Raw reveries, polaroid reveries: Some hypotheses about possible functions and technical uses of reveries in the session.

The author tries to show how the epiphany of a reverie during a session can become a source of unexpected intuitions about the essence and possible figurability of the emotional experience which is flowing in the here-and-now of the analytic life. Reverie becomes an important analytic source above all when an analyst is in contact with primordial states of the mind, characterized by turbulences of unrepresentable feelings and sensations. In this paper the author outlines a hypothetical kit of functions, technical uses and analytic effects of a reverie in an analytic process, working through the idea of analysis as the transformation in dreaming of the nightmares and terrors which beset and trouble the patient's mind. In particular the author describes: (a) the use of reverie as a criterion of analysability in first consultation meetings; (b) the specificity of two different types of reverie, which the author names reveries polaroid and raw reveries; and (c) the possible disclosure of a reverie in case of a specific kind of reverie that the author calls polaroid reverie. Sketches of analytic life become living portraits of the hypothesis proposed by the author about these different possible uses of a reverie in analytic work, as a probe and resource for beginning and developing a course of analysis that engages with archaic and presymbolic areas of psychic functioning.

Associations between frequent nightmares, nightmare distress and depressive symptoms in adolescent psychiatric patients.

BACKGROUND: Nightmares are common in patients with psychiatric disorders. Patients with psychiatric disorders often experience depressive symptoms. Nightmares have been associated with depressive symptoms among adolescents. Previous studies have explored the mediating role of nightmare distress in the relationship between frequent nightmares and depressive symptoms in the general adolescent population. We aimed to explore the associations between frequent nightmares, nightmare distress, and depressive symptoms in Chinese adolescent patients with psychiatric disorders. METHODS: A total of 408 adolescents participated in this study. A self-administered questionnaire was used to measure nightmare frequency, nightmare distress, depressive symptoms, and covariates. Linear regressions and mediation analyses were performed to examine the associations between nightmare frequency, nightmare distress, and depressive symptoms. RESULTS: The mean age of participants was 15.31 ± 1.88 years, and 152 (37.3%) were boys. The prevalence of frequent nightmares in adolescent patients with psychosis was 49.3%. Girls reported more frequent nightmares and had significantly higher scores of depressive symptoms and nightmare distress. Patients with frequent nightmares had higher scores of nightmare distress and depressive symptoms. Frequent nightmares and nightmare distress were significantly associated with depressive symptoms. Nightmare distress had a full mediating effect on the correlation between frequent nightmares and depressive symptoms. CONCLUSIONS: In Chinese adolescent patients with psychiatric disorders, frequent nightmares and nightmare distress were associated with depressive symptoms, whereas the association between frequent nightmares and depressive symptoms was mediated by nightmare distress. Interventions for nightmare distress may be more useful in reducing depressive symptoms in adolescent patients with psychiatric disorders.

Psychosocial treatments for nightmares in adults and children: a systematic review.

BACKGROUND: As nightmares may be a risk factor for, or symptom of, multiple psychological disorders, some researchers suggest that nightmares should be screened, diagnosed, and treated. Treatments for nightmares include trauma-focused Cognitive Behavioural Therapy and Image Rehearsal Therapy, and pharmacological interventions such as prazosin and nitrazepam. As recent research has put into question our current understanding of treatment efficacy, there is a need to systematically review findings related to the effectiveness of nightmare treatments to inform best practice. The current review assessed the efficacy of psychosocial treatments of nightmare in all cohorts. METHODS: A systematic search of four databases for peer reviewed journal articles from 2000 onwards produced 69 (35 RCTs, 34 non-RCTs) eligible articles that underwent narrative synthesis. RESULTS: The results provide strong evidence for exposure and image rehearsal treatments for the reduction of nightmare frequency, severity, and distress, in civilian, military, idiopathic, and posttraumatic stress disorder (PTSD) cohorts. There is emerging evidence that self-guided and brief treatment modalities offer efficient and effective treatment options. There is an urgent need for clinical trials of treatment effectiveness in children. CONCLUSIONS: The results suggest that treatments for nightmares are most effective when they facilitate a sense of control or mastery by directly targeting the nightmare content and/or the client's emotional responses to the nightmare content. TRIAL REGISTRATION: A review protocol was registered with PROSPERO (CRD42020204861).

What are the neural mechanisms and physiological functions of dreams?

