Characteristics of the frequent nightmare sufferer.

Previous research has found that persons who experience frequent nightmares score highly on scales that measure psychotic symptomatology. Neurotic symptoms have also been implicated as correlates of nightmare frequency. In this study, 30 adult lifelong nightmare sufferers were compared with 30 control subjects, matched for age, sex, and socioeconomic status. Subjects were asked to record all dreams for 1 month and to complete the Minnesota Multiphasic Personality Inventory (MMPI) and the Eysenck Personality Questionnaire (EPQ). Nightmare subjects scored significantly higher on the EPQ Neuroticism scale and on 8 MMPI clinical scales than did the control group. These scales also best discriminated between the groups in a direct discriminant analysis. The results are interpreted as a reflection of global maladjustment rather than of specific psychotic symptomatology.     

The prevalence of nightmares and their independence from anxiety

Although several studies have examined the prevalence of nightmares and their relationship to anxiety, this is the first to have used daily dream logs, rather than retrospective self-reports, to monitor nightmare frequency. 220 undergraduates were administered self-report measures of anxiety and for 2 weeks recorded the number of their nightmares in logs. 47% of Ss reported at least one nightmare during the study period. The dream logs yielded an estimated mean annual nightmare frequency of 23.6, which is 2.5 times as great as the estimate yielded by retrospective reports (p less than .01). Nightmare frequency and anxiety were uncorrelated. The findings indicate that nightmares are more prevalent than has been reported, and their frequency unrelated to self-reported anxiety.     

Exploring Thematic Nightmare Content and Associated Self‐Harm Risk

Nightmares have been shown to be robust predictors of self‐harm risk, beyond depressive symptoms and hopelessness at times. However, few studies have investigated associations between nightmare content and increased self‐harm risk. This study explored associations of thematic nightmare content with history of self‐harm, and risk of self‐harm phenomena the morning following a nightmare. A mixed‐method diary study was performed. Prospective nightmare reports were obtained from 72 participants. A total of 47 nightmare reports met inclusion criteria and were analyzed for themes using inductive thematic analysis. Chi‐square and bootstrap Pearson's correlation tests were performed to assess the associations between nightmare themes and self‐harm history, and risk of self‐harm phenomena following a nightmare. “ Powerlessness to Change Behavior” was associated with a history of self‐harm engagement, whereas “Financial Hardship” indicated reduced risk. Themes were not significantly associated with increased risk of self‐harm phenomena following a nightmare. Content may be of use in detecting lifetime history of self‐harm engagement, particularly in populations where disclosure is seen as taboo. However, nightmare symptom severity remains a better indicator of risk. Evidence for the utility of nightmare content in assessing immediate self‐harm risk is presently lacking. Replication with increased power is recommended.     

Nightmare frequency,nightmare distress,and anxiety

Using the self-reports of 300 university students, we replicated and extended the results of a 1971 study of Hersen by demonstrating a significant relationship between both nightmare frequency and nightmare distress with two dimensions of anxiety. Our results are not consistent with the 1990 findings of Wood and Bootzin who concluded that both nightmare frequency and nightmare distress were not correlated with anxiety.     

The multiplicity of dreams: cognitive-affective correlates of lucid, archetypal, and nightmare dreaming

This preliminary research is the first to compare lucid, nightmare, and archetypal-mythological dreams on dimensions important in previous research on each. A first study of 100 subjects showed all three forms significantly correlated with each other and with estimates of dream recall. In a second study, 41 subjects were selected from the above on the basis of relative specialization in each dream form, with a control group equally high on dream recall. Here, the lucid and archetypal dreamers tended to separate themselves from nightmare sufferers on the basis of high imaginativeness, proclivity to waking mystical experience, spatial/analytic skills, and physical balance. It appears that the intensification of dreaming is expressed positively or negatively, depending on variations in these cognitive dimensions.     

Finding our way in the dark

Accepting the common lay definition of nightmare as any form of upsetting, dreamlike cognition occurring in the midst of sleep, the author argues for a classification of nightmares that would be based, not on physiological findings, but on what the upsetting nocturnal occurrence turns out to mean to the dreamer. Three types of nightmare identified on this basis are illustrated through dream sequences from classic Hollywood movies and amplified by clinical examples: (1) the dream that symbolizes the next stage of life as unusually daunting, (2) the dream that exposes the shadow of another person in a shocking way, and (3) the 'empathy dream', in which the dreamer experiences directly the anxieties of another subject. It is suggested that the accurate interpretation of a particular upsetting dream depends upon which type of nightmare the dream turns out to be.     

Nightmare frequency versus nightmare distress: relations to psychopathology and cognitive style.

The hypotheses that psychopathology is related to nightmare distress but not nightmare frequency and that cognitive style is related to nightmare frequency were examined. The sample consisted of 85 subjects (58 women and 27 men) who completed several measures: a sleep and dream inventory, Symptom Check List-90-R, Fear Survey Schedule-II, Beck Depression Inventory, an abbreviated version of the Harvard Group Scale of Hypnotic Susceptibility, Vividness of Visual Imagery, an absorption scale, a social desirability scale, and the Boundaries Questionnaire. The results strongly support the first hypothesis but only slightly the second. Such findings underscore the need to differentiate nightmare frequency from suffering (waking distress associated with nightmares) and suggest that although frequency may be related to an intensification of dreaming process, suffering is related to waking emotional adjustment.     

