Research Paper Title

A Pilot Randomized Controlled Trial of Cognitive Behavioral Treatment for Trauma-Related Nightmares in Active Duty Military Personnel.

Background

The aim of this study was to obtain preliminary data on the efficacy, credibility, and acceptability of Exposure, relaxation, and rescripting therapy for military service members and veterans (ERRT-M) in active duty military personnel with trauma-related nightmares.

Methods

Forty participants were randomised to either 5 sessions of ERRT-M or 5 weeks of minimal contact control (MCC) followed by ERRT-M. Assessments were completed at baseline, post-treatment/post-control, and 1-month follow-up.

Results

Differences between ERRT-M and control were generally medium in size for nightmare frequency (Cohen d = -0.53), nights with nightmares (d = -0.38), nightmare severity (d = -0.60), fear of sleep (d = -0.44), and symptoms of insomnia (d = -0.52), and depression (d = -0.51).

In the 38 participants who received ERRT-M, there were statistically significant, medium-sized decreases in nightmare frequency (d = -0.52), nights with nightmares (d = -0.50), nightmare severity (d = -0.55), fear of sleep (d = -0.48), and symptoms of insomnia (d = -0.59), post-traumatic stress disorder (PTSD) (d = -0.58) and depression (d = -0.59) from baseline to 1-month follow-up.

Participants generally endorsed medium to high ratings of treatment credibility and expectancy.

The treatment dropout rate (17.5%) was comparable to rates observed for similar treatments in civilians.

Conclusions

ERRT-M produced medium effect-size reductions in nightmares and several secondary outcomes including PTSD, depression, and insomnia.

Participants considered ERRT-M to be credible.

An adequately powered randomised clinical trial is needed to confirm findings and to compare ERRT-M to an active treatment control.

Reference

Pruiksma, K.E., Taylor, D.J., Mintz, J., Nicholson, K.L., Rodgers, M., Young-McCaughan, S., Hall-Clark, B.N., Fina, B.A., Dondanville, K.A., Cobos, B., Wardle-Pinkston, S., Litz, B.T., Roache, J.D., Perterson, A.L. & STRONG STAR Consortium. (2020) A Pilot Randomized Controlled Trial of Cognitive Behavioral Treatment for Trauma-Related Nightmares in Active Duty Military Personnel. Journal of Clinical Sleep Medicine. 16(1), pp.29-40. doi: 10.5664/jcsm.8116. Epub 2019 Nov 26.