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Treating nightmares with imagery interventions


- candidate number21145
- NTR NumberNTR4951
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR11-dec-2014
- Secondary IDs2014-CP-3794 
- Public TitleTreating nightmares with imagery interventions
- Scientific TitleMechanisms of change in the treatment of nightmares: Imagery rescripting vs. Imaginal exposure therapy
- ACRONYM
- hypothesisIt is hypothesized that imagery rescripting and imaginal exposure therapy are both effective in the treatment of nightmare disorder. Whereas it is expected that the two therapies will both be effective in the treatment of nightmares, it might be possible that the therapies work through different mechanisms. The current study aims at exploring the working mechanisms of the two therapies by assessing the effects of several proposed mediators (see 'secondary outcome measures') of the treatment effect (see 'primary outcome measures').
- Healt Condition(s) or Problem(s) studiedNightmares, Imagery rescripting therapy, Imaginal exposure therapy
- Inclusion criteria18 years of age or older; one or more nightmare(s) per week, with a recurrent (emotional) theme; nightmares have to impair the daily functioning of the client (nightmare disorder according to DSM-5); fluency in Dutch
- Exclusion criteriaA current diagnosis of alcohol and/or drug abuse or dependency; PTSD resulting from protracted and recurring trauma (type 2 trauma); psychotic disorder; CBT-based psychotherapy for nightmare symptoms in the preceding 12 months; Co-morbidity as such will not be reason for exclusion but the nightmares must be the principal diagnosis. If applicable, participants will be asked to keep their medication intake stable during and 1-8 weeks before treatment (depending on the type of medication).
- mec approval receivedyes
- multicenter trialno
- randomisedyes
- masking/blindingNone
- controlNot applicable
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 5-jan-2015
- planned closingdate30-dec-2015
- Target number of participants90
- InterventionsBoth active interventions will be delivered by trained and experienced therapists. Imagery rescripting (IR) therapy: participants will receive an adapted 3-session intervention of the original IR protocol by Arntz en Weertman (1999). Here, the script of a nightmare is actively changed in the imagination of the participant, after the original nightmare has been reactivated. Imaginal exposure (IE) therapy: participants will receive 3 sessions of a standard IE intervention (Foa & Rothbaum, 1989). Here, the nightmare is reactivated and subsequently re-lived in the participantsí imagination, until the emotions accompanied by the nightmare become tolerable. Wait-list control condition: 5 weeks. Note that after the waiting period, participants will receive either one of the active treatments (by randomization). Here, treatment will be delivered by unexperienced therapists (e.g., students). Primary and secondary outcome measures (but no mediators of the treatment effect) will be assessed at time points 1 and 5 to investigate whether the treatment effects found in the main study (i.e., treatment delivered by experienced therapists) can be replicated with a group of unexperienced therapists.
- Primary outcome1. Nightmare frequency 2. Nightmare distress
- Secondary outcome1. Zelf Inventarisatie Lijst (ZIL; Hovens, Bramsen, & van der Ploeg, 2000) 2. Sleep complaints (Insomnia Severity Index; Morin, 1993) 3. Nightmare beliefs (10-15 item questionnaire regarding nightmare beliefs) Mediators of the treatment effect: 1. Nightmare distress (at night, as well as during the day) 2. Nightmare mastery (nightmare content) 3. Nightmare controllability (emotions elicited by the nightmare) 4. Predictability of emotions experienced during the nightmare 5. Tolerability of emotions experienced during the nightmare 6. Nightmare vividness 7. Sleep quality
- Timepoints(1) Pre-assessment ; (2, 3, 4) treatment sessions; (5) Post-assessment ; (6) 3-months follow-up ; (7) 6-months follow-up
- Trial web site
- statusplanned
- CONTACT FOR PUBLIC QUERIES Jaap Lancee
- CONTACT for SCIENTIFIC QUERIES Jaap Lancee
- Sponsor/Initiator University of Amsterdam (UvA), Department of Clinical Psychology
- Funding
(Source(s) of Monetary or Material Support)
Netherlands Organisation for Scientific Research (NWO)
- Publications
- Brief summaryThe proposed study aims at investigating the effectivity of two CBT-based treatments for nightmares (i.e., imagery rescripting and imaginal exposure), as well as possible working mechanisms underlying these therapeutic techniques.
- Main changes (audit trail)19-jan-2016: EB
Secondary outcome NEW:
8. Subjective Units of Distress (SUDs)
- RECORD11-dec-2014 - 19-jan-2016


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