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Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial.
J Trauma Stress. 2018 08; 31(4):591-601.JT

Abstract

Sleep disturbances are common among sexual assault victims with posttraumatic stress disorder (PTSD), but cognitive behavioral therapy (CBT) for PTSD does not directly address sleep-related symptoms. Trauma-related sleep disturbances are associated with more impairment and contribute to the maintenance of PTSD. In this study, we evaluated the efficacy of a combination of CBT and nightmare therapy (imagery rehearsal therapy; IRT) compared to CBT alone for the treatment of PTSD. We recruited 42 adult victims of sexual assault who were suffering from PTSD and randomly assigned them to either the experimental (IRT + CBT) or control condition (waiting period followed by CBT). After CBT, both groups demonstrated significant decreases in nighttime symptoms (except nightmare frequency) and PTSD symptoms and showed improvements in functional impairment and mental health, ds = 0.13-0.83, ps = .005-.008. Outcomes between the two groups did not differ significantly after CBT; however, we observed medium to medium-large differences between the control group and experimental group in terms of nighttime symptoms, ds = 0.45-0.63. Although results did not clearly establish the superiority of IRT + CBT over CBT alone, they demonstrated that IRT yielded greater improvement in nighttime symptoms than the waiting period, ds = 0.72-1.13, ps = .006-.047 for all interaction effects. Findings suggest that targeting nightmares at the beginning of treatment for PTSD may yield rapid improvement in nighttime symptoms. This strategy could be useful for patients with time or resource constraints or those for whom nightmares are the primary complaint.

Authors+Show Affiliations

School of Psychology, Laval University, Quebec, Canada.School of Psychology, Laval University, Quebec, Canada.School of Psychology, Laval University, Quebec, Canada.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30070398

Citation

Belleville, Geneviève, et al. "Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: a Randomized Controlled Trial." Journal of Traumatic Stress, vol. 31, no. 4, 2018, pp. 591-601.
Belleville G, Dubé-Frenette M, Rousseau A. Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial. J Trauma Stress. 2018;31(4):591-601.
Belleville, G., Dubé-Frenette, M., & Rousseau, A. (2018). Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial. Journal of Traumatic Stress, 31(4), 591-601. https://doi.org/10.1002/jts.22306
Belleville G, Dubé-Frenette M, Rousseau A. Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: a Randomized Controlled Trial. J Trauma Stress. 2018;31(4):591-601. PubMed PMID: 30070398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial. AU - Belleville,Geneviève, AU - Dubé-Frenette,Mylène, AU - Rousseau,Andréanne, Y1 - 2018/08/02/ PY - 2017/05/30/received PY - 2018/03/19/revised PY - 2018/04/02/accepted PY - 2018/8/3/pubmed PY - 2019/11/5/medline PY - 2018/8/3/entrez SP - 591 EP - 601 JF - Journal of traumatic stress JO - J Trauma Stress VL - 31 IS - 4 N2 - Sleep disturbances are common among sexual assault victims with posttraumatic stress disorder (PTSD), but cognitive behavioral therapy (CBT) for PTSD does not directly address sleep-related symptoms. Trauma-related sleep disturbances are associated with more impairment and contribute to the maintenance of PTSD. In this study, we evaluated the efficacy of a combination of CBT and nightmare therapy (imagery rehearsal therapy; IRT) compared to CBT alone for the treatment of PTSD. We recruited 42 adult victims of sexual assault who were suffering from PTSD and randomly assigned them to either the experimental (IRT + CBT) or control condition (waiting period followed by CBT). After CBT, both groups demonstrated significant decreases in nighttime symptoms (except nightmare frequency) and PTSD symptoms and showed improvements in functional impairment and mental health, ds = 0.13-0.83, ps = .005-.008. Outcomes between the two groups did not differ significantly after CBT; however, we observed medium to medium-large differences between the control group and experimental group in terms of nighttime symptoms, ds = 0.45-0.63. Although results did not clearly establish the superiority of IRT + CBT over CBT alone, they demonstrated that IRT yielded greater improvement in nighttime symptoms than the waiting period, ds = 0.72-1.13, ps = .006-.047 for all interaction effects. Findings suggest that targeting nightmares at the beginning of treatment for PTSD may yield rapid improvement in nighttime symptoms. This strategy could be useful for patients with time or resource constraints or those for whom nightmares are the primary complaint. SN - 1573-6598 UR - https://www.unboundmedicine.com/medline/citation/30070398/Efficacy_of_Imagery_Rehearsal_Therapy_and_Cognitive_Behavioral_Therapy_in_Sexual_Assault_Victims_With_Posttraumatic_Stress_Disorder:_A_Randomized_Controlled_Trial_ L2 - https://doi.org/10.1002/jts.22306 DB - PRIME DP - Unbound Medicine ER -