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Results for “DREAM complex”

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PubMed1987

Levinsonian studies of women's adult development.

We reviewed four unpublished dissertations that used Levinson's theory to study women's adult development. The 39 biographies presented in these studies suggested that the women progressed through the same developmental periods as had men in Levinson's study and at roughly the same ages. Although the timing of the periods and the nature of the developmental tasks appeared to be similar, the ways of working on these tasks as well as the outcomes achieved were different. These differences are understood in part as consequences of the greater complexity of women's dreams and the problems encountered in living them out.

Adult↗
PubMed2002

[Clinical and polysomnographic features of rapid eye movement sleep behavior disorder].

OBJECTIVE: To evaluate the clinical and polysomnographic features of rapid eye movement sleep behavior disorder (RBD) in Chinese patients. METHODS: Six parasomnic patients, 4 males and 2 females, with the mean onset age of 58 years (range 50 approximately 66 years) and 6 age and sex matched controls, were video-monitored for successive two nights, to record the electroencephalography, electrooculography, electromyography, electrocardiography and nasal airflow. RESULTS: Polysomnographic recordings disclosed an augmented muscle tone, which appeared intermittently or continuously in REM sleep, accompanied by complex behaviors correlated to dream contents observed by video-monitoring, and without seizure activity. All the 6 patients presented with a long history of parasomnia. The average total-sleep time of the patients was 353 +/- 42 minutes, the stage II sleep time was 139 +/- 76 minutes, and sleep efficiency was 74.3% +/- 12.3% lower compared with that of the controls. Pakinsonism occurred in 1 patient 9 years after parasomnia and dementia in 2 patients 8 and 18 years respectively after symptom of RBD. Clonazepam was administered for parasomnia in 3 cases with a favorable response. CONCLUSION: REM sleep without atonia is demonstrated in association with violent movements by video-monitored polysomnography in 6 Chinese patients.

Adult↗
PubMed1989

New frontiers in psychotherapy.

The author examines new frontiers in psychotherapy from the perspective of four major movements in clinical psychiatry today: (1) the science of psychotherapy, (2) time-limited and tailored treatment, (3) governmental guidelines and public policy-making, and (4) conceptual and clinical rapprochement. Attempts to standardize psychotherapy are evidenced by more refined diagnostic and statistical instruments, operationalized training and treatment manuals, and use of the computer in human simulation. The second movement is manifested by innovative short-term therapies, particularly tailored to depressed populations. The third direction is more extrinsic as cost-effectiveness increasingly becomes the guiding criterion of mental health care. The final frontier reflects attempts to weld various polarities in the field, not only by drawing on a vast psychological armamentarium but by providing new neurobiologic models for complex "psychological" phenomena, from dreams to dependency.

Forecasting↗
PubMedDate not supplied

[Daily experiences of a health care team. Case report].

The authors present daily experience report of a health staff, based in some aspects of microsociology in which the human being manifests all of its "theatrical behavior". Daily life is revealed in a closer look by the health field professionals. Daily life is the "stage" where the plot of life takes place in all of its complexity, the joy, the dreams, the conflicts and the suffering of each day, of each human being. This report analysis some aspects of the "underground centralization of actions", which determines human existence. It has been observed that the power category represented by the "game" had outstanding relevance in the work social relations of the staff. The "theatrical behavior" was the other element found in the analysis made.

Humans↗
PubMed1984

Deconstructing the manifest dream.

A major part of the analyst's task is to discover the basis for the patient's misidentification of his present life situation with significant but threatening events of his earlier life, now repressed and inaccessible to conscious recall. Reconstructing the patient's history is a crucial step in this process of discovery, but the dynamic relation between the present and the past must be reconstructed as well. The structure of the manifest dream contains the key to this relation. The imagery of the dream is a composite of experimental materials drawn from important drive-related events of the present and the past. The complex formed by the manifest dream and the patient's associations provides the analyst with data about both of these distinct sets of drive-related experiences. As Freud's discussion of his M elusine dream illustrates, one associative thread can be traced to an experience that incorporates a conflicted current wish. Another thread will lead to an experience in which a repressed wish of childhood has been expressed. Where the two associative threads converge, in the composite imagery of the dream, the basis for the identification between the wishes of the present and the past will be exposed. An understanding of the structure of the manifest dream helps to clarify some of the important theoretical issues left unresolved in Freud's writings. These include: the function of the day residue and the mechanism through which it is formed, the relation of the screen memory to the associative process, and the differing roles of condensation and displacement in dream construction and free association. A simple procedure is described for enhancing the recovery of the significant childhood memories whose details have been incorporated into the composite imagery of the manifest dream.

