Affective and Personality Characteristics in Function of Nightmare Prevalence, Nightmare Distress, and Interference Due to Nightmares.

This study analyzes the relationships among nightmare frequency, nightmare distress, and interference due to nightmares, sleep quality, psychopathology (anxiety and depression), and personality (neuroticism, psychoticism, and boundaries). The nightmare parameters were evaluated with the Nightmare Frequency Questionnaire (B. Krakow et al., 2000; see also record 2000-16731-002), the Nightmare Distress Questionnaire (K. Belicki, 1992b; see also record 1993-08389-001), and the Nightmare Effects Survey (Krakow et al., 2000). The sample was composed of 147 healthy students. The results demonstrated that the 2 measurements of distress (subjective distress associated with nightmares and, especially, deterioration of psychosocial functioning) were the dimensions that best related to the variables studied, although the relationships were modulated by nightmare frequency. The parameter of nightmare frequency was found to be useful as an indicator of certain personality characteristics rather than psychological perturbation. Having nightmares on a weekly basis was strongly associated with depressed mood. The knowledge about these relations is relevant not only theoretically but also as a practical guide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trait–state interactions in the etiology of nightmares.

Various personality and psychopathology traits are associated with nightmare frequency. This study investigated whether trait variables might also account for individual differences in the longitudinal relationship between daily mood and nightmare incidence each night. Forty-two participants (35 women, 7 men; mean age = 40.10 years) reported having nightmares at least once per month and completed a 14-day dream and mood (anxiety and depression) log. Within-subject correlations between state anxiety and nightmare incidence or absence the following night and between state depression and nightmare incidence or absence were computed. None of the trait measures had significant correlations with these within-subject correlations. However, when only participants scoring above the group median on Hartman’s thin boundariness were analyzed, thin boundariness, Symptom Checklist—Global Severity, adverse life events, and childhood adversity were associated with the incidence of nightmares as a function of state anxiety or depression on a night-by-night basis, with correlation coefficients between .43 and .52. This supports the hypothesis of trait predispositions for a nightmare reaction to daily state anxiety or depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of chronic nightmares in a trauma-exposed treatment-seeking sample.

Chronic nightmares pose a significant problem for many individuals affected by trauma. The present study attempts to extend current knowledge on the nature, characteristics, and associated sequelae of chronic nightmares. Data were collected from 94 trauma-exposed, treatment-seeking participants (74 women and 20 men). These data suggest that most participants reported their nightmares to be similar or dissimilar to their traumatic experience rather than exact replications (replicative). Not surprisingly, though, nightmare-related distress was positively related to the degree of similarity between their nightmare and their trauma, with replicative nightmares eliciting the greatest distress. Persons with a current diagnosis of posttraumatic stress disorder (PTSD) were more likely to report problems related to nightmares and sleep disturbance than persons without current PTSD. Nonetheless, even after controlling for PTSD-related symptomatology, frequency and severity of nightmares significantly predicted some distress outcomes (e.g., poor sleep quality), suggesting that nightmares contribute to psychological distress above and beyond PTSD symptoms. Implications for future research, and for the treatment of nightmares and PTSD, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares

Background

We previously suggested that abnormal sleep behaviors, i.e., as found in parasomnias, may often be the expression of increased activity of the reward system during sleep. Because nightmares and sleepwalking predominate during REM and NREM sleep respectively, we tested here whether exploratory excitability, a waking personality trait reflecting high activity within the mesolimbic dopaminergic (ML-DA) system, may be associated with specific changes in REM and NREM sleep patterns in these two sleep disorders.

Methods

Twenty-four unmedicated patients with parasomnia (12 with chronic sleepwalking and 12 with idiopathic nightmares) and no psychiatric comorbidities were studied. Each patient spent one night of sleep monitored by polysomnography. The Temperament and Character Inventory (TCI) was administered to all patients and healthy controls from the Geneva population (n = 293).

