CHAPITRE IV : CONCLUSION GÉNÉRALE
4.6 Conclusion Générale
Cette thèse a permis de répertorier six hypothèses expliquant l'efficacité des traitements des cauchemars et de les réunir en un modèle théorique pour témoigner de leur interrelation. Les stratégies thérapeutiques des divers protocoles de traitement appuyés par les données probantes auraient toutes le potentiel d'activer ces mécanismes; ainsi, l'optimisation des traitements, plutôt que de viser l'ajout de techniques, devrait viser à s'assurer de l'activation de ces MAs, plus particulièrement le traitement émotionnel de la structure de peur. Idéalement, ce modèle permettrait de réunir les auteurs de tous les types de traitement des cauchemars à travailler de concert pour éviter la duplicité des protocoles actuellement observée. Dans un souci de guider les études futures et d'apporter un appui à ce modèle, des propositions sur les façons de mesurer quantitativement les différents MAs ont été avancées. Notamment, une mesure de PEP spécifique aux rêves et cauchemars s'est avérée prometteuse pour rendre compte du MA de sentiment de contrôle dans l'efficacité de la RRIM sur l'insomnie et la qualité du sommeil. Néanmoins, ce MA ne serait pas central dans le traitement des cauchemars ou nécessite d'être mieux opérationnalisé, étudié en relation avec d'autres MAs et mesuré sur plusieurs temps de mesure pour bien témoigner de sa contribution.
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