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A Biopsychosocial Model of Chronic Posttraumatic Nightmares
[Technical Report, Doctoral Thesis]
UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD
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Posttraumatic nightmares are estimated to be present in more than 90 of PTSD cases. Posttraumatic nightmares are associated with a number of deleterious effects such as decreased quality of life and increased risk of suicide. Despite the substantial impact on patients lives, current treatments are often insufficient to resolve posttraumatic nightmares. Importantly, there is a dearth of knowledge regarding the underlying mechanisms involved in the initiation and maintenance of posttraumatic nightmares. Thus, an increased understanding into the possible mechanisms involved in their perpetuation may improve treatment strategies. Currently, proposed models conceptualize posttraumatic nightmares as the same as idiopathic nightmares. However, posttraumatic nightmares are related to a traumatic experience whereas idiopathic nightmares do not have a known cause. Although these two types of nightmares may share some overlap, it is unwise to assume aspects of the trauma experience or other distinctions between the two types of nightmares do not result in disparate pathways to chronicity. Some models of posttraumatic nightmares exist however, these models consider singular predictors of posttraumatic nightmares and lack the important perspective of a comprehensive approach. Therefore, the present project aimed to develop and examine a comprehensive biopsychosocial model of posttraumatic nightmares utilizing data from the clinical database of the Intensive Outpatient Program at the National Intrepid Center of Excellence.
[A, Approved For Public Release]