NightmaresPhase 1/2NCT00291031
Study of the Effect of Imagery Rehearsal Therapy (IRT) of Nightmares
A Phase 1/2 study testing Imagery Rehearsal Therapy (IRT) in people with Nightmares and Anxiety Disorders, run by GGZ Centraal at 3 sites in Netherlands.
Trial summary
The purpose of this study is to determine whether Imagery Rehearsal Therapy(IRT) is effective in the reduction of the number of nightmares and the nightmare distress in a population of patients with psychiatric disorders. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Nightmares, Anxiety Disorders, Mood Disorders
- What is being tested?
- Imagery Rehearsal Therapy (IRT)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 112 participants
- Where
- 3 sitesNetherlands
- Study dates
- Feb 2006to Aug 2011
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Minimum of 3 nightmares per month
- Nightmares are associated with distress in daily life
- Subject wants to get treatment for the nightmares
Who cannot join
- Imagery rehearsal therapy for nightmares in the past
- Psychotic disorders
- Acute psychiatric crisis
- Mentally challenged or neuropsychiatric syndrome
- Severe addiction problems
- Insufficient mastery of the Dutch language
Trial locations and contacts
3 sites in 1 country.
Netherlands3 sites
GGZ Centraal, De Meregaard
Almere Stad, 1326 AD
GGZ Centraal, Zon & Schild
Amersfoort, 3818 EW
GGZ Centraal, De Rembrandthof
Hilversum, 1200 AE
About this study
Official title: A Randomised Controlled Trial of Imagery Rehearsal Therapy (IRT) of Nightmares in a Psychiatric Population
The purpose of this study is to determine whether Imagery Rehearsal Therapy(IRT) is effective in the reduction of the number of nightmares and the nightmare distress in a population of patients with psychiatric disorders.
Read the detailed description
Within the normal population 4-8% of the people suffer regularly from nightmares. Clinical observations show that nightmares are a common problem for patients who suffer from all kinds of psychiatric disorders, and not just for the patients diagnosed with PTSD. Often nightmares can lead to sleep disorders, which have a negative impact on emotional well-being and cognitive functioning during the day. As well as this a strong relationship between severity of nightmares and severity of psychopathology has been found. This gives a strong argument for treatment of nightmares as a symptom, separate from the psychiatric disorder.
A few controlled studies of the treatment of nightmares have been published, in which behavioral therapy, relaxation techniques, exposure and systematic desensitization have been studied, all of which have shown positive results. But these techniques do not seem to reduce the number of nightmares in patients who suffer from PTSD. These last few years more controlled studies of a cognitive behavioral technique called 'Imagery Rehearsal Therapy' (IRT) have been published. With IRT patients have to change the script of their nightmares into a different outcome, and rehearse this new script using cognitive imagery a few times a day.
Comparisons: treatment of nightmares with IRT compared to a waitlist control group who do not get IRT until 6 months later.
- Conditions
- Nightmares, Anxiety Disorders, Mood Disorders, Personality Disorders
- Being tested
- Imagery Rehearsal Therapy (IRT)
- Keywords
- nightmare, sleep disorder, sleep, imagery rehearsal, anxiety disorders, mood disorders, personality disorders
- Medical subject headings
- Anxiety Disorders, Mood Disorders, Personality Disorders, Sleep Wake Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Imagery Rehearsal Therapy (IRT)Behavioural
Also called IRT
Imagery Rehearsal Therapy is given by psychologists, psychotherapists or psychiatrists. The IRT therapists are all trained by Annette van Schagen, principal investigator.
IRT consists of six 1-hour sessions. The six sessions are given in a period of three months. Each session is described in the IRT Manual. The IRT Manual is devised by the principal investigator Annette van Schagen in colaboration with Victor Spoormaker PhD. There is a patient version of the IRT manual available for the patients, which includes descriptions of the IRT sessions and homework assignments.