Dreams are mental experiences, including perceptions, thoughts, and emotions, that occur during sleep. In dreams, hallucinatory perceptions, particularly visual and motoric, are often accompanied by negative emotions. When people dream, they perceive them as real even though they are bizarre and distorted in time and space. People often cannot recall their dreams, even though people dream every night. Dreaming is a strange physiological phenomenon. Research has demonstrated that dreaming is closely associated with rapid eye movement (REM) sleep. It is known that dreaming also occurs during non-REM (NREM) sleep, but the content appears to be different. Dreams during REM sleep tend to be longer, more vivid, more story-like, and more bizarre than those during NREM sleep. In this review, the neural circuits underlying dreaming and the physiological functions associated with it are summarized. Two major theories have been proposed regarding the neural circuits involved in dreaming. One is that dreams are generated by the activation of neural activity in the brainstem and its signal transmission to the cortex. The other is that dreams are caused by forebrain activation by dopamine. Whereas the physiological function of dreams remains unclear, several hypotheses have been proposed that are associated with memory and emotions.

Chain mediating effect of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents.

BACKGROUND: The study explored the differences in nightmare, insomnia, depression, anxiety, and cognitive deficits among adolescents and the chain mediating effects of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents. METHODS: An online survey was used to collect demographic data of 6014 adolescents and assess nightmare, insomnia, depression, anxiety, and cognitive deficits using the Chinese Version of Nightmare Distress Questionnaire, Insomnia Severity Index, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and Perceived Deficits Questionnaire-Depression. Spearman correlation analysis and the SPSS function "PROCESS macro" were used for correlation and mediation analyses, respectively. RESULTS: Female adolescents, senior high school, and poor academic performance had higher nightmare, insomnia, and cognitive deficit scores; those living in the city had higher depression and anxiety scores. Cognitive deficits were positively correlated with nightmares, insomnia, depression, and anxiety. Further, insomnia, depression, and anxiety had a chain mediating effect between nightmares and cognitive deficits in adolescents. Nightmares indirectly affect cognition deficits by affecting insomnia and then depression and anxiety symptoms. LIMITATIONS: As this was a cross-sectional study, the causal relationship between the variables could not be determined. Moreover, reporting bias and volunteer bias might be present. CONCLUSIONS: These findings suggest that clinicians should identify adolescents with frequent nightmares early and provide timely treatment to minimize negative outcomes and possibly limit the chronicity of nightmare disorder. It is significant to maintain the physical and mental health development of adolescents to reduce the risk of insomnia, depression, anxiety, and cognitive deficits.

Bad Dreams and Nightmares Preceding Suicidal Behaviors.

Objective: Nightmares seem to predict suicidal behaviors, and the aim of this study is to explore the chronology and trajectories of alterations in dream contents before a suicidal crisis, distinguishing 3 different experiences: bad dreams, nightmares, and suicidal scenarios during dreams.Methods: This naturalistic study included individuals hospitalized between January 2021 and May 2021 in a psychiatric post-emergency room unit for suicidal crisis (thoughts and attempts).Results: The study observed that 80% (n = 32/40) of patients had altered dreams (AD) before the suicidal crisis, including 27 (67.5%) with bad dreams, 21 (52.5%) with nightmares (bad dreams that awaken the sleeper), and 9 (22.5%) with suicidal scenarios during dreams. No differences were observed between the AD group versus patients with no altered dreams (ND) regarding sociodemographic characteristics. We observed a progression of dream content alterations: bad dreams appear 111 days (4 months) before the suicidal crisis, then nightmares appear 87.3 days before (3 months), and suicidal scenarios during dreams were reported 45.2 days before (1.5 months). For the AD and ND populations in suicidal crisis, 80% had at least 1 subtype of dream alterations, 40% had bad dreams and nightmares, and 17.5% had all 3 subtypes. The AD group, compared to the ND group, had significantly more family history of insomnia (P = .046). Almost all patients (97.5%) had depressive symptoms (Montgomery-Asberg Depression Rating Scale [MADRS] score ≥ 7; 82.5% had moderate to severe symptoms, MADRS ≥ 20), 60% had insomnia (Insomnia Severity Index > 14), 92.5% had altered sleep quality (Pittsburgh Sleep Quality Index > 5), and 57.5% reported sleepiness (Epworth Sleepiness Scale > 10).Conclusions: Dream alterations and their progression can be readily assessed and may help to better identify prodromal signs of suicidal behaviors.

Enhancing imagery rehearsal therapy for nightmares with targeted memory reactivation.

