EMDR Therapy Shows Effectiveness in Treating Personality Disorders: JAMA
Netherlands: A new study has shown that eye movement desensitization and reprocessing (EMDR) therapy led to significant reductions in personality disorder (PD) symptoms, with nearly half of the participants achieving diagnostic remission, highlighting its potential as an effective treatment option.
Personality disorders affect a substantial portion of the population and are frequently linked to adverse childhood experiences. While trauma-focused treatments are well established for posttraumatic stress disorder (PTSD), their role in managing personality disorders is less clear. Researchers from the Department of Personality Disorders at Parnassia Psychiatric Institute in The Hague, the Netherlands, sought to explore whether EMDR could offer meaningful symptom relief for this complex group of conditions. Their findings were published in JAMA Network Open.
The randomized clinical trial enrolled 159 adults who met diagnostic criteria for a personality disorder using the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD). Participants were randomly assigned to receive either EMDR therapy or to remain on a waiting list. The EMDR group underwent ten 90-minute sessions over five weeks, focusing on traumatic or adverse memories believed to drive personality-related symptoms. Assessments occurred before treatment, immediately after the program, and again three months later, using multiple validated scales to measure personality functioning and emotional regulation.
Participants had an average age of 35 years, and women represented roughly 82% of the study population. Seventy-nine individuals received EMDR, while 80 served as controls. Only a small fraction—about 5%—discontinued therapy, and no serious adverse events were reported.
The results were striking:
- EMDR therapy significantly outperformed the waiting-list control on all major outcome measures both immediately after treatment and at the three-month follow-up.
- Patients receiving EMDR showed marked improvements in overall personality disorder severity, emotional regulation, and level of functioning.
- Remission rates were higher in the EMDR group, with 38.3% achieving remission post-treatment compared with 6.8% in the control group.
- At three-month follow-up, 45.4% of EMDR participants remained in remission compared with 5.9% of controls.
- A second diagnostic interview showed similar results, with nearly half of EMDR recipients maintaining remission three months later.
The authors emphasized that EMDR’s benefits extended to patients regardless of whether they also had PTSD, underscoring its potential as a broad intervention for personality disorders. They noted, however, that several limitations warrant caution. The trial relied on a waiting-list control rather than an active comparison treatment, which can exaggerate perceived effect sizes. Double-blinding was not feasible, and the follow-up period of three months was relatively short to judge long-term outcomes. Moreover, the sample was dominated by more common personality disorder types such as borderline, avoidant, and obsessive-compulsive, limiting the ability to generalize findings to rarer diagnoses.
Despite these caveats, the study provides compelling evidence that trauma-focused approaches like EMDR can substantially reduce the severity of personality disorder symptoms. The researchers call for further investigations comparing EMDR with established psychotherapies and examining its long-term effectiveness, which could help refine treatment options for individuals living with these challenging conditions.
Reference:
Hofman S, Hafkemeijer L, de Jongh A, Slotema CW. Eye Movement Desensitization and Reprocessing Therapy in Persons With Personality Disorders: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(9):e2533421. doi:10.1001/jamanetworkopen.2025.33421
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