TY - JOUR
T1 - A pilot randomized controlled trial of cognitive behavioral treatment for trauma-related nightmares in active duty military personnel
AU - STRONG STAR Consortium
AU - Pruiksma, Kristi E.
AU - Taylor, Daniel J.
AU - Mintz, Jim
AU - Nicholson, Karin L.
AU - Rodgers, Matthew
AU - Young-McCaughan, Stacey
AU - Hall-Clark, Brittany N.
AU - Fina, Brooke A.
AU - Dondanville, Katherine A.
AU - Cobos, Briana
AU - Wardle-Pinkston, Sophie
AU - Litz, Brett T.
AU - Roache, John D.
AU - Peterson, Alan L.
N1 - Funding Information:
All authors have seen and approved this manuscript. This research was conducted at Carl R. Darnall Army Medical Center, Fort Hood, TX. This was an investigator-initiated study funded by an American Academy of Sleep Medicine Foundation Focused Program Award grant awarded to Dr. Pruiksma. The authors report no conflicts of interest. The study did not involve off-label or investigational use of any pharmaceutical or medical treatment. The views expressed herein are solely those of the authors and do not reflect an endorsement by or the official policy or position of the U.S. Army, the Department of Defense, the Department of Veterans Affairs, or the U.S. Government.
Publisher Copyright:
© 2020 American Academy of Sleep Medicine. All rights reserved.
PY - 2020/1/15
Y1 - 2020/1/15
N2 - Study Objectives: 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 randomized to either 5 sessions of ERRT-M or 5 weeks of minimal contact control (MCC) followed by ERRT-M. Assessments were completed at baseline, posttreatment/postcontrol, 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), posttraumatic 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 randomized clinical trial is needed to confirm findings and to compare ERRT-M to an active treatment control. Clinical Trial Registration: Registry: ClinicalTrials.gov; Title: A Pilot Randomized Controlled Trial of Treatment for Trauma-Related Nightmares In Active Duty Military Personnel; Identifier: NCT02506595; URL: https://clinicaltrials.gov/ct2/show/NCT02506595.
AB - Study Objectives: 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 randomized to either 5 sessions of ERRT-M or 5 weeks of minimal contact control (MCC) followed by ERRT-M. Assessments were completed at baseline, posttreatment/postcontrol, 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), posttraumatic 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 randomized clinical trial is needed to confirm findings and to compare ERRT-M to an active treatment control. Clinical Trial Registration: Registry: ClinicalTrials.gov; Title: A Pilot Randomized Controlled Trial of Treatment for Trauma-Related Nightmares In Active Duty Military Personnel; Identifier: NCT02506595; URL: https://clinicaltrials.gov/ct2/show/NCT02506595.
KW - Exposure
KW - Imagery rehearsal
KW - Nightmares
KW - Rescripting
KW - Trauma
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U2 - 10.5664/JCSM.8116
DO - 10.5664/JCSM.8116
M3 - Article
C2 - 31957648
AN - SCOPUS:85078044271
SN - 1550-9389
VL - 16
SP - 29
EP - 40
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 1
ER -