Results

Sleepwalkers were more anxious than patients with idiopathic nightmares (Spielberger Trait anxiety/STAI-T), but the patient groups did not differ on any personality dimension as estimated by the TCI. Compared to controls, parasomnia patients (sleepwalkers together with patients with idiopathic nightmares) scored higher on the Novelty Seeking (NS) TCI scale and in particular on the exploratory excitability/curiosity (NS1) subscale, and lower on the Self-directedness (SD) TCI scale, suggesting a general increase in reward sensitivity and impulsivity. Furthermore, parasomnia patients tended to worry about social separation persistently, as indicated by greater anticipatory worry (HA1) and dependence on social attachment (RD3). Moreover, exploratory excitability (NS1) correlated positively with the severity of parasomnia (i.e., the frequency of self-reported occurrences of nightmares and sleepwalking), and with time spent in REM sleep in patients with nightmares.

Conclusions

These results suggest that patients with parasomnia might share common waking personality traits associated to reward-related brain functions. They also provide further support to the notion that reward-seeking networks are active during human sleep.     

A comparison of lifelong and posttrauma nightmares in a civilian trauma sample: Nightmare characteristics, psychopathology, and treatment outcome.

Nightmares and sleep disturbances are thought to play a key role in the development of posttrauma problems. Research efforts have increased in an attempt to understand this association. The present study examined differences in nightmare characteristics, related psychopathology, treatment outcome, and trauma history among trauma-exposed individuals whose nightmares began before a traumatic event and those whose nightmares began after a traumatic event, while controlling for posttraumatic stress disorder status. Individuals whose nightmares began following a trauma experienced more depression and posttraumatic stress symptoms and poorer sleep quality, reported a higher number of traumatic events, and were more likely to report nightmares replicative of or similar to the trauma than those whose nightmares began before the trauma. No other between-groups differences were found for nightmare characteristics or response to treatment. This study is an important step in understanding the nature of nightmares and their relationship to traumatic events and consequences, but additional research is warranted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Behavioral Effects of Nightmares and Their Correlations to Personality Patterns

Factors affecting or inducing nightmares have been investigated repeatedly. However, little research is carried out on the behavioral consequences of nightmares. The present study thus served to investigate behavioral effects of nightmares in correlation to personality variables. 41 non-clinical participants, who suffer from about 2 nightmares per month recorded their dreams and nightmares over a 4-week period. A nightmare was defined as a dream that frightens the dreamer and could be recalled in detail on awakening. Anxiety and mood were monitored every morning. All nightmares and their behavioral consequences were noted on a questionnaire. Personality traits and life events were assessed at the beginning of the investigation. 100 nightmares were reported by the subjects over the 4-week period (range: 0–8). Following a nightmare, the subjects were significantly more anxious and were of a less stable mental condition compared to nights without nightmares. Additionally, nightmares induced physical complaints. This was considered to be an indicator that something was wrong in their lives and induced them to solve personal problems. The behavioral effects were most pronounced in subjects scoring high on neuroticism and on the number of physical complaints and low on achievement orientation and openness. The results suggest that sufferers of nightmares intend to change their lives, especially those with a neurotic-like personality.     

Differences in the relationship between nightmares and coping with stress for Asians and Caucasians: A brief report.

In contrast to posttraumatic nightmares, some nightmares can also be idiopathic. Previous research indicates that nightmares may serve a beneficial function as there is a positive relationship between nightmares and “waking” coping strategies. As a result, nightmares may fit into a continuity of coping throughout the sleep/wake cycle. In the present analysis, the relationship between nightmares and one measure of coping was only significant for those who identified themselves as Asian when compared those who identified themselves as Caucasian. These results represent one of the first differences in nightmares between ethnic groups. Such research is important for understanding the role of idiopathic nightmares in coping and understanding the importance of ethnicity when presented with patients complaining of nightmares. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Auditory event-related potentials in waking infants and adults: a developmental perspective

