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Pinus M, Lassri D, Rahamim O, Schiller M, Soffer-Dudek N, Shahar G. Identifying state self-criticism subscales within the Brief Symptoms Inventory: Analyses of data from Israeli young adults. Personality and Individual Differences 2023. [DOI: 10.1016/j.paid.2022.111989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Vadukapuram R, Shah K, Ashraf S, Srinivas S, Elshokiry AB, Trivedi C, Mansuri Z, Jain S. Adverse Childhood Experiences and Their Impact on Sleep in Adults: A Systematic Review. J Nerv Ment Dis 2022; 210:397-410. [PMID: 35640064 DOI: 10.1097/NMD.0000000000001480] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adverse childhood experiences (ACEs) before the age of 18 years are pervasive and noteworthy public health concerns. The ACEs are associated with sleep disorders in later life. In this study, we conduct a systematic review to explore the effects of ACEs on sleep in adulthood. Using Medical Subject Headings keywords, we searched Medline, PubMed, PubMed Central, the American Psychological Association PsycArticles, and PsychInfo databases to evaluate the association between ACEs and sleep disturbances. ACEs increase the odds of developing chronic short sleep duration, that is, <6 hours of sleep per night compared with optimal sleep duration of 7-9 hours per night during adulthood. The ACEs are positively associated with poor sleep characteristics such as short sleep duration and long-term sleep problems. Clinicians should pay close attention to developmental trauma care, access community health programs, and help develop better coping skills, resiliency, and good sleep habits in their patients.
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Lynn SJ, Polizzi C, Merckelbach H, Chiu CD, Maxwell R, van Heugten D, Lilienfeld SO. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annu Rev Clin Psychol 2022; 18:259-289. [PMID: 35226824 DOI: 10.1146/annurev-clinpsy-081219-102424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identify empirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Steven Jay Lynn
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Craig Polizzi
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Chui-De Chiu
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China
| | - Reed Maxwell
- Department of Psychiatry, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dalena van Heugten
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Baltzan M, Yao C, Rizzo D, Postuma R. Dream enactment behavior: review for the clinician. J Clin Sleep Med 2020; 16:1949-1969. [PMID: 32741444 PMCID: PMC8034224 DOI: 10.5664/jcsm.8734] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022]
Abstract
NONE Dream enactment behavior commonly occurs on occasion in normal children and adults. Disruptive and frequent dream enactment behavior may come to the attention of the clinician either as the primary reason for consultation or as a prominent characteristic of a patient with other sleep disorders. Questioning patients with chronic neurologic and psychiatric disorders may also reveal previously unrecognized behavior. In the absence of sleep pathology, process of dream enactment likely begins with active, often emotionally charged dream content that may occasionally break through the normal REM sleep motor suppressive activity. Disrupted sleep resulting from many possible causes, such as circadian disruption, sleep apnea, or medications, may also disrupt at least temporarily the motor-suppressive activity in REM sleep, allowing dream enactment to occur. Finally, pathological neurological damage in the context of degenerative, autoimmune, and infectious neurological disorders may lead to chronic recurrent and severe dream enactment behavior. Evaluating the context, frequency, and severity of dream enactment behavior is guided first and foremost by a structured approach to the sleep history. Physical exam and selected testing support the clinical diagnosis. Understanding the context and the likely cause is essential to effective therapy.
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Affiliation(s)
- Marc Baltzan
- Faculty of Medicine, Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montréal, Canada
- Centre Intégré Universitaire des Soins et Services Sociaux du Nord de L’île de Montréal, Montréal, Canada
- Mount Sinai Hospital, Centre Intégré Universitaire des Soins et Services Sociaux du Centre-ouest de L’île de Montréal, Montréal, Canada
- Institut de Médecine du Sommeil, Montréal, Canada
| | - Chun Yao
- Integrated Program in Neuroscience, McGill University, Montréal, Canada
- Research Institute of McGill University Health Centre, Montréal, Canada
| | - Dorrie Rizzo
- Faculty of Medicine, Department of Family Medicine, McGill University, Montréal, Canada
- Lady Davis Institute for Medical Research, Centre Intégré Universitaire des Soins et Services Sociaux de l’ouest de l’île, Montréal, Canada
| | - Ron Postuma
- Research Institute of McGill University Health Centre, Montréal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
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Lynn SJ, Maxwell R, Merckelbach H, Lilienfeld SO, Kloet DVHVD, Miskovic V. Dissociation and its disorders: Competing models, future directions, and a way forward. Clin Psychol Rev 2019; 73:101755. [DOI: 10.1016/j.cpr.2019.101755] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/20/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022]
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Abstract
Four states of consciousness are considered here: the hypnagogic state (the transitional state between waking and sleeping); the hypnopompic state (the transitional state between sleeping and waking); lucid dreaming (insight to the fact that one is currently dreaming); and the out-of-the-body experience (perceiving the world from a location outside the physical body). There are different patterns of occurrence of experience with these states of consciousness, and the present data set deriving from a cross-sectional study (a convenience sample comprising 251 participants who had completed a battery of questionnaires, as reported in Glicksohn & Barrett, 2003), enables one to plot these configurations. There are two contrasting positions on the relationship that trait Absorption will bear on the pattern of occurrence of these different profiles of subjective experience, or configuration of profiles of states. One is that higher Absorption will entail more differentiation among these states of consciousness; the other is that higher Absorption will entail less differentiation among these states. Both positions find support in the present data set: higher Absorption entails more differentiation as one moves from those respondents scoring slightly lower than the median to those scoring slightly higher than the median on Absorption, whereas very high Absorption entails less differentiation relative to very low Absorption.
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Affiliation(s)
- Joseph Glicksohn
- Department of Criminology, Bar-Ilan University
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Israel
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Otheman Y, Satté A, Mounach J, Kadiri M, Bichra MZ. [Sleep related dissociative disorder: A case complicated by a suicide attempt]. Encephale 2018; 45:271-273. [PMID: 29983174 DOI: 10.1016/j.encep.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/10/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Y Otheman
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc.
| | - A Satté
- Service de neurophysiologie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - J Mounach
- Service de neurophysiologie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - M Kadiri
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - M Z Bichra
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
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Soffer‐Dudek N, Todder D, Shelef L, Deutsch I, Gordon S. A neural correlate for common trait dissociation: Decreased EEG connectivity is related to dissociative absorption. J Pers 2018; 87:295-309. [DOI: 10.1111/jopy.12391] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 02/05/2018] [Accepted: 03/26/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | - Doron Todder
- Mental Health Center, Ministry of HealthBeer‐Sheva Israel
- Zlotowski Center for NeuroscienceBen‐Gurion University of the Negev
| | - Leah Shelef
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
| | - Inbal Deutsch
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
| | - Shirley Gordon
- Department of PsychologyBen‐Gurion University of the Negev
- Israel Defense Force Medical CorpsTel Hashomer Ramat‐Gan Israel
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Barton J, Kyle SD, Varese F, Jones SH, Haddock G. Are sleep disturbances causally linked to the presence and severity of psychotic-like, dissociative and hypomanic experiences in non-clinical populations? A systematic review. Neurosci Biobehav Rev 2018; 89:119-131. [DOI: 10.1016/j.neubiorev.2018.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/26/2018] [Accepted: 02/12/2018] [Indexed: 12/15/2022]
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Aviram L, Soffer-Dudek N. Lucid Dreaming: Intensity, But Not Frequency, Is Inversely Related to Psychopathology. Front Psychol 2018; 9:384. [PMID: 29623062 PMCID: PMC5875414 DOI: 10.3389/fpsyg.2018.00384] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/08/2018] [Indexed: 11/17/2022] Open
Abstract
Lucid dreaming (LD) is awareness that one is dreaming, during the dream state. However, some define and assess LD relying also on controlling dream events, although control is present only in a subset of lucid dreams. LD has been claimed to represent well-being, and has even been used as a therapeutic agent. Conversely, LD is associated with mixed sleep-wake states, which are related to bizarre cognitions, stress, and psychopathology, and have been construed as arousal permeating and disrupting sleep. We propose that previous conflicting findings regarding relations between LD and both psychopathology and well-being, stem from the non-differentiated assessment of frequency and control. The present study aimed to develop an expansive measure of several LD characteristics (the Frequency and Intensity Lucid Dream questionnaire; FILD), and explore their relations with symptomatology. Undergraduate students (N = 187) self-reported trait LD, psychopathology (depression, anxiety, obsessive-compulsive symptoms, dissociation, and schizotypy), stress, and sleep problems; 2 months later, a subsample (n = 78) reported psychopathology again, and also completed a dream diary each morning for 14 days. Preliminary evidence supports the reliability and validity of the FILD. Items converged into four domains: frequency, intensity (e.g., control, activity, certainty of dreaming), emotional valence, and the use of induction techniques. We report an optimal frequency cutoff score to identify those likely to experience LD within a 2-week period. Whereas LD frequency was unrelated to psychopathology, LD intensity, and positive LD emotions, were inversely associated with several psychopathological symptoms. Use of deliberate induction techniques was positively associated with psychopathology and sleep problems. Additionally, we demonstrated directionality by employing a prospective-longitudinal design, showing that deliberate LD induction predicted an increase in dissociation and schizotypy symptoms across 2 months. We conclude that lucidity should not be considered as necessarily suggestive of well-being; LD may be positive or negative, depending on lucidity characteristics. Additionally, deliberate LD induction may harbor negative long-term risk.
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Affiliation(s)
| | - Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract
Objective Poor sleep quality has a number of significant negative effects on daytime function. However, few studies have examined sleep quality in patients with dizziness. Here, we investigated the potential association between sleep quality and various types of dizziness. Subjects and methods We examined dizziness and sleep disturbance in 237 patients experiencing dizziness using Korean versions of the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and Dizziness Handicap Inventory (DHI). All participants were classified as having benign paroxysmal positional vertigo (BPPV), Ménière’s disease (MD), vestibular neuritis (VN), vestibular migraine (VM), psychogenic dizziness (PD), or Other. Results The mean PSQI and ISI scores were highest in the PD group. The rate of sleep disturbance was highest in the Other group when the cut-off score for each questionnaire was set differently, except ISI ≥ 15. The correlation between DHI and sleep disturbance indices was highest in the VM group. Multivariate regression showed that PSQI score and DHI-E score were significantly related to the PD and Other groups, while the Other group was significantly related to the ISI score. Conclusion The findings of this study strongly suggest that there are associations between sleep quality and some disease subtypes associated with dizziness. Therefore, it is important to consider sleep disturbance in patients with psychogenic dizziness, such as phobic postural vertigo and chronic subjective dizziness, or nonspecific dizziness.
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13
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Soffer-Dudek N. Arousal in Nocturnal Consciousness: How Dream- and Sleep-Experiences May Inform Us of Poor Sleep Quality, Stress, and Psychopathology. Front Psychol 2017; 8:733. [PMID: 28539902 PMCID: PMC5423938 DOI: 10.3389/fpsyg.2017.00733] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/24/2017] [Indexed: 11/13/2022] Open
Abstract
The term "sleep experiences," coined by Watson (2001), denotes an array of unusual nocturnal consciousness phenomena; for example, nightmares, vivid or recurrent dreams, hypnagogic hallucinations, dreams of falling or flying, confusional arousals, and lucid dreams. Excluding the latter, these experiences reflect a single factor of atypical oneiric cognitions ("general sleep experiences"). The current study is an opinionated mini-review on the associations of this factor-measured with the Iowa sleep experiences survey (ISES, Watson, 2001)-with psychopathological symptoms and stress. Findings support a strong relation between psychological distress and general sleep experiences. It is suggested that that they should be viewed as a sleep disturbance; they seem to represent involuntary intrusions of wakefulness into sleep, resulting in aroused sleep. These intrusions may stem from excessively thin boundaries between consciousness states (e.g., "transliminality"), or, conversely, they may follow an attempt at disconnecting mental elements (e.g., dissociation), which paradoxically results in a "rebound effect." The extent to which unusual dreaming is experienced as intrusive, rather than controlled, may explain why general sleep experiences are related to psychopathology, whereas lucid dreams are related to psychological resilience. In conclusion, the exploration of the interplay between psychopathology and sleep should be expanded from focusing almost exclusively on quantitative aspects (e.g., sleep efficiency, latency) to including qualitative conscious experiences which may reflect poor sleep quality. Taking into account nocturnal consciousness-including unusual dreaming and permeable sleep-wake boundaries-may unveil rich information on night-time emotional states and broaden our definition of poor sleep quality.
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Affiliation(s)
- Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the NegevBeer-Sheva, Israel
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Andorko ND, Mittal V, Thompson E, Denenny D, Epstein G, Demro C, Wilson C, Sun S, Klingaman EA, DeVylder J, Oh H, Postolache TT, Reeves GM, Schiffman J. The association between sleep dysfunction and psychosis-like experiences among college students. Psychiatry Res 2017; 248:6-12. [PMID: 27988426 DOI: 10.1016/j.psychres.2016.12.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 10/26/2016] [Accepted: 12/07/2016] [Indexed: 11/24/2022]
Abstract
Sleep problems are prominent and pervasive clinical issues experienced by many people with psychotic disorders, often causing distress and functional impairment. Sleep problems are also related to psychosis-like experiences (PLE; non-diagnosable phenomenon such as transient perceptual disturbances, unusual thoughts, periodic suspiciousness) in epidemiological studies. Prior studies in this field have used brief measures that precluded the ability to test (1) whether risk for psychosis-like experiences are related to specific sub-types of sleep disturbance, and (2) whether sleep disturbance is specifically related to clinically significant (i.e., distressing) psychosis-like experiences. The current project examined the relation between specific sleep issues, and PLEs and distress associated with PLEs, in a college sample. Participants (N=420) completed the Prodromal Questionnaire-Brief (PQ-B), which assesses PLEs and associated distress, and the Iowa Sleep Disturbances Inventory - extended version (ISDI-E), which assesses thirteen separate disturbed sleep domains. Symptoms of fragmented sleep, sleep hallucinations, and night anxiety significantly correlated with PLEs, and several sleep domains were significantly associated with PLE-related distress.
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Soffer-Dudek N. Sleep-related experiences longitudinally predict elevation in psychopathological distress in young adult Israelis exposed to terrorism. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2015.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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16
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Soffer-dudek N, Lassri D, Soffer-dudek N, Shahar G. Dissociative absorption: An empirically unique, clinically relevant, dissociative factor. Conscious Cogn 2015; 36:338-51. [DOI: 10.1016/j.concog.2015.07.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 11/22/2022]
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Angulo-Franco M, Bush-Martínez A, Nenclares-Portocarrero A, Jiménez-Genchi A. Trichotillomania and non-epileptic seizures as sleep-related dissociative phenomena. J Clin Sleep Med 2015; 11:271-3. [PMID: 25515284 DOI: 10.5664/jcsm.4542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 07/11/2014] [Indexed: 11/13/2022]
Abstract
ABSTRACT The occurrence of non-epileptic seizures (NES) and trichotillomania during sleep is rare. We describe the case of an adult woman with a personal history of childhood maltreatment and psychiatric morbidity (major depression, trichotillomania, and conversion disorder), who was referred to the sleep unit because of nocturnal hair-pulling and psychomotor agitation during sleep. An all-night PSG recording with audiovisual monitoring documented seven episodes of trichotillomania and one NES, all of which arose from unequivocal wakefulness. Improvement of nocturnal behaviors was observed after long-term psychotherapy. This case illustrates that nocturnal trichotillomania and NES may be symptoms of a sleep-related dissociative disorder.
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Affiliation(s)
- Melina Angulo-Franco
- Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Tlalpan, México
| | - Alejandra Bush-Martínez
- Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Tlalpan, México
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van Heugten-van der Kloet D, Merckelbach H, Giesbrecht T, Broers N. Night-time experiences and daytime dissociation: a path analysis modeling study. Psychiatry Res 2014; 216:236-41. [PMID: 24560022 DOI: 10.1016/j.psychres.2013.12.053] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 08/03/2013] [Accepted: 12/29/2013] [Indexed: 11/22/2022]
Abstract
Dissociative symptoms may be the by-products of a labile sleep-wake cycle (Koffel and Watson, 2009a). This may help to explain why dissociation overlaps with fantasy proneness and cognitive failures. Using path analysis, we tested to what extent data gathered in a nonclinical, predominantly female sample (N=139) supported two conceptual models. The first model assumes that unusual sleep experiences increase fantasy proneness and cognitive failures, which in turn encourage trait dissociation and reports of trauma. The second model assumes that trauma leads to dissociative experiences both directly and through its influence on sleep. In this cross-sectional design, the data were reasonably well described by both models. Importantly, in both models, unusual sleep experiences serve as antecedents of trait dissociation. Our analysis underlines the importance of unusual sleep experiences and may inspire treatment intervention focusing on sleep normalization.
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Lassri D, Soffer-Dudek N, Lerman SF, Rudich Z, Shahar G. Self-Criticism Confers Vulnerability to Psychopathology in the Face of Perceived Stress Related to Missile Attacks: Three Longitudinal Studies. Int J Cogn Ther 2013. [DOI: 10.1521/ijct.2013.6.3.221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van Der Kloet D, Giesbrecht T, Franck E, Van Gastel A, De Volder I, Van Den Eede F, Verschuere B, Merckelbach H. Dissociative symptoms and sleep parameters--an all-night polysomnography study in patients with insomnia. Compr Psychiatry 2013; 54:658-64. [PMID: 23374906 DOI: 10.1016/j.comppsych.2012.12.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/13/2012] [Accepted: 12/31/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Dissociative disorders encompass a range of symptoms varying from severe absent-mindedness and memory problems to confusion about one's own identity. Recent studies suggest that these symptoms may be the by-products of a labile sleep-wake cycle. METHODS In the current study, we explored this issue in patients suffering from insomnia (N=46). We investigated whether these patients have raised levels of dissociative symptoms and whether these are related to objective sleep parameters. Patients stayed for at least one night in a specialized sleep clinic, while sleep EEG data were obtained. In addition, they completed self-report measures on dissociative symptoms, psychological problems, and sleep characteristics. RESULTS Dissociative symptom levels were elevated in patients suffering from insomnia, and were correlated with unusual sleep experiences and poor sleep quality. Longer REM sleep periods and less time spent awake during the night were predictive of dissociation. CONCLUSIONS This is the first study to show that insomnia patients have raised dissociative symptom levels and that their dissociative symptoms are related to objective EEG parameters. These findings are important because they may inspire sleep-related treatment methods for dissociative disorders.
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Abstract
In psychopathology, dissociation typically refers to a disturbance in the normal integration of thoughts, feelings, and experiences into consciousness and memory. In this article, we review the literature on how sleep disturbances relate to dissociative symptoms and memory failure. We contend that this body of research offers a fresh perspective on dissociation. Specifically, we argue that dissociative symptoms are associated with a labile sleep–wake cycle, in which dreamlike mentation invades the waking state, produces memory failures, and fuels dissociative experiences. The research domain of sleep and dissociation can accommodate the dominant idea in the clinical literature that trauma is the distal cause of dissociation, and it holds substantial promise to inspire new treatments for dissociative symptoms (e.g., interventions that focus on normalization of the sleep-wake cycle). We conclude with worthwhile paths for further investigations and suggest that the sleep–dissociation approach may help reconcile competing interpretations of dissociative symptoms.
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Abstract
The relationship between resilience and lucid dreams, which involves awareness of the experience of dreaming, was examined in 79 Israeli young adults. Psychological distress and lucid dreams 3 years prior to exposure to terrorism, and exposure levels and psychological distress 1 week following exposure, were assessed. Both indirect exposure through media and perceived stress predicted an increase in distress during the 3-year interval under low, but not high, levels of lucid dreams. Possible mechanisms are discussed.
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Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
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Koffel E, Watson D. Unusual sleep experiences, dissociation, and schizotypy: Evidence for a common domain. Clin Psychol Rev 2009; 29:548-59. [PMID: 19581031 DOI: 10.1016/j.cpr.2009.06.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Revised: 06/10/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
Abstract
This paper reviews studies that have examined associations between unusual sleep experiences (including nightmares, vivid dreaming, narcolepsy symptoms, and complex nighttime behaviors) and dissociation and schizotypy. Using correlational studies and structural analyses, evidence is provided that unusual sleep experiences, dissociation, and schizotypy belong to a common domain. It is demonstrated that unusual sleep experiences show specificity to dissociation and schizotypy compared to other daytime symptoms (e.g., anxiety, depression, substance use) and other sleep disturbances (e.g., insomnia, lassitude/fatigue). The paper also outlines the methodological limitations of the existing evidence and makes suggestions for future research. Finally, three models for the overlap of daytime and nighttime symptoms are reviewed, including biological abnormalities, trauma, and personality traits. Although further research is needed, it is suggested that daytime and nighttime symptoms result from problems with sleep-wake state boundaries, which may be precipitated by stress or trauma. In addition, association between daytime and nighttime symptoms can be attributed to the higher order personality trait of Oddity.
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Affiliation(s)
- Erin Koffel
- Department of Psychology, University of Iowa, Iowa City, IA 52242-1407, USA.
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