Eye Movement Desensitization and Reprocessing (EMDR) on reactive attachment disorder in children aged 8-12 years

The parent-child relationship is one of the most important components of social life and plays an essential role in children's mental health. Unlike a safe child, who can count on the accountability of the caregiver, an unsafe child must deal with the constant need for the caregiver and cope with the continued failure and unbalanced behavior of this person. Insecure children should constantly be concerned about their caring location, as they cannot count on availability when needed. Because of the possible inaccessibility of these caregivers, unsafe children live with a constant fear of being left alone. The fear of separation and abandonment is transferred to the postnatal period, as the fear of loneliness persists when the need for comfort or support continues throughout childhood and adulthood. Desensitization and reprocessing with eye movements can help to improve children's reactive attachment disorder. Therefore, this study aimed to determine the effectiveness of desensitization and reprocessing methods through eye movements on symptoms of reactive attachment disorder in children aged 8-12 years.

The research method was semi-experimental with pre-test, post-test, and follow-up with two groups in this study. The statistical population consisted of all students of 8-12 years with reactive attachment disorder in the academic year of 2019 in districts 1, 3, and 22 of Tehran who had expressed a desire in calling through cyberspace. Sixteen eligible volunteer children were included in the study and randomly assigned to experimental and control groups among the mentioned population. The number of samples was calculated based on similar studies considering the effect size of 0.40, the confidence level of 0.95, the test power of 0.80 and the loss rate of 10% for each group of 8 persons. In the experimental group, desensitization and reprocessing methods were performed by eye movements of 8 students, and in the control group, eight students were placed. Inclusion criteria included age between 8 and 12 years, score higher than 30 in Randolph attachment disorder questionnaire and exclusion criteria, physical, sensory, and motor problems, lack of proper cooperation in regular participation in meetings or doing exercises at home. The intervention was presented as desensitization and reprocessing with eye movements every week. Participants completed the attachment disorder questionnaire (Randolph, 2000), Achenbach behavioral log (Achenbach, 2000), and Wisconsin card classification test (Grant & Berg, 1948) and follow-up period three months later. Data were analyzed by SPSS software using repeated variance analysis. The significance level of the tests in this study was considered 0.05.

The results showed that desensitization and reprocessing training through eye movements significantly reduced antisocial behaviors (effect of group: p<0.001, time effect: p<0.001, time effect*Group: p<0.001), impulsivity (group effect: p<0.001; time effect: p<0.001; time effect*Group: p<0.001), and bullying (group effect p<0.001, Time effect: p<0.001, time effect*Group: p<0.001) in the experimental group was post-tested and followed up, but the scores of antisocial behavior, impulsivity and bullying were not changed in the control group.

It can be concluded that the use of desensitization and reprocessing approach with eye movement can be effective in reducing the symptoms of reactive attachment disorder and can be used as a therapeutic intervention tailored to the child's condition.