Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares

Kristi E. Pruiksma, Christopher Cranston, Jamie L. Rhudy, Rachel L. Micol, Joanne L. Davis

Research output: Contribution to journalArticle

Abstract

Objective: The aim of this study was to conduct a preliminary dismantling study of exposure, relaxation, and rescripting therapy (ERRT) for nightmares. Method: Participants (N = 70) were randomized to 1 of 2 conditions: ERRT with nightmare exposure and rescripting (full protocol; EX) or ERRT without nightmare exposure and rescripting (NEX). Participants completed follow-ups at 1 week, 3 months, and 6 months posttreatment. Results: Both conditions yielded statistically significant improvements with medium to large effect sizes on primary outcomes related to nightmares (i.e., nights with nightmares, nightmares per week, and nightmare severity). Both conditions also yielded statistically significant improvements on secondary outcomes with medium to large effect sizes on fear of sleep, sleep quality, insomnia severity, daytime sleepiness, posttraumatic stress disorder symptom severity, and depression severity. The conditions did not differ at any time point. Conclusions: Findings indicate that ERRT with and without nightmare exposure and rescripting can significantly alleviate nightmares and related distress. The addition of nightmare exposure and rescription did not contribute incrementally to outcomes in this sample. It is possible that the dose of exposure was not sufficient to result in group differences or that the treatment components included in both conditions (i.e., psychoeducation about trauma, nightmares, and sleep; sleep habit modification; and relaxation training) may adequately treat factors that maintain nightmares for some individuals. Theoretical implications of findings are discussed. The reduction of symptoms of other conditions following this brief intervention provides further evidence for the primary role of nightmares and sleep disturbances posttrauma.

Original languageEnglish (US)
Pages (from-to)67-75
Number of pages9
JournalPsychological Trauma: Theory, Research, Practice, and Policy
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Relaxation Therapy
Randomized Controlled Trials
Wounds and Injuries
Sleep
Sleep Initiation and Maintenance Disorders
Post-Traumatic Stress Disorders
Habits
Fear

Keywords

  • Exposure
  • Imagery rehearsal
  • Nightmares
  • Rescripting
  • Trauma

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology

Cite this

Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares. / Pruiksma, Kristi E.; Cranston, Christopher; Rhudy, Jamie L.; Micol, Rachel L.; Davis, Joanne L.

In: Psychological Trauma: Theory, Research, Practice, and Policy, Vol. 10, No. 1, 01.01.2018, p. 67-75.

Research output: Contribution to journalArticle

@article{2de3a3101cf84908a4b7d8324e089329,
title = "Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares",
abstract = "Objective: The aim of this study was to conduct a preliminary dismantling study of exposure, relaxation, and rescripting therapy (ERRT) for nightmares. Method: Participants (N = 70) were randomized to 1 of 2 conditions: ERRT with nightmare exposure and rescripting (full protocol; EX) or ERRT without nightmare exposure and rescripting (NEX). Participants completed follow-ups at 1 week, 3 months, and 6 months posttreatment. Results: Both conditions yielded statistically significant improvements with medium to large effect sizes on primary outcomes related to nightmares (i.e., nights with nightmares, nightmares per week, and nightmare severity). Both conditions also yielded statistically significant improvements on secondary outcomes with medium to large effect sizes on fear of sleep, sleep quality, insomnia severity, daytime sleepiness, posttraumatic stress disorder symptom severity, and depression severity. The conditions did not differ at any time point. Conclusions: Findings indicate that ERRT with and without nightmare exposure and rescripting can significantly alleviate nightmares and related distress. The addition of nightmare exposure and rescription did not contribute incrementally to outcomes in this sample. It is possible that the dose of exposure was not sufficient to result in group differences or that the treatment components included in both conditions (i.e., psychoeducation about trauma, nightmares, and sleep; sleep habit modification; and relaxation training) may adequately treat factors that maintain nightmares for some individuals. Theoretical implications of findings are discussed. The reduction of symptoms of other conditions following this brief intervention provides further evidence for the primary role of nightmares and sleep disturbances posttrauma.",
keywords = "Exposure, Imagery rehearsal, Nightmares, Rescripting, Trauma",
author = "Pruiksma, {Kristi E.} and Christopher Cranston and Rhudy, {Jamie L.} and Micol, {Rachel L.} and Davis, {Joanne L.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1037/tra0000238",
language = "English (US)",
volume = "10",
pages = "67--75",
journal = "Psychological Trauma: Theory, Research, Practice, and Policy",
issn = "1942-9681",
publisher = "American Psychological Association Inc.",
number = "1",

}

TY - JOUR

T1 - Randomized controlled trial to dismantle exposure, relaxation, and rescripting therapy (ERRT) for trauma-related nightmares

AU - Pruiksma, Kristi E.

