Abstract
Posttraumatic nightmares are a hallmark of PTSD and distinct from general nightmares as they are often repetitive and faithful representations of the traumatic event. This paper presents data from a pilot study that examined the use of Imagery Rehearsal in treating combat-related nightmares of 12 Vietnam veterans with PTSD. Three treatment groups, comprising 4 veterans in each, completed standardised treatment across 6 sessions. Treatment effects were investigated using nightmare diaries and established instruments, including the IES-R, BDI, BAI, and SCL-90-R. The data demonstrate significant reductions in nightmares targeted, and improvements in PTSD and comorbid symptomatology. The paper recommends that, on the basis of the promising preliminary data, a randomised control trial be established to assess imagery ability and attidude toward nightmares.
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Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Blake, D. D., Weathers, F., Nagy, L. M., Kaloupek, D. G., Klauminzer, G., Chamey, D. S., & Keane, T. M. (1995). The development of a clinician administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.
Bryant, R. A., & Harvey, A. G. (1996). Visual imagery in posttraumatic stress disorder. Journal of Traumatic Stress, 9, 613–619.
Celluci, A., & Lawrence, P. (1978). The efficiency of systematic desensitization in reducing nightmares. Journal of Behavior Therapy and Experimental Psychiatry, 9, 109–114.
Coalson, B. (1995). Nightmare help: Treatment of trauma survivors with PTSD. Psychotherapy, 32, 381–388.
Creamer, M., Morris, P., Biddle, D., & Elliott, P. (1999). Treatment outcome in Australian veterans with combat-related posttraumatic stress disorder: A cause for cautious optimism? Journal of Traumatic Stress, 12, 545–558.
Derogatis, L. R. (1994). SCL-90-R administration, scoring, and procedures manual (3rd ed.). Minneapolis: National Computer Systems.
Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualisations of posttraumatic stress disorder. Behavior Therapy, 20, 155–176.
Fontana, A., & Rosenhenck, R. (1997). Effectiveness and cost of the inpatient treatment of PTSD: Comparison of three models of treatment. American Journal of Psychiatry, 154, 758–765.
Halliday, G. (1987). Direct psychological therapies for nightmares: A review. Clinical Psychology Review, 7, 501–523.
Hartmann, E. (1996). Who develops PTSD nightmares and who doesn't. In D. Barrett (Ed.), Trauma and dreams (pp. 101–113). Cambridge, MA: Harvard University Press.
Kellner, R., Singh, G., & Irigoyen-Rascon, F. (1991). Rehearsal in the treatment of recurring nightmares in posttraumatic stress disorders and panic disorder: Case histories. Annals of Clinical Psychiatry, 3(1), 67–71.
Krakow, B., Germain, A., Tandberg, D., Koss, M., Schrader, R., Hollifield, M., Cheg, D., & Edmond, T. (1996). Long term reduction in nightmares with imagery rehearsal treatment. Behavioural and Cognitive Psychotherapy, 24, 135–148.
Krakow, B., Kellner, R., Neidhardt, J., Pathak, D., & Lambert, L. (1993). Imagery rehearsal treatment of chronic nightmares: With a 30 month followup. Journal of Behavior Therapy and Experimental Psychiatry, 24, 325–330.
Krakow, B., Kellner, R., Pathak, D., & Lambert, L. (1995). Imagery rehearsal treatment of chronic nightmares. Behavior Research and Therapy, 33, 837–843.
Krakow, B., McBride, L., Hollifield, M., Schrader, R., Yau, C. L., & Tandberg, D. (1996). Treatment of chronic nightmares in sexual assault survivors. Sleep Research, 25, 137.
Krakow, B., Tandberg, D., Cutchen, L., McBride, L., Hollifield, M., Lauriello, J., Schrader, R., Yau, C. L., & Cheng, D. T. (1997). Imagery rehearsal treatment of chronic nightmares in PTSD: A controlled study. Sleep Research, 26, 245.
Laor, N., Wolmer, L., Wiener, Z., Sharon, O., Weizman, R., Toren, P., & Ron, S. (1999). Image vividness as a psychophysiological regulator in posttraumatic stress disorder. Journal of Clinical and Experimental Neuropsychology, 21, 39–48.
Marks, I. (1978). Rehearsal relief of a nightmare. The British Journal of Psychiatry, 133, 461–465.
Miller, W., & Di Palato, M. (1983). Treatment of nightmares via relaxation and desensitization: A controlled evaluation. Journal of Consulting and Clinical Psychology, 51, 870–877.
Spiegel, D., Hunt, T., & Dondershine, H. E. (1988). Dissociation and hypnotizability in posttraumatic stress disorder. American Journal of Psychiatry, 145, 301–305.
Thompson, K., Hamilton, M., & West, J. (1995). Group treatment for nightmares in veterans with combat-related PTSD. National Center for PTSD Clinical Quarterly (Fall), 13–17.
van der Kolk, B., Blitz, R., Burr, W., Sherry, S., & Hartmann, E. (1984). Nightmares and trauma: A comparison of nightmares after combat with lifelong nightmares in veterans. American Journal of Psychiatry, 141, 187–190.
Weiss, D. S., & Marmar, C. R. (1997). The impact of event scale—revised. In J. P. Wilson, & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). New York: Guilford Press.
Wood, J. M., & Bootzin, R. R. (1990). The prevalence of nightmares and their independence from anxiety. Journal of Abnormal Psychology, 99, 64–68.
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Forbes, D., Phelps, A. & McHugh, T. Brief Report: Treatment of Combat-Related Nightmares Using Imagery Rehearsal: A Pilot Study. J Trauma Stress 14, 433–442 (2001). https://doi.org/10.1023/A:1011133422340
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DOI: https://doi.org/10.1023/A:1011133422340