Physiological–Emotional Reactivity to Nightmare-Related Imagery in Trauma-Exposed Persons With Chronic Nightmares
Abstract
Script-driven imagery was used to assess nightmare imagery-evoked physiological-emotional reactivity (heart rate, skin conductance, facial electromyogram, subjective ratings) in trauma-exposed persons suffering from chronic nightmares. Goals were to determine the efficacy of nightmare imagery to evoke physiological-emotional reactivity, correlates (mental health, nightmare characteristics) of reactivity, and consequences (sleep and health problems) of reactivity. Nightmare imagery resulted in significant reactivity relative to control imagery. No mental health variable (posttraumatic stress disorder status, depressive symptoms, dissociation) or nightmare characteristic (months experienced, frequency, similarity to trauma) was associated with reactivity level. However, nightmare imagery-evoked autonomic responses were associated with greater sleep disturbance and reported health symptoms, even when nightmare frequency was controlled. These results suggest nightmare-related autonomic reactions may contribute to sleep and health disturbance.
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No study utilizing personalized trauma stimuli found a relationship between skin conductance and trait dissociation.
“No study utilizing personalized trauma stimuli found a relationship between SC and trait dissociation (Bichescu-Burian et al., 2017; Rhudy et al., 2008; Schmahl et al., 2004; Vermes et al., 2020).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Rhudy et al., 2008
Cites
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
Journal of Clinical Psychiatry
(2018) · Journal of Clinical Psychiatry · doi:10.5505/kpd · Cited by 13,703 · see citing works
Measuring emotion: The self-assessment manikin and the semantic differential
Bradley, M. M., & Lang, P. J. (1994) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(94)90063-9 · Cited by 9,538 · see citing works
Beck, A. T., Steer, R. A., & Brown, G. (2011) · PsycTESTS Dataset · doi:10.1037/t00742-000 · Cited by 7,535 · see citing works
Stress, adaptation, and disease. Allostasis and allostatic load
McEWEN, B. S. (1998) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1998.tb09546.x · Cited by 5,092 · see citing works
(2001) · doi:10.1017/cbo9780511546396 · Cited by 4,482 · see citing works
Development, reliability, and validity of a dissociation scale
BERNSTEIN, E. M., & PUTNAM, F. W. (1986) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198612000-00004 · Cited by 3,793 · cited 3× · see citing works
“@The DES is a reliable, self-report questionnaire that assesses frequency of 28 dissociative experiences on a 0% to 100% scale with 10-point intervals ( Carlson & Putnam, 1993 ; Dubester & Braun, 1995 ).”
BackgroundMethodLooking at pictures: Affective, facial, visceral, and behavioral reactions
LANG, P. J., GREENWALD, M. K., BRADLEY, M. M., & HAMM, A. O. (1993) · Psychophysiology · doi:10.1111/j.1469-8986.1993.tb03352.x · Cited by 3,190 · see citing works
Dawson, M., Schell, A., & Filion, D. L. (2007) · Cambridge University Press eBooks · doi:10.1017/cbo9780511546396.007 · Cited by 2,425 · see citing works
Emotion and motivation I: Defensive and appetitive reactions in picture processing.
Bradley, M. M., Codispoti, M., Cuthbert, B. N., & Lang, P. J. (2001) · Emotion · doi:10.1037/1528-3542.1.3.276 · Cited by 2,224 · see citing works
The Psychology of Physical Symptoms
Pennebaker, J. W. (1982) · Springer eBooks · doi:10.1007/978-1-4613-8196-9 · Cited by 1,776 · see citing works
Guidelines for Human Electromyographic Research
Fridlund, A. J., & Cacioppo, J. T. (1986) · Psychophysiology · doi:10.1111/j.1469-8986.1986.tb00676.x · Cited by 1,737 · see citing works
(1993) · Cited by 1,279 · see citing works
Shin, L. M., Orr, S. P., Carson, M. A., Rauch, S. L., Macklin, M. L., Lasko, N. B., Peters, P. M., Metzger, L. J., Dougherty, D. D., Cannistraro, P. A., et al. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.2.168 · Cited by 790 · see citing works
Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans
Pitman, R. K. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800230050009 · Cited by 758 · see citing works
Weathers, F. W., Ruscio, A. M., & Keane, T. M. (1999) · Psychological Assessment · doi:10.1037/1040-3590.11.2.124 · Cited by 707 · see citing works
Raskind, M. A., Peskind, E. R., Kanter, E. D., Petrie, E. C., Radant, A. D., Thompson, C. E., Dobie, D. J., Hoff, D., Rein, R. J., Straits-Tröster, K. A., et al. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.2.371 · Cited by 607 · see citing works
The psychophysiology of posttraumatic stress disorder: a meta-analysis
Pole, N. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.5.725 · Cited by 582 · cited 2× · see citing works
“with PTSD-negative individuals (Carson et al., 2000; Lindauer et al., 2006; Orr et al., 1998; Pitman et al., 2001; Pole, 2007; Schmahl et al., 2004; Shin et al., 2004).”
