Relationships between non-pathological dream-enactment and mirror behaviors

Dream enactment behavior: review for the clinician

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.

Nightmare frequency is related to a propensity for mirror behaviors

We previously reported that college students who indicated engaging in frequent dream-enacting behaviors also scored high on a new measure of mirror behaviors, which is the propensity to imitate another person's emotions or actions. Since dream-enacting behaviors are frequently the culmination of nightmares, one explanation for the observed relationship is that individuals who frequently display mirror behaviors are also prone to nightmares. We used the Mirror Behavior Questionnaire (MBQ) and self-reported frequencies of nightmares to assess this possibility. A sample of 480 students, consisting of 188 males (19.2±1.73 years) and 292 females (19.0±1.55 years) enrolled in a first-year university psychology course, participated for course credit. They completed a battery of questionnaires that included the 16-item MBQ, plus an item about nightmare frequency (NMF) in the past 30 days. NMF scores were split to create low, medium, and high NMF groups. MBQ total scores were significantly higher for female than for male subjects, but an interaction revealed that this was true only for Hi-NMF subjects. MBQ Factor 4, Motor Skill Imitation, paralleled this global interaction for females, whereas MBQ Factor 3, Sleepiness/Anger Contagion, was elevated only for Hi-NMF males. Item analyses indicated that Hi- and Med-NMF females scored higher than Lo-NMF females on the 3 items of Factor 4 that reflect voluntary imitation (imitating famous/cartoon voices, being a physically active spectator, and learning new skills by observing), as well as on 2 other items that reflect involuntary imitation (contagious yawning and self-rated empathy). Although Hi- and Lo-NMF males differed most clearly on the sleepiness item of Factor 3, all 3 items on this factor (including anger contagion and contagious yawning) are plausibly associated with perception of and response to social threat. Results provide evidence that among females nightmares are associated with voluntary and involuntary mirror behaviors during wakefulness, while among males nightmares are associated with threat-related mirror behaviors during wakefulness. They thus support the possibility that the association between mirror behaviors and dream-enacting behaviors is due to a common mirror neuron mechanism that underlies mirror behaviors and nightmares and that involves motor, rather than emotional, resonance. These results have implications for understanding the comorbidity of nightmares and other pathological symptoms such as imitative suicidal behaviors, the influence of observational learning on dissociative symptomatology, and the predominance of threat and aggression in the dream enacting behaviors of REM sleep behavior disorder.