Nightmare disorder (ND) is characterized by dreams with strong negative emotions occurring during rapid eye movement (REM) sleep. ND is mainly treated by imagery rehearsal therapy (IRT), where the patients are asked to change the negative story line of their nightmare to a more positive one. We here used targeted memory reactivation (TMR) during REM sleep to strengthen IRT-related memories and accelerate remission of ND. Thirty-six patients with ND were asked to perform an initial IRT session and, while they generated a positive outcome of their nightmare, half of the patients were exposed to a sound (TMR group), while no such pairing took place for the other half (control group). During the next 2 weeks, all patients performed IRT every evening at home and were exposed to the sound during REM sleep with a wireless headband, which automatically detected sleep stages. The frequency of nightmares per week at 2 weeks was used as the primary outcome measure. We found that the TMR group had less frequent nightmares and more positive dream emotions than the control group after 2 weeks of IRT and a sustained decrease of nightmares after 3 months. By demonstrating the effectiveness of TMR during sleep to potentiate therapy, these results have clinical implications for the management of ND, with relevance to other psychiatric disorders too. Additionally, these findings show that TMR applied during REM sleep can modulate emotions in dreams.

Predictive coding, multisensory integration, and attentional control: A multicomponent framework for lucid dreaming.

Lucid dreaming (LD) is a mental state in which we realize not being awake but are dreaming while asleep. It often involves vivid, perceptually intense dream images as well as peculiar kinesthetic sensations, such as flying, levitating, or out-of-body experiences. LD is in the cross-spotlight of cognitive neuroscience and sleep research as a particular case to study consciousness, cognition, and the neural background of dream experiences. Here, we present a multicomponent framework for the study and understanding of neurocognitive mechanisms and phenomenological aspects of LD. We propose that LD is associated with prediction error signals arising during sleep and occurring at higher or lower levels of the processing hierarchy. Prediction errors are resolved by generating a superordinate self-model able to integrate ambiguous stimuli arriving from sensory periphery and higher-order cortical regions. While multisensory integration enables lucidity maintenance and contributes to peculiar kinesthetic experiences, attentional control facilitates multisensory integration by dynamically regulating the balance between the influence of top-down mental models and the precision weighting of bottom-up sensory inputs. Our novel framework aims to link neural correlates of LD with current concepts of sleep and arousal regulation and provide testable predictions on interindividual differences in LD as well as neurocognitive mechanisms inducing lucid dreams.

Acute sleep interventions as an avenue for treatment of trauma-associated disorders.

Scientific evidence that acute, posttrauma sleep disturbances (eg, nightmares and insomnia) can contribute significantly to the pathogenesis of trauma-induced disorders is compelling. Sleep disturbances precipitating from trauma are uniquely predictive of daytime posttrauma symptom occurrence and severity, as well as subsequent onset of mental health disorders, including post-traumatic stress disorder. Conversely, adequate sleep during the acute posttrauma period is associated with reduced likelihood of adverse mental health outcomes. These findings, which are broadly consistent with what is known about the role of sleep in the regulation of emotion, suggest that the acute posttrauma period constitutes a "window of opportunity" during which treatment of sleep disturbances may be especially effective for preventing or mitigating progression of aberrant psychophysiological processes. At this point, the weight of the scientific evidence supporting this possibility warrants initiation of clinical trials to confirm the benefits of targeted prophylactic sleep enhancement, and to establish treatment guidelines as appropriate. CITATION: Swift KM, Thomas CL, Balkin TJ, Lowery-Gionta EG, Matson LM. Acute sleep interventions as an avenue for treatment of trauma-associated disorders. J Clin Sleep Med. 2022;18(9):2291-2312.

[Nightmares in patients with insomnia]. / Nochnye koshmary u bol'nykh insomniei.

Studies show a high frequency of comorbidity of insomnia and nightmares, which aggravate and chronicle each other. The mechanisms of their mutual influence are different. Insomnia changes the nature of dreams, both indirectly through emotional hyperactivation characteristic of insomnia, and as a result of frequent awakenings. However, frequent recurring unpleasant and frightening dreams can themselves increase the frequency of nocturnal awakenings and worsen the quality of sleep. The comorbidity of insomnia and nightmares should be taken into account when choosing a therapeutic approach in this category of patients. Priority are drugs that do not cause nightmares as a side effect, as well as psychotherapy.

Neurobiology of Dream Activity and Effects of Stimulants on Dream.

