Cognit ive-Behavioral Treatment for Chronic Nightmares in Trauma-Exposed Persons: Assessing Physiological Reactions to Nightmare-Related Fear m

Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psycho-logical distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N5 40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiolo-gical and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implica-tions are discussed. & 2010 Wiley Periodicals, Inc. J Clin Psychol 66