Temporal associations between nightmares and PTSD symptoms in the acute post-sexual assault period: An ecological momentary assessment study
Journal of Mood and Anxiety Disorders July 10, 2026 Ashby Boland, Lauren D Reyes, Jenny Black et al.
Nightmares are common after sexual assault and may contribute to posttraumatic stress disorder (PTSD) development, but daily links between nightmares and PTSD symptoms in the acute aftermath are not well understood. In 54 women sexual assault survivors followed with daily surveys for six weeks, most had clinically significant PTSD symptoms and frequent nightmares (42.8% of days). At the within-person level, nightmares predicted next-survey PTSD symptoms and vice versa, but these effects disappeared after adjusting for how symptoms carried over from one time to the next. Between individuals, those with more frequent nightmares had higher PTSD symptoms, with models accounting for 43-44% of the variance. Short-term nightmare fluctuations may not drive PTSD changes once stability is considered; nightmares may instead indicate overall PTSD severity.