Premium
Efficacy of Imagery Rehearsal Therapy and Cognitive Behavioral Therapy in Sexual Assault Victims With Posttraumatic Stress Disorder: A Randomized Controlled Trial
Author(s) -
Belleville Geneviève,
DubéFrenette Mylène,
Rousseau Andréanne
Publication year - 2018
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22306
Subject(s) - cognitive processing therapy , cognitive behavioral therapy , sexual assault , psychology , posttraumatic stress , clinical psychology , cognitive therapy , cognition , randomized controlled trial , psychotherapist , psychiatry , anxiety disorder , poison control , injury prevention , medicine , anxiety , medical emergency , surgery
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, d s = 0.13–0.83, p s = .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, d s = 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, d s = 0.72–1.13, p s = .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.