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[Dream recall and sleep disorders].

The present study investigated the relationship between dream recall and sleep disorders. The sample comprised 762 patients who were diagnosed in the sleep laboratory. In the course of the examination they completed the sleep questionnaire SF-B (Görtelmeyer 1986). The results showed a heightened dream recall frequency (DRF) in insomniacs and patients with myoclonia. This result as well as the findings in the control group supports the arousal-retrieval model of dream recall (Koulack u. Goodenough 1976) which emphasizes the importance of nocturnal awakenings. However, this model seems only to be valid for males. In females, DRF is mainly influenced by emotional stress which is best explained by the salience hypothesis of Cohen and MacNeilage (1974). They pointed out that intensive dream emotions lead to high recallability of dream experience. The data gives evidence to the hypothesis of Ermann et al. (1993, 1994) which states that reduced DRF in terms of unsuccessful dream work is accompanied by frequent nocturnal awakenings. DRF of patients with sleep apnea syndrome did not differ from DRF in healthy controls. In addition, sleep apnea parameters did not correlate substantially with DRF. The finding that insomniacs reported more negatively toned dreams in comparison to persons who were examined for sleep apnea but did not showed a pathological apnea index. This may be an hint to increased emotional stress in this patient group. To summarize, the results are promising in clarifying the relationship between sleep disorders and dream life. The next step is to investigate dream reports of these patients by means of content analysis.

Adult↗

Toward a new theory of dreaming.

A new Process Scoring System for dreams was developed and applied in an intensive single-S case study that spanned 5 1/2 years and 754 dreams. In it two hypotheses derived from a new transformative theory of dreams were tested. Both the transformation hypothesis, which holds that it is possible to shift from a symbolic to a directly expressive mode of dreaming, as well as the parallelism hypothesis, which holds that the expression of affect in dreams parallels the expression of affect in waking, were supported by the results. In contrast to Freud's analytic theory, which deals with content and interprets dreams as coded symbolic messages, our transformative theory focuses on dynamic dream processes and views dreams as pictures of feelings.

Adult↗

A parapraxis in a dream.

When a parapraxis is put on display in a dream, one can only wonder what service the willful mistake is rendering to resourceful dream work. Freud taught us that anything that appears in the manifest content of a dream may well be a disguise or a distortion of a subject that originally made an anxiety-provoking, and hence short-lived, first appearance in latent dream thoughts. Dreams in dreams and jokes in dreams have been examined from this perspective (Mahon 2002a, 2002b), and this paper focuses on the appearance and meaning of a parapraxis in a dream, with the argument that seemingly casual "mistakes" are highlighted in the manifest display to cover up some latent, much more deliberate subject matter.

Adult↗

The genius of the dream.

In Act V of A Midsummer Night's Dream, Theseus and Hippolyta exchange views on the dreamlike adventures reported by the young lovers. Theseus dismisses their stories as fantasies of wish fulfillment, but Hippolyta points out that despite their strangeness, the tales reflect an adaptive change in the psychic reality of the lovers. The dramatic action of the play supports Hippolyta's view. The release of Demetrius from his transferential infatuation with Hermia comes at the moment of awakening from a dream in which he has matched his current feelings for Hermia with a repressed libidinal fantasy of childhood. This example of a correction dream illustrates how condensation in dreams functions adaptively in matching a new experience with previously stored representations of related events in the past. It also illustrates the ability of the matching process to go beyond the narrow logical categories of waking thought to reach deeper levels of experience otherwise inaccessible to the dreamer. This ability accounts for the important role played by dreaming in the creative process generally and in the day-to-day working-through process of psychoanalytic therapy. The adaptive function of dreaming is subject at many points to interference from the censorship mechanisms discovered and emphasized by Freud. A theory of dreaming combining these antagonistic processes is more consistent with the data of the sleep laboratory than the traditional psychoanalytic theory alone. It also provides a better fit with the introspective date more familiar to the analyst as illustrated by Freud's well-documented analysis of his own dreams.

Creativity↗

Dream dimension differences during a life change.