| Study group | Role | What they receive |
|---|---|---|
| IRT | Experimental | Patients randomly assigned to the IRT condition receive Imagery Rehearsal Therapy after 4 weeks since the entrance into the trial next to their treatment as usual. Receives: Behavioral: Imagery Rehearsal Therapy (IRT) |
| TAU | No intervention | Patients that are randomly assigned to the waiting list control condition get treatment as usual (TAU) and complete the daily nightmare logs for a period of three months. These patients get the IRT intervention after waiting for 6 months. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Frequency of nightmares scored in prospective daily nightmare logs
Measured: Daily logs for 18 weeks, then periods of 4 weeks every 3 months
Frequency of nightmares scored on the Nightmare Frequency Questionnaire
Measured: At beginning of trial, 4, 16, 30, 42 and 56 weeks
Secondary outcomes (8)
Intensity of nightmares scored in prospective daily nightmare logs
Measured: Daily logs for 18 weeks, then periods of 4 weeks every 3 months
Effects of nightmares scored on the Nightmare Effects Survey
Measured: 1, 4, 16, 30, 42 and 56 weeks
Nightmare distress scored on the Nightmare Distress Questionnaire
Measured: 1, 4, 16, 30, 42 and 56 weeks
Sleep problems scored on the SLEEP-50
Measured: 1, 4, 16, 30, 42 and 56 weeks
Psychiatric symptoms scored on the Symptom Check List (SCL-90)
Measured: 1, 4, 16, 30, 42 and 56 weeks
Symptoms of post-traumatic stress disorder scored on the Zelf Inventarisatie Lijst PTSS ZIL (= PTSD Inventory)
Measured: 1, 4, 16, 30, 42 and 56 weeks
Quality of life scored on the abbreviated World Health Organization Quality of Life scale (WHOQoL-Bref)
Measured: 1, 4, 16, 30, 42 and 56 weeks
Nightmare efficacy and content measured by Nightmare Efficacy & Content Questionnaire
Measured: 1, 4, 16, 30, 42 and 56 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Feb 2006 (estimated)
- Study startFeb 2006
- Primary completionJan 2011
- Study completionAug 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for NightmaresStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 112 participants (actual)
Sponsor and investigators
- Lead sponsor
- GGZ Centraal
- Sponsor type
- University, hospital or other
- Collaborators
- Utrecht University
- Responsible party
- Principal investigator, Annette van Schagen, GGZ Centraal
- Investigators
- Annette M. van Schagen, MA, Principal investigator, GGZ Centraal (previously Symfora groep)Jan van den Bout, PhD, Study chair, Utrecht UniversityVictor I. Spoormaker, PhD, Study chair, Max-Planck-Institute of PsychiatryJaap Lancee, PhD, Study chair, University of Amsterdam
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00291031
- Sponsor's protocol ID
- WO-SG-114NM
- Status last verified
- Oct 2013
- First submitted
- 10 Feb 2006
- Last updated
- 17 Oct 2013
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Krakow B, Hollifield M, Johnston L, Koss M, Schrader R, Warner TD, Tandberg D, Lauriello J, McBride L, Cutchen L, Cheng D, Emmons S, Germain A, Melendrez D, Sandoval D, Prince H. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA. 2001 Aug 1;286(5):537-45. doi: 10.1001/jama.286.5.537.
PubMed 11476655Spoormaker VI, Schredl M, van den Bout J. Nightmares: from anxiety symptom to sleep disorder. Sleep Med Rev. 2006 Feb;10(1):19-31. doi: 10.1016/j.smrv.2005.06.001. Epub 2005 Dec 27.
PubMed 16377217Benca RM, Obermeyer WH, Thisted RA, Gillin JC. Sleep and psychiatric disorders. A meta-analysis. Arch Gen Psychiatry. 1992 Aug;49(8):651-68; discussion 669-70. doi: 10.1001/archpsyc.1992.01820080059010.
PubMed 1386215Blagrove M, Farmer L, Williams E. The relationship of nightmare frequency and nightmare distress to well-being. J Sleep Res. 2004 Jun;13(2):129-36. doi: 10.1111/j.1365-2869.2004.00394.x.
PubMed 15175092Rothbaum BO, Mellman TA. Dreams and exposure therapy in PTSD. J Trauma Stress. 2001 Jul;14(3):481-90. doi: 10.1023/A:1011104521887.
PubMed 11534880Spoormaker VI, Verbeek I, van den Bout J, Klip EC. Initial validation of the SLEEP-50 questionnaire. Behav Sleep Med. 2005;3(4):227-46. doi: 10.1207/s15402010bsm0304_4.
