The Role of Executive Function in Predicting Children's Outcomes in a Cognitive Behavioral Treatment for Trauma-Related Nightmares and Secondary Sleep Disturbances.
Mollie E Rischard, Lisa D Cromer
Journal of Child & Adolescent Trauma March 2, 2019 DOI: 10.1007/s40653-019-00252-6 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational pre-post treatment study Peer reviewed |
|---|---|
| Sample size | 23 |
| Population | Children aged 5 to 17 presenting with post-traumatic nightmares |
| Topics | Dreaming |
| Keywords | Sleep Treatment outcome Nightmares Predictors Executive function |
| Key findings | Executive function was not a statistically significant predictor of treatment outcomes for nightmare frequency and distress, sleep quality, or PTSD symptoms, though effect sizes suggested it was a moderate predictor of sleep quality outcomes. The authors propose that treatment duration could be tailored to executive function, with briefer interventions for children with high EF and longer protocols for those with low EF. |
Abstract
Predictors of children's outcomes in trauma-focused interventions are well documented. However, little is known about the role of higher-order cognitive processes, specifically executive function (EF) abilities, in determining children's responses to treatments specifically for trauma-related sleep disturbances. EF is independently related to PTSD reactions, sleep deficits, and nightmares. Furthermore, well-developed EF can be protective; thus, we sought to examine whether higher EF predicted better treatment outcomes for trauma-related sleep disturbances. Twenty-three children aged 5 to 17 presenting with post-traumatic nightmares (PTNs) participated in a cognitive behavioral therapy to address their trauma-related nightmares (CBT-NC). Pre- and post-treatment data were used in analyses. Findings from discriminant function analyses revealed that EF was not a statistically significant predictor of treatment outcomes across indices of nightmare frequency and distress, sleep quality, and PTSD symptomology. However, effect sizes suggested that EF was a moderate predictor of sleep quality outcomes, which has clinical implications. Treatment duration for sleep problems could be related to EF with briefer interventions being more suitable for children with high EF, whereas children with low EF may benefit from longer treatment protocols.
Comparable studies
Other non-randomized and open-label trials on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A combined group treatment for nightmares and insomnia in combat veterans: A pilot study Combat veterans with PTSD | 2009 | Open clinical trial | n = 10 |
| Cognitions in Sleep: Lucid Dreaming as an Intervention for Nightmares in Patients With Posttraumatic Stress Disorder. Patients suffering from posttraumatic stress disorder (PTSD) | 2020 | Pre-post intervention study | |
| Managing Insomnia Using Lucid Dreaming Training: A Pilot Study. Adults with Insomnia Disorder | 2021 | Open-label trial | n = 48 |
| Dream content and political ideology. U.S. adults who identified as members of the political right or political left (28 per... | 2002 | Pilot study | n = 56 |
| Imagery rehearsal therapy for the treatment of nightmares in individuals with borderline personality disorder – A pilot study Individuals with borderline personality disorder | 2024 | Between-subjects design, pilot study | n = 44 |
Citations in the library
Cites 3
- Impaired executive functions in subjects with frequent nightmares as reflected by performance in different neuropsychological tasks. Brain and Cognition April 1, 2012
- Physiological predictors of response to exposure, relaxation, and rescripting therapy for chronic nightmares in a randomized clinical trial. Journal of Clinical Sleep Medicine December 1, 2011
- Nightmares: from anxiety symptom to sleep disorder. Sleep Medicine Reviews February 1, 2006