Nightmare
Conditions
Keywords
nightmares, treatment, substance use, imagery rehearsal therapy
Brief summary
The purpose of the study is to assess the efficacy of a 2-session intervention to reduce nightmares among Veterans admitted VA mental health residential rehabilitation treatment programs.
Detailed description
Sleep disturbances and suicide are highly prevalent among Veterans and recent research also suggests high comorbid rates of sleep and suicide in Veterans discharged from VA mental health residential rehabilitation treatment programs (MHRRTP; domiciliaries). Nightmares are a frequent concern identified by MHRRTP patients and are a modifiable risk factor for suicide risk. Little is known, however, about the treatment of nightmares and subsequent impact in this setting. The primary aims of the present project are to investigate the efficacy and acceptability of delivering a 2-session intervention to reduce nightmares among Veterans admitted to a MHRRTP. This study will examine this intervention's impact on reducing nightmare distress and nightmare frequency, as well as assess treatment acceptability. Changes in suicide risk following intervention will also be explored. This research will be conducted within the Canandaigua and Bath VA domiciliary programs which currently accommodate \ 150-175 Veterans. The study will be a randomized control trial with a hybrid design that uses stratification based on prescription use and randomly assigns individuals (N = 48) to either the treatment group or treatment as usual group (TAU). Veterans referred for the protocol will be screened for eligibility and then if appropriate, scheduled for a baseline evaluation, randomized to either the treatment group or TAU group, seen for two intervention sessions one week apart, and then be followed up with 4- and 8-weeks post initial treatment via telephone. This research has potential to highlight valuable targets for cross-cutting treatment in a rehabilitation setting that can be delivered in civilian and Veteran samples.
Interventions
BEHAVIORALbrief Imagery Rehearsal Therapy
Two-sessions of behaviorally-based imagery rehearsal therapy.
OTHERTreatment As Usual
may include medication treatment or behavioral treatment for nightmares other than imagery rehearsal therapy
Sponsors
Canandaigua VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* English-speaking * endorses nightmares at least once a week * score of 10 or greater on the Disturbing Dreams and Nightmares Severity Index
Exclusion criteria
* unable to consent * diagnosis of serious mental illness (schizophrenia, schizoaffective disorder) * active suicide ideation with plan and intent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nightmare Frequency | Change in total nights with nigthmares in the past week from baseline to 8 week follow-up. | Disturbing Dreams and Nightmares Severity Index. The score for frequency ranges from 0-7. |
| Nightmare Severity | Change in nigthmare severity from baseline to 8 week follow-up. | Disturbing Dreams and Nightmares Severity Index. The score for severity ranges from 0-6. |
Outcome results
None listed