BackgroundKrakow, B., Hollifield, M., Johnston, L., Koss, M., Schrader, R., Warner, T. D., Tandberg, D., Lauriello, J., McBride, L., Cutchen, L., et al. (2001) · JAMA · doi:10.1001/jama.286.5.537 · Cited by 557 · see citing works
Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., & Menon, R. S. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01367-7 · Cited by 505 · cited 1× · see citing works
“Because evidence suggests dissociation is associated with reduced physiological reactivity to fear cues (Griffin, Resick, & Mechanic, 1997; Lanius et al., 2002; Pole et al., 2005), we predicted that dissociation would be negatively associated with reactivity to nightmare imagery.”
BackgroundThe validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD
Forbes, D., Creamer, M. C., & Biddle, D. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(00)00084-x · Cited by 470 · see citing works
Neylan, T. C., Marmar, C. R., Metzler, T. J., Weiss, D. S., Zatzick, D., Delucchi, K., Wu, R. M., & Schoenfeld, F. B. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.929 · Cited by 455 · see citing works
(1993) · Behavior Therapy · Cited by 409 · see citing works
Koren, D., Arnon, I., Lavie, P., & Klein, E. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.5.855 · Cited by 384 · see citing works
Objective assessment of peritraumatic dissociation: psychophysiological indicators
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.8.1081 · Cited by 347 · see citing works
Nightmares and trauma: a comparison of nightmares after combat with lifelong nightmares in veterans
(1984) · American Journal of Psychiatry · doi:10.1176/ajp.141.2.187 · Cited by 305 · see citing works
Keane, T. M., Kolb, L. C., Kaloupek, D. G., Orr, S. P., Blanchard, E. B., Thomas, R. G., Hsieh, F. Y., & Lavori, P. W. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.6.914 · Cited by 282 · see citing works
Germain, A., Hall, M. H., Krakow, B. J., Shear, M. K., & Buysse, D. J. (2004) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2004.02.001 · Cited by 247 · see citing works
Orr, S. P., Pitman, R. K., Lasko, N. B., & Herz, L. R. (1993) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.102.1.152 · Cited by 243 · see citing works
Pitman, R. K., Orr, S. P., Forgue, D. F., Altman, B., de Jong, J. B., & Herz, L. R. (1990) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.99.1.49 · Cited by 239 · see citing works
Krakow, B. J., Hollifield, M. A., Schrader, R., Koss, M. P., Tandberg, D., Lauriello, J., McBride, L., Warner, T. D., Cheng, D., Edmond, T. E., et al. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007854015481 · Cited by 230 · see citing works
Psychophysiological assessment: clinical applications for PTSD
Orr, S. P., & Roth, W. T. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00340-2 · Cited by 229 · see citing works
Keane, T. M., Kolb, L. C., Kaloupek, D. G., Orr, S. P., Blanchard, E. B., Thomas, R. G., Hsieh, F. Y., & Lavori, P. W. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.6.914 · Cited by 221 · see citing works
Affective modulation of nociception at spinal and supraspinal levels
Rhudy, J. L., Williams, A. E., McCabe, K. M., Nguyê˜n, M. A. T. V., & Rambo, P. (2005) · Psychophysiology · doi:10.1111/j.1469-8986.2005.00313.x · Cited by 218 · see citing works
Self-citationBoscarino, J. A., & Chang, J. (1999) · Annals of Behavioral Medicine · doi:10.1007/bf02884839 · Cited by 216 · see citing works
(1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.4.620 · Cited by 177 · see citing works
Orr, S. P., Lasko, N. B., Metzger, L. J., Berry, N. J., Ahern, C. E., & Pitman, R. K. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.6.906 · Cited by 173 · see citing works
Randomized clinical trial for treatment of chronic nightmares in trauma‐exposed adults
Davis, J. L., & Wright, D. C. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20199 · Cited by 164 · see citing works
Self-citationPsychometric properties of the dissociative experiences scale
DUBESTER, K. A., & BRAUN, B. G. (1995) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199504000-00008 · Cited by 149 · see citing works
Dreams in the acute aftermath of trauma and their relationship to PTSD
Mellman, T. A., David, D., Bustamante, V., Torres, J., & Fins, A. (2001) · Journal of Traumatic Stress · doi:10.1023/a:1007812321136 · Cited by 149 · see citing works