AU - Cranston, Christopher

AU - Rhudy, Jamie L.

AU - Micol, Rachel L.

AU - Davis, Joanne L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: The aim of this study was to conduct a preliminary dismantling study of exposure, relaxation, and rescripting therapy (ERRT) for nightmares. Method: Participants (N = 70) were randomized to 1 of 2 conditions: ERRT with nightmare exposure and rescripting (full protocol; EX) or ERRT without nightmare exposure and rescripting (NEX). Participants completed follow-ups at 1 week, 3 months, and 6 months posttreatment. Results: Both conditions yielded statistically significant improvements with medium to large effect sizes on primary outcomes related to nightmares (i.e., nights with nightmares, nightmares per week, and nightmare severity). Both conditions also yielded statistically significant improvements on secondary outcomes with medium to large effect sizes on fear of sleep, sleep quality, insomnia severity, daytime sleepiness, posttraumatic stress disorder symptom severity, and depression severity. The conditions did not differ at any time point. Conclusions: Findings indicate that ERRT with and without nightmare exposure and rescripting can significantly alleviate nightmares and related distress. The addition of nightmare exposure and rescription did not contribute incrementally to outcomes in this sample. It is possible that the dose of exposure was not sufficient to result in group differences or that the treatment components included in both conditions (i.e., psychoeducation about trauma, nightmares, and sleep; sleep habit modification; and relaxation training) may adequately treat factors that maintain nightmares for some individuals. Theoretical implications of findings are discussed. The reduction of symptoms of other conditions following this brief intervention provides further evidence for the primary role of nightmares and sleep disturbances posttrauma.

AB - Objective: The aim of this study was to conduct a preliminary dismantling study of exposure, relaxation, and rescripting therapy (ERRT) for nightmares. Method: Participants (N = 70) were randomized to 1 of 2 conditions: ERRT with nightmare exposure and rescripting (full protocol; EX) or ERRT without nightmare exposure and rescripting (NEX). Participants completed follow-ups at 1 week, 3 months, and 6 months posttreatment. Results: Both conditions yielded statistically significant improvements with medium to large effect sizes on primary outcomes related to nightmares (i.e., nights with nightmares, nightmares per week, and nightmare severity). Both conditions also yielded statistically significant improvements on secondary outcomes with medium to large effect sizes on fear of sleep, sleep quality, insomnia severity, daytime sleepiness, posttraumatic stress disorder symptom severity, and depression severity. The conditions did not differ at any time point. Conclusions: Findings indicate that ERRT with and without nightmare exposure and rescripting can significantly alleviate nightmares and related distress. The addition of nightmare exposure and rescription did not contribute incrementally to outcomes in this sample. It is possible that the dose of exposure was not sufficient to result in group differences or that the treatment components included in both conditions (i.e., psychoeducation about trauma, nightmares, and sleep; sleep habit modification; and relaxation training) may adequately treat factors that maintain nightmares for some individuals. Theoretical implications of findings are discussed. The reduction of symptoms of other conditions following this brief intervention provides further evidence for the primary role of nightmares and sleep disturbances posttrauma.

KW - Exposure

KW - Imagery rehearsal

KW - Nightmares

KW - Rescripting

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=85006339777&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006339777&partnerID=8YFLogxK

U2 - 10.1037/tra0000238

DO - 10.1037/tra0000238

M3 - Article

C2 - 27977223

AN - SCOPUS:85006339777

VL - 10

SP - 67

EP - 75

JO - Psychological Trauma: Theory, Research, Practice, and Policy

JF - Psychological Trauma: Theory, Research, Practice, and Policy

SN - 1942-9681

IS - 1

ER -