Abstract
Nightmares are often a distressing symptom for veterans with chronic combat-related posttraumatic stress disorder (PTSD). A psychological treatment that has recently shown considerable promise is Imagery Rehearsal Therapy (IRT). In a pilot study by the current authors, IRT was demonstrated to be effective in the treatment of posttraumatic nightmares in a group of combat veterans up to 3-month posttreatment. This study reports the 12-month follow-up data of the pilot study, examining the longer term outcome of the IRT treatment. Twelve Australian Vietnam veterans with chronic combat-related PTSD were treated with 6 once weekly sessions of imagery rehearsal and assessed using standardised measures of nightmare frequency and intensity, PTSD, depression, anxiety and broader symptomatology at intake, posttreatment, and 3-and 12-month follow-up. Significant improvements in targeted nightmare frequency and intensity were evident to 12-month posttreatment. Similarly, improvements in overall PTSD, depression, anxiety, and broader based symptomatology were also maintained to 12 months. This study provides preliminary evidence that the positive treatment effects of IRT on posttraumatic nightmares, PTSD, and broader symptomatology in males with chronic combat-related PTSD are maintained in the longer term.
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References
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.
Blake, D. D., Weathers, F., Nagy, L. M., Kaloupek, D. G., Klauminzer, G., Charney, D. S., et al. (1995). The development of a clinician administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.
Brannon, N., Labbate, L., & Huber, M. (2000). Gabapentin treatment for posttraumatic stress disorder. Canadian Journal of Psychiatry, 45(1), 84.
Clark, R. D., Canive, J. M., Calais, L. A., Qualls, C., Brugger, R. D., & Vosburgh, T. B. (1999). Cyproheptadine treatment for nightmares associated with posttraumatic stress disorder. Journal of Clinical Psychopharmacology, 19, 486–487.
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.
Davidson, J. R. T., Weisler, R. H., Malik, M. L., & Connor, K. M. (1998). Treatment of posttraumatic stress disorder with nefazodone. International Clinical Psychopharmacology, 13(3), 111–113.
Derogatis, L. (1977). SCL-R-90 Version: Manual-I. Baltimore: John Hopkins University Press.
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.
Forbes, D., Creamer, M., & Biddle, D. (2001). The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD. Behavior Research and Therapy, 39, 977–986.
Forbes, D., Phelps, A. J., & McHugh, A. F. (2001). Imagery rehearsal in the treatment of posttraumatic nightmares in combat-related PTSD. Journal of Traumatic Stress, 14, 433–442.
Friedman, M. J. (1997). Drug treatment for PTSD: Answers and questions. Annals of the New York Academy of Sciences, 821, 359–371.
Gillin, J. C., Smith-Vaniz, A., Schnierow, B., Rapaport, M. H., Kelsoe, J., Raimo, E., et al. (2001). An open-label, 12 week clinical and sleep EEG study of nefazodone in chronic combat-related posttraumatic stress disorder. Journal of Clinical Psychiatry, 62(10), 789–796.
Gupta, S., Popli, A., Bathurst, E., Hennig, L., Droney, T., & Keller, P. (1998). Efficacy of cyproheptadine for nightmares associated with posttraumatic stress disorder. Comprehensive Psychiatry, 39, 160–164.
Jacobs-Rebhun, S., Schnurr, P. P., Friedman, M. J., Peck, R., Brophy, M., & Fuller, D. (2000). Posttraumatic stress disorder and sleep difficulty. American Journal of Psychiatry, 157, 1525–1526.
Krakow, B., Hollifield, M., Johnston, L., Koss, M., Schrader, R., Warner, T. D., et al. (2001). Imagery rehearsal for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: A randomized trial. JAMA, 286, 537–545.
Krakow, B., Hollifield, M., Schrader, R., Koss, M., Tandberg, D., Lauriello, J., et al. (2000). A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: A preliminary report. Journal of Traumatic Stress, 13(4), 589–609.
Krakow, B., Johnston, L., Melendrez, D., Hollifield, M., Warner, T. D., Chavez-Kennedy, D., et al. (2001). An open label trial of evidence based cognitive behavior therapy for nightmares and insomnia for crime victims with PTSD. Amercian Journal of Psychiatry, 158(12), 2043–2047.
O'Toole, B. I., Marshall, R. P., Grayson, D. A., Schureck, R. J., Dobson, M., French, M., et al. (1996). The Australian Vietnam veterans health study: III. Psychological health of Australian Vietnam veterans and its relationship to combat. International Journal of Epidemiology, 25, 331–339.
Taylor, F., & Raskind, M. A. (2002). The alpha-sub-1-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder. Journal of Clinical Psychopharmacology, 22(1), 82–85.
Thompson, K., Hamilton, M., & West, J. (1995). Group treatment for nightmares in veterans with combat-related PTSD. National Centre for PTSD Clinical Quarterly (Fall), 13–17.
Weiss, D., & Marmar, C. (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.
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Forbes, D., Phelps, A.J., McHugh, A.F. et al. Imagery Rehearsal in the Treatment of Posttraumatic Nightmares in Australian Veterans with Chronic Combat-Related PTSD: 12-Month Follow-Up Data. J Trauma Stress 16, 509–513 (2003). https://doi.org/10.1023/A:1025718830026
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DOI: https://doi.org/10.1023/A:1025718830026