We pilot tested the efficacy of a virtual reality-based imagery rehearsal and rescripting treatment (ReScript) for nightmares. Nineteen community volunteers (Mage = 49 years) who varied in terms of their nightmare distress levels participated in a 4-week-long trial of ReScript therapy. Participants used VR manual controls in an Oculus headset to manipulate 3 scary or threatening images per session with 2 sessions per week. The object was to manipulate these images into less scary or threatening images so as to gain cognitive control over intrusive imagery and to lessen overall anxiety or nightmare distress or nightmare daytime effects. Images were taken from the International Affective Picture System database and varied along 3 affective dimensions (valence, arousal, and dominance) important for nightmare imagery. Results demonstrated a significant reduction (from baseline to trial end) in anxiety levels, nightmare distress, and nightmare effects (all effect sizes .63 or above), as well as a significant decrease in anxiety words and a significant increase in cognitive process words in rescripted narratives. Nightmare frequency was also significantly reduced though effect size was small. No significant side or adverse effects were reported by participants during the 4-week trial. Indeed, Depersonalization and Posttraumatic Stress Disorder Symptom Checklist scores significantly declined and mood function tests improved over the 4-week trial. We conclude that ReScript may be a safe and effective short-term therapy for nightmare distress but should next be tested with a randomized, double-blind, placebo-controlled trial.

中文翻译：

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支持虚拟现实的噩梦治疗。

我们试点测试了基于虚拟现实的图像排练和重写治疗 (ReScript) 对噩梦的功效。19 名社区志愿者（法师 = 49 岁）参加了为期 4 周的 ReScript 疗法试验，他们的噩梦痛苦程度各不相同。参与者使用 Oculus 耳机中的 VR 手动控制在每个会话中操纵 3 个可怕或威胁的图像，每周 2 个会话。目的是将这些图像处理成不那么可怕或威胁性较小的图像，以便获得对侵入性图像的认知控制，并减少整体焦虑或噩梦困扰或噩梦白天的影响。图像取自国际情感图片系统数据库，并沿着对噩梦图像很重要的 3 个情感维度（效价、唤醒和支配）变化。结果表明，焦虑水平、噩梦困扰和噩梦效应（所有效应大小为 0.63 或以上）显着降低（从基线到试验结束），焦虑词显着减少，认知过程词显着增加改写的叙述。尽管效果很小，但噩梦频率也显着降低。在为期 4 周的试验期间，参与者没有报告显着的副作用或不良反应。事实上，在为期 4 周的试验中，人格解体和创伤后应激障碍症状清单评分显着下降，情绪功能测试有所改善。我们得出的结论是，ReScript 可能是一种安全有效的短期噩梦疗法，但接下来应该通过随机、双盲、安慰剂对照试验进行测试。