Combat-related PTSD nightmares and imagery rehearsal: nightmare characteristics and relation to treatment outcome.
Journal of Traumatic Stress October 1, 2012 Gerlinde C. Harb, Richard Thompson, Richard J Ross et al.
The nightmares of 48 male U.S. Vietnam war veterans with combat-related PTSD were predominantly replays of actual combat events involving death, violence, and fear for one's life. In Imagery Rehearsal therapy, rescripted dreams that addressed or resolved the nightmare theme were linked to reduced sleep disturbance, but including violent details in the rescripted dream predicted poorer treatment outcome in nightmare frequency (B = 5.69, SE = 1.14). Experiencing olfactory sensations in nightmares, a possible marker of nightmare intensity, also predicted poorer treatment response (B = 2.95, SE = 1.06). The therapy may be most effective when rescripted dreams resolve the nightmare theme and exclude violent content.