Posttraumatic Nightmares and Imagery Rehearsal

The Possible Role of Lucid Dreaming

Harb, Gerlinde C.
Brownlow, Janeese A.
Ross, Richard J.

Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Corporal Michael J. Crescenz Veterans Affairs Medical Center and Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania

This work was supported by the Department of Defense (DOD) Congressionally Directed Medical Research Programs (CDMRP) Award W81XWH-08-2–0104. The views expressed in this article do not represent those of the Department of Veterans Affairs or the United States Government. We would like to acknowledge J. Cobb Scott for lending his statistical expertise in the preparation of this manuscript.

Gerlinde C. Harb, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Research and Development Service (151), 3900 Woodland Avenue, Philadelphia, PA 19104 [email protected]

Dreaming 26(3):p 238-249, September 2016. | DOI: 10.1037/drm0000030

Lucid dreaming (LD) is a distinct behavioral state characterized by an awareness of dreaming while a dream occurs and, at times, an ability to, during dreaming, control dream events and/or purposefully awaken from a dream. LD and its potential role as a mechanism of action of Imagery Rehearsal therapy (IR) were investigated in military veterans with posttraumatic stress disorder and recurrent nightmares. This study reports on the nature of LD constructs in 33 treatment-seeking Iraq and Afghanistan combat veterans participating in a larger clinical trial of 6 sessions of 1 of 2 therapies: components of Cognitive–Behavioral Therapy for Insomnia (cCBT-I) or IR + cCBT-I. Participants completed questionnaires regarding sleep and nightmares, other PTSD symptoms, and LD before and after treatment. Before treatment, veterans demonstrated a LD profile characterized by high dream awareness and low dream content control. After IR + cCBT-I treatment, control of dream content, but not lucid awareness, increased more than after cCBT-I treatment (ES = .68). This increase in dream content control was related to a reduction in nightmare distress. An increase in 1 component of LD, namely control of dream content, appears to contribute to therapeutic change with IR for recurrent posttraumatic nightmares.