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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)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized wait-list controlled trial Peer reviewed
Sample size 104
Population Participants with nightmare disorder
Interventions Imagery rescripting Imaginal exposure
Topics Dreaming
Keywords Imagery rescripting Imaginal exposure Mechanism Mediator Nightmares
Key findings 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.

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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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