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

TLDR

The study evaluated the effectiveness of imagery‑rehearsal therapy for chronic nightmares in sexual assault survivors with PTSD. A randomized controlled trial with 169 women assigned to a 5‑week, three‑session imagery‑rehearsal program or wait‑list control, with 3‑month follow‑up of 91 completers. At 3‑month follow‑up, the treatment group showed significant reductions in nightmare frequency, PTSD severity, and improvements in sleep quality, with moderate to large effect sizes (Cohen's d 0.57–1.26), confirming the therapy’s efficacy despite high dropout.

Abstract

Abstract 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.