Dreams reported from laboratory awakening of stably married women differed from those of women undergoing divorce: The former dreamed of the experiment; the latter had more threat themes. Those coping well during the divorce had more positive motives in the last dream than those who were depressed. Dreams of the nondepressed divorcées increased in anxiety from first to last dream report, whereas those of the depressed increased in masochism. Affiliation motives were common in dreams of the married subjects, while harm avoidance predominated in the divorcées' dreams. Nurturance and abasement were also common needs in the dreams of the depressed sample.

Adaptation, Psychological↗

Relation of dreams to waking concerns.

To test that dreams are influenced by the pre-sleep waking emotional concerns of the sleeper and have an effect on waking adaptation, 20 depressed and 10 control subjects, who were all going through a divorce, were enrolled in a repeated measures study lasting 5 months. A Current Concerns test was administered on three occasions before nights when every REM period was interrupted to record recalled mental content. The degree of waking concern about the ex-spouse correlated significantly with the number of dreams in which the former partner appeared as a dream character. Those who were in remission at the follow-up evaluation had a higher percentage of well-developed dreams than those who remained depressed. Dreams of the former spouse reported by those in remission differed from those who remained depressed in the expression of dream affect and in the within-dream linkage among units of associated memory material. Dreams of the former spouse that are reported by those who are not in remission lack affect and connection to other memories.

Adult↗

Role of REM sleep and dream variables in the prediction of remission from depression.

To test the hypothesis that REM sleep and/or dreams contribute to overnight mood regulation, 61 subjects were tested on the Beck Depression Inventory (BDI), and for 3 nights of monitored sleep on two occasions, once close to, and 1 year after, a marital separation. Forty-nine percent of the variance in the follow-up BDI could be accounted for by the initial BDI score, and three sleep and dream variables associated with the mood regulatory hypothesis: eye movement density in the first REM, strength of the affect in the first dream and total number of negative dreams recalled from REM awakenings. Among the 39 who met BDI depression criteria initially, 71.8% could be classified correctly as remitted or not remitted at follow-up by discriminant function analysis based on the presence of negative dreams the first vs. second half of the night. Subjects reporting more negative dreams at the beginning and fewer at the night's end were more likely to be in remission 1 year later than were those with fewer negative dreams at the beginning and more at the end of the night. Early negative dreams may reflect a within-sleep mood regulation process taking place, while those that occur later may indicate a failure in the completion of this process.

Adult↗

Defective inhibition of dream event memory formation: a hypothesized mechanism in the onset and progression of symptoms of schizophrenia.

An average person normally spends at least 90 min to 2 h per night dreaming. Nevertheless, memories of dream events are not retrieved while awake unless the person awoke shortly after a dream. It is hypothesized here that schizophrenic delusions initially arise because a system that normally inhibits the formation of memories of dream events is defective. Therefore, memories of dream events or fragments would be occasionally made and placed in the normal memory store. The only reason that we really know anything happened to us in the past is that we have a memory of it, and having a memory of an event is sufficient to really believe it. Therefore, the schizophrenic would believe that the dream events actually happened. It is proposed that this is the basis of primary delusions. Because memories are represented by strengthened neural connections there will be an accumulation of connections that do not correspond to reality. This accumulation may account for other symptoms of schizophrenia such as thought disorder, loosening of associations, and hallucinations. The brain trying to draw conclusions from several memories may be the basis of secondary delusions. Evidence is presented for the ideas that primary delusions are due to memories of dream events, that a substance, with vasotocin-like bioactivity, is released in the brain during dreaming and inhibits memory formation, that the lateral habenula is a brain area involved in vasotocin actions and is affected by neuroleptics, and that brain mechanisms involved in vasotocin actions show pathological alterations in schizophrenia.

Delusions↗

Evaluation of dream content in combat-related PTSD.

Nightmares that replicate traumatic events are among the criteria that define posttraumatic stress disorder (PTSD); however, there has been limited systematic assessment of the content of dreams in PTSD. A PTSD dream rating instrument was developed to operationalize features attributed to dreams associated with combat-related PTSD that incorporated dimensions from the dream content analysis literature, and its reliability was assessed. Then the instrument was used to characterize dream reports in 18 Vietnam combat veterans diagnosed with PTSD. Approximately half of the group's target dreams contained features characteristic of combat, and all but 3 (17%) were moderately to highly threatening. Fifty-three percent were set at least partially in the present and 79% contained distorted elements. We therefore conclude that target dreams of combat veterans with PTSD vary with regard to replication of trauma and elements normally associated with dreaming, but typically are threatening.

