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Behavioral Sleep Medicine 2022Patient-centered outcomes are increasingly sought to evaluate social interactions and healthcare interventions in patients with sleep disorders. Yet, measures to assess...
RATIONALE
Patient-centered outcomes are increasingly sought to evaluate social interactions and healthcare interventions in patients with sleep disorders. Yet, measures to assess quality of life (QoL) are lacking for those who experience nightmares.
OBJECTIVE
The aim of the study is to describe the development and validation of a new health-related quality of life (HRQoL) instrument for patients with nightmares.
METHODS
Attributes obtained from a focus group of patients (n = 113) with established nightmares were analyzed using exploratory factor analysis to elicit salient QoL themes for the new instrument. A validation cohort (n = 34) was used to determine the psychometric performance of the 16-item questionnaire including item-scaling, concurrent validity, and test-retest reliability tested four weeks apart.
RESULTS
Four factors (sleep health, emotional and psychological well-being, social interaction, and motivation) explained 53.9% of the total variance. The Nightmare Quality of Life (NQoL) showed good internal consistency (Cronbach's alpha 0.85) and test-retest reliability (ICC = 0.89). Concurrent validity was evidenced by a strong correlation with the Nightmare Distress Questionnaire (r = 0.87; < .001) and more modest associations with the Nightmare Frequency Questionnaire (r = , 0.69; < .001), SF-36 (r = -0.68; < .001), and PSQI (r = 0.45; = .007).
CONCLUSIONS
The NQoL has demonstrable construct validity and reliability and represents a promising multi-dimensional instrument to assess outcome measures for quality of life in patients with nightmares.
Topics: Dreams; Humans; Psychometrics; Quality of Life; Reproducibility of Results; Surveys and Questionnaires
PubMed: 34842013
DOI: 10.1080/15402002.2021.2008394 -
Trends in Cognitive Sciences May 2024The vividness of imagery varies between individuals. However, the existence of people in whom conscious, wakeful imagery is markedly reduced, or absent entirely, was... (Review)
Review
The vividness of imagery varies between individuals. However, the existence of people in whom conscious, wakeful imagery is markedly reduced, or absent entirely, was neglected by psychology until the recent coinage of 'aphantasia' to describe this phenomenon. 'Hyperphantasia' denotes the converse - imagery whose vividness rivals perceptual experience. Around 1% and 3% of the population experience extreme aphantasia and hyperphantasia, respectively. Aphantasia runs in families, often affects imagery across several sense modalities, and is variably associated with reduced autobiographical memory, face recognition difficulty, and autism. Visual dreaming is often preserved. Subtypes of extreme imagery appear to be likely but are not yet well defined. Initial results suggest that alterations in connectivity between the frontoparietal and visual networks may provide the neural substrate for visual imagery extremes.
Topics: Humans; Imagination; Memory, Episodic; Dreams
PubMed: 38548492
DOI: 10.1016/j.tics.2024.02.007 -
Sleep Apr 2023
Topics: Dreams; Humans
PubMed: 36656722
DOI: 10.1093/sleep/zsad010 -
Philosophical Transactions of the Royal... Feb 2021Metacognitive reflections on one's current state of mind are largely absent during dreaming. Lucid dreaming as the exception to this rule is a rare phenomenon; however,...
Metacognitive reflections on one's current state of mind are largely absent during dreaming. Lucid dreaming as the exception to this rule is a rare phenomenon; however, its occurrence can be facilitated through cognitive training. A central idea of respective training strategies is to regularly question one's phenomenal experience: is the currently experienced world , or just a dream? Here, we tested if such lucid dreaming training can be enhanced with dream-like virtual reality (VR): over the course of four weeks, volunteers underwent lucid dreaming training in VR scenarios comprising dream-like elements, classical lucid dreaming training or no training. We found that VR-assisted training led to significantly stronger increases in lucid dreaming compared to the no-training condition. Eye signal-verified lucid dreams during polysomnography supported behavioural results. We discuss the potential mechanisms underlying these findings, in particular the role of synthetic dream-like experiences, incorporation of VR content in dream imagery serving as memory cues, and extended dissociative effects of VR session on subsequent experiences that might amplify lucid dreaming training during wakefulness. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
Topics: Dreams; Humans; Virtual Reality
PubMed: 33308070
DOI: 10.1098/rstb.2019.0697 -
Journal of the American Psychoanalytic... Aug 2022The post-Bionian paradigm in psychoanalysis invites us to listen to the session as a waking-dream-thought where unconscious-thinking-in progress is continuous. The...
The post-Bionian paradigm in psychoanalysis invites us to listen to the session as a waking-dream-thought where unconscious-thinking-in progress is continuous. The hypothesis put forward here and illustrated using clinical material is that we can use the notion of day's residues as a metaphor to refer to the incoming narrative of the patient. Whatever the patient brings to the session can be conceived as "day's residues" in that they are potential instigators of waking-dream-thought in the session. This metaphor helps the analyst place brackets around the outside of the session, deconcretizing what apparently are hard facts, so that immediate contact is made to create a shared perspective, possibly producing in this session "food" for the mind. To create the waking-dream-thought of the session, the analyst may consider listening to the incoming narrative as a metaphor. This is not a new or different concept but a particular kind of elaboration on the metaphoric stance taken by psychoanalysts of all stripes; it is an elaboration that expands the ways we can describe the session and narrow the gap between talking about the session and the experience of the session itself.
