# The Processing Difficulties Scale (PDS) in EMDR Trauma Therapy: A Preliminary Analysis - URL: https://alisanburak.com/en/emdr-travma-terapisinde-isleme-guclukleri-olcegi-pds-bir-on-analiz - Language: en - Last updated: 2026-09-15 - Page title: The Processing Difficulties Scale (PDS) in EMDR Trauma Therapy: A Preliminary Analysis | Assoc. Prof. Dr. Alişan Burak Yaşar > The Processing Difficulties Scale (PDS) in EMDR Trauma Therapy: A Preliminary Analysis (The Processing Difficulties Scale (PDS) in EMDR trauma therapy: A P This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/emdr-travma-terapisinde-isleme-guclukleri-olcegi-pds-bir-on-analiz) [← Back to blog](https://alisanburak.com/en/blog) # The Processing Difficulties Scale (PDS) in EMDR Trauma Therapy: A Preliminary Analysis July 30, 2024EMDR Europe Symposium 2024 Posters **The Processing Difficulties Scale (PDS) in EMDR Trauma Therapy: A Preliminary Analysis (The Processing Difficulties Scale (PDS) in EMDR trauma therapy: A Preliminary Analysis)** Ramallo-Machín, Alejandra (1), Gómez-Salas, Francisco J (2), Burgos-Julián, Francisco (3), Rial-Rivas, Adriana (4), Santed-Germán M.A (5) and González -Vázquez, Ana Isabel (6) Numerous factors influence how psychotherapeutic processes work. In EMDR therapy, the effects of dissociative symptoms, complex trauma, and emotional dysregulation on the effectiveness of working with traumatic memories have been analyzed. However, few studies examine the within-session process and the factors that influence it, focusing on process analysis rather than outcome analysis. Both aspects are complementary and necessary in every psychotherapeutic approach, yet there has been little development in this area in EMDR therapy to date. METHODS A descriptive and exploratory factor analysis was conducted with a clinical sample of 228 individuals (N=229). This analysis revealed different factors related to patients' processing styles from a transdiagnostic perspective. Accordingly, based on item retention and refinement of the factor structure, the initial 32-item scale was reduced to a final 17-item solution grouped into four factors (see Figure 1). In addition, a correlation analysis was conducted between the four factors and the following scales: Adverse Childhood Experiences International Questionnaire (ACE-IQ; The International ACE Research Network, 2009); Dissociative Experiences Scale (DES; Bestein & Putnam, 1986) and Difficulties in Emotion Regulation Scale (DERS; Gratz & Roener, 2004) (see Figure 2). Results The factor solution proposed in the exploratory factor analysis (EFA) comprises four factors explaining 55% of the total variance, with adequate goodness of fit based on the proposed indices: Root Mean Square Error of Approximation (RMSEA = 007); Tucker-Lewis Index I = 091%); Comparative Fit Index (CFI = 0.95). Specifically, Factor I (Good Processing) showed a Cronbach's alpha of .92 and an omega index of .94. Factor 2 (Lack of Generalization and/or Absence of Changes) yielded alpha and omega values of .87 and .90, respectively. For Factor 3 (Poor Emotional Processing), an alpha of .83 and an omega of .85 were obtained. Factor 4 (Loss of Dual Attention) had an alpha of .82 and an omega of .83. For the total scale, both coefficients exceeded .90, with an alpha of .92 and an omega of .94. The correlation analysis revealed that the DERS did not correlate significantly with any of the scale's four factors. The ACE, on the other hand, showed a significant positive correlation with Factor 4 (r= .28, p< .05, 95% CI (.07, .47). Finally, the DES showed a significant negative correlation with Factor 1 (r= -.26, p< .05, 95% CI (-.45, -.05)) and a significant positive correlation with Factor 4 (r=3, p< .01, 95% CI (.10, -49). CONCLUSIONS Based on the preceding results, different factors related to processing style can be identified: 1) indicators of good processing, 2) indicators of a lack of generalization and/or absence of changes during processing, 3) indicators of poor emotional processing, and 4) indicators of a loss of dual attention. Based on the results of the correlation analysis between the four factors and the scales used, emotional dysregulation measured by the DERS does not appear to predict poor processing. In contrast, the number of early traumatic events measured by the ACE is related only to indicators of a loss of dual attention (Factor 4); the greater the number of early traumatic events, the greater the likelihood of losing dual attention and experiencing dissociation during the process. Finally, the DES is related to indicators of good processing (Factor 1), meaning that lower levels of dissociation are associated with a greater likelihood of good processing during the session. However, it does not appear to be related to indicators of a lack of change or generalization during processing (Factor 2). It is also related to indicators of a loss of dual attention (Factor 4), as higher levels of dissociation are associated with a greater likelihood of losing dual attention during processing. In light of the above, it may be useful to assess