Schmahl, C. G., Elzinga, B. M., Ebner, U. W., Simms, T., Sanislow, C., Vermetten, E., McGlashan, T. H., & Douglas Bremner, J. (2004) · Psychiatry Research · doi:10.1016/j.psychres.2004.01.005 · Cited by 132 · see citing works
Nocturnal re‐experiencing more than forty years after war trauma
Schreuder, B. J. N., Kleijn, W. C., & Rooijmans, H. G. M. (2000) · Journal of Traumatic Stress · doi:10.1023/a:1007733324351 · Cited by 129 · see citing works
Stallard, P. N., & Smith, E. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01692.x · Cited by 124 · see citing works
Carson, M. A., Paulus, L. A., Lasko, N. B., Metzger, L. J., Wolfe, J., Orr, S. P., & Pitman, R. K. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.890 · Cited by 119 · see citing works
Lang, P. J. (1988) · Springer eBooks · doi:10.1007/978-94-009-2792-6_7 · Cited by 113 · see citing works
Forbes, D., Phelps, A. J., McHugh, A. F., Debenham, P., Hopwood, M., & Creamer, M. (2003) · Journal of Traumatic Stress · doi:10.1023/a:1025718830026 · Cited by 104 · see citing works
Germain, A., & Nielsen, T. (2003) · Behavioral Sleep Medicine · doi:10.1207/s15402010bsm0103_2 · Cited by 104 · see citing works
Hartmann, E. L. (1998) · Psychiatry · doi:10.1080/00332747.1998.11024834 · Cited by 98 · see citing works
Treatment of combat‐related nightmares using imagery rehearsal: A pilot study
Forbes, D., Phelps, A. J., & McHugh, T. (2001) · Journal of Traumatic Stress · doi:10.1023/a:1011133422340 · Cited by 96 · see citing works
Prevalence of PTSD symptoms in combat veterans seeking medical treatment
Blake, D. D., Keane, T. M., Wine, P. R., Mora, C. A., Taylor, K. L., & Lyons, J. A. (1990) · Journal of Traumatic Stress · doi:10.1002/jts.2490030103 · Cited by 85 · see citing works
Characteristics of chronic nightmares in a trauma-exposed treatment-seeking sample.
Davis, J. L., Byrd, P., Rhudy, J. L., & Wright, D. C. (2007) · Dreaming · doi:10.1037/1053-0797.17.4.187 · Cited by 83 · see citing works
Self-citationPsychophysiologic Assessment of Posttraumatic Stress Disorder in Breast Cancer Patients
Pitman, R. K., Lanes, D. M., Williston, S. K., Guillaume, J. L., Metzger, L. J., Gehr, G., & Orr, S. P. (2001) · Psychosomatics · doi:10.1176/appi.psy.42.2.133 · Cited by 80 · see citing works
Direct psychological therapies for nightmares: A review
Halliday, G. (1987) · Clinical Psychology Review · doi:10.1016/0272-7358(87)90041-9 · Cited by 80 · see citing works
Evaluation of dream content in combat‐related PTSD
Esposito, K. F., Benitez, A., Barza, L., & Mellman, T. A. (1999) · Journal of Traumatic Stress · doi:10.1023/a:1024725319777 · Cited by 73 · see citing works
Blanchard, E. B. (1990) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(90)90015-2 · Cited by 72 · see citing works
Shalev, A. Y., Orr, S. P., & Pitman, R. K. (1992) · PubMed · Cited by 63 · see citing works
Lindauer, R., van Meijel, E. P. M., Jalink, M., Olff, M., Carlier, I. V. E., & Gersons, B. P. R. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000188566.35902.e7 · Cited by 57 · see citing works
Psychophysiologic Reactivity: Implications for Conceptualizing PTSD
Orr, S. P., McNally, R. J., Rosen, G. M., & Shalev, A. Y. (2004) · Wiley eBooks · doi:10.1002/9780470713570.ch6 · Cited by 36 · see citing works
Sleep latency testing as a time course measure of state arousal
Bonnet, M. H., & Arand, D. L. (2005) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2005.00489.x · Cited by 28 · see citing works
Pole, N., Cumberbatch, E., Taylor, W. M., Metzler, T. J., Marmar, C. R., & Neylan, T. C. (2006) · Journal of Trauma & Dissociation · doi:10.1300/j229v06n04_04 · Cited by 27 · see citing works
Dream Anxiety Attacks (Nightmares)
Erman, M. K. (1987) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(18)30541-0 · Cited by 17 · see citing works
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Self-citationBeutler, S., Mertens, Y. L., Ladner, L., Schellong, J., Croy, I., & Daniels, J. K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2132599 · Cited by 64 · see citing works
“No study utilizing personalized trauma stimuli found a relationship between SC and trait dissociation (Bichescu-Burian et al., 2017; Rhudy et al., 2008; Schmahl et al., 2004; Vermes et al., 2020).”