Auditory event-related potentials (AERPs) were recorded in waking 1 month olds, 3 month olds, 6 month olds and adults in order to study the morphology and development of the wave form in the waking subject. Previous data were generally obtained in sleeping or drowsy infants.The findings indicated that there were 3 quantitative changes in the AERP over the first 6 months of life in waking infants: an increase in the latency of peaks, an increase in peak amplitude, and a decrease in intersubject variability. Adult peak latencies were generally shorter than those for 3 month olds and 6 month olds. Further, latencies ofearlier AERP peaks for 1 and 6 month olds, in the present study, were comparable to those reported in previous investigations with sleeping infants. However, latencies oflater AERP peaks differed from those of previous reports and were closer to those reported for waking adults.With respect to the amplitude, the 6 month olds, in general, had the highest amplitudes, the 1 month olds the lowest, and the 3 month olds and adults fell in between the two groups. Some differences were present between early and late components.The findings of this study are significant in that the AERPs were quantitatively different from those reported in earlier work with sleeping or drowsy infants. If cognitive and perceptual development is to be studied, it is necessary to obtain data on waking subjects. The data presented in this report are consistent with behavioral studies of biobehavioral shifts that are associated with changes in responsivity of the organism to stimuli during the first 6 months of life.     

The influence of impactful dreams on self-perceptual depth and spiritual transformation.

Two studies contrasted the short-term effects of nightmares, existential dreams, and transcendent dreams (Busink & Kuiken, 1996; Kuiken & Sikora, 1993). Results from Study 1 indicated that existential dreams were more likely than mundane dreams, transcendent dreams, or nightmares to be followed by reported self-perceptual depth; also, transcendent dreams were more likely than mundane dreams, existential dreams, or nightmares to be followed by reported spiritual transformation. Results from Study 2 replicated these findings for existential dreams, indicating also that the type of spiritual transformation associated with transcendent dreams involved an ecstatic sense of release from everyday entanglements. Both existential dreams and transcendent dreams moved the dreamer toward an unbounded sense of life in all things, as did lucid forms of all three dream types. Such unbounded enlivenment suggests an aesthetic substrate to the changes induced by each of these dream types. The contrasting short-term effects of impactful dream types may require integration into a comprehensive model of long-term dream function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catecholamines and the sleep-wake cycle I. EEG and behavioral arousal

The exact role of catecholamines (CA) on the sleep-wake cycle is still controversial. Critical analysis of lesion studies tends to suggest a neuromodulatory role for both dopamine (DA) and norepinephrine (NE) on EEG and behavioral arousal. Support for this view is provided by pharmacological studies in which catecholaminergic systems are activated or inhibited. Taken together they show that disturbances in the dynamic balance between neurochemical systems may alter the conditions for wake-triggering mechanisms to express at optimal levels. Large electrolytic or neurotoxic lesions which affect noradrenergic and dopaminergic structures are associated with marked and prolonged EEG changes and decreased behavioral arousal, respectively. In contrast, specific and circumscribed damage restricted to these systems is followed by a transient decrease in waking activity. Thus, results observed after large central lesions are most probably related to destruction of non-catecholaminergic neurons. Inhibition of brain CA synthesis causes behavioral sedation and a decrease in waking activity. Selective pharmacological stimulation of presynaptic alpha-adrenergic (∝ 2) receptors tends to decrease waking, while opposite effects result from ∝2-receptor blockade. Drugs with agonistic activity at postsynaptic alpha-adrenergic (∝1) sites increase EEG desynchronization, but specific blockade of ∝1-receptor does not result in marked decreases of waking EEG. In contrast, treatments which simultaneously block NE and DA receptors significantly affect waking. Beta-adrenergic receptor blockers show no conclusive effects on waking or sleep. Selective DA-receptor agonists induce biphasic effects, with low doses decreasing and large doses increasing cortical desynchronization and motility. Opposite effects are observed in laboratory animals after injection of specific DA-receptor blockers.     

Nightmare frequency as a function of age, gender, and September 11, 2001: Findings from an Internet questionnaire.

