A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: A preliminary report

Imagery-rehearsal therapy for chronic nightmares was assessed in a randomiz ed, controlled study of sexual assault survivors with posttraumatic stress disorder (PTSD). Nightmares, sleep quality, and PTSD were assessed at basel ine for 169 women, who were randomized into two groups: treatment (n = 87) and wait-list control (n = 82). Treatment consisted of two 3-hr sessions an d one 1-hr session conducted over 5 weeks. Of 169 participants, 91 women (T reatment, n = 43, Control, n = 48) completed a 3-month follow-up and 78 did not. At follow-up, nightmare frequency and PTSD severity decreased and sle ep quality improved in the treatment group with small to minimal changes in the control group. Treatment effects were moderate to high (Cohen's d rang ed from 0.57 to 1.26). Notwithstanding the large dropout rate, imagery-rehe arsal therapy is an effective treatment for chronic nightmares in sexual as sault survivors with PTSD and is associated with improvement in sleep quali ty and decreases in PTSD severity.