Introduction: Both imagery rescripting and imaginal exposure have been proven to be effective in the treatment of chronic nightmares when compared to a waitlist condition. Little is known about their comparative efficacy and their efficacy compared to an active control. Objective: The aims of this study were to compare the two treatments to one another and to positive imagery as an active control, and to explore covariates of the treatment effect. Methods: In this single-blinded randomized controlled trial, 96 patients with nightmare disorder (idiopathic nightmares) from an outpatient clinic were randomly assigned to a single individual treatment session of rescripting, exposure, or positive imagery and 4 weeks of practice at home. The primary outcome was nightmare distress, and the secondary outcomes were nightmare frequency, nightmare effects, self-efficacy, and general psychopathology. Results: Nightmare distress was reduced in all groups (imagery rescripting: Cohen’s d = –1.04, imaginal exposure: d = –0.68, positive imagery: d = –0.57), as were nightmare frequency, nightmare effects, and psychopathology. Self-efficacy was enhanced. No differential treatment effects were found on any primary or secondary measure. Treatment gains were not associated with demographic or disorder characteristics, baseline values, treatment credibility, or the number of practice sessions. Conclusions: Even short nightmare treatments are effective regardless of personal characteristics, and different interventions produce similar results. Future research should aim to clarify the mechanisms of action. Health care should make more use of these powerful and easy-to-administer nightmare treatments.
Psychother Psychosom

中文翻译：

---

与积极意象相比，梦魇障碍中的意象复述和想象暴露：一项随机对照试验

简介：与候补条件相比，图像重写和想象暴露都已被证明在治疗慢性噩梦方面是有效的。关于它们的比较功效以及与活性对照相比的功效知之甚少。目的：本研究的目的是将两种治疗相互比较，并将正面意象作为主动对照，并探讨治疗效果的协变量。方法：在这项单盲随机对照试验中，来自门诊的 96 名患有噩梦障碍（特发性噩梦）的患者被随机分配到一个单独的单独治疗阶段，包括复述、暴露或正面想象，以及 4 周的在家练习。主要结局是噩梦困扰，次要结局是噩梦频率、噩梦效应、自我效能感和一般精神病理学。结果：所有组的噩梦困扰都减少了（图像重写：Cohen's d = –1.04，想象曝光：d = –0.68，正面图像：d= –0.57)，噩梦频率、噩梦效应和精神病理学也是如此。自我效能感增强。在任何主要或次要措施上都没有发现不同的治疗效果。治疗效果与人口统计学或疾病特征、基线值、治疗可信度或练习次数无关。结论：无论个人特征如何，即使是短暂的噩梦治疗也是有效的，不同的干预措施会产生相似的结果。未来的研究应着眼于阐明作用机制。医疗保健应更多地使用这些强大且易于管理的噩梦疗法。
心理咨询师