Topics: Dreams; Humans; Metaphor; Psychoanalysis
PubMed: 36047628
DOI: 10.1177/00030651221115848 -
Trends in Cognitive Sciences Jun 2023Newly encoded memory traces are spontaneously reactivated during sleep. Since their discovery in the 1990s, these memory reactivations have been discussed as a potential... (Review)
Review
Newly encoded memory traces are spontaneously reactivated during sleep. Since their discovery in the 1990s, these memory reactivations have been discussed as a potential neural basis for dream experiences. New results from animal and human research, as well as from the rapidly growing field of sleep and dream engineering, provide essential insights into this question, and reveal both strong parallels and disparities between the two phenomena. We suggest that, although memory reactivations may contribute to subjective experiences across different states of consciousness, they are not likely to be the primary neural basis of dreaming. We identify important limitations in current research paradigms and suggest novel strategies to address this question empirically.
Topics: Animals; Humans; Dreams; Sleep; Consciousness
PubMed: 36959079
DOI: 10.1016/j.tics.2023.02.006 -
Frontiers in Psychology 2020In addition to a large variety of somatic symptoms, fever also affects cognition, sleep, and mood. In an online survey with 164 participants, 100 fever dream reports...
In addition to a large variety of somatic symptoms, fever also affects cognition, sleep, and mood. In an online survey with 164 participants, 100 fever dream reports were submitted. Fever dreams were more bizarre and more negatively toned and included more references to health and temperature perception compared to "normal" most recent dreams - findings that are in line with the continuity hypothesis of dreaming. Future studies should follow up this line of research by conducting diary studies during naturally occurring febrile illnesses and sleep laboratory studies with experimentally induced fever. It would also be very interesting to study the effect of thermal stimulation applied during sleep on dream content. This research helps to understand subjective experiences while sleeping in an extreme condition (elevated body temperature).
PubMed: 32047464
DOI: 10.3389/fpsyg.2020.00053 -
Psychotherapy (Chicago, Ill.) Sep 2023In this article, we describe methods for working with dreams and nightmares in individual psychotherapy, provide clinical examples, and review research evidence of... (Meta-Analysis)
Meta-Analysis Review
In this article, we describe methods for working with dreams and nightmares in individual psychotherapy, provide clinical examples, and review research evidence of immediate and distal outcomes of each method. An original meta-analysis of eight studies using the cognitive-experiential dream model with 514 clients showed moderate effect sizes for session depth and insight gains. In the nightmare treatment literature, a previous meta-analysis of 13 studies with 511 clients showed moderate to large effects in reducing nightmare frequency and small to moderate effects in decreasing sleep disturbance for imagery rehearsal therapy and exposure, relaxation, and rescripting therapy. Limitations of the current meta-analysis of cognitive-experiential dreamwork and of the reviewed research on nightmare methods are described. Training implications and therapeutic practice recommendations are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Dreams; Psychotherapy
PubMed: 37104805
DOI: 10.1037/pst0000484 -
Frontiers in Human Neuroscience 2023Dreams are still an enigma of human cognition, studied extensively in psychoanalysis and neuroscience. According to the Freudian dream theory and Solms' modifications of... (Review)
Review
Dreams are still an enigma of human cognition, studied extensively in psychoanalysis and neuroscience. According to the Freudian dream theory and Solms' modifications of the unconscious derived from it, the fundamental task of meeting our emotional needs is guided by the principle of homeostasis. Our innate value system generates conscious feelings of pleasure and unpleasure, resulting in the behavior of approaching or withdrawing from the world of objects. Based on these experiences, a hierarchical generative model of predictions () about the world is constantly created and modified, with the aim to optimize the meeting of our needs by reducing prediction error, as described in the model of cognition. Growing evidence from neuroimaging supports this theory. The same hierarchical functioning of the brain is in place during sleep and dreaming, with some important modifications like a lack of sensual and motor perception and action. Another characteristic of dreaming is the predominance of , an associative, non-rational cognitive style, which can be found in similar altered states of consciousness like the effect of psychedelics. Mental events that do not successfully fulfill an emotional need will cause a prediction error, leading to conscious attention and adaptation of the priors that incorrectly predicted the event. However, this is not the case for (RPs), which are defined by the inability to become reconsolidated or removed, despite ongoing error signal production. We hypothesize that Solms' RPs correspond with the , as described by Moser in his dream formation theory. Thus, in dreams and dream-like states, these unconscious RPs might become accessible in symbolic and non-declarative forms that the subject is able to and make sense of. Finally, we present the similarities between dreaming and the psychedelic state. Insights from psychedelic research could be used to inform dream research and related therapeutic interventions, and vice versa. We propose further empirical research questions and methods and finally present our ongoing trial "Biological Functions of Dreaming" to test the hypothesis that dreaming predicts intact sleep architecture and memory consolidation, a lesion model with stroke patients who lost the ability to dream.
PubMed: 36875230
DOI: 10.3389/fnhum.2023.1080177 -
Journal of Sleep Research Apr 2024
Topics: Humans; Sleep Initiation and Maintenance Disorders; Dreams; Mental Health; Depression; Stress Disorders, Post-Traumatic
PubMed: 38384134
DOI: 10.1111/jsr.14188