The sleep-wake cycle is the result of the activity of multiple neurobiological network interactions. The dreaming feature is one interesting sleep on that represents sensorial components, mostly visual perceptions, accompaniedby intense emotions. Further complexity has been added to the topic of the neurobiological mechanism of dream generation by the current data suggesting drugs' influence on dream generation. Here, we discuss the review of some of the neurobiological mechanisms of the regulation of dream activity, with special emphasis on the effects of stimulants on dreaming.

Dream recall frequency and psychosomatics.

The ability to remember dreams can depend on a wide range of factors such as personality, creativity, mental state, cognitive functions as well as somatic symptoms. In the course of their studies, medical researchers have demonstrated that about 80% patients, woken up at their Rapid Eye Movement (REM) sleep phase, can remember their own dreams, whereas, in clinical practice, young adults can remember their dreams on their awakenings only once or twice a week. Let us now come to the point: in this study we suggest some hypotheses that could explain the reason why patients suffering from psychosomatic disorders seem to remember dreams much less frequently than healthy individuals.

Analytic Work: The Essential and the Accidental in Psychoanalysis.

This article explores what is essential to analytic work by drawing not only on Freud, but also on two additional sources: Friedman's (2019) notion of the psychoanalytic phenomenon as described in Freud's book on technique; and Weber's (1991, 2000) understanding of Freud's metapsychology as a creation of terms that are necessary in order to work with a non-observable object, the unconscious. Using Freud's emphasis on the importance of dreams as a form of thinking, the author links the work of Friedman and Weber and extends it in doing a close reading of a specific passage by Freud, showing that the precarious nature of metapsychology is understandable as a form of paradigmatic logic. A dream of the author's gives a certain counterpoint to the paper.

Brief behavioral treatment for insomnia decreases trauma-related nightmare frequency in veterans.

STUDY OBJECTIVES: Trauma-related nightmares are highly prevalent among veterans and are associated with higher-severity insomnia and posttraumatic stress disorder. Cognitive behavioral therapy for insomnia (typically 6-8 sessions) has been shown to reduce trauma-related nightmares. Brief behavioral treatment for insomnia (BBTI, 4 sessions) has been found to be comparable to CBT-I in decreasing insomnia severity; however, the effects of BBTI on nightmares have not been investigated. The current study tested the effects of BBTI on both trauma-related nightmares and nontrauma-related bad dreams using an active control group treated using progressive muscle relaxation therapy. In addition, we tested whether baseline trauma-related nightmare frequency and baseline nontrauma-related bad dream frequency moderated changes in insomnia severity. METHODS: Participants were 91 military veterans with insomnia disorder randomized to BBTI or progressive muscle relaxation therapy. Participants reported insomnia severity on the Insomnia Severity Index and reported trauma-related nightmare frequency and nontrauma-related bad dream frequency on the Pittsburgh Sleep Quality Index-PTSD Addendum. RESULTS: We found that BBTI significantly reduced trauma-related nightmares from baseline to posttreatment, whereas progressive muscle relaxation therapy did not. However, reductions in trauma-related nightmares were not maintained at the 6-month follow up. Neither BBTI nor progressive muscle relaxation therapy reduced nontrauma-related bad dreams from baseline to posttreatment. We also found that neither baseline trauma-related nightmare frequency nor baseline nontrauma-related bad dream frequency moderated changes in insomnia symptom severity. CONCLUSIONS: Findings from the current study suggest that BBTI may help reduce trauma-related nightmares. Further research is needed to better understand the potential mechanisms underlying how improved sleep may reduce trauma-related nightmares. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Brief Behavioral Insomnia Treatment Study (BBTI); URL: https://clinicaltrials.gov/ct2/show/NCT02571452; Identifier: NCT02571452. CITATION: Ranney RM, Gloria R, Metzler TJ, Huggins J, Neylan TC, Maguen S. Brief behavioral treatment for insomnia decreases trauma-related nightmare frequency in veterans. J Clin Sleep Med. 2022:18(7):1831-1839.

Associations between experienced aggression, poor sleep, and suicide risk among Chinese adolescents.

STUDY OBJECTIVES: The physical and mental health of adolescents is an important study area. This study aims to examine the occurrence of aggression, sleep disturbances, and suicide risk among Chinese adolescents, along with the relationships between these factors. METHODS: This is a cross-sectional study conducted through an online survey. Of the original 7011 Chinese adolescent respondents, the analysis included data from 6122 adolescents