Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-17T18:09:18.202Z Has data issue: false hasContentIssue false

Postal self-exposure treatment of recurrent nightmares

Randomised controlled trial

Published online by Cambridge University Press:  02 January 2018

Mary Burgess*
Affiliation:
Chronic Fatigue Research Unit, London
Isaac M. Marks
Affiliation:
Institute of Psychiatry, London
Michael Gill
Affiliation:
St James Hospital, Dublin, Ireland
*
Mary Burgess, Chronic Fatigue Research Unit. The New Medical School, Bessemer Road, London SES 9PJ; Tel/Fax: 0171 346 3363

Abstract

Background

Marry nightmare sufferers do not consult a health care professional. Though behaviour and cognitive therapy can help, they have not been tested as a self-treatment method at home using a manual.

Method

One hundred and seventy adults with primary nightmares were randomised to four weeks' self-exposure or self-relaxation at home using manuals posted to them, or to a waiting-list as a control group for four weeks. Individuals recorded nightmare frequency and intensity in four-week diaries.

Results

At one- and six-month follow-up, the self-rated nightmare frequency felt more significantly in exposure subjects than relaxation or waiting-list subjects. The self-exposure group had the most drop-outs but remained superior in an over-cautious intent-to-treat analysis. The individuals' partners confirmed the superiority of self-exposure to self-relaxation at one- and six-month follow-up.

Conclusions

Recurrent nightmare sufferers improved more with self-exposure manuals than with self-relaxation manuals or by being on a waiting-list. Self-exposure may be needed for longer than four weeks in order to reduce nightmare intensity as well as frequency. Despite a high drop-out rate, some sufferers of other conditions may benefit from self-treatment manuals.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Beck, A., Ward, C., Mendelson, M., et al (1961) Inventory to measure depression. Archives of General Psychiatry 4, 561567.CrossRefGoogle Scholar
Burgess, M., Marks, I. M. & Gill, M. (1994) Postal self-exposure of recurrent nightmares. British Journal of Psychiatry, 165, 388391.CrossRefGoogle ScholarPubMed
Cellucci, A. & Lawrence, P. (1978) Efficacy of systematic desensitization in reducing nightmares. Journal of Behaviour Therapy and Experimental Psychiatry 9, 109114.CrossRefGoogle Scholar
Cutting, D. (1979) Relief of nightmares (letter). British Journal of Psychiatry 134, 647.CrossRefGoogle Scholar
Donnan, P., Hutchinson, A., Paxton, R., et al (1990) Self-help materials for anxiety: a randomised controlled trial in general practice. British Journal of General Practice, 40, 498501.Google ScholarPubMed
Durham, R. C. & Turvey, A. A. (1987) Cognitive therapy vs behaviour therapy in the treatment of chronic general anxiety Behaviour Research and Therapy, 25, 229234.CrossRefGoogle ScholarPubMed
Hoffman, L., De-Luise, M. & Martin, F. I. (1981) Fallibility of postal questionnaire follow-up for detection of hypothyroidism after iodine-131 therapy. Medical Journal of Australia, 1, 303304.CrossRefGoogle ScholarPubMed
Jacobsen, E. (1929) Progressive Relaxation. Chicago. IL: University of Chicago Press.Google Scholar
Kellner, R., Neldhart, E. J., Krakow, B., et al (1992) Changes in chronic nightmares after one session of desensitiztion or rehearsal instructions American Journal of Psychiatry, 149, 659663.Google ScholarPubMed
Krakow, B., Kellner, R., Pathak, D., et al (1995) Imagery rehearsal treatment for chronic nightmares Behaviour Research and Therapy, 33, 837843 CrossRefGoogle ScholarPubMed
Mark, I. M. (1978) Rehearsal relief of a nightmare. British Journal of Psychiatry 133, 461465 CrossRefGoogle Scholar
Mark, I. M. (1986) Behavioural Psychotherapy Maudsley Pocket Book of Clinical Management. Bristol: Wright Google Scholar
Mark, I. M. & Matthews, A. M. (1979) Brief standard self-rating for phobic patients Behaviour Research and Therapy, 17, 263267 CrossRefGoogle Scholar
Miller, W. & Dipilato, M (1983) Treatment of nightmares via relaxation and desensitization, a controlled evaluation. Journal of Consulting and Clinical Psychology, 51, 870877.CrossRefGoogle ScholarPubMed
Neidhart, E. J., Krakow, B., Kellner, R., et al (1992) The beneficial effects of one treatment session and recording of nightmares on chronic nightmare sufferers Sleep, 15, 470473.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.