Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility

Krakow, Barry; Sandoval, Diane; Schrader, Ron; Keuhne, Bruce; Mcbride, Leslie; Yau, C.L; Tandberg, Dan

« Previous Next »Journal of Adolescent Health
Volume 29, Issue 2 , Pages 94-100, August 2001

Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility☆

Barry Krakow, M.D.
- Sleep and Human Health Institute, Albuquerque, New Mexico, USA (B. Krakow)
- Address correspondence to: Barry Krakow, M.D. Sleep and Human Health Institute, 4775 Indian School N.E., Suite 305, Albuquerque, NM 87110
Diane Sandoval, B.S.
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA (B.K., D.S., L.B., D.T.)
Ron Schrader, Ph.D.
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico, USA (R.S., C.L.Y.)
Bruce Keuhne, B.A.
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA (B.K., D.S., L.B., D.T.)
- Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA (B.K.)
- Wyoming Girls School, Sheridan, Wyoming, USA (B. Keuhne)
Leslie Mcbride, B.S.
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA (B.K., D.S., L.B., D.T.)
C.L Yau
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico, USA (R.S., C.L.Y.)
Dan Tandberg, M.D.
- Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA (B.K., D.S., L.B., D.T.)

Accepted 1 July 2000.

Abstract

Purpose: To evaluate imagery rehearsal therapy for the treatment of chronic nightmares in a sample of adolescent girls.

Methods: Adolescent girls ranging in age from 13 to 18 years were recruited from the Wyoming Girls School in Sheridan, Wyoming (treatment group, n = 9; control group, n = 10). These girls had previously suffered a high prevalence of unwanted sexual experiences in childhood and adolescence, and thus many suffered from nightmares, sleep complaints, and posttraumatic stress symptoms. Imagery rehearsal therapy was provided in a 1-day (6-h) workshop. Imagery rehearsal consists of three steps, all of which are performed in the waking state: (a) select a nightmare, (b) “change the nightmare any way you wish,” and (c) rehearse the images of the new version (“new dream”) 5 to 20 min each day. Control participants received no intervention.

Results: At baseline, these girls had been suffering from nightmares, on average, for 4.5 years, and they reported experiencing 20 nightmares per month, which occurred at a frequency of at least one bad dream every other night. At 3 months, self-reported, retrospectively assessed nightmare frequency measured in nights per month decreased 57% (p = .01, d = 1.4) and measured in nightmares per month decreased 71% (p = .01, d = 1.7) in the treatment group, compared with no significant changes in the control group. No significant changes were noted for sleep and posttraumatic stress disorder measures in either group.

Conclusion: Imagery rehearsal therapy was an effective treatment option for chronic nightmares in this adjudicated adolescent population.

Keywords: Adolescence, Nightmares, Posttraumatic stress disorder, Sleep