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Efficacy of imagery rescripting and imaginal exposure for nightmares: A randomized wait-list controlled trial.

Anna E Kunze, Arnoud Arntz, Nexhmedin Morina, Merel Kindt, Jaap Lancee

Behaviour Research and Therapy June 16, 2017 DOI: 10.1016/j.brat.2017.06.005 (opens in new tab)

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AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 104
Population Patients with a primary DSM-5 diagnosis of nightmare disorder, predominantly idiopathic nightmare sufferers
Interventions Imagery rescripting Imaginal exposure
Duration Three weekly individual sessions; follow-up at 3 and 6 months
Topics Dreaming
Keywords Humans Treatment outcome Dreams Implosive therapy Waiting lists Female Young adult Imagery, psychotherapy Nightmares Rct Imagery rehearsal therapy Nightmare disorder Imaginal exposure Imagery rescripting
Key findings Compared with a wait-list condition, both imagery rescripting and imaginal exposure effectively reduced nightmare frequency and distress, with effects comparable to other psychological nightmare treatments and sustained at 3- and 6-month follow-up. The authors conclude that both interventions seem to be efficacious treatment components of nightmare therapies.

Abstract

Nightmares can be effectively treated with cognitive-behavioral therapies. Though it remains elusive which therapeutic elements are responsible for the beneficial effects on nightmare symptoms, imagery rescripting (IR) and imaginal exposure (IE) are commonly identified as active treatment components of nightmare therapies. With this randomized controlled trial, we compared IR and IE as individual treatments to a wait-list (WL) condition to determine whether these particular therapeutic elements ameliorate nightmare symptoms. For this purpose, 104 patients with a primary DSM-5 diagnosis of nightmare disorder were randomly assigned to three weekly individual sessions of either IR or IE, or WL. Results showed that compared to WL, both interventions effectively reduced nightmare frequency (ΔdIR-WL = 0.74; ΔdIE-WL = 0.70) and distress (ΔdIR-WL = 0.98; ΔdIE-WL = 1.35) in a sample that predominantly consisted of idiopathic nightmare sufferers. The effects of IR and IE were comparable to those observed for other psychological nightmare treatments. Initial effects at post-treatment were sustained at 3- and 6-months follow-up, indicating that IR and IE both seem to be efficacious treatment components of nightmare therapies. Additional research is needed to directly compare IR and IE among both idiographic and posttraumatic nightmare sufferers with respect to treatment expectancy, acceptability, and effectiveness.

Comparable studies

Other randomized controlled trials on dreaming, most cited first.

Study Year Design Participants
Efficacy of a Cognitive‐Behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD Combat veterans of Operation Enduring Freedom and/or Operation Iraqi Freedom (mean age... 2013 Randomized controlled trial n = 40
Lucid Dreaming Treatment for Nightmares: A Pilot Study Chronic nightmare sufferers 2006 Randomized controlled trial n = 23
Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study Participants spending three consecutive nights in a sleep laboratory 2013 Randomized controlled trial n = 19
Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study Adults with high dream recall and an interest in lucid dreaming 2018 Randomized crossover trial n = 121
Studies with lucid dreaming as add-on therapy to Gestalt therapy Adults with nightmares (ICD-10: F51.5) at least twice a week 2015 Randomized controlled trial n = 32

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