Implicazioni neurobiologiche del trauma e dell'EMDR: Nuove evidenze da uno studio di hdEEG sul processamento neurale delle emozioni nei bambini con trauma complesso

ABSTRACT: Theoretical background: Neuroimaging research has extensively investigated neurobiological correlates of Post-Traumatic Stress Disorder (PTSD). Findings from these studies have identified hyper-reactivity of the amygdalae with acquisition of fear responses, and impairment of the medial prefrontal cortex in properly regulating fear extinction, that could account for increased trauma-related symptoms with traumatic reminders., As diagnosis for adult onset trauma, PTSD is often applied to traumatized children as well. Nevertheless, PTSD diagnosis fails to account for the complex symptomatology that emerges following early chronic interpersonal traumatization, that occurs primarily within the caregiving system and whose consequences are instead more fully described by the diagnostic construct of "complex trauma". Early traumatization exerts a deleterious impact on children's abilities to recognize facial emotions and regulate inner emotional states. Neuroscience research has provided compelling evidence for the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in restoring affective regulation in Post-Traumatic Stress Disorder (PTSD) patients. However, the effectiveness of EMDR on emotion processing of children with complex trauma has yet to be explored. Aim: The present contribution aims at illustrating the recent findings from neuroscience research on PTSD and EMDR, shedding new light on the efficacy of EMDR on neural processing of emotions in children with complex trauma. Methodology: After presenting the limitations of DSM-IV-TR criteria in the diagnosis of PTSD in childhood, we will introduce the diagnostic construct of "complex trauma", particularly considering its effects on children's emotional regulation. We will then provide an overview of scientific literature on neurobiological correlates of PTSD and EMDR, and present a high-density Electroencephalography (hdEEG) study where we investigated the effects of EMDR on brain responses to adult emotions in children with histories of early maltreatment. Critical discussion and conclusions: Trauma exerts a deleterious impact on the anatomy and functionality of specific cerebral areas associated with the emotional response to traumatic reminders as well as to the onset of psychopathological outcomes. Traumatic experiences have clinical relevance especially during childhood, since they alter trajectories of brain development, decreasing the functionality of cerebral regions related to emotion processing. Findings from our hdEEG study provide evidence for the effectiveness of EMDR in restoring affect regulation in children, promoting the cognitive processing of emotional stimuli that resemble traumatic events.