PubMed 16190812Strine TW, Chapman DP. Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Med. 2005 Jan;6(1):23-7. doi: 10.1016/j.sleep.2004.06.003.
PubMed 15680291van de Willige G, Wiersma D, Nienhuis FJ, Jenner JA. Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQoL. Qual Life Res. 2005 Mar;14(2):441-51. doi: 10.1007/s11136-004-0689-y.
PubMed 15892433van Schagen AM, Lancee J, de Groot IW, Spoormaker VI, van den Bout J. Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial. J Clin Psychiatry. 2015 Sep;76(9):e1105-13. doi: 10.4088/JCP.14m09216.
PubMed 26455674
Study at a glance
From the registry record, last updated by the sponsor on 17 Oct 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomised Controlled Trial of Imagery Rehearsal Therapy (IRT) of Nightmares in a Psychiatric Population
- ClinicalTrials.gov ID
- NCT00291031
- Acronym / sponsor ID
- WO-SG-114NM
- Conditions
- Nightmares, Anxiety Disorders, Mood Disorders, Personality Disorders
- Keywords
- nightmare, sleep disorder, sleep, imagery rehearsal, anxiety disorders, mood disorders, personality disorders
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 112 participants (actual)
- Lead sponsor
- GGZ CentraalUniversity, hospital or other
- Collaborators
- Utrecht University
- Study start
- Feb 2006
- Primary completion
- Jan 2011 (actual)
- Study completion
- Aug 2011 (actual)
- First posted
- 13 Feb 2006 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether Imagery Rehearsal Therapy(IRT) is effective in the reduction of the number of nightmares and the nightmare distress in a population of patients with psychiatric disorders.
Detailed description
Within the normal population 4-8% of the people suffer regularly from nightmares. Clinical observations show that nightmares are a common problem for patients who suffer from all kinds of psychiatric disorders, and not just for the patients diagnosed with PTSD. Often nightmares can lead to sleep disorders, which have a negative impact on emotional well-being and cognitive functioning during the day. As well as this a strong relationship between severity of nightmares and severity of psychopathology has been found. This gives a strong argument for treatment of nightmares as a symptom, separate from the psychiatric disorder.
A few controlled studies of the treatment of nightmares have been published, in which behavioral therapy, relaxation techniques, exposure and systematic desensitization have been studied, all of which have shown positive results. But these techniques do not seem to reduce the number of nightmares in patients who suffer from PTSD. These last few years more controlled studies of a cognitive behavioral technique called 'Imagery Rehearsal Therapy' (IRT) have been published. With IRT patients have to change the script of their nightmares into a different outcome, and rehearse this new script using cognitive imagery a few times a day.
Comparisons: treatment of nightmares with IRT compared to a waitlist control group who do not get IRT until 6 months later.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| IRT | Experimental | Behavioral: Imagery Rehearsal Therapy (IRT)Patients randomly assigned to the IRT condition receive Imagery Rehearsal Therapy after 4 weeks since the entrance into the trial next to their treatment as usual. |
| TAU | No intervention | –Patients that are randomly assigned to the waiting list control condition get treatment as usual (TAU) and complete the daily nightmare logs for a period of three months. These patients get the IRT intervention after waiting for 6 months. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Minimum of 3 nightmares per month
- Nightmares are associated with distress in daily life
- Subject wants to get treatment for the nightmares
Key exclusion criteria (6 listed)
- Imagery rehearsal therapy for nightmares in the past
- Psychotic disorders
- Acute psychiatric crisis
- Mentally challenged or neuropsychiatric syndrome
- Severe addiction problems
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Imagery Rehearsal Therapy (IRT)Also: IRTImagery Rehearsal Therapy is given by psychologists, psychotherapists or psychiatrists. The IRT therapists are all trained by Annette van Schagen, principal investigator. IRT consists of six 1-hour sessions. The six sessions are given in a period of three months. Each session is described in the IRT Manual. The IRT Manual is devised by the principal investigator Annette van Schagen in colaboration with Victor Spoormaker PhD. There is a patient version of the IRT manual available for the patients, which includes descriptions of the IRT sessions and homework assignments. | Behavioural | IRT |
Primary outcome
Frequency of nightmares scored in prospective daily nightmare logs
Time frame: Daily logs for 18 weeks, then periods of 4 weeks every 3 months
Frequency of nightmares scored on the Nightmare Frequency Questionnaire
Time frame: At beginning of trial, 4, 16, 30, 42 and 56 weeks
8 secondary outcomes
Intensity of nightmares scored in prospective daily nightmare logs
Time frame: Daily logs for 18 weeks, then periods of 4 weeks every 3 months
Effects of nightmares scored on the Nightmare Effects Survey
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Nightmare distress scored on the Nightmare Distress Questionnaire
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Sleep problems scored on the SLEEP-50
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Psychiatric symptoms scored on the Symptom Check List (SCL-90)
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Symptoms of post-traumatic stress disorder scored on the Zelf Inventarisatie Lijst PTSS ZIL (= PTSD Inventory)
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Quality of life scored on the abbreviated World Health Organization Quality of Life scale (WHOQoL-Bref)
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Nightmare efficacy and content measured by Nightmare Efficacy & Content Questionnaire
Time frame: 1, 4, 16, 30, 42 and 56 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Oct 2013.
