title: Self-exposure treatment of recurrent nightmares: waiting-list-controlled trial and 4-year follow-up.
abstract: BACKGROUND
  In open and randomized controlled trials self-exposure therapy reduced the frequency of nightmares but follow-up ceased at 7 months post-entry.
  
  
  METHODS
  Ten adults who attended an outpatient clinic and had DSM-IV nightmare disorder were put on a 3-month waiting-list. After 3 months they were given a self-exposure manual and were asked to follow its instructions for 4 weeks and were then followed up for 4 years. They were rated at 0, 3, 4, 5, 7, 10, 16, 28 and 52 months. At month 0 only, a matched control group of 10 subjects from the same clinic who had no axis I or II disorder was also rated.
  
  
  RESULTS
  At month 0, the nightmare sufferers had more nightmares, anxiety, depression, hostility and somatic symptoms than the matched control group. All 10 nightmare sufferers completed the 3-month waiting-list, 4-week self-exposure therapy and 4-year follow-up without any dropouts. The recurrent nightmares and most associated symptoms did not improve while on the waiting-list but improved markedly after self-exposure therapy and remained improved over the 4-year follow-up.
  
  
  CONCLUSIONS
  Adults' recurrent nightmares and associated symptoms failed to improve over a 3-month waiting-list period but reduced greatly after subsequent self-exposure therapy with minimal therapist contact over 1 month, and these gains continued over the next 4 years.
authors.affiliation: Department of Psychology, University of Bologna, Bologna, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Grandi
authors.forename: Stefania
authors.initials: S
authors.lastname: Fabbri
authors.forename: Naike
authors.initials: N
authors.lastname: Panattoni
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Gonnella
authors.forename: Isaac
authors.initials: I
authors.lastname: Marks
mesh_terms: D000328:Adult; D001294:Attitude to Health; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004325:Dreams; D005500:Follow-Up Studies; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D012008:Recurrence; D012657:Self-Help Groups; D012893:Sleep Wake Disorders / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome; D014850:Waiting Lists