The nightmare severity index (NSI): A short new multidimensional tool for assessing nightmares.
Pierre A Geoffroy, Émilie Stern, Julia Maruani, Renaud Cornic, Balthazar Bazin, Emmanuelle Clerici, Marine Ambar Akkaoui, Régis Lopez, Justine Frija Masson, Marie-Pia d'Ortho, Michel Lejoyeux, Jean-Arthur Micoulaud-Franchi, Camille Couffignal
Journal of Sleep Research May 1, 2024 DOI: 10.1111/jsr.14065 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Psychometric pilot study Peer reviewed |
|---|---|
| Sample size | 102 |
| Population | Patients with mood disorders (depression and bipolar disorder) and frequent PTSD comorbidity, mostly women and outpatients |
| Topics | Dreaming PTSD |
| Keywords | Bad dreams Nightmare disorder Nightmares Sleep disorders |
| Key points | The Nightmare Severity Index demonstrates good internal validity and acceptability, with higher scores aligning with DSM-5/ICSD-3 nightmare disorder criteria. |
Abstract
This psychometric pilot study aims to evaluate a new multidimensional simple scale, named the nightmare severity index (NSI) - close to the existing insomnia (ISI) and hypersomnia (HSI) severity indexes. The NSI encompasses all main dimensions of nightmare disorder, evaluating four subdimensions: frequency, emotional impact, diurnal impact, and nocturnal impact of nightmares. The NSI was completed by a total of 102 patients. The majority of the population consisted of women (64%) and outpatient individuals (76%) diagnosed with mood disorders such as depression (31%) and bipolar disorder (41%). Comorbidity with post-traumatic stress disorder (PTSD) was prevalent (44%), and psychotropic medications were commonly used (47%). Internal validity analyses indicated that the NSI was well suited for exploratory factor analysis. All items demonstrated satisfactory correlations with the factors, and the questionnaire exhibited good internal consistency (Cronbach's alpha >0.7). Higher NSI scores were observed among individuals experiencing nightmare symptoms considering the DSM-5/ICSD-3 criteria. In summary, the NSI proves to be a promising and valuable tool for clinical practice, demonstrating good acceptability, internal validity, and the ability to assess nightmare severity.
Comparable studies
Other non-randomized and open-label trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A combined group treatment for nightmares and insomnia in combat veterans: A pilot study Combat veterans with PTSD | 2009 | Open clinical trial | n = 10 |
| Cognitions in Sleep: Lucid Dreaming as an Intervention for Nightmares in Patients With Posttraumatic Stress Disorder. Patients suffering from posttraumatic stress disorder (PTSD) | 2020 | Pre-post intervention study | |
| Managing Insomnia Using Lucid Dreaming Training: A Pilot Study. Adults with Insomnia Disorder | 2021 | Open-label trial | n = 48 |
| Dream content and political ideology. U.S. adults who identified as members of the political right or political left (28 per... | 2002 | Pilot study | n = 56 |
| Imagery rehearsal therapy for the treatment of nightmares in individuals with borderline personality disorder – A pilot study Individuals with borderline personality disorder | 2024 | Between-subjects design, pilot study | n = 44 |
Citations in the library
Cited by 7
- Nightmares matter: rethinking suicide risk assessment and intervention in depression Sleep April 8, 2026
- Nightmares Fluctuate Across the Menstrual Cycle and May be More Pronounced in Women With Premenstrual Syndrome Brain and Behavior February 28, 2025
- Dream and nightmare alterations in patients presenting with suicidal crisis: A prospective study in psychiatric emergency department. Sleep Medicine July 2, 2026
- Efficacy of imagery rehearsal therapy in the treatment of traumatic nightmares in youth with complex post-traumatic stress disorder. Journal of Clinical Sleep Medicine June 17, 2026
- Dream tyranny: Hyperonirism diagnostic criteria. L'Encephale June 1, 2026
and 2 more in the library
Cites 11
- How are you dreaming? A very simple question to screen for suicide risk Bipolar Disorders April 9, 2023
- Bad Dreams and Nightmares Preceding Suicidal Behaviors. The Journal of Clinical Psychiatry November 23, 2022
- Imagery Rescripting and Imaginal Exposure in Nightmare Disorder Compared to Positive Imagery: A Randomized Controlled Trial. Psychotherapy and Psychosomatics 2021
- Examining the Factor Structure, Reliability, and Validity of the Disturbing Dreams and Nightmare Severity Index (DDNSI) Consequences Sub-component Behavioral Sleep Medicine December 21, 2020
- Nightmares in Patients with Major Depressive Disorder, Bipolar Disorder, and Psychotic Disorders: A Systematic Review. Journal of Clinical Medicine December 9, 2020
and 6 more in the library