewedAt": "2026-10-23"
              },
              "evidence": {
                "evidenceType": "Molecular biomarkers",
                "measuredGenes": [],
                "relationshipNote": "Saliva timing depended on participant adherence. This is the same registered component trial as the 2024 neurocognitive report, not an independent replication.",
                "trialId": "ISRCTN55239132"
              },
              "recordId": "pmid-40706348",
              "quotes": [],
              "sourcePages": [],
              "summary": "Ninety-one adults with PTSD received eye-movement desensitization or memory retrieval alone. Both groups showed reduced stress reactivity; the study found no specific overall benefit of eye movements and inconsistent cortisol differences.",
              "limitation": "Saliva timing depended on participant adherence. This is the same registered component trial as the 2024 neurocognitive report, not an independent replication.",
              "id": "vision-biomarkers-pmid-40706348",
              "paperTrustAssessment": {
                "score": 2,
                "scope": "Paper",
                "status": "assessed",
                "randomizedControlledTrial": true,
                "blinding": "not-confirmed",
                "peerReviewed": true,
                "basis": "Publication identity and reported study design checked. Outcome blinding is not established in the material reviewed; no single- or double-blind RCT classification is assigned.",
                "sources": [
                  "https://pubmed.ncbi.nlm.nih.gov/40706348/",
                  "https://doi.org/10.1016/j.jbtep.2025.102052"
                ],
                "reviewScope": "Existing publication-specific assessments and bibliographic indexing; no blanket full-text appraisal.",
                "assessedAt": "2026-10-27"
              }
            }
          ],
          "number": "4.3",
          "trustAssessment": {
            "score": 1,
            "scope": "Subchapter",
            "minimumQualifyingStudies": 3,
            "status": "assessed",
            "qualifyingRecords": {
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