Adult↗
PubMed2000

The reinterpretation of dreams: an evolutionary hypothesis of the function of dreaming.

Several theories claim that dreaming is a random by-product of REM sleep physiology and that it does not serve any natural function. Phenomenal dream content, however, is not as disorganized as such views imply. The form and content of dreams is not random but organized and selective: during dreaming, the brain constructs a complex model of the world in which certain types of elements, when compared to waking life, are underrepresented whereas others are over represented. Furthermore, dream content is consistently and powerfully modulated by certain types of waking experiences. On the basis of this evidence, I put forward the hypothesis that the biological function of dreaming is to simulate threatening events, and to rehearse threat perception and threat avoidance. To evaluate this hypothesis, we need to consider the original evolutionary context of dreaming and the possible traces it has left in the dream content of the present human population. In the ancestral environment human life was short and full of threats. Any behavioral advantage in dealing with highly dangerous events would have increased the probability of reproductive success. A dream-production mechanism that tends to select threatening waking events and simulate them over and over again in various combinations would have been valuable for the development and maintenance of threat-avoidance skills. Empirical evidence from normative dream content, children's dreams, recurrent dreams, nightmares, post traumatic dreams, and the dreams of hunter-gatherers indicates that our dream-production mechanisms are in fact specialized in the simulation of threatening events, and thus provides support to the threat simulation hypothesis of the function of dreaming.

Animals↗
PubMed1993

Humans' perceptions of animal mentality: ascriptions of thinking.

On rating scales, 294 students indicated whether it was reasonable to say that a dog, cat, bird, fish, and school-age child had the capacity for 12 commonplace human mental operations or experiences. Factor analysis of responses identified 2 levels of attributions, simple thinking and complex thinking. The child and all animals were credited with simple thinking, but respondents were much more likely to ascribe complex thinking to the child. (A pilot study with 8 animal-behavior professionals generally replicated these results.) Certain mental categories (e.g., emotion) were judged by students to be simple for all target types; others (e.g., conservation) were judged to be universally complex. Further factoring revealed articulate ascriptions for key mental categories. Play and imagine was seen as simple in the animals but complex for the child, but enumeration and sorting and dream were seen as simple in the child but complex for the animals.

Adult↗
PubMed1985

The use of dreams as a psychotherapeutic technique with brain injured patients.

Reports of dreams elicited from brain-injured patients at the Loewenstein Rehabilitation Hospital in Israel were incorporated into the psychotherapeutic process. Our experience indicated that: It is possible to increase and enrich dream activity in quantity and in substance in the course of the treatment; This approach can affect all of the components of the personality which have been in regression after injury; Dream analysis does not require complex cognitive abilities and surmounts the special difficulty these patients have in using language and abstract concepts; It is possible to bring to the surface inner and subconscious contents residing in the patient that were ignored before; and The residual content of the premorbid personality is also expressed, thus facilitating the patient's inner contact between his former identity and his new one. This permits a renewed consolidation of the personality while making use of the psychic forces and parts which remained intact.

Adult↗
PubMedDate not supplied

Physician acceptance of new medical information systems: the field of dreams.

Physicians often fail to embrace a complex information system, may not see its relevance to their practices, and are characteristically reluctant to invest the time and energy to be trained in its use. Why is widespread physician buy-in so difficult to achieve? From physicians overwhelmed with change to failing to begin with an adequate physician base of support, this article explores some of the reasons that physicians demonstrate little buy-in to this process and offers suggestions to help create a more successful implementation. Ways to build acceptance include acknowledging the importance of physicians as customers and training them early and often.

Attitude to Computers↗
PubMed2005

REM sleep behaviour disorder.

