Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD

Thünker, Johanna; Pietrowsky, Reinhard

doi:10.1016/j.brat.2012.05.006

Cited by 61 publications

(69 citation statements)

References 28 publications

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“…This might be a confounder regarding the findings as patients with mental disorders suffer quite often from a co-morbid nightmare disorder 20 , even though one might argue that we asked specifically for seeking help for nightmares, and there is no reason why patients with mood or anxiety disorders should seek explicitly help for nightmares and not for their mental disorder. A recent study 21 showed that imagery rehearsal is very effective in depressed patients with a co-morbid nightmare disorder.…”

Section: Discussionmentioning

confidence: 99%

Seeking professional help for nightmares: a representative study

Schredl

2013

Eur. J. Psychiat.

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GERMANYABSTRACT -Background and Objectives: Nightmares are defined as disturbing mental experiences that generally occur during REM sleep and often result in awakening. Even though about 5% of the general population suffers from nightmares, little is known about seeking professional help in this patient group.Methods: A quota sample of 2019 participants representative for the German population was studied.Results: The findings indicate that every eighth person with frequent nightmares (cutoff: every other week or more often) sought at one time of his/her life for professional help for coping with nightmares. Socio-demographic variables did not correlate with helpseeking behavior.Conclusions: Nightmares are an undertreated condition and future studies should aim at a more throughout understanding why nightmare sufferers rarely seek help for their condition.

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Section: Discussionmentioning

confidence: 99%

Seeking professional help for nightmares: a representative study

Schredl

2013

Eur. J. Psychiat.

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“…Table 1 presents descriptive characteristics for each study included in the meta-analysis, ordered by publication year. Of these, there are 4 pharmacological trials including prazosin, [24][25][26][27] 10 studies including IRT, either alone or combined with another form of psychological intervention, [28][29][30][31][32][33][34][35][36][37] and one study comprising both IRT and prazosin interventions administered to 2 groups randomly assigned to these treatments. 38 All studies were published between 2000 and 2013.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…37 In another study, sleep quality and PTSS were not included as treatment outcomes. 36 In studies where there was more than one nightmare measure, we selected the number of nights per week with nightmares as the primary nightmare outcome. 30,31,34,37,38 If this information was not available, we then used one of the following: nights with nightmares per month or number of nightmares per week/ month.…”

Section: Total Of 21 Recordsmentioning

confidence: 99%

“…30,31,34,37,38 If this information was not available, we then used one of the following: nights with nightmares per month or number of nightmares per week/ month. 25,28,29,32,33,35,36 In 3 studies, 24,26,27 nightmare outcomes were solely assessed with the item on the Clinician-Administered PTSD Scale (CAPS) "Recurrent distressing dreams." 39 This nightmare-related outcome combines nightmare frequency and nightmare intensity within the same score, which can range from 0 to 8 points.…”

Section: Total Of 21 Recordsmentioning

confidence: 99%

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Comparative Meta-Analysis of Prazosin and Imagery Rehearsal Therapy for Nightmare Frequency, Sleep Quality, and Posttraumatic Stress

Seda

Sánchez-Ortuño

Welsh

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objective:In this meta-analysis, we compare the shortterm effi cacy of prazosin vs. IRT on nightmares, sleep quality, and posttraumatic stress symptoms (PTSS). Methods: Reference databases were searched for randomized controlled trials using IRT or prazosin for nightmares, sleep disturbance, and/or PTSS. Effect sizes were calculated by subtracting the mean posttest score in the control group from the mean posttest score in the treatment group, and dividing the result by the pooled standard deviation of both groups. Mixed effects models were performed to evaluate effects of treatment characteristics, as well as sample characteristics (veteran vs. civilian) on treatment effi cacy. Results: Four studies used prazosin, 10 used IRT alone or in combination with another psychological treatment, and 1 included a group receiving prazosin and another group receiving IRT. Overall effect sizes of both treatments were of moderate magnitude for nightmare frequency, sleep quality, and PTSS (p < 0.01). Effect size was not signifi cantly different with type of treatment (psychological vs. pharmacological However, when these frightening dreams occur in a recurrent fashion, the nightmare activity may constitute a disorder. In fact, nightmare disorder is listed in both the DSM-5 and in the ICSD-3 as a distinct disorder whose essential features are the presence of repeated negative dreams that lead to awakening, such that the individual becomes fully alert and aware of his or her surroundings. 2,3Nightmares can have an idiopathic origin or may occur after traumatic events. 4 Along with other sleep disturbances (e.g., insomnia and poor sleep quality), 5 nightmares are a typical symptom of posttraumatic stress disorder (PTSD). 6 Indeed, it has been estimated that around 70% of individuals with PTSD report posttraumatic nightmares. 7,8 Nonetheless, nightmares are not exclusive to PTSD, since they are also associated with anxiety and depression, among other mental health comorbidities. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Imagery rehearsal therapy (IRT) and prazosin are both used for treatment of nightmares in posttraumatic stress. The main aim of this study was a comparative meta-analysis of each treatment on nightmare frequency, sleep quality, and posttraumatic stress disorder symptoms. Study Impact: IRT and prazosin had similar effects for nightmare frequency, sleep quality, and posttraumatic stress disorder symptoms; however, adding cognitive-behavior therapy for insomnia to IRT enhanced its effects for improving sleep quality as well as posttraumatic stress disorder symptoms.

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“…Afterwards the revised dream (which should no longer be a nightmare) is rehearsed through imagination [18]. For the present study, we developed an internet-based IRT intervention based on a manualized and evaluated IRT treatment program [19]. Recently, a large number of internet-based intervention trials have been published demonstrating its efficacy, including posttraumatic stress disorder [20,21] and insomnia [22,23,24].…”

Section: Introductionmentioning

confidence: 99%

The Effects of an Internet-Based Imagery Rehearsal Intervention: A Randomized Controlled Trial

Gieselmann

Böckermann

Sorbi

et al. 2017

Psychother Psychosom

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Background: Nightmares are extremely dysphoric dreams, which are prevalent and associated with psychological strain. This study investigated (a) the efficacy of an internet-based imagery rehearsal therapy (IRT), (b) the role of imagery rescription, and (c) the role of guidance during internet-based IRT. Methods: A total of 127 patients suffering from mainly idiopathic nightmares were randomly assigned to 1 of 2 IRT internet-based groups (guided IRT; unguided IRT) or to 1 of 2 active control groups (frequency control group; narrative control group). Results: IRT was more effective than a nightmare frequency control condition with respect to nightmare frequency and nightmare distress. Compared to the narrative control group, IRT was only superior in improving nightmare distress but not in nightmare frequency because the narrative control group also improved regarding nightmare frequency. Guidance by a nightmare coach did not affect efficacy, compliance, or dropout. Conclusion: Internet-based IRT seems to be an effective treatment even when offered with minimal guidance by a nightmare coach. Describing the nightmare narrative in detail already decreased nightmare frequency. However, with regard to inducing decreases in nightmare frequency and nightmare distress, IRT was superior to the narrative control group. The results are discussed with reference to the mastery hypothesis.

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Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD

Cited by 61 publications

References 28 publications

Seeking professional help for nightmares: a representative study

Seeking professional help for nightmares: a representative study

Comparative Meta-Analysis of Prazosin and Imagery Rehearsal Therapy for Nightmare Frequency, Sleep Quality, and Posttraumatic Stress

The Effects of an Internet-Based Imagery Rehearsal Intervention: A Randomized Controlled Trial

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