Physiological reactivity during EMDR therapy in adults with mild intellectual disabilities: A feasibility study

Background People with mild intellectual disabilities (MID) are at increased risk of developing PTSD. EMDR therapy appears to be an effective treatment for the treatment of PTSD but communicating stress levels during therapy can be challenging. Wearables may provide additional insight into physiological arousal during treatment. This feasibility study evaluated the acceptability and potential clinical value of wearable physiological monitoring during EMDR therapy in four adults with MID and PTSD. Methods A single-case design was used, collecting minute-by-minute physiological data during EMDR therapy sessions. Feasibility of wearable use was assessed with customized questionnaires completed by participants and therapists. Physiological data were synchronized with EMDR protocol components and analyzed descriptively alongside subjective units of distress (SUD) scores. Overall patterns of arousal across sessions were summarized using boxplots. Results Wearables were considered acceptable by participants and therapists, although technical difficulties were reported. Participants showed reductions in subjective distress during EMDR therapy, but physiological findings were heterogeneous. Little support for a pronounced pattern of de-arousal across EMDR sessions was found, with observed changes being small relative to between-session variability. Conclusion Using wearables during EMDR therapy in adults with MID and PTSD appears acceptable although technical problems seem to be a feasibility barrier. Physiological findings were difficult to interpret, limiting conclusions about consistent patterns of ANS functioning during EMDR therapy. Future research should include larger samples, contextual factors, and baseline and follow-up measurements.