Effect of EMDR for Reduction of Pain Interference in Children With Sickle Cell Disease

The efficacy of EMDR in reducing PTSD symptoms. The Child and Adolescent Trauma Screen (CATS) questionnaire is a screening instrument based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD. It measures potentially traumatic events and PTSD symptoms (PTSS). The questionnaire consists of 15 items measuring traumatic events, 20 items measuring DSM-5 PTSD symptoms, and 5 items measuring psychosocial functioning, and it is administered in approximately 15 minutes. The 4-point symptom response scales indicate the reported frequency/severity of each symptom.

For children aged 6-7 years, using the caregiver-report version, the possible score range is 0-48, and the recommended cut-off point indicative of (sub)clinically relevant levels of symptoms is 12 points or more. For children aged 8 years and older, using the self-report version, the possible score range is 0-60, and the cut-off point is 15 points or more.

The efficacy of EMDR in reducing anxiety. PROMIS Anxiety questionnaires assess fear (fearfulness, panic), anxious misery (worry, dread), hyperarousal (tension, nervousness, restlessness), and somatic symptoms related to arousal (racing heart, dizziness). They assess anxiety over the past seven days (recall period). PROMIS T-scores are calculated per version, with higher T-scores representing greater anxiety.

The efficacy of EMDR in reducing depressive symptoms. PROMIS Depressive Symptoms questionnaires assess negative mood (sadness, guilt), views of self (self-criticism, worthlessness), and social cognition (loneliness, interpersonal alienation), as well as decreased positive affect and engagement (loss of interest, meaning, and purpose). Somatic symptoms (changes in appetite, sleeping patterns) are not included, which eliminates consideration of these item's confounding effects when assessing children with comorbid physical conditions. The questionnaires are universal rather than disease-specific, making scores easily comparable to the general population. They assess depressive symptoms over the past seven days (recall period). The PROMIS T-scores are calculated per version. A higher PROMIS T-score represents more depressive symptoms.

The efficacy of EMDR in reducing physical complaints. These questionnaires assess activities of physical mobility such as getting out of bed or a chair to activities such as running. They assess mobility over the past seven days (recall period). The PROMIS T-scores are calculated per version. A higher PROMIS T-score represents more mobility.

The efficacy of EMDR in reducing pain frequency. At T0, T1i/T1.1c, T1c and T2, participants should complete a diary and report for each day of the week if they had pain (yes/no).

The efficacy of EMDR in reducing pain severity. At T0, T1i/T1.1c, T1c and T2, participants should complete a diary and rate, for each day of the week that they had pain, the severity of the pain on a numeric rating scale (NRS, 0 - 10, 10 indicating the highest pain). It will also be investigated before and after each EMDR session using the same NRS, and will be registered by the therapist as part of the session report.

The efficacy of EMDR in reducing pain medication use. At T0, T1i/T1.1c, T1c and T2, participants should complete a diary and report for each day of the week any pain medication used. The (multiple-choice) options available are: no pain medication, paracetamol, diclofenac/ibuprofen, tramadol.

The efficacy of EMDR in reducing school absence. At T0, T1i/T1.1c, T1c and T2, participants should complete a diary and report for each day of the week if they went to school (yes/no; if 'no' is chosen, they can also answer why, in a free text format).