Treating your worst nightmare: a case-series of imagery rehearsal therapy for nightmares in individuals experiencing psychotic symptoms

2015 ◽  
Vol 8 ◽  
Author(s):  
Bryony Sheaves ◽  
Juliana Onwumere ◽  
Nadine Keen ◽  
Elizabeth Kuipers
Keyword(s):  
Working Memory ◽  
Sleep Quality ◽  
Emotional Response ◽  
Case Series ◽  
Small Sample ◽  
Psychotic Symptoms ◽  
Imagery Rehearsal Therapy ◽  
Affective Symptoms ◽  
Additional Control ◽  
Imagery Rehearsal

AbstractPrevious research has indicated that nightmares might be a common problem for people with psychotic symptoms. Furthermore, more distressing nightmares have been associated with higher levels of delusional severity, depression, anxiety, stress and working memory. However no known research has investigated the use of nightmare treatments in those with symptoms of psychosis. This study aimed to assess the acceptability and feasibility of using imagery rehearsal (IR) therapy as a treatment of nightmares for those presenting with co-morbid psychotic symptoms. Six participants presenting with frequent distressing nightmares and psychotic symptoms were recruited. Five participants attended 4–6 sessions of IR. Measures of nightmares, sleep quality, psychotic and affective symptoms were completed at baseline and immediately following the intervention. It was feasible to adapt IR for those experiencing psychotic symptoms. Descriptive improvements were noted on measures of nightmare-related distress, vividness and intensity. Positive post-session feedback endorsed the acceptability of IR. Nightmare frequency did not reduce following IR; however, participants described a change in emotional response. IR was an acceptable and feasible intervention for this small sample. A larger study powered to detect group changes, with an additional control is warranted to test the efficacy of the intervention for those with psychosis.

scholarly journals Comparative Meta-Analysis of Prazosin and Imagery Rehearsal Therapy for Nightmare Frequency, Sleep Quality, and Posttraumatic Stress

2015 ◽  
Vol 11 (01) ◽  
pp. 11-22 ◽  
Author(s):  
Gilbert Seda ◽  
Maria M. Sanchez-Ortuno ◽  
Carolyn H. Welsh ◽  
Ann C. Halbower ◽  
Jack D. Edinger
Keyword(s):  
Sleep Quality ◽  
Posttraumatic Stress ◽  
Meta Analysis ◽  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

scholarly journals 1222 Does Creativity & “Dose” Enhance Outcomes in Imagery Rehearsal Therapy? A Case of Successful IRT

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A467-A467
Author(s):  
Alicia J Roth ◽  
Michelle Drerup
Keyword(s):  
Sleep Quality ◽  
Verbal Memory ◽  
Self Efficacy ◽  
Guided Imagery ◽  
Average Intensity ◽  
Mild Depression ◽  
Written Narratives ◽  
Imagery Rehearsal Therapy ◽  
Nightmare Disorder ◽  
Imagery Rehearsal

Abstract Introduction Imagery Rehearsal Therapy (IRT) is an efficacious treatment for Nightmare Disorder. In IRT, patients practice pleasant guided imagery techniques, then use these skills to re-script recurring nightmares, which lowers the frequency and intensity of overall nightmare activity. However, the most efficacious methods and dosage of guided imagery and nightmare re-scripting is undetermined. Report of Case The patient was a 70-year-old male with Nightmare Disorder. Patient denied any precipitating event or trauma associated with nightmare onset. He has a longstanding history of depression and OSA (uses CPAP). He was taking Seroquel, which reduced severity of nightmares but not frequency. Trials of other medications for nightmares had failed (including prazosin, Depakote, and trazodone). Patient presented as highly distressed, exhibited distrust towards medical providers, and was skeptical about the effectiveness of IRT. Despite his skepticism, patient self-initiated very detailed and media-enhanced methods for pleasant guided imagery and nightmare re-scripting, including written narratives, voice recordings, and created a movie of his re-scripted nightmare with pictures set to music. He listened to the recordings 2-3x/day. Themes of nightmares included lack of mastery over problems; patient’s re-scripted dreams put him back in control of frightening scenarios. Nightmare logs at baseline showed sleep quality=1.9/5; average=2.0 nightmares/night; average intensity= 6.2/10. At week 15 of treatment, sleep quality=3/5; nightmares/night average=0.25; average intensity=6/10. Sleep disturbance also improved (ISI=18-moderately severe clinical insomnia to 11-subthreshold insomnia); mood was stable (PHQ=5-mild depression). Conclusion Previous studies have suggested that IRT increases patients’ sense of mastery or perceived self-efficacy over nightmares (Rousseau et al., 2018). Additionally, higher verbal memory in persons with trauma-related nightmares has been shown to improve nightmare frequency and severity in IRT (Scott et al., 2017). In this case study, self-efficacy may have been activated by the highly detailed and media-enhanced imagery the patient created. Further empirical research on the mechanisms for enhancing IRT is warranted.