REM sleep behaviour disorder (RBD) is a parasomnia characterised by nocturnal complex motor activity associated with dream mentation. RBD, which affects mainly older men, may be idiopathic or associated with other neurological disorders. A strong association between RBD and alpha-synucleinopathies has been recently observed, with the parasomnia often heralding the clinical onset of the neurodegenerative disease. The idiopathic form accounts for up to 60% of the cases reported in the three largest series of RBD patients. Follow-up studies in small samples revealed that a proportion of RBD patients will eventually develop Parkinson's disease and/or a dementia of Lewy bodies type in the years following the RBD diagnosis. Recently, neurophysiological and neuropsychological studies in idiopathic RBD have found evidence of central nervous system dysfunction. An impairment of cortical activity, specific neuropsychological deficits, signs of autonomic dysfunction and olfactory impairment have been observed in these patients, challenging the concept of idiopathic RBD. The detection of early markers of neurodegenerative disorders in idiopathic RBD, and the evaluation of their value by the combined application in prospective studies may be crucial for developing early intervention strategies.

Aggression↗
PubMed2002

Agrypnia Excitata: a generalized overactivity syndrome and a useful concept in the neurophysiopathology of sleep.

OBJECTIVES: To analyse the clinicophysiological features of delirium tremens (DT), Morvan's fibrillary chorea (MC) and fatal familial insomnia (FFI) as representative of the new concept of Agrypnia Excitata (AE). METHODS: DT, MC and FFI were compared for their clinical and polysomnographic features and, for MC and FFI, post-mortem verification. RESULTS: DT, MC and FFI all display profound loss of slow-wave sleep (SWS) and abnormal rapid eye movement (REM) sleep with lack of muscular atonia and enacted dreams. Sleep spindles and K complexes are severely reduced. Motor overactivity is associated with increased sympathergic functions. Neuropathology discloses severe loss of neurons in the thalami and cingular areas in FFI, and leakage of antibodies in the thalamus in MC. CONCLUSIONS: Based on the similarities in DT, MC and FFI, we propose the new concept of AE as a clinical condition characterized by loss of SWS and abnormal REM sleep, associated with motor and autonomic sympathergic activation. AE is due to dysfunction of the thalamo-limbic system. Moreover, the preservation of light sleep in the face of severe loss of deep sleep in AE argues that 3 rather than the usually considered two (non REM and REM) independent states of sleep exist.

Humans↗
PubMed2003

Drug induced nightmares--an etiology based review.

OBJECTIVE: Recent clinical trials have included patient complaints of nightmares as a category of reportable medication side effects. This study integrates that data into current experimental and theoretical research of drug effects that may alter dreaming and nightmares. The objective is to provide a clinical and theoretical framework useful in categorizing the potential and reported drug effects on nightmares. METHODOLOGY: This study reviews case reports and clinical trials that have reported nightmares or alterations in dreaming occurring secondary to medication usage. These data are analysed as to the probability of the drug/nightmare association, and integrated into current electrophysiological and neurochemical theories of dreaming and nightmares. RESULTS: Pharmacological agents affecting the neurotransmitters norepinephrine, serotonin and dopamine are clearly associated with patient reports of nightmares. Agents affecting immunological response to infectious disease are likely to induce nightmares in some patients. A possible association exists between reports of nightmares and agents affecting the neurotransmitters acetylcholine, GABA and histamine, as well as for some anesthetics, antipsychotics and antiepileptic agents. CONCLUSION: By utilizing our current experimental and theoretical knowledge base, the potential etiology of a majority of reported drug effects on nightmares can be classified. These data support current neurochemical theories of dreaming, as well as suggesting that the biochemical basis for dreaming and nightmare induction may be more complex than generally suggested.

Causality↗
PubMed2005

The association between narcolepsy and REM behavior disorder (RBD).