BackgroundInfluentialSleep and Dreaming in Posttraumatic Stress Disorder
Miller, K. E., Brownlow, J. A., Woodward, S., & Gehrman, P. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0827-1 · Cited by 67 · see citing works
Rhudy, J. L., Davis, J. L., Williams, A. E., McCabe, K. M., Bartley, E. J., Byrd, P. M., & Pruiksma, K. E. (2010) · Journal of Clinical Psychology · doi:10.1002/jclp.20656 · Cited by 43 · see citing works
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Heilemann, M. V., Choudhury, S. M., Kury, F. S., & Lee, K. A. (2012) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2011.05918.x · Cited by 37 · see citing works
Mendoza-Alvarez, M., Balthasar, Y., Verbraecken, J. A., Claes, L., Someren, E. J. W. V., van Marle, H. J. F., Vandekerckhove, M. M. P., & Picker, L. D. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.12.037 · Cited by 29 · see citing works
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Kirmayer, L. J. (2009) · Culture Medicine and Psychiatry · doi:10.1007/s11013-009-9136-4 · Cited by 19 · see citing works
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Long, M. E., Davis, J. L., Springer, J. R., Elhai, J. D., Rhudy, J. L., Teng, E. J., & Frueh, B. C. (2011) · Journal of Clinical Psychology · doi:10.1002/jclp.20804 · Cited by 16 · see citing works
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Bergmann, M., Högl, B., & Stefani, A. (2024) · Clinical Neurophysiology Practice · doi:10.1016/j.cnp.2023.10.003 · Cited by 15 · see citing works
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Savard, M., Merlo, R., Samithamby, A., Paas, A., & Coffey, E. B. J. (2024) · Psychophysiology · doi:10.1111/psyp.14642 · Cited by 12 · see citing works
Isaac, F., Klein, B., Nguyen, H., Watson, S., & Kennedy, G. A. (2025) · JMIR Human Factors · doi:10.2196/65228 · Cited by 9 · see citing works
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Faccini, J., Joshi, V., & Del-Monte, J. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.09.035 · Cited by 8 · see citing works
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Pruiksma, K. E., Wachen, J. S., Wardle‐Pinkston, S., & Resick, P. A. (2017) · Springer eBooks · doi:10.1007/978-1-4939-7148-0_24 · Cited by 6 · see citing works
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McGrory, C. M., Mendelsohn, A. K., Pineles, S. L., Lasko, N. B., Ivković, V., Moon, M., Cetinkaya, D., Bazer, O. M., Fortier, E., Kelly, A., et al. (2024) · SLEEP Advances · doi:10.1093/sleepadvances/zpae060 · Cited by 2 · see citing works
Ocean, S. E. (2014) · The Mathematics Enthusiast · Cited by 2 · see citing works
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Kobayashi, I., Pereira, M. E., Jenkins, K., Johnson, F. L., & Pace-Schott, E. F. (2023) · Neuromethods · doi:10.1007/978-1-0716-3218-5_4 · Cited by 1 · see citing works
- Authors
- Rhudy, J. L., Davis, J. L., Williams, A. E., McCabe, K. M., & Byrd, P. M.
- Affiliations
- University of Tulsa (US)
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2008-07-15
- Volume
- 6
- Issue
- 3
- Pages
- 158-177
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- OpenAlex
- W2075206726
- Cited by
- 19
- References
- 61
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2019: 1 · 2017: 2 · 2014: 1 · 2012: 1
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioral Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- physiological reactivity, emotional reactivity, autonomic responses, heart rate, skin conductance, facial electromyography, trauma exposure, post-traumatic stress disorder, sleep disorders, health symptoms, dissociation, depressive symptoms
- MeSH terms
- Adult, Dreams, Electromyography, Facial Muscles, Female, Galvanic Skin Response, Heart Rate, Humans, Imagination, Male, Middle Aged, Surveys and Questionnaires, Recurrence, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy
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