Retrospective estimates of nightmare frequency for a sample of 23,990 respondents to an Internet questionnaire (female: N = 19,367, mean age = 24.9 ± 10.14 years; male: N = 4,623; mean age = 25.5 ± 10.81) were evaluated as a function of age, gender, and pre- versus post-September 11, 2001. Female respondents reported more frequent monthly nightmares (4.44 ± 6.71) than did male respondents (3.39 ± 6.07), and this result was seen for all age strata younger than 60. Also, for female respondents, nightmare frequency increased from ages 10-19 to 20-39 then decreased monotonically to ages 50-59. For male respondents, nightmare frequency was stable from ages 10-19 to 30-39 then decreased to ages 50-59. An increase in nightmare frequency was observed post-September 11 only for male respondents-particularly for 10- to 29-year-olds. This increase was sustained 2 years later. These effects were maintained when dream recall was held constant. Results replicate, in a single sample, previously published gender and age effects and provide new evidence that the nightmares of males may be differentially sensitive to traumatic events for which victims and/or perpetrators are primarily male. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression,Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma: A Register-Based Cohort Study

Aim

The purpose of the study was to determine anxiety and depression, quality of life, and their determinants in long-term survivors of malignant melanoma.

Methods

In a state cancer registry a cohort of survivors of malignant melanoma was contacted via the physician registered. Of 1302 contactable patients, 689 (52.2%) completed a questionnaire including the Patient Health Questionnaire with generalized anxiety (GAD-7) and depression (PHQ-9) and the EORTC Quality of Life Questionnaire (EORTC QLQ 30). Based on multiple regression analysis, predictors of quality of life and distress were identified. Comparison data were assessed in two waves of representative face-to-face household surveys of the adult German population.

Results

An average of 8.4 (5.7 to 12.2) years after diagnosis, distress was higher in women compared to men and in middle adulthood (vs. older patients). Symptoms were higher in women than in men, and there was a decline of functioning and increase of symptoms across the age range of both genders. Compared to the general population, there were slightly increased depression and anxiety (only women), but no impaired global quality of life. Yet, survivors evidenced functional decline and more physical symptoms. Distress and reduced quality of life were consistently predicted by lack of social support, fear of recurrence, pessimism and self-blame. Distress was increased by a family history of melanoma, and additional mental and somatic diseases.

Conclusion

Overall, long-term survivors have adjusted well achieving a global quality of life comparable to the general population. Yet, compromised functional dimensions, physical symptoms and distress indicate the need for integrating psychooncological screening into oncological follow-up, which might be guided by predictors such as family history or social support. Further prospective study is needed to determine the course of adaptation to the disease and corroborate the risk factors identified.     

WELL.ME - Wellbeing therapy based on real-time personalized mobile technologies, vs. cognitive therapy, to reduce psychological distress and promote healthy lifestyle in cardiovascular disease patients: study protocol for a randomized controlled trial

ABSTRACT: BACKGROUND: There is compelling evidence that psychological factors may have the same or even greater impact on the possibility of adverse events on cardiac diseases (CD) than other traditional clinical risk factors. Anxiety and depression are predictors of short- and long-term adverse outcomes, increased risk for higher rates of in-hospital complications, re-infarction, malignant arrhythmias, and mortality in CD patients. Despite researchers finding that cognitive behavior therapy (CBT) reduced depressive and anxiety symptoms, the fact that such results are maintained only in the short term and the lack of maintenance of the long-term affects the absence of changes in lifestyles, preventing the possibility of a wide generalization of results. Recently wellbeing therapy (WBT) has been proposed as a useful approach to improve healthy lifestyle behaviors and reduce psychological distress.Methods/designThe present randomized controlled study will test WBT, in comparison with CBT, as far as the reduction of symptoms of depression, anxiety and psychological distress, and the improvement of lifestyle behaviors and quality of life in cardiac patients are concerned. Moreover, innovations in communication technologies allow patients to be constantly followed in real life. Therefore WBT based on personalized mobile technology will allow the testing of its effectiveness in comparison with usual WBT. DISCUSSION: The present study is a large outpatient study on the treatment of co-morbid depression, anxiety, and psychological distress in cardiac patients. The most important issues of this study are its randomized design, the focus on promotion of health-related behaviors, and the use of innovative technologies supporting patients' wellbeing in real life and in a continuous way. First results are expected in 2012.Trial registrationClinicalTrials.gov Identifier: NCT01543815.     

