Imagery Rescripting for Fear Associated with Bad Dreams in Japanese Children: A Web-Based Pilot Study

Abstract

Nightmares are distressing sleep experiences associated with emotional difficulties, impaired daytime functioning, and reduced sleep quality. Although imagery rescripting (IR) has demonstrated effectiveness in reducing nightmare-related distress among adults, evidence regarding its applicability in children remains limited, particularly in Japan. IR is thought to operate, at least in part, by enabling individuals to actively modify threatening imagery and thereby enhance a sense of mastery or perceived control over distressing dream experiences. Although developmental factors may influence how children engage with this process, current evidence does not establish that the fundamental mechanism of IR differs substantially between children and adults. This pilot study examined immediate changes in self-reported fear associated with recalled bad dreams following a brief web-based imagery-rescripting procedure in non-clinical Japanese elementary school children and explored children’s rescripting strategies. Participants were thirty-five fourth- and sixth-grade students (aged 9–12 years) recruited from public elementary schools in Japan. Using a web-based procedure, participants recalled a safe image, described a memorable bad dream, rated its fear intensity, rescripted the dream, and then re-rated fear intensity. Among the 23 participants with complete pre- and post-task ratings, self-reported fear was significantly lower after the procedure than before it. Subgroup patterns according to rescripting status and rescripting strategy were examined descriptively. These findings indicate that self-reported fear associated with recalled bad dreams decreased immediately following the procedure. Further research using larger samples and controlled designs is needed to determine the specific contribution of imagery rescripting and the durability and clinical relevance of these changes.