The phenomenology of nightmares in post-traumatic stress disorder and complex post-traumatic stress disorder
European Journal of Trauma & Dissociation June 30, 2023 DOI: 10.1016/j.ejtd.2023.100335 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 398 |
| Population | Adults who reported experiencing a lifetime trauma |
| Topics | Dreaming Philosophy of mind PTSD |
| Citations | 10 |
| Key findings | Nightmare characteristics such as frequency of awakenings, severity, impact on wellbeing, and perceived realism were associated with more severe PTSD and CPTSD symptoms. Increased nightmare frequency, vividness, and emotional intensity predicted more severe PTSD symptoms but not CPTSD symptoms, suggesting other factors may better predict CPTSD symptom severity. |
Abstract
Nightmares are a re-experiencing symptom of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). They are intrusive, involuntary and have a significant impact on wellbeing, suggesting they have substantial clinical relevance. However, little is known about the phenomenological features of post-traumatic nightmares and how they impact the severity of PTSD and CPTSD symptoms. Participants (N=398) who identified they had experienced a lifetime trauma completed various self-report questionnaires related to PTSD symptoms, CPTSD symptoms and nightmare characteristics. Participants also described their sensory experiences and rated the emotional intensity and vividness of their post-traumatic nightmares. We found that elevated scores on various characteristics of nightmares including frequency of awakenings, nightmare severity, impact on wellbeing and the perceived realism of the nightmare were linked to more severe PTSD and CPTSD symptoms. Further, increased frequency, vividness, and emotional intensity of nightmares significantly predicted more severe PTSD symptoms but not CPTSD symptoms. Our study was largely exploratory and was the first to identify that specific nightmare features are related to PTSD and CPTSD symptom severity. However, although nightmare features of frequency, vividness and intensity appear to be related to CPTSD symptom severity, other variables may better predict CPTSD symptoms. Possible explanations for our findings, implications for treatment and directions for future research are discussed.
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 5
- Psychometric Properties of the Nightmare Distress Questionnaire in Veterans with Posttraumatic Nightmares Behavioral Sleep Medicine September 12, 2026
- Nightmares, Dream Engineering, and Evolutionary Thresholds of Dysfunction Psychology International July 24, 2026
- Temporal associations between nightmares and PTSD symptoms in the acute post-sexual assault period: An ecological momentary assessment study Journal of Mood and Anxiety Disorders July 10, 2026
- Enhancing primary care detection and referral of nightmare disorder: a quality improvement initiative : Journal name: Sleep and Breathing. Sleep & Breathing June 26, 2026
- Enhancing identification and diagnosis of nightmare disorder in active duty patients at a sleep disorders center: A quality improvement initiative. Journal of Clinical Sleep Medicine January 22, 2026
Cites 10
- Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Sleep June 1, 2010
- An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Sleep November 21, 2017
- Psychometric properties of the Disturbing Dream and Nightmare Severity Index-Korean version. Journal of Clinical Sleep Medicine March 1, 2021
- Management of nightmares in patients with posttraumatic stress disorder: current perspectives. Nature and Science of Sleep November 26, 2018
- Nightmares as predictors of suicide: an extension study including war veterans. Scientific Reports March 15, 2017
and 5 more in the library