Cognitive-Behavioral Therapy for Children With Nightmares as a Mediator of Suicide Risk (COMAA)

Change on the Child Adolescent Trauma Screen (CATS) - Child Version,Change on the Trauma Related Nightmare Survey - Child Version (TRNS-C),Change on Sleep Locus of Control (SLOC),Change on Nightmare Locus of Control (NLOC),Change in reports on Sleep Journal,Change on the Child Adolescent Trauma Screen (CATS) - Caregiver Report regarding child,Change on Center for Epidemiologic Studies Beliefs and Attitudes About Sleep Scale (DBAS-16),Change on Center for Epidemiologic Studies Depression Scale for Children (CES-DC)

Youth suicide risk has increased 56% in the last decade, and suicide is the leading cause of
 preventable death in children and adolescents. Experiencing chronic nightmares doubles the
 risk of suicidal ideation in children and adolescents. Decades of research support that even
 when controlling for depression and insomnia, nightmares predict suicidality. Contemporary
 theories model nightmares as the mediating link between depression and suicide. Numerous
 studies examine the effect of nightmare-specific therapies on reducing suicide in adults, but
 none have examined whether nightmare therapies can reduce youth suicidality. The proposed
 pilot will evaluate the feasibility of the Cognitive Behavioral Therapy for Nightmares in
 Children paradigm (CBT-NC), recruiting and retaining children ages 6-17 who experience
 chronic nightmares. Utilizing a waitlist control (WL) model, participants (n=30) will be
 randomized after baseline assessment to either immediate treatment or a WL. Feasibility will
 be evaluated by examining retention through treatment (or WL) to post WL and post treatment
 assessments. Both groups will be evaluated before and after the treatment for suicidal
 ideation, sleep quality, and nightmare distress and frequency, in order to document
 improvements due to therapy. The proposed pilot will provide preliminary data about
 recruitment, retention, and allow for effect size calculations between groups. These results
 will be used to develop a larger treatment study that would ultimately evaluate the mediating
 effect of treatment for chronic nightmares on suicidality in children.