Benefit of Clomipramine-quetiapine Combination in Obsessive-compulsive Disorder with Non Response to Serotonin Selective Reuptake Inhibitors. Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Marian ◽  
B. Ionescu ◽  
D. Ghinea ◽  
N. Alina
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Case Series ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Work Related ◽  
Affective Symptoms

Background:Patients who suffer of obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. the condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning.Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as adjuvant to antidepressant medication have proven to be effective in several case series and pilot clinical trials.The objective of this case was to evaluate the effectiveness of clomipramine-quetiapine combination in OCD refractory to serotonin selective reuptake inhibitors treatment patient.Method:23 years unemployed male was diagnosed with OCD after 1 year from onset and received 3 trials with serotonin selective reuptake inhibitors at therapeutical doses, without any improvement and even more with worsening of affective associated symptoms. We managed this case by using a tricyclic antidepressant (clomipramine up to 100 mg/day) with an atypical antipsychotic (quetiapine up to 200 mg/day). We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Hamilton Depression rating Scale (HDRS) at baseline, weekly for the first 2 months and monthly after (follow up 2 years).Results:Patient achieved a very fast and sustained improvement both in obsessive-compulsive and affective symptoms, which provided a very good social and work rehabilitation.Conclusion:Clomipramine-quetiapine combination may be a benefit for OCD refractory to serotonin selective reuptake inhibitors and a safe strategy.

Chronische Alpträume: Wirksamkeit eines deutschsprachigen Manuals zur angeleiteten Selbsthilfe mit Imagery Rehearsal Therapy

2012 ◽  
Vol 41 (4) ◽  
pp. 249-257 ◽  
Author(s):  
Tana Kröner ◽  
Kathrin Hansen ◽  
Regina Steil
Keyword(s):  
Face To Face ◽  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

Theoretischer Hintergrund: Chronische Alpträume stellen eine weit verbreitete Schlafstörung dar, welche einen hohen Leidensdruck hervorruft. Als besonders wirksam in der Behandlung gilt die Imagery Rehearsal Therapy (IRT). Selbsthilfeprogramme stellen hierbei eine effektive, ökonomische Behandlungsoption dar. Fragestellung: Die vorliegende Pilotstudie untersucht die Wirksamkeit einer neuen, IRT-basierten, angeleiteten Selbsthilfe. Methode: 10 Patienten mit chronischen Alpträumen wurden im Rahmen von 4 face-to-face-Sitzungen vor Intervention (T1) sowie 4 Wochen (T2) und 3 Monate (T3) danach hinsichtlich Alptraumhäufigkeit sowie verschiedener psychosozialer Parameter untersucht. Ergebnisse: Die Alptraumhäufigkeit reduzierte sich innerhalb von 4 Wochen signifikant (T1-T2; Effektstärke: 1,0). Dieser Effekt blieb über 3 Monate stabil (T1-T3; Effektstärke: 1,26). Zudem reduzierten sich signifikant Depressions-, Angst- und Anspannungsparameter sowie das Stresserleben. Schlussfolgerung: Das deutschsprachige Selbsthilfemanual könnte eine wirksame Behandlungsmöglichkeit zur Reduktion von Alpträumen darstellen.

Rem-Tracker

Schlaf ◽  
2018 ◽  
Vol 07 (02) ◽  
pp. 76-80
Author(s):  
Friedrich Gauger ◽  
Gerhart Schroff ◽  
Wilhelm Stork
Keyword(s):  
Imagery Rehearsal Therapy ◽  
Imagery Rehearsal

Die Behandlung von Albträumen erfolgt bislang meist psychotherapeutisch. Ein in der Praxis bewährtes Verfahren ist die Imagery Rehearsal Therapy (IRT). Untersuchungen zeigen, dass die Effektivität der IRT erhöht werden kann, wenn der Patient die Fähigkeit zum Klarträumen erlangt. Die gängige Technologie zur Klartrauminduktion kann bislang nur in entsprechend qualifizierten Schlaflaboren eingesetzt werden.Der REM-TRACKER bietet erstmals die Möglichkeit der Klartrauminduktion mittels einer einfach handhabbaren Technologie, die auch im häuslichen Umfeld eingesetzt werden kann.

scholarly journals Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series

2020 ◽  
Author(s):  
Sean Horoho ◽  
Stephen Musik ◽  
David Bryant ◽  
William Brooks ◽  
Ian M Porter
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Posture Analysis ◽  
Surface Stability ◽  
Single Positive ◽  
Means Of Transmission ◽  
Respiratory Droplets

ABSTRACT It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.

The effect of caloric restriction on working memory in healthy non-obese adults

CNS Spectrums ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Emilie Leclerc ◽  
Alisson Paulino Trevizol ◽  
Ruth B. Grigolon ◽  
Mehala Subramaniapillai ◽  
Roger S. McIntyre ◽  
...  
Keyword(s):  
Working Memory ◽  
Energy Expenditure ◽  
Sleep Quality ◽  
Caloric Restriction ◽  
Neuropsychological Tests ◽  
Spatial Working Memory ◽  
Multicenter Trial ◽  
Obese Adults ◽  
Parallel Group ◽  
Lower Protein

Objective.We aim to evaluate the effect of caloric restriction (CR) in cognition by comparing performance in neuropsychological tests for working memory between a group of non-obese healthy subjects doing CR for 2 years with another consuming ad libitum diet (AL).Methods.This study was part of a larger multicenter trial called CALERIE that consisted of a randomized clinical trial with parallel-group comparing 2 years of 25% CR and AL in 220 volunteers with a BMI between 22 and 28 kg/m2, across 3 sites. The cognitive tests used were the Cambridge Neuropsychological Tests Automated Battery (CANTAB) for Spatial Working Memory (SWM) including the total number of errors (SWMTE) and strategy (SWMS). Included as possible moderators were sleep quality, mood states, perceived stress, and energy expenditure. Analyses were performed at baseline and months 12 and 24.Results.After adjustments, there was a significantly greater improvement in working memory assessed by the SWM for CR individuals, compared to AL. At month 24, it was related mostly to lower protein intake, compared to other macronutrients. Changes in SWM were moderated by changes in sleep quality, physical activity, and energy expenditure.Conclusion.On the long term, CR in healthy individuals seems to have a slightly positive effect on working memory. The study of brain CR targets opens new possibilities to prevent and treat cognitive deficits.

Abstract 3725: Simvastatin but Not Pravastatin Affects Sleep: Findings from the UCSD Statin Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Beatrice A Golomb ◽  
Edwin K Kwon ◽  
Michael H Criqui ◽  
Joel E Dimsdale
Keyword(s):  
Sleep Quality ◽  
Rating Scale ◽  
Sleep Problems ◽  
Small Sample Size ◽  
Case Reports ◽  
Controlled Trial ◽  
Small Sample ◽  
T Test ◽  
Secondary Outcome ◽  
Regression Analyses

Background : Case reports have suggested possible effects of lipophilic statins on sleep in some subjects. Most randomized studies evaluating the effect of statins on sleep have had small sample size and short duration (≤ 6 weeks). Whether statins affect sleep on average, favorably or adversely, has been unclear. Goal : To assess the effects of lipophilic and hydrophilic statins on sleep. Subjects : 1016 adult men and women without diabetes or heart disease, with LDL-cholesterol 115–190mg/dL. Design : Randomized double blind placebo-controlled trial of simvastatin 20mg, pravastatin 40mg or placebo for 6 months. Sleep was a prespecified secondary outcome. It was assessed by both an adaptation of the Leeds sleep scale (a visual analog scale of sleep quality); and a rating scale of sleep problems. Both items were measured at baseline and on-treatment. Analysis : Baseline comparability of randomization groups including sleep measures was affirmed. T-test of mean on-treatment sleep scores across randomization groups was performed. This complemented regression analyses, adjusted for baseline values of the respective sleep assessment. Results : Groups were comparable at baseline on variables including both sleep measures. Simvastatin use was associated with significantly worse sleep quality, and significantly greater reported sleep problems than either pravastatin or placebo, by t-test and regression analyses. Pravastatin did not differ significantly from placebo on any sleep outcome. Conclusion : Findings were compatible with the hypothesis that statins may impair sleep in some subjects, and that this impairment may arise selectively with lipophilic statins. Table 1. Effects of Statins on Sleep: Regression Analysis

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