A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: A preliminary report

• Published in: Journal of traumatic stress Vol. 13; no. 4; pp. 589 - 609
• Main Authors: Krakow, Barry, Hollifield, Michael, Schrader, Ron, Koss, Mary, Tandberg, Dan, Lauriello, John, McBride, Leslie, Warner, Teddy D., Cheng, Diana, Edmond, Tonya, Kellner, Robert
• Format: Journal Article
• Language: English
• Published: Germantown Periodicals Service Company 01-10-2000; Wiley; Wiley Subscription Services, Inc
• Subjects: Adult; Behavior therapy. Cognitive therapy; Biological and medical sciences; Chronic Disease; Dreams - psychology; Female; Follow-Up Studies; Humans; Imagery (Psychotherapy) - methods; Male; Medical sciences; Periodicity; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sex Offenses - psychology; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - etiology; Sleep Wake Disorders - psychology; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - therapy; Surveys and Questionnaires; Survival Rate; Treatments; Short term; Human; Cognitive therapy; Posttraumatic syndrome; Treatment efficiency; Anxiety disorder; Restructuration; Group psychotherapy; Victimology; Imagery; Stress; Symptomatology; Chronic; Sleep; Treatment; Follow up study; Female; Sexual abuse; Nightmare; Diagnosis
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1023/A:1007854015481

Imagery‐rehearsal therapy for chronic nightmares was assessed in a randomized, controlled study of sexual assault survivors with posttraumatic stress disorder (PTSD). Nightmares, sleep quality, and PTSD were assessed at baseline for 169 women, who were randomized into two groups: treatment (n = 87) and wait‐list control (n = 82). Treatment consisted of two 3‐hr sessions and one 1‐hr session conducted over 5 weeks. Of 169 participants, 91 women (Treatment, n = 43, Control, n = 48) completed a 3‐month follow‐up and 78 did not. At follow‐up, nightmare frequency and PTSD severity decreased and sleep quality improved in the treatment group with small to minimal changes in the control group. Treatment effects were moderate to high (Cohen's d ranged from 0.57 to 1.26). Notwithstanding the large dropout rate, imagery‐rehearsal therapy is an effective treatment for chronic nightmares in sexual assault survivors with PTSD and is associated with improvement in sleep quality and decreases in PTSD severity.