- Research Blog 7 - Literature Review 3 -
- Literature Review #3 -
~ Citation ~
Cognitions in Sleep: Lucid Dreaming as an Intervention for Nightmares in Patients With Posttraumatic Stress Disorder
Holzinger, Brigitte, et al. “Cognitions in Sleep: Lucid Dreaming as an Intervention for Nightmares in Patients With Posttraumatic Stress Disorder.” Frontiers in Psychology, vol. 11, 2020, doi:10.3389/fpsyg.2020.01826.
This journal article was punished in volume 11 of Frontiers in Psychology. The institutions that they are all connected to are the Institute for Consciousness and Dream Research, Certificat Programme Sleep Coaching, Department of Psychiatry, and Department of Neurology in the Medical University of Vienna, Austria. Other than this article, each article is credited to numerous other research that has been done in their respective fields of study.
~ Summary ~
The article first begins by describing what nightmares are and how their frequency can cause major distress and impact nighttime or daytime functioning and become classified as a nightmare disorder. In order to be diagnosed the minimal criteria are as follows: (1) the patient suffers from repeated episodes of extended, extremely dysphoric, and well-remembered dreams that involve threats to survival, security, or physical integrity, (2) a person must experience rapid orientation and alertness upon waking up from the dysphoric dreams, and (3) the dream experience itself or the sleep disorder resulting from it causes distress or impairment in social, occupational, or other important areas of functioning. It also provides statistics about nightmares and their effects and describes the physiological changes that lead up to the creation of nightmares and what occurs because of them. The introduction concludes by describing why this investigation is needed and then explaining what Lucid Dreaming Therapy is, mentioning that LD can be a useful tool for those affected by nightmares and that the overall purpose of the study is to (1) evaluate LDT in patients with PTSD with nightmares (2) if LDT leads to a sustainable reduction of nightmares, with a secondary goal of investigating its efficiency and sustainability in regards to reducing nightmare frequency.
The following section of the article discusses the material and methods that were used for this study and is broken up into four subsections. The first subsection is titled Participants and Procedures and explains that there were 31 adult participants in the study, with all of them recruited through an inpatient treatment center for psychiatric patients in Ybbs. These 31 subjects kept a sleep diary for 6 weeks and were randomly assigned to LDT or a credible active comparison condition for the treatment of nightmares. During the 6 weeks, those assigned to LDT received an additional 60-min group session each week. After the 6 weeks, there was a follow-up survey that followed 6 weeks after the intervention. The second subsection is titled Lucid Dream Therapy Sessions and describes what occurred during the sessions and how it was documented and done. The third subsection was Measurements and Questionnaires and described the different measures used such as a symptom checklist, Impact of Events Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Self-Rating Anxiety Scale, Self-rating Depression Scale, Perceived Stress Scale, and a Sleep/Dream Checklist. The final subsection was titled Data Analysis and explained the type of data collection that was used in order to analyze the information collected.
The final parts of the article described and explained the results and discussed what they meant and the implications of the findings. Where it was concluded that the results provide some support of the effectiveness of LDT in the treatment of nightmares, specifically those with psychological disorders, but that there were limitations in their study and so it would require further investigation. The sample size was quite small and there was a high-drop out rate. There was also difficult due to comorbidity of substance use that affected concentration and lucidity with some patients and kept them from being able to induce LD. The article also explains that many of the methodological shortcomings could be resolves, but its potential is worth investigating amongst other psychological disorders other than PTSD. The article finally makes the concluding statement that due to a number of mediators and moderators, further investigation is necessary, but the overall potential is interesting.
~ Quotes ~
"...LD could provide a useful tool for people affected by nightmares, since it could activate self-responsibility and self-control in a frightening situation...it presents an advantage over therapeutic treatments as it can be applied in the situation itself, while the nightmare is happening, and not afterwards.." (pg 3)
"Our findings provide some support on the effectivenes of LDT in the treatment of nightmares, especially when it comes to patients with psychological disorders." (pg 5)
"It has to be taken into account that LDT as an intervention technique belongs to the factors or variables that in general explain 10-15% of the variance of the therapy outcome." (pg 6)
~ Value ~
This particular article is valuable due to it being a relatively new publishing related to the topic of LD and nightmares. Meaning that, it should have some new information regarding the topic based on the number of newer studies investigating LD and its potential uses. Despite the sample size being rather small and the other limitations, the findings it has reported thus far shows promise in reducing anxiety and depression in patients, and if anything, shows support in its use not as a primary intervention, but as a supplement for another intervention. It also provides insight in the variance that comes with investigating LD among individuals and how it may be useful in more than just PTSD, anxiety disorders, and depression. The article also has some interesting references and citations that can also help in forming a paper investigating LD and nightmares.
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