Articlebronze2002

Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance

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Abstract

STUDY OBJECTIVES: The relationship between nightmare prevalence, nightmare distress, and self-reported psychological disturbance was assessed prospectively. DESIGN: Differences in self-reported psychological disturbance as a function of nightmare prevalence was investigated by MANCOVA's with non-nightmare dreams as the covariate as well as Pearson correlations. The relative contribution of nightmare prevalence and distress to the prediction of psychological disturbance was investigated through multiple regression analyses. SETTING: N/A. PARTICIPANTS: 116 participants (mean age = 20 years) completed self-report indices of depression, anxiety, dissociation, psychosis-proneness, and a psychiatric symptom checklist and kept a nightmare log for 21 consecutive nights. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Frequent nightmares were associated with higher levels of psychological disturbance. Individuals who reported 3 or more nightmares across the 3 weeks reported more dissociation, psychosis-proneness and psychiatric symptoms than participants reporting 2 nightmares or less. However, nightmare prevalence and distress were not significantly correlated and differentially predicted to different types of waking psychological disturbance. Multiple regressions further indicated that nightmare distress accounted for much of the unique explanatory variance in predicting clinical states associated with high negative affect (anxiety and depression). Last, there was no evidence for a specific relationship between nightmares and psychosis-proneness. CONCLUSIONS: The findings suggest that it is not the incidence of nightmares which is associated with poorer waking psychological functioning, especially anxiety and depression states, but the reported distress associated with the nightmare experience which is the critical variable in predicting higher psychological disturbance.

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References

1970Manual for the State-Trait Anxiety Inventory 1988Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation 1979Prevalence of sleep disorders in the Los Angeles metropolitan area 2001Imagery Rehearsal Therapy for Chronic Nightmares in Sexual Assault Survivors With Posttraumatic Stress Disorder 2000Nightmares and bad dreams: Their prevalence and relationship to well-being.1984Nightmares and trauma: a comparison of nightmares after combat with lifelong nightmares in veterans

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2006Clinical Management of Chronic Nightmares: Imagery Rehearsal Therapy 2015The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review 2004A brief Sleep Scale for Posttraumatic Stress Disorder: Pittsburgh Sleep Quality Index Addendum for PTSD 2018Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper 2005Nightmares: from anxiety symptom to sleep disorder 2004The relationship of nightmare frequency and nightmare distress to well‐being 2019

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