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Dreaming and mental health
Published in Josie Malinowski, The Psychology of Dreaming, 2020
The research for IRT is unequivocal – it works (Krakow & Zadra, 2006). Following a course of IRT, those suffering from nightmare disorder (with PTSD or not) have fewer disturbing nightmares and better sleep quality, and the effect is maintained long-term – even once the therapy has finished. Amazingly, it also reduces other symptoms of PTSD as well, those experienced during the daytime. How exactly this works is still unknown, but somehow, by changing a nightmare with waking imagination, PTSD sufferers can find relief from all of their symptoms.
Classification of sleep disorders
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
The REM-related parasomnias include RBD, recurrent isolated sleep paralysis (RISP), and nightmare disorder. RBD, which consists of repeated episodes of vocalizations and/or complex motor behaviors, requires the polysomnographic evidence of REM sleep without atonia.10 RISP is the recurrent inability to move the trunk and all of the limbs at sleep onset or upon awakening from sleep that causes distress or fear of sleep. Nightmare disorder consists of repeated occurrences of extended, extremely dysphoric and well-remembered dreams that usually involve threats to survival, security, or physical integrity that are associated with significant distress or psychosocial, occupational, or other areas of impaired functioning.
The Nightmare Quality of Life Questionnaire
Published in Behavioral Sleep Medicine, 2022
Ali A. El-Solh, Yolanda Lawson, Gregory E. Wilding
Opinions about the questionnaire were solicited as part of unstructured interviews with 20 patients with different degree of nightmare severity. The diagnosis of Nightmare Disorder was based on the DSM-5 criteria (American Psychiatric Association, 2013): 1) Recurrent episodes of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival or security or physical integrity, generally occurring in the second half of a major sleep episode; 2) Upon awakening from the nightmare, the individual rapidly becomes oriented and alert; 3) The episodes cause significant distress or impairment in social, occupational or other areas of functioning; 4) The nightmares cannot be explained by the effects of a drug of abuse or medication; and 5) The nightmares cannot be attributed to another mental disorder or medical condition. All patients completed the initial version of the instrument and evaluated it with regard to comprehensibility, relevance, acceptability, and feasibility. Patients’ responses were analyzed, and minor changes applied to the instrument. In consultation with the panel of experts, three items were added to cover more general daily activities and evening social activities. In addition, the instrument was supplemented by an additional question involving a subjective estimate of the frequency with which nightmares made it difficult to perform a 40-hour work week schedule.
Preliminary Findings of a Four-Session Psychoeducational Group for Combat-Related Posttraumatic Stress Disorder
Published in Military Behavioral Health, 2020
Jason D. Stolee, Tim Hoyt, Chauncy T. Brinton
The majority of participants were diagnosed by their referring provider (as reflected in the medical record) with PTSD (67%, n = 82), with a significant proportion (25%, n = 30) diagnosed with an unspecified anxiety disorder (i.e., sub-threshold PTSD symptoms), consistent with U.S. Army policy indicating that posttraumatic symptoms not reaching the full threshold for PTSD should be provided such a diagnosis (U.S. Army Medical Command, 2014). Eight other participants (6%) were diagnosed with other trauma-related disorders, and two participants (2%) were diagnosed with a trauma-related nightmare disorder. 72% of participants (n = 88) were in concurrent individual treatment during the course of the group sessions. “Concurrent” treatment was operationalized as a participant having had an encounter with a behavioral health therapist, a prescribing provider, or an additional group treatment at some point between the first and the last group session attended by the participant. Of the group participants in concurrent treatment, 85% (n = 75) attended at least one session of individual psychotherapy (M = 1.7, SD = 1.2), 27% (n = 24) attended at least one session for psychiatric medication management (M = .37, SD = .63), and 22% (n = 19) attended at least one session of a separate group intervention (M = .55, SD = 1.3). Taken together, those in concurrent treatment attended a mean of 2.6 (SD = 2.2) treatment sessions in addition to PTSD group attendance, with total encounters outside of group ranging from 1–14.
Treatment of Nightmares in Psychiatric Inpatients With Imagery Rehearsal Therapy: An Open Trial and Case Series
Published in Behavioral Sleep Medicine, 2019
Thomas E. Ellis, Katrina A. Rufino, Michael R. Nadorff
Both pharmacological and psychological therapies have been introduced to treat nightmare disorder (Aurora et al., 2010), although they are generally underutilized (Nadorff, Nadorff, & Germain, 2015). There is a substantial literature supporting several different treatments for nightmares, with prazosin (a sympatholytic drug typically used for high blood pressure and anxiety) and Imagery Rehearsal Therapy (IRT) having the strongest empirical support. (For recent reviews, see Augedal, Hansen, Kronhaug, Harvey, & Pallesen, 2013; Hansen, Höfling, Kröner-Borowik, Stangier, & Steil, 2013; Kung, Espinel, & Lapid, 2012; Nadorff, Lambdin, & Germain, 2014).