Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial.
Geneviève Belleville, Mylène Dubé-Frenette, Andréanne Rousseau
Journal of Traumatic Stress August 1, 2018 DOI: 10.1002/jts.22306 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 42 |
| Population | Adult victims of sexual assault with PTSD |
| Interventions | Cognitive behavioral therapy Imagery rehearsal therapy |
| Topics | PTSD |
| Key findings | Adding imagery rehearsal therapy to CBT yielded greater improvement in nighttime symptoms than a waiting period, but the combined treatment was not clearly superior to CBT alone. |
Abstract
Sleep disturbances are common among sexual assault victims with posttraumatic stress disorder (PTSD), but cognitive behavioral therapy (CBT) for PTSD does not directly address sleep-related symptoms. Trauma-related sleep disturbances are associated with more impairment and contribute to the maintenance of PTSD. In this study, we evaluated the efficacy of a combination of CBT and nightmare therapy (imagery rehearsal therapy; IRT) compared to CBT alone for the treatment of PTSD. We recruited 42 adult victims of sexual assault who were suffering from PTSD and randomly assigned them to either the experimental (IRT + CBT) or control condition (waiting period followed by CBT). After CBT, both groups demonstrated significant decreases in nighttime symptoms (except nightmare frequency) and PTSD symptoms and showed improvements in functional impairment and mental health, ds = 0.13-0.83, ps = .005-.008. Outcomes between the two groups did not differ significantly after CBT; however, we observed medium to medium-large differences between the control group and experimental group in terms of nighttime symptoms, ds = 0.45-0.63. Although results did not clearly establish the superiority of IRT + CBT over CBT alone, they demonstrated that IRT yielded greater improvement in nighttime symptoms than the waiting period, ds = 0.72-1.13, ps = .006-.047 for all interaction effects. Findings suggest that targeting nightmares at the beginning of treatment for PTSD may yield rapid improvement in nighttime symptoms. This strategy could be useful for patients with time or resource constraints or those for whom nightmares are the primary complaint.
Comparable studies
Other randomized controlled trials on PTSD, most cited first.
Citations in the library
Cited by 8
- Psychosocial treatments for nightmares in adults and children: a systematic review BMC Psychiatry April 21, 2023
- An Expert Consensus Statement for Implementing Cognitive Behavioral Therapy for Nightmares in Adults Behavioral Sleep Medicine January 15, 2025
- Nightmare Rescripting: Using Imagery Techniques to Treat Sleep Disturbances in Post-traumatic Stress Disorder Frontiers in Psychiatry April 4, 2022
- Voices of Wildfire Survivors: Sleep Disturbance Treatment and Post-Traumatic Growth The Family Journal September 7, 2026
- Status of Imagery Rehearsal Therapy and Other Interventions for Nightmare Treatment in PTSD. Current Psychiatry Reports November 1, 2025
and 3 more in the library
Cites 8
- Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder Archives of Trauma Research May 12, 2016
- Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial. Journal of Consulting and Clinical Psychology December 21, 2015
- A Meta-analysis of Imagery Rehearsal for Post-trauma Nightmares: Effects on Nightmare Frequency, Sleep Quality, and Posttraumatic Stress Clinical Psychology Review June 30, 2012
- Imagery rehearsal for posttraumatic nightmares: A randomized controlled trial Journal of Traumatic Stress October 1, 2010
- Best practice guide for the treatment of nightmare disorder in adults. Journal of Clinical Sleep Medicine August 1, 2010
and 3 more in the library