Combat-related PTSD nightmares and imagery rehearsal: nightmare characteristics and relation to treatment outcome.
Gerlinde C. Harb, Richard Thompson, Richard J Ross, Joan M. Cook
Journal of Traumatic Stress October 1, 2012 DOI: 10.1002/jts.21748 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 48 |
| Population | Male U.S. Vietnam war veterans with combat-related PTSD |
| Intervention | Imagery Rehearsal therapy |
| Topics | Dreaming PTSD |
| Key findings | Rescripted dreams that resolved the nightmare theme were associated with reduced sleep disturbance, while violent details in the rescripted dream and olfactory sensations in nightmares predicted poorer treatment outcome. |
Abstract
The characteristics of nightmares of 48 male U.S. Vietnam war veterans with combat-related posttraumatic stress disorder (PTSD), as well as revised dream scripts developed in the course of Imagery Rehearsal therapy, were examined in relation to pretreatment symptomatology and treatment outcome. Features, content, and themes of nightmares and rescripted dreams were coded by 2 independent raters. Nightmares were replete with scenes of death and violence and were predominantly replays of actual combat events in which the veteran was under attack and feared for his life. Although addressing or resolving the nightmare theme with rescripting was associated with a reduction in sleep disturbance, references to violence in the rescripted dream were related to poorer treatment outcome in nightmare frequency; B = 5.69 (SE = 1.14). The experience of olfactory sensations in nightmares, a possible index of nightmare intensity, was also related to poorer treatment response; B = 2.95 (SE = 1.06). Imagery rehearsal for individuals with severe, chronic PTSD and fairly replicative nightmares may be most effective when the rescripted dream incorporates a resolution of the nightmare theme and excludes violent details.
Comparable studies
Other observational and cohort studies on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder Women with chronic PTSD secondary to sexual assault | 2008 | Observational cohort | n = 6 |
| An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Treatment-seeking veterans, current serving military members, and emergency service... | 2017 | Observational study using ambulatory polysomnography | n = 35 |
| Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Female sexual assault survivors with chronic nightmares | 2004 | Observational cohort | n = 44 |
| Posttraumatic stress symptoms following near-death experiences. Persons who report near-death experiences and those who came close to death without NDEs | 2001 | Observational study | |
| Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD | 2018 | Retrospective review | n = 37 |
Citations in the library
Cited by 20
- My Dream, My Rules: Can Lucid Dreaming Treat Nightmares? Frontiers in Psychology 2019
- The nature of posttraumatic nightmares and school functioning in war-affected youth PLoS One November 25, 2020
- 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
and 15 more in the library
Cites 10
- The relationship of nightmare frequency and nightmare distress to well‐being Journal of Sleep Research May 26, 2004
- Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Dreaming December 1, 2004
- Post-Traumatic Stress Disorder Nightmares and Sleep Disturbance in Iraq War Veterans: A Feasible and Promising Treatment Combination Journal of Aggression Maltreatment & Trauma July 23, 2009
- Imagery rehearsal for posttraumatic nightmares: A randomized controlled trial Journal of Traumatic Stress October 1, 2010
- Dreaming in posttraumatic stress disorder: A critical review of phenomenology, psychophysiology and treatment. Psychotherapy and Psychosomatics 2007
and 5 more in the library