Adult↗

Development of beliefs about the origins and controllability of dreams.

In three studies the authors investigated the development of beliefs about dreaming. Study 1 assessed 3- to 5-year-old children's beliefs about the origins and controllability of dreams. Results revealed significant changes in children's beliefs about the roles of behavioral experiences and mental processes in the generation of dream content. Results also revealed that young children consider both dreams and imagination to be highly controllable. In Study 2, preschool-age children, elementary school-age children, and adults received either imagination or dream stories and were questioned about controllability. In Study 3, emotional valence of the dream content was varied. Results of Studies 2 and 3 revealed significant development in beliefs that dreams are not subject to conscious control. Beliefs in controllability were higher among females. Study 3 showed that the emotional content of a dream affects these claims.

Child↗

Physical motion in dreams: one measure of three theories.

As a normal psychological event, dreaming is an object of fascination and of conflicting explanation. In biopsychological terms, this article compares 3 explanations of 1 salient feature of dream cognition. Physical movement can be measured in dream reports, can be understood in physiologic terms, and can provide a focus for comparing dream theories. In addition, dreamed motion may have functional importance. The authors discuss dream motor data that conflict with Freud's explanation of dream movement and with a distributed activation explanation but coincide with an activation-synthesis hypothesis. Because physiologic models of sleep intersect with physiologic models of psychopathology, this approach may be relevant to psychopathological dreaming.

Arousal↗

Dreams and rapid eye movement sleep in the multiple sleep latency test.

Dreams are closely associated with rapid eye movement (REM) sleep. The purpose of this study was to evaluate the reliability of dreams in predicting the presence of REM sleep during naps of the multiple sleep latency test (MSLT). We prospectively analyzed MSLTs performed in the evaluation of 44 patients with excessive daytime sleepiness. A total of 167 naps were studied. The patients' ages ranged from 11 to 69 years (mean 45 years). There were 26 males and 18 females. The relationship between the presence of reported dreams and the presence of REM sleep was as follows: sensitivity (percentage of naps with REM in which dreams were reported), 59%; specificity (percentage of naps without REM in which no dreams were reported), 63%; positive predictive value (probability that REM occurred if dreaming is present), 29%; and negative predictive value (probability that REM did not occur when no dreaming is present), 85%. In the daytime naps of the MSLT, the presence of reported dreaming did not appear to be a reliable indicator of the presence of REM sleep in the preceding nap.

Adolescent↗

Dream recall after sleep interruption in brain-injured patients.

Nineteen patients with unilateral hemispheric lesions of a vascular or neoplastic nature were studied. Before the onset of disease, these patients had experienced dream recall at least once a week. During hospitalization their dream recall was investigated using a morning diary for 10 consecutive days. During this period, seven patients reported having dreamed, whereas 12 had no dream recall. Subsequently, the patients' sleep was interrupted during both stage 2 NREM and REM sleep. With this method, 11 patients reported having dreamed at least once, whereas eight had no dream recall. Patients with lesions in the temporo-parieto-occipital region had a more frequent loss of dream recall than those with lesions outside this area. The agreement between the results obtained using the diary and those from provoked awakening was significant. The results obtained from compilation of a diary on morning awakening appear sufficiently reliable to reveal the presence or absence of dream recall in patients with focal cerebral lesions in the acute phase of the disease.

Aged↗

Do dreams reflect a biological state?

The purpose of this study was to prospectively evaluate the hypothesis that dreams reflect biological states. Inpatients on a nonacute cardiology service were studied. Dream material was gathered by an independent interviewer using the Staged Interview Technique, a newly developed interview technique that limited bias. The outcome measures used were obtained at the time of cardiac catheterization. Different levels of severity of cardiac disease with these measures were interpreted as representing different biological states. The patients' dreams were evaluated for the predicted correlations of the number of dream references to death (men) and separation (women) with different levels of severity of heart disease. The severity of heart disease was evaluated with anatomical (coronary angiography) and physiological (ejection fraction) measures obtained at cardiac catheterization, each represented by a 6-point scale of increasing severity. There was no correlation of the number of dream references with the severity of abnormalities on coronary angiography. However, the number of dream references to death and separation correlated with the severity of cardiac dysfunction, as measured by the ejection fraction, which is a more sensitive parameter of disease severity. The data provided prospective support for the hypothesis by showing that dreams reflected a biological state, the ejection fraction. This suggested a possible biological "meaning" of dreams.