Content of waking life events and of nightmare themes

Examined the relationship of incidence of 3 types of nightmare themes to incidence of specific events listed in the Social Readjustment Rating Scale and in the Life Events Inventory. The former list of events was administered to 98 and the latter to 56 part-time college students. Information on nightmares' content was available for both samples. Events and nightmare themes were retrospectively reported for the last 6 mo. No significant relationships were found between specific types of nightmare content and specific events. Persons who experienced more events of the Life Events Inventory also reported more nightmare themes, however, similar relationship was not observed for events listed in the readjustment scale.     

Dream recall and nightmare frequency: a family study

The present study investigated dream recall as well as nightmare frequency in families. Whereas a positive correlation for nightmare frequencies between children and mothers was found (but not for children and their fathers), the relationship for dream recall frequency was small and nonsignificant. Assuming that mothers are still the primary caregivers in the modern family, and, thus, might encourage or discourage children to talk about their dreams, the findings of the study support Cohen's 1973 hypothesis of a socialization effect on nightmare frequency and maybe a smaller effect on dream recall frequency.     

THE UNHOLY ALLIANCE OF SEX AND GENDER

Abstract: Several decades ago, feminists differentiated between the biologically given basis of sex identity (sex) and the socially constructed cultural practices anchored by sex identity (gender). In recent years, many feminists have challenged that distinction, arguing that biological sex is as much a social construct as are the practices comprising gender. I survey two examples from biological studies of sex identity that, by contrast (I maintain), warrant saving the concept of biologically given sex identity. The result is not antithetical to feminism, however, since these studies also suggest that sex identity proliferates beyond the rigid female/male dichotomy. If articulated carefully, this view can avoid metaphysically essentialist baggage while enriching feminist conceptions of sex identity.     

Psychopathological correlates of contextualized images in dreams

A contextualized image is a powerful central image in a dream which provides a picture context for the dominant emotion of the dreamer. This study examined the psychopathological correlates of both dream and nightmare contextualized images in a community-based sample of 378. As predicted, mean nightmare contextualized image scores were significantly higher than mean dream scores. In addition, while dream contextualized images were unrelated to psychopathology, nightmare contextualized images were significantly associated with elevated scores on three SCL-90-R subscales and the General Symptom Distress Index.     

Nightmare prevalence in the healthy elderly.

Fifty-one healthy elderly subjects (median age = 65) gave retrospective estimates of nightmare frequency in questionnaires and recorded the occurrence of nightmares in daily logs over a 2-week period. (a) Mean annual nightmare frequency as estimated from logs was only 65% as high among college student controls. (b) Elderly subjects were about 1/5 as likely as college students to report a problem with nightmares. (c) Frequency estimates on the basis of logs were over 10 times higher than retrospective estimates.     

Effectiveness of Imagery Rehearsal Therapy for the Treatment of Combat-Related Nightmares in Veterans

Imagery Rehearsal Therapy (IRT) has been shown to be efficacious in reducing nightmares, but the treatment has not been well-studied in veterans. The effectiveness of IRT was assessed from a chart review of veterans seeking outpatient treatment for chronic, trauma-related nightmares. Of those offered IRT, veterans who completed a full course of treatment for PTSD in the past year were more likely to initiate treatment. However, completion of IRT was not related to previous treatment, demographic variables, or nightmare severity reported at the first treatment session. Treatment completers reported significant reductions in nightmare frequency and intensity, severity of insomnia, and subjective daytime PTSD symptoms. Insomnia and PTSD symptoms, on average, were below clinical cutoffs following treatment, and 23% of patients showed a complete treatment response (≤ 1 nightmare/week). Findings suggest IRT may be an effective short-term treatment for nighttime and daytime PTSD symptoms among veterans who complete a full course of treatment.     

Snoring, breathing pauses, and nightmares

The present study investigated the correlations among snoring, breathing pauses during sleep, and nightmare frequency in a sample of 444 healthy individuals. Breathing pauses, but not snoring, were associated with heightened nightmare frequency. Whereas the hypothesis that shortage of oxygen directly causes nightmares is not supported by the literature, novel internal stimuli might affect dream content.     

Night terrors

Night terrors and nightmare had for years been equated terms. Early writers tended to ignore the differences. Even today with a clearer definition and understanding of these sleep disturbances, practitioners have been at a loss on how to ameliorate the very upsetting set of occurrences (to the patient as well as to the family). This paper briefly reviews some of the literature on Night Terrors and reports successes in the amelioration of this phenomenon.     

Sleep disturbances in the aftermath of trauma and posttraumatic stress disorder

Sleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of PTSD have been inconsistent in terms of documenting objective impaired sleep maintenance but have been somewhat more consistent in indicating alterations of rapid eye movement (REM) sleep. Studies of the early aftermath of trauma can reduce the complexity associated with chronicity and comorbidity, and may have implications for early diagnosis and prevention. Multiple studies indicate that dream content is affected by recent threatening experiences. The development of PTSD is associated with a more replicative type of nightmare content. Sleep is reported to be generally disrupted following trauma especially among those developing PTSD. The limited number of studies that provide objective recorded indices during the early aftermath of trauma also provide a mixed picture regarding overall sleep maintenance. Recent data suggest that a more specific disruption of REM sleep may be associated with the development of PTSD and that this disruption is associated with an increased signal of sympathetic nervous system activation during REM sleep. Disrupted REM sleep and increased sympathetic/noradrenergic activity may have implications for understanding recent promising interventions for PTSD sleep disturbance that can be applied to early intervention.