Intensive eye movement desensitization and reprocessing across the posttraumatic spectrum: Preliminary outcomes in veterans with clinical and subclinical symptom levels

Intensive treatment formats enhance therapeutic efficacy and reduce dropout rates; however, such programs have not been sufficiently examined in individuals with subclinical PTSD, particularly using eye movement desensitization and reprocessing (EMDR) as the primary psychotherapeutic intervention. This article reports preliminary findings from an intensive EMDR-based intervention for veterans with varied levels of PTSD symptoms, comparing treatment responses between individuals with clinical and subclinical PTSD. Participants (N = 38, M_age = 33.07 years, SD = 9.57) presenting with PTSD symptoms were enrolled: 23 met the diagnostic criteria for PTSD, and 15 presented with subclinical PTSD. The program involved 6 days of consecutive treatment, incorporating twice-daily EMDR sessions alongside supplemental supportive interventions. PTSD symptoms were assessed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and self-report PTSD Checklist for DSM-5 (PCL-5). Participants also completed self-report measures of depression, anxiety, well-being, and trauma-specific coping. Linear mixed-effects models revealed significant reductions in PTSD symptoms from baseline to 3-month follow-up in both groups. For the CAPS-5, a significant interaction indicated greater improvements in the clinical group, d = 1.74, than in the subclinical group, d = 1.17. PCL-5 trajectories were comparable between groups, with very large effects in both the clinical, d = 1.56, and subclinical, d = 1.63, groups. At 3-month follow-up, most participants demonstrated reliable improvement on the CAPS-5 (63.9%) and PCL-5 (77.4%). These findings highlight the feasibility and potential effectiveness of intensive EMDR-based interventions and suggest that intensive formats may also benefit individuals with subclinical PTSD.