Adult↗

Progression of dreams of crack cocaine abusers as a predictor of treatment outcome: a preliminary report.

This study tested the hypotheses that a) the dream content of crack cocaine abusers in Trinidad and Tobago changes during abstinence, and b) the change in dream content can be used to predict treatment outcome. The sample comprised 46 consecutive patients who completed a 3-month residential treatment program and were followed up after 6 months. Dreams and associated emotions were recorded during the first month of inpatient treatment and at 6 months follow-up. Forty-one (89.1%) patients reported drug dreams during the first month, mainly of using the drug. Twenty-eight (60.9%) had drug dreams at 6 months follow-up, mainly of using or refusing the drug. There was an abstinence rate of 56.5% at 6 months. A better treatment outcome was associated with having drug dreams at 6 months follow-up (p < .05) and dreams of refusing the drug (p < .05). Findings support the need to further explore the progression of dreams during treatment as a predictive tool.

Adult↗

Anxiety and hostility in the manifest dreams of schizophrenic patients.

Aside from delusions, hallucinations, and thought disorders, affective disturbances belong to the most prominent symptoms of the schizophrenic process. However, nearly no empirical work has been done on the systematic investigation of the dream affects of patients with schizophrenia. We compared 96 dreams of 19 patients with schizophrenia and an equal number of dreams of 19 healthy controls collected over an 8-week period by means of the Gottschalk-Gleser Analysis Scales. Additionally, central psychopathological syndromes were measured by means of the AMDP-scales each day a patient reported a dream. Although cluster analyses showed general similarities in the organization of dream affects in the two groups, we found differences between patient and control groups in the frequency and intensity of anxious and hostile affects. As in delusions of persecution, patients experience themselves in their dreams more frequently as victims of hostility from outside, which corresponds well with a significantly higher intensity of threat anxieties (death, mutilation). On the other hand, value anxieties (guilt and separation) are found less frequently in the dreams of patients with schizophrenia pointing, together with a less differentiated organization of the dream affects, to the typical affective flattening of residual syndromes.

Adult↗

Dreaming, fenfluramine, and vitamin C.

The effect of increasing doses of fenfluramine on dream patterns was studied in 20 patients receiving a reducing diet with or without a controlled dietary intake of vitamin C daily. The dream pattern was unchanged in six patients and dreams disappeared in another who normally dreamed often. In 13 patients dreams increased in frequency and intensity, and in five the dreams assumed frightening proportions. There was a significant straight-line relation between response and the size of the dose. When placebo tablets were given to four patients their dreams disappeared or assumed their pretreatment normal pattern. Absence of vitamin C from the diet did not significantly affect the dream pattern. That fenfluramine has dose-related cerebral effects should be remembered in patients with a history of mental illness.

Ascorbic Acid↗

Dreams as an aid in determining diagnosis, prognosis, and attitude towards treatment.

The are certain types of dreams, in both psychosomatic and general medical patients, that address themselves directly - in undisguised form - to illness. From a collection of 60 such dreams, examples are presented which illustrate the objective value dreams can have in determining diagnosis, prognosis, and patient's attitude towards treatment. These dreams bring to light crucial factors that could affect treatment, such as the unconscious need for symptoms, the purposive function of symptoms, and unconscious resistances to treatment. Dreams may also reveal an unconscious knowledge of impending death in terminal patients. Although it is usually the patient who has dreams relevant to an existing illness, family members or the physician or therapist may also have them. This study makes a link with ancient Greek medical tradition in which dreams had a central role in both diagnosis and treatment. The possibility of revitalizing this tradition is noted, and the need for systematic research into dreams associated with illness is emphasized.

Adult↗