Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fear

J Clin Psychol. 2010 Apr;66(4):365-82. doi: 10.1002/jclp.20656.

Abstract

Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Chronic Disease
  • Cognitive Behavioral Therapy / methods*
  • Depression / physiopathology
  • Depression / psychology
  • Dreams / physiology*
  • Dreams / psychology
  • Fear / physiology
  • Fear / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Physiologic
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / physiopathology*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Stress, Psychological / physiopathology*
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome