Characteristics of Posttraumatic Nightmares and Their Relationship to PTSD Severity Among Combat Veterans With PTSD and Hazardous Alcohol Use.
Kyle Possemato, Nina Silander, Nardos Bellete, J Bronte Emery, Leigha De Stefano, Wilfred R Pigeon
The Journal of Nervous and Mental Disease March 1, 2022 DOI: 10.1097/nmd.0000000000001422 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of cross-sectional data Peer reviewed |
|---|---|
| Sample size | 76 |
| Population | Combat veterans with PTSD and at-risk alcohol use |
| Topics | Dreaming PTSD |
| Keywords | Humans Treatment outcome Dreams Combat disorders Stress disorders, post-traumatic Veterans |
| Key findings | In 76 combat veterans with PTSD and at-risk alcohol use, nightmares that were more realistic and more replicative of the trauma were associated with greater PTSD severity. The authors argue this pattern is consistent with emotional processing theory and may indicate that less emotional processing of the trauma has occurred. |
Abstract
ABSTRACT: Although nightmares are known to predict the clinical course of posttraumatic stress disorder (PTSD), research on the relationship between specific nightmare characteristics and PTSD severity is sparse. This study conducted a secondary analysis to explore how five nightmare characteristics are cross-sectionally related to PTSD severity in 76 combat veterans with PTSD and at-risk alcohol use. Consistent with emotional processing theory, we hypothesized that more replicative, threatening, realistic, and easily recalled nightmares would be associated with more severe PTSD, whereas those with greater symbolism would predict lower PTSD severity. Nightmares narratives were audio-recorded and rated by multiple coders. Multiple analyses of variance explored the relationship between nightmare characteristics and PTSD clinical indicators. Most nightmares were realistic, easily recalled, and involved significant threat. Greater realism and replication were associated with greater PTSD severity. Realistic and replicative nightmares may be markers of more severe PTSD and may indicate that less emotional processing of the trauma has occurred.
Comparable studies
Other cross-sectional and survey studies on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Assessing the quality of publicly available videos on MDMA‐assisted psychotherapy for PTSD Videos on YouTube about MDMA-assisted psychotherapy for PTSD | 2022 | Cross-sectional study | n = 100 |
| Perceptions of psychedelic-assisted therapy among Black Americans. Black and White American adults | 2023 | Cross-sectional survey | n = 294 |
| Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders German adolescent SUD patients aged 13–18 years at an outpatient clinic | 2022 | Cross-sectional study | n = 111 |
| Risk factors of sleep paralysis in a population of Polish students. Polish university students under 35 | 2022 | Cross-sectional survey | n = 2,553 |
| Expert opinions on implementation of MDMA-assisted therapy in Europe: critical appraisal towards training, clinical practice, and regulation. Researchers and clinicians involved in MDMA-AT clinical trials and contributors to the... | 2024 | Survey | n = 68 |
Citations in the library
Cited by 4
- Bad dream, nightmares and psychopathology: a systematic review Frontiers in Psychiatry October 8, 2024
- Comparison of autonomic reactivity to trauma and nightmare imagery: A Pilot Study SLEEP Advances 2024
- The Distressing Dream Content Inventory: Development and Initial Validation in Acute Trauma Patients. Journal of Sleep Research March 17, 2026
- Understanding nightmares after traumatic events in Detroit (UNiTED): prospective associations with interpersonal violence and posttraumatic stress disorder symptoms European Journal of Psychotraumatology October 8, 2024
Cites 5
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- Nightmares in United States Military Personnel With Sleep Disturbances. Journal of Clinical Sleep Medicine March 15, 2018
- Association of Posttraumatic Nightmares and Psychopathology in a Military Sample Psychological Trauma: Theory, Research, Practice and Policy October 9, 2017
- Combat-related PTSD nightmares and imagery rehearsal: nightmare characteristics and relation to treatment outcome. Journal of Traumatic Stress October 1, 2012
- Dreaming in posttraumatic stress disorder: A critical review of phenomenology, psychophysiology and treatment. Psychotherapy and Psychosomatics 2007