Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial.
Annette van Schagen, Jaap Lancee, Izaäk W De Groot, Victor I. Spoormaker, Jan Van den Bout
The Journal of Clinical Psychiatry September 1, 2015 DOI: 10.4088/jcp.14m09216 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 90 |
| Population | Patients with psychiatric disorders (DSM-IV-TR) |
| Intervention | Imagery rehearsal therapy |
| Duration | 6 individual sessions, 3-month follow-up |
| Topics | Dreaming |
| Registration | NCT00291031 |
| Key findings | Imagery rehearsal therapy moderately reduced nightmare frequency, distress, and psychopathology compared with treatment as usual, with effects largely sustained at 3-month follow-up. |
Abstract
Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is imagined during the day. However, the effects of IRT in a psychiatric population remain unknown. The aim of this study was to determine the effectiveness of IRT in a heterogeneous psychiatric population. Between January 2006 and July 2010, 90 patients with psychiatric disorders (DSM-IV-TR) were randomized to IRT or treatment-as-usual conditions. IRT consisted of 6 individual sessions added to the treatment as usual. Nightmare frequency was assessed using daily nightmare logs and the Nightmare Frequency Questionnaire. Nightmare distress was assessed using the Nightmare Distress Questionnaire and the Nightmare Effects Survey. General psychiatric symptoms were assessed using the Symptom Checklist-90 and a PTSD symptom questionnaire. Assessments were administered at the start of the trial, after the IRT and at follow-up 3 months later. IRT showed a moderate effect (Cohen d = 0.5-0.7, P < .05) on nightmare frequency, nightmare distress, and psychopathology measures compared with treatment as usual. These effects were largely sustained at the 3-month follow-up (Cohen d = 0.4-0.6, P < .10). IRT is an effective treatment for nightmares among patients with comorbid psychiatric disorders and can be employed in addition to the on-going treatment. ClinicalTrials.gov identifier: NCT00291031.
Comparable studies
Other randomized controlled trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 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 |
Citations in the library
Cited by 19
- Aetiology and treatment of nightmare disorder: State of the art and future perspectives Journal of Sleep Research January 29, 2019
- 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
- The Effectiveness of Dream Analysis in Reducing Idiopathic Nightmares by Hermeneutic Single Case Efficacy Design (HSCED) Journal of Qualitative Research in Health Sciences September 20, 2022
- Imagery Rehearsal Therapy (IRT) is associated with reduced nightmare severity and depressive, anxiety and suicidal symptoms in adults with Major Depressive Episode. International journal of clinical and health psychology : IJCHP 2026
and 14 more in the library
Cites 14
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- Prevalence of Nightmare Disorder in Psychiatric Outpatients Psychotherapy and Psychosomatics 2013
- Measuring nightmare and bad dream frequency: impact of retrospective and prospective instruments Journal of Sleep Research May 13, 2008
- Combat-related PTSD nightmares and imagery rehearsal: nightmare characteristics and relation to treatment outcome. Journal of Traumatic Stress October 1, 2012
and 9 more in the library