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Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD.

Johanna Thünker, Reinhard Pietrowsky

Behaviour Research and Therapy May 30, 2012 DOI: 10.1016/j.brat.2012.05.006 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational study with a randomized control condition nested in the PTSD group Peer reviewed
Sample size 69
Population Adults with nightmares: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, and 26 patients with PTSD and nightmares
Intervention Imagery Rehearsal Therapy
Topics Anxiety Depression Dreaming PTSD
Keywords Humans Night terrors Treatment outcome Attitude to health Dreams Stress disorders, post-traumatic Adult Female Imagery, psychotherapy
Key findings Nightmare frequency and nightmare-related anxiety decreased following Imagery Rehearsal Therapy across all groups. The PTSD group had the highest initial nightmare frequency and anxiety, and its anxiety scores decreased least; depressive patients and primarily nightmare sufferers showed anxiety reductions during intervention, and primarily nightmare sufferers maintained low anxiety through the catamnesis period, suggesting they benefited most.

Abstract

Nightmares are a common and serious problem in psychotherapeutic practice, although they are seldom considered as independent mental disorders. There are some promising approaches to the treatment of nightmares, notably Imagery Rehearsal Therapy, a cognitive-restructuring treatment. The core of this approach is the modification of the nightmare script and repeated imagination of the new script. However, most evaluation surveys have been conducted only with trauma patients, and thus far there is no standardized manual in the German language. 69 participants were examined using self-rating questionnaires. Participants belonged to three groups: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, 26 with PTSD and nightmares. 12 of the PTSD patients were randomly assigned to a control condition. Primary outcome measures were nightmare frequency and anxiety during nightmares. Overall, nightmare frequency and the anxiety they caused decreased following the treatment. Nightmare frequency and anxiety during the nightmares were highest in the PTSD group initially. Nightmare frequency decreased in all groups. Anxiety scores decreased least in PTSD patients, in depressive patients and primarily nightmare sufferers anxiety scores decreased during intervention. In primarily nightmare sufferers anxiety remained low up to the catamnesis period as well. Thus, those who suffered primarily from nightmares showed the strongest benefit from the nightmare treatment.

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Anxiety Depression Dreaming PTSD