Responses of pet cats to being held by an unfamiliar person,from weaning to three years of age

Abstract

We have determined the extent to which individual responses of domestic cats on being handled by an unfamiliar person are stable between 2 and 33 months of age. Twenty-nine household cats from nine litters were tested at 2, 4, 12, 24 and 33 months of age, by being held for 1 minute by a standard, unfamiliar person. Between 4 and 33 months of age, individual differences in the number of attempts made by the cat to escape, and in whether or not it showed signs of distress, were stable, with the partial exception of the test at 12 months. There was no consistency between tests in whether or not a particular cat purred. At 2 months of age, the number of escape attempts was highest in cats which had been handled the least in the second month of life, but this trend was reversed in the number of escape attempts made at 4 months. The lack of distress exhibited by all cats in the test at 2 months indicated that all had received at least adequate socialization to people, and that none were therefore comparable with the unsocialized cats used in several previous studies. We conclude that under normal domestic conditions, the behavior of a cat when handled by an unfamiliar person reflects a stable character trait, and that extensive handling during the socialization period may be subsequently associated with a reduction in inhibited behavior when interacting with an unfamiliar person.     

Comparison of dream anxiety and subjective sleep quality between chronotypes

Morning and evening-type individuals differ on a number of psychological and biological variables. In this study, we aimed to investigate the relationship between sleep quality, dream anxiety, and chronotypes. A sample of 264 university students, aged between 17 and 26 years, completed the Morningness-Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, and the Van Dream Anxiety Scale for assessing nightmare frequency and the dream anxiety caused by frightening dreams. Main findings indicated that evening-type individuals were significantly more likely to suffer from poor sleep quality, daytime dysfunction, nightmares, and nightmare-related disturbances as compared to either intermediate- or morning-type individuals. Previous studies have pointed out the possible connections of irregular sleep-wake habits and circadian dysregulation with a tendency to reveal eveningness chronotypical characteristics. Current findings suggest that evening-type individuals are more prone to experience psychologically deteriorating nightmares and sleep-related anxiety. Poor sleep quality is also a significant antecedent of dream anxiety after controlling for age and gender.

     

Psychological distress, depression and prolactin response in stressed persons

We examined the relationship of psychological distress to serum prolactin response in 54 persons who had lost a spouse or were threatened with a loss. We found that our two measures of psychological distress, both separation anxiety and depression, were directly correlated with prolactin response during a stressful interview (p less than .05). When we stratified the sample first by depression score and then by separation anxiety, we found a positive correlation between separation anxiety and prolactin response only in the highly depressed half of the sample (r = .32) and a positive correlation between depression and prolactin response only in the highest quartile of intensity for separation anxiety (r = .49, p less than .05). This suggested that both depression and separation anxiety, each in conjunction with high levels of the other but not independently, rendered the individual under stress more physiologically sensitive to distressing challenges such as a stressful interview. Alternatively, it was global distress above a certain threshold that was associated with degree of physiological response.     

Nightmares Among Cambodian Refugees: The Breaching of Concentric Ontological Security

This article explores the nightmares of Cambodian refugees in a cultural context, and the role of nightmares in the trauma ontology of this population, including their role in generating post-traumatic stress disorder (PTSD). Among Cambodian refugees attending a psychiatric clinic, we found that having a nightmare was strongly associated with having PTSD (χ² = 61.7, P < 0.001, odds ratio = 126); that nightmares caused much distress upon awakening, including panic attacks, fear of bodily dysfunction, flashbacks and difficulty returning to sleep; that nightmare content was frequently related to traumatic events; that nightmares resulted in a decrease in the sense of “concentric ontology security” (i.e., in an increased sense of physical and spiritual vulnerability in a culture that conceives of the self in terms of concentric, protective layers), including fears of being attacked by ghosts; and that nightmares frequently led to the performance of specific practices and rituals aiming to extrude and repel attacking forces and to create “protective layers.” Cases are presented to illustrate these findings. The Discussion considers some treatment implications of the study.

Dream emotions, waking emotions, personality characteristics and well-being--A positive psychology approach.

The study aimed to discover whether personality characteristics and waking emotions relate to dreaming emotions. There were 123 participants, ranging in age from 17 to 82 years. It was hypothesized that participants with significant positive emotional trait and state ratings in waking life would experience more positive dreams. Data collection utilized diaries and questionnaires, including Hartmann's Boundary Questionnaire, IPIP Emotional Stability Scale, Staats' Hope Scale, Adult Dispositional Hope Scale, and the Positive and Negative Affect Schedule to assess personality and attitudinal characteristics. Participants recorded and rated their waking and dream emotions over a 3-week period. Median correlations between corresponding waking and dream emotions were .58 for positive emotions and .47 for negative emotions. There were also low, but significant correlations between some personality characteristics and participants' tendency to experience positive or negative emotions in dreams. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Respiratory function of people with amyotrophic lateral sclerosis and caregiver distress level: a correlational study

ABSTRACT: BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a rare, fatal neurodegenerative disorder with no curative treatment characterized by degeneration of motor neurons involving a progressive impairment of motor and respiratory functions. Most patients die of ventilator respiratory failure. Caregivers have a great influence on the patient"s quality of life as well as on the quality of care. Home influence of the caregiver on patient care is notable. To date, no study has investigated how psychological issues of caregivers would influence respiratory variables of ALS patients. The study aimed at finding out if there is a relationship between the respiratory function of ALS patients and the level of distress of their caregivers. METHODS: A cross-sectional study was conducted to investigate respiratory issues (PCF and FVC) and the perception of social support of ALS patients. Caregivers filled questionnaires about trait anxiety, depression, and burden of care. Forty ALS patients and their caregivers were recruited. RESULTS: FVC and PCF were positively related to patient perception of social support and negatively related to caregiver anxiety, depression, and burden. DISCUSSION: The distress of ALS caregivers is related to patient respiratory issues. The first and more intuitive explanation emphasizes the impact that the patient's clinical condition has with respect to the caregiver. However, it is possible to hypothesize that if caregivers feel psychologically better, their patient's quality of life improves and that a condition of greater well-being and relaxation could also increase ventilatory capacity. Furthermore, care management could be carried out more easily by caregivers who pay more attention to the patient's respiratory needs. CONCLUSION: Patient perception of social support and caregiver distress are related to respiratory issues in ALS.     

Relationship of stressful life events, anxiety and depression to hyperthyroidism in an asian population

BACKGROUND: Psychological disturbances are well-known disorders in patients with hyperthyroidism, with anxiety and depression being the most commonly described. Stressful life events may play an important role in the relationship of anxiety, depression and hyperthyroidism. We assessed the associations of these disorders by three-part rating scales, including the Hamilton Rating Scale for Anxiety (HAM-A) indicating anxiety, the Zung Self-Rating Depression Scale (Zung Scale) indicating depression and the Social Readjustment Rating Scale (SRRS) indicating external stress from life events in this study. METHODS: Eighty-six outpatients who visited an endocrine clinic with suspicion of thyroid disease and 18 healthy volunteers were enrolled in the study. In all of these individuals, thyroid functions were assessed and questionnaires were completed during an interview. RESULTS: The outpatients with hyperthyroidism (n = 39) had higher scores of HAM-A (15.7 +/- 1.1 vs. 8.0 +/- 0.8, p < 0.001), Zung scale (46.2 +/- 1.5 vs. 37.5 +/- 1.4, p < 0.001) and SRRS (92.9 +/- 13.5 vs. 56.9 +/- 8.4, p = 0.015) than those with euthyroidism (n = 47). The scores of the three-part rating scales were also higher in the outpatients with hyperthyroidism than in healthy volunteers (n = 18), with no significant differences between the outpatients with euthyroidism and healthy volunteers. CONCLUSION: In patients with hyperthyroidism, anxiety, depression and stressful life events were more severe than in those with normal thyroid function. There were no correlations between these psychological disorders and thyroid function tests of the subjects with hyperthyroidism. The role of psychotherapy in the development of hyperthyroidism deserves further investigations.