processing styles and their relationships with various indicators in order to develop specific interventions for phase 2 of EMDR therapy. This could help inform the debate among clinicians and researchers about the need for a preparatory phase in patients with complex early traumatization, dissociative symptoms, and/or emotional dysregulation. The Processing Difficulties Scale (PDS) in EMDR trauma therapy: A Preliminary Analysis Ramallo-Machín, Alejandra (1), Gómez-Salas, Francisco J (2), Burgos-Julián, Francisco (3), Rial-Rivas Adriana (4), Santed-Germán M.A (5) and González -Vázquez, Ana Isabel (6) There are numerous factors that influence the functioning of psychotherapy therapy processes. In EMDR therapy, the influence of dissociative symptoms, complex trauma or emotional dysregulation on the effectiveness of working with traumatic memories has been analyzed. However, there are few studies that analyze the process within the session and the factors that influence it, focusing on a process analysis rather than an analysis of results. Both aspects are complementary and necessary in each psychotherapeutic orientation, and today, with little development in EMDR therapy. METHODS A descriptive and exploratory factor analysis was carried out with a clinical sample of 228 people (N=229). This analysis showed different factors related with styles of processing in patients from a transdiagnostic perspective. Therefore, and based on the item retention c and refinement of the factor structure, the initial scale composed of 32 items was converted to a final solution of 17 grouped into four factors (see Figure 1). Additionally, a correlational analysis of the four factors was carried out with the following scale: Adverse Childhood Experiences International Questionmaire (ACE-IQ; The International ACE Research Network, 2009); Dissociative Experience Scale (DES; Bestein & Putnam, 1986) and Difficulties in Emotion Regulation Scale (DERS; Gratz & Roener, 2004) (see Figure 2). Result in exploratory factor analysis (EFA), the proposed factorial solution is based on four factors with a total variance explained of 55% and an adequate goodness of fit, based on the proposed indices: Root Mean Square Error of Approximation (RMSEA = 007); Tucker-Lewis Index I = 091%); Comparative Fit Index (CFI = 0,95). Specifically, Factor I (Good Processing) showed a Cronbach's alpha of .92 and an Omega index of .94. Factor 2 (Lack of Generaliation and/or Absence of Changes) recorded values of .87 and .90 for alpha and Omega, respectively. Factor 3 (Poor Emotional Processing), values of .83 alpha for and .85 for Omega were obtained. Factor 4 (Loss of Dual Attention) presented an alpha of .82 and an Omega of .83. In the case of the total scale, both coefficients exceeded .90, with an alpha of .92 and Omega of .94. The results of correlational analysis show that the DERS did not significantly correlate with any of the four factors of the scale. On the other hand, the ACE showed a significant positive correlation with factor with factor 4 (r= .28, p< .05, 95% CI (.07, .47). Finally the DES showed a significant negative correlation with factor 1 (r= -.26, p< .05, 95% CI (-.45, -.05)) as well as a significant positive correlation with factor 4 (r=3, p< .01, 95% CI (.10, -49). CONCLUSIONS Taking into account the previous results, different factors related to the processing style can be defined: 1) indicators of good processing, 2) indicators of a lack of generalization and/or absence of changes during processing, 3) indicators of poor emotional processing, 4) indicators of a loss of dual attention. From the results obtained in the correlational analysis between the four factors and the scales used, it seems that emotional dysregulation measured with the DERS does not predict poor processing. On the other hand, the number of early traumatic events measured with ACE is only related to the indicators of a loss of dual attention (Factor 4), in the sense that the greater the number of early traumatic events, the higher the probability of loss dual attention and dissociation during the process. Finally, the DES is related to the indicators of good processing (Factor 1), in the sense that the lower the levels of dissociation, the greater the probability of good processing during the session. However, it does not seem to be related to indicators of a lack of change or generalization (Factor 2) during the processing. Likewise, it is related to the indicators of loss of dual attention (Factor 4), in the sense that the higher the level of dissociation, the greater the probability of a loss of dual attention during the processing. Taking into account what was mentioned above, it could be interesting to evaluate processing styles and their relationship with various indicators, in order to develop specific interventions in phase 2 for EMDR therapy, thus improving the controversy between clinicans and researchers about the need for a prepration phase in patients with complex early traumatization, dissociative symptoms, and/or emotional dysregulation. 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