McGrory Christopher M, Kram Mendelsohn Augustus, Pineles Suzanne L, Lasko Natasha B, Ivkovic Vladimir, Moon Mabelle, Cetinkaya Doga, Bazer Oren, Fortier Elizabeth, Kelly Anne, Bragdon Laura B, Arditte Hall Kimberly A, Tanev Kaloyan, Orr Scott P, Pace-Schott Edward F
National Center for PTSD, Women's Health Sciences Division at VA Boston Healthcare System, USA.
Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, USA.
Sleep Adv. 2024 Aug 13;5(1):zpae060. doi: 10.1093/sleepadvances/zpae060. eCollection 2024.
Trauma-related nightmares (TRNs) are a hallmark symptom of PTSD and are highly correlated with PTSD severity and poor sleep quality. Given the salience and arousal associated with TRNs, they might be an effective target for imaginal exposures during Prolonged Exposure (PE) therapy. As a first step in this line of research, the current study compared participants' emotional reactivity during recollection of TRNs to their recollection of the index traumatic event.
Seventeen trauma-exposed participants with clinical or sub-clinical PTSD who reported frequent TRNs engaged in script-driven imagery using scripts depicting their index trauma and their most trauma-like TRN. Heart rate (HRR), skin conductance (SCR), corrugator EMG (EMGR) responses, and emotional ratings were recorded.
HRR, SCR, and EMGR did not differ significantly between trauma-related and TRN scripts. Bayesian analyses confirmed support for the null hypothesis, indicating no differences. With the exception of "Sadness," for which TRNs elicited significantly lower ratings than trauma scripts, individual emotion ratings showed no significant differences, suggesting likely parity between the emotionality of trauma-related and TRN recollections.
Together, TRN content elicited psychophysiological reactivity similar to that of the index trauma in this pilot study. Upon replication, studies testing TRNs as potential targets for imaginal exposures during PE may be warranted.
创伤相关噩梦（TRN）是创伤后应激障碍（PTSD）的标志性症状，与PTSD严重程度和睡眠质量差高度相关。鉴于TRN所具有的显著性和唤起效应，它们可能是延长暴露（PE）疗法期间想象暴露的有效靶点。作为这一研究方向的第一步，本研究比较了参与者在回忆TRN时与回忆索引创伤事件时的情绪反应。
17名有临床或亚临床PTSD且报告经常做TRN的创伤暴露参与者使用描述其索引创伤和最像创伤的TRN的脚本进行脚本驱动意象。记录心率（HRR）、皮肤电导率（SCR）、皱眉肌肌电图（EMGR）反应和情绪评分。
创伤相关脚本和TRN脚本之间的HRR、SCR和EMGR没有显著差异。贝叶斯分析证实支持零假设，表明没有差异。除了“悲伤”（TRN引发的评分显著低于创伤脚本）外，个体情绪评分没有显著差异，这表明创伤相关回忆和TRN回忆在情绪性方面可能相当。
在这项初步研究中，TRN内容引发的心理生理反应与索引创伤相似。经重复验证后，可能有必要开展研究，将TRN作为PE期间想象暴露的潜在靶点进行测试。
