Imagery Rescripting and Imaginal Exposure in Nightmare Disorder Compared to Positive Imagery: A Randomized Controlled...

Area of Science:

• Psychology
• Clinical Psychology
• Sleep Medicine

Background:

• Imagery rescripting and imaginal exposure are effective for chronic nightmares compared to waitlist conditions.
• Comparative efficacy and effectiveness against active controls for these nightmare treatments are not well understood.

Purpose of the Study:

• Compare imagery rescripting and imaginal exposure to each other and to positive imagery (active control).
• Explore factors influencing treatment effectiveness for nightmare disorder.

Main Methods:

• Single-blind randomized controlled trial with 96 patients diagnosed with nightmare disorder.
• Participants received one session of imagery rescripting, imaginal exposure, or positive imagery, followed by 4 weeks of home practice.
• Primary outcome: nightmare distress. Secondary outcomes: nightmare frequency, effects, self-efficacy, and general psychopathology.

Main Results:

• All treatments significantly reduced nightmare distress, frequency, and psychopathology, and enhanced self-efficacy.
• No significant differences were found between imagery rescripting, imaginal exposure, and positive imagery on any outcome measure.
• Treatment outcomes were not associated with demographic factors, baseline characteristics, treatment credibility, or practice adherence.

Conclusions:

• Short-term nightmare treatments, including imagery rescripting, imaginal exposure, and positive imagery, are effective regardless of patient characteristics.
• Different interventions yield comparable results for nightmare disorder.
• Healthcare providers should increase the utilization of these accessible and potent nightmare treatments.