BACKGROUND AND PURPOSE: Rapid eye movement (REM) sleep Behavior Disorder (RBD) is a movement disorder associated with loss of REM-related muscle atonia and is characterized by complex, vigorous and frequently violent dream-enacting behavior during REM sleep. RBD is usually idiopathic or secondary to neurological problems such as Parkinson's disease. This study looked at the association of RBD with another sleep disorder, narcolepsy. PATIENTS AND METHODS: Seventy-eight questionnaires were sent to known narcoleptics chosen at random from those with contact details available at the center. The questionnaire addressed current narcolepsy symptoms, medication use and symptoms of RBD. Positive questionnaire results were followed up with a telephone interview. Limited polysomnography (PSG) data was also analyzed. RESULTS: Fifty-five patients responded (response rate 71%). Of these, 20 (36%) had symptoms suggestive of RBD. The typical RBD patient is an older male (mean age of onset 60.9 years, 87% male); however, in this study, females were as likely to have RBD as males, and the mean age was 41 years. Sixty-eight percent of patients who regularly experienced cataplexy and the associated symptoms of narcolepsy (sleep paralysis, hypnogogic hallucinations and automatic behavior) had RBD, compared to 14% of those who never or rarely experienced these symptoms. CONCLUSION: This study implies a stronger relationship between these disorders than a previously published figure of 7-12% This is clinically significant as RBD is a potentially distressing but readily treatable disorder. It follows that narcoleptics, especially those with cataplexy and other associated symptoms, should be questioned about symptoms of RBD and treated accordingly. Similarly, anyone presenting with RBD should be assessed for symptoms of narcolepsy, particularly if female or of a younger age group than would otherwise be expected.

Adolescent↗
PubMed2005

REM sleep behaviour disorder: clinical profiles and pathophysiology.

Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterized by the intermittent loss of electromyographic atonia normally present during REM sleep and the emergence of purposeful complex motor activity associated with vivid dreams. Rapid eye movement sleep behaviour disorder usually affects older males and can be either idiopathic or symptomatic of various underlying disorders, in particular neurodegenerative diseases; in the latter case, RBD may be a prodromal symptom of the neurological disease. Several brainstem regions have been implicated in RBD pathophysiology, although the exact mechanism of the disorder in humans remains to be clarified. On clinical grounds, differentiation of RBD should be made from several non-REM parasomnias and other aberrant behaviours occurring during sleep. Rapid eye movement sleep behaviour disorder can be diagnosed on the basis of a systematic medical, neurological and psychiatric evaluation of the patient, assisted by a standard polysomnographic recording that includes continuous overnight videotaping; a brain imaging study is mandatory when an underlying brain disease is being suspected. Clonazepam at bedtime is the treatment of choice for RBD; alternatively, melatonin or pramipexole can be administered when clonazepam is contraindicated.

Diagnosis, Differential↗
PubMed2002

The neural basis of Charles Bonnet hallucinations: a hypothesis.

OBJECTIVES: To describe the hallucinations occurring as a result of a macular hole in each eye and to investigate the neural basis. METHODS: Psychophysical observations including sketches of the hallucinations calibrated for size. RESULTS: All the hallucinations were of the geometric (patterned) type and lasted for only a few days. CONCLUSIONS: The observations can be explained on the basis of a "deafferentation" model, which is described in some detail. It is proposed that the hallucinations result from activation of the "blobs" of area V1 and the "stripes" of area V2 in the visual cortex. A theory is proposed to account for the disappearance of the hallucinations by a "filling in" mechanism.

Animals↗
PubMed2006

Update on the pharmacology of REM sleep behavior disorder.

REM sleep behavior disorder (RBD) is characterized by complex behavioral manifestations in response to dream content that may cause sleep disruption or injuries to the patient or the bed partner. In this case, the patients need treatment to control their symptoms. Pharmacologic agents have been reported to have positive and negative impacts on REM sleep muscle atonia and the motor behaviors associated with RBD. Clonazepam is efficacious and well tolerated by the majority of patients afflicted by RBD and should be considered as initial treatment. In patients at risk of falls who have cognitive impairment or who have obstructive sleep apneas, melatonin may be a good alternative to clonazepam. Anticholinesterase inhibitors and dopaminergic agents are not of clear benefit. Monoamine oxidase inhibitors, tricyclic antidepressants, serotonergic synaptic reuptake inhibitors, and noradrenergic antagonists can induce or aggravate RBD symptoms and should be avoided in patients with RBD. When these agents are prescribed to patients with neurodegenerative disorders or narcolepsy who are at risk of developing RBD, systematic follow-up may be warranted to detect the emergence of RBD symptoms.

Anticonvulsants↗