DARC-NESS: a mastery-based cognitive-behavioral model for treating chronic nightmares in youth

Area of Science:

• Psychology
• Sleep Medicine
• Clinical Psychology

Background:

• Chronic nightmares are often maintained by dysfunctional beliefs, anxiety, poor sleep habits, and sleep deprivation.
• Existing theories suggest self-efficacy plays a role in mitigating nightmares.
• A comprehensive model is needed to explain nightmare maintenance and guide treatment.

Purpose of the Study:

• Introduce the DARC-NESS theory of nightmare maintenance.
• Emphasize nightmare self-efficacy as a central mechanism.
• Provide a theoretical framework for cognitive behavioral therapy (CBT) for child nightmares.

Main Methods:

• The DARC-NESS model is presented as a mnemonic for its components: Dream content, Appraisals, Resources for regulation, Conditioned arousal, Nightmare Efficacy, Sleep hygiene and patterns, and Sleep quality and quantity.
• Treatment counterparts for each component are proposed.
• A case illustration demonstrates the application of these interventions.

Main Results:

• The DARC-NESS model integrates multiple factors contributing to nightmare maintenance.
• Nightmare self-efficacy is identified as a crucial factor influencing the maintenance cycle.
• The proposed interventions show potential in disrupting the cycle of chronic nightmares.

Conclusions:

• The DARC-NESS model offers a comprehensive understanding of nightmare maintenance.
• Targeting specific components of the DARC-NESS model can effectively treat chronic nightmares.
• Flexible, modular interventions can be tailored to individual patient needs.