title: Efficacy of psychological interventions aiming to reduce chronic nightmares: a meta-analysis.
abstract: This study presents a meta-analysis of the effectiveness of psychological treatments for chronic nightmares using imaginal confrontation with nightmare contents (ICNC) or imagery rescripting and rehearsal (IRR). Pre-post effect sizes (Hedges' g) were calculated for the outcome measures of nightmare frequency, nights per week with nightmares, sleep quality, depression, anxiety, and PTSD severity. Fixed-effects and random-effects models were applied. High effect sizes were found for nightmare frequency (g=1.04), nights per week with nightmares (g=0.99), and PTSD severity (g=0.92). Most of the effect sizes for the secondary outcomes were moderate. One objective was to clarify whether ICNC or IRR is more important for nightmare reduction. The results indicate that a higher duration of time for ICNC is associated with greater improvements: The minutes of applied ICNC moderate the effect sizes for nightmare frequency at follow-up 2 and for nights per week with nightmares at post and follow-up 1. The percentage of applied ICNC moderates the effect sizes for nightmare frequency and nights per week with nightmares at follow-up 1. Thus, dismantling studies are necessary to draw conclusions regarding whether ICNC or IRR is the most effective in the psychological treatment of chronic nightmares.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Johann Wolfgang Goethe University, Frankfurt, Germany. Kathrin.Hansen@gmx.de
authors.forename: Kathrin
authors.initials: K
authors.lastname: Hansen
authors.forename: Volkmar
authors.initials: V
authors.lastname: Höfling
authors.forename: Tana
authors.initials: T
authors.lastname: Kröner-Borowik
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stangier
authors.forename: Regina
authors.initials: R
authors.lastname: Steil
mesh_terms: D000328:Adult; D004325:Dreams / Q000523:psychology*; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000523:psychology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome