Evaluation of dream content in combat-related PTSD

Nightmares that replicate traumatic events are among the criteria that defi ne posttraumatic stress disorder (PTSD); however; there has been limited sy stematic assessment of the content of dreams in PTSD. A PTSD dream rating i nstrument was developed to operationalize features attributed to dreams ass ociated with combat-related PTSD that incorporated dimensions from the drea m content analysis literature, and its reliability was assessed. Then the i nstrument was used to characterize dream reports in 18 Vietnam combat veter ans diagnosed with PTSD. Approximately half of the group's target dreams co ntained features characteristic of combat, and all but 3 (17%) were moderat ely to highly threatening. Fifty-three percent were set at least partially in the present and 79% contained distorted elements. We therefore conclude that target dreams of combat veterans with PTSD vary with regard to replica tion of trauma and elements normally associated with dreaming, but typicall y are threatening.