Promoting Well-being After Trauma: A Randomized Controlled Trial on the Superior Efficacy of Combined Eye Movement Desensitization and Imagery Rescripting

Traumatic life events often lead to a complex interplay of persistent emotional distress and a diminished capacity for psychological recovery. This study evaluated the effectiveness and underlying mechanisms of an integrated intervention—combining Eye Movement Desensitization (EMD) and Imagery Rescripting (IR)—for individuals with traumatic experiences. Participants (N = 95) were randomly assigned to a combined EMD+IR group, a standalone IR group, or a care-as-usual (CAU) control. Assessments of emotional distress (anxiety and depression) and positive psychological resources (self-efficacy and resilience) were conducted at baseline, post-intervention, and one-month follow-up. Linear Mixed Models indicated that the EMD+IR protocol was significantly more effective in alleviating anxiety and depression than the other conditions, with these advantages sustained over time. Meanwhile, both intervention groups demonstrated comparable efficacy in fostering self-efficacy and resilience. Notably, mediation analysis revealed that the enhancement of resilience was fully driven by a multi-dimensional restructuring of traumatic memories, specifically through the concurrent reduction of imagery vividness, emotional arousal, and negative beliefs. These findings suggest a synergistic mechanism where the simultaneous processing of physiological distress and cognitive schemas facilitates holistic memory integration. This study provides practical evidence for designing comprehensive interventions that move beyond symptom reduction to achieve sustainable well-being and post-traumatic growth.