Mediators of Change in Imagery Rescripting and Imaginal Exposure for Nightmares: Evidence From a Randomized Wait-List Controlled Trial.
Anna E Kunze, Jaap Lancee, Nexhmedin Morina, Merel Kindt, Arnoud Arntz
Behavior therapy September 1, 2019 DOI: 10.1016/j.beth.2019.03.003 (opens in new tab) via PubMed
Summary
AI-generated from the abstractImagery rescripting and imaginal exposure are both effective treatments for nightmare disorder, but they work through different underlying mechanisms. In a randomized wait-list controlled trial with 104 participants, enhanced mastery or self-efficacy regarding nightmare content mediated the therapeutic effects of imagery rescripting. In contrast, increased tolerability of negative emotions elicited by nightmares mediated the effects of imaginal exposure. Although both treatments produce similar therapeutic outcomes, they appear to engage distinct psychological processes.
Study at a glance
| Characteristics | Randomized wait-list controlled trial Peer reviewed |
|---|---|
| Sample size | 104 |
| Population | Participants with nightmare disorder |
| Interventions | Imagery rescripting Imaginal exposure |
| Keywords | Imagery rescripting Imaginal exposure Mechanism Mediator Nightmares |
| Key finding | Enhanced mastery mediated the effects of imagery rescripting, while increased tolerability of negative emotions mediated the effects of imaginal exposure. |
Abstract
Imagery rescripting (IR) and imaginal exposure (IE) are two efficacious treatments for nightmare disorder, but their discrete underlying mechanism(s) remain largely unknown. We therefore examined mediators of the treatment effects of IR and IE in a randomized wait-list controlled trial (N = 104). Therapeutic outcomes were assessed at pre- and post-assessment, and mediator assessment took place in between treatment sessions to establish a temporal relationship between mediators and nightmare symptoms (i.e., frequency and distress). In line with the hypothesis, enhanced mastery (or self-efficacy) of the nightmare content mediated the therapeutic efficacy of IR. Furthermore, the treatment effects of IE were mediated by increased tolerability of the negative emotions elicited by nightmares. Even though IR and IE for nightmares seem to produce similar therapeutic effects, the results of this study suggest that IR and IE tap into different underlying processes.