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COMBAT-RELATED PTSD INSOMNIA CLINICAL TRIAL
273
production and widening of trance phenomena with emphasis on dis-
sociative bodily features. Using age-regression, participants were
returned to earlier periods in which normal restorative sleep was
present (e.g., after an exhausting day of games with friends during
childhood). Details of these past experiences were enhanced and asso-
ciated with the “here and now” feelings of the participant. Direct,
open-ended hypnotic work was performed to deal with present-day
symptoms of sleep disturbances. Permissive and coping posthypnotic
suggestions both overt and hidden were used for strengthening ego.
The choice and timing of ego-strengthening procedures were based on
the therapist’s understanding of many factors, such as patient history,
his or her communication style, etc. The final part of each session was
devoted to reviewing the session and repetition of symptom-oriented
posthypnotic suggestions.
None of the patients in the zolpidem group had received this drug
in the past, and none of the hypnotherapy group patients had been
hypnotized or treated by hypnotherapy in the past.
Statistical Analyses
A repeated measures two-way ANOVA was performed to compare
the zolpidem and the hypnotherapy treatment effects on PTSD symp-
toms, depression, and sleep disorders across the time: pretreatment,
posttreatment, and at 1-month follow-up. In addition, the effects of
treatment and assessment time were tested. All tests were two-tailed,
and
p
<.05 was considered to be significant.
R
ESULTS
Demographics and Pretreatment Comparisons
The two treatment groups did not differ significantly with respect
to age (mean, 31.7 years, range, 21–40 years) or gender. Both groups
were also equal with respect to prestudy scores in severity of post-
traumatic and depressive symptoms (
p
= .65 and
p
= .67), stress reac-
tions (
p
= .56), or subjective ratings of quality of sleep (
p
= .35). In
addition, there were no differences in the mean doses of antidepres-
sants between groups.
PTSD Symptoms
There was a significant main effect in the treatment group,
F
(1, 30) =
4.96;
p
= .034, with PTSD symptoms as measured by the PDS being
lower in the hypnotherapy group (HT) compared to the zolpidem
group (ZT). There was also a significant main effect of the assessment
time,
F
(2, 60) = 43.32;
p
< .0005. Post hoc tests indicated that PTSD
symptoms reduced from a mean of 36.7 (
SD
= 9.4) at pretreatment to a
mean of 31.7 (
SD
= 9.8) posttreatment. This effect was preserved at
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