Eye Movement Desensitization and Reprocessing (EMDR) in a forensic patient with Posttraumatic Stress Disorder (PTSD) resulting from homicide: a case study

Abstract

Posttraumatic Stress Disorder (PTSD) resulting from perpetration, is highly prevalent in forensic populations and has been associated with future risk of anger, aggressive behavior, and criminal recidivism. Since forensic psychiatry aims at reducing violence and recidivism, treatment of PTSD in this population is of great importance. Controlled studies to the feasibility and effectiveness of PTSD treatment within forensic populations are lacking. In five case studies, however, feasibility of EMDR is demonstrated in offenders with PTSD and comorbid disorders like psychosis or depression. The present case study aimed to expand this knowledge by describing the application of EMDR to a forensic psychiatric patient with a narcissistic personality disorder with antisocial and borderline features, and PTSD resulting from a murder he committed. Over the course of EMDR, PTSD symptoms (both established by clinical interview and self-report) decreased. Posttreatment, the patient did not meet the criteria for PTSD anymore. Importantly, results were maintained during eight months follow-up and no adverse events took place. The results of this case study offer strong support for a randomized controlled study.