- Background: PubMed 11476655Krakow B, Hollifield M, Johnston L, Koss M, Schrader R, Warner TD, Tandberg D, Lauriello J, McBride L, Cutchen L, Cheng D, Emmons S, Germain A, Melendrez D, Sandoval D, Prince H. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA. 2001 Aug 1;286(5):537-45. doi: 10.1001/jama.286.5.537.
- Background: PubMed 16377217Spoormaker VI, Schredl M, van den Bout J. Nightmares: from anxiety symptom to sleep disorder. Sleep Med Rev. 2006 Feb;10(1):19-31. doi: 10.1016/j.smrv.2005.06.001. Epub 2005 Dec 27.
- Background: PubMed 1386215Benca RM, Obermeyer WH, Thisted RA, Gillin JC. Sleep and psychiatric disorders. A meta-analysis. Arch Gen Psychiatry. 1992 Aug;49(8):651-68; discussion 669-70. doi: 10.1001/archpsyc.1992.01820080059010.
- Background: PubMed 15175092Blagrove M, Farmer L, Williams E. The relationship of nightmare frequency and nightmare distress to well-being. J Sleep Res. 2004 Jun;13(2):129-36. doi: 10.1111/j.1365-2869.2004.00394.x.
- Background: PubMed 11534880Rothbaum BO, Mellman TA. Dreams and exposure therapy in PTSD. J Trauma Stress. 2001 Jul;14(3):481-90. doi: 10.1023/A:1011104521887.
- Background: PubMed 16190812Spoormaker VI, Verbeek I, van den Bout J, Klip EC. Initial validation of the SLEEP-50 questionnaire. Behav Sleep Med. 2005;3(4):227-46. doi: 10.1207/s15402010bsm0304_4.
- Background: PubMed 15680291Strine TW, Chapman DP. Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Med. 2005 Jan;6(1):23-7. doi: 10.1016/j.sleep.2004.06.003.
- Background: PubMed 15892433van de Willige G, Wiersma D, Nienhuis FJ, Jenner JA. Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQoL. Qual Life Res. 2005 Mar;14(2):441-51. doi: 10.1007/s11136-004-0689-y.
- Derived from this study: PubMed 26455674van Schagen AM, Lancee J, de Groot IW, Spoormaker VI, van den Bout J. Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial. J Clin Psychiatry. 2015 Sep;76(9):e1105-13. doi: 10.4088/JCP.14m09216.
- The website of Symfora groep, Centres for Mental Health CareLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Annette M. van Schagen, MA principal investigator
GGZ Centraal (previously Symfora groep)
Jan van den Bout, PhD study chair
Utrecht University
Victor I. Spoormaker, PhD study chair
Max-Planck-Institute of Psychiatry
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Imagery Rehearsal Therapy (IRT) in people with Nightmares and Anxiety Disorders, run by GGZ Centraal at 3 sites in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Oct 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Frequency of nightmares scored in prospective daily nightmare logs (time frame: Daily logs for 18 weeks, then periods of 4 weeks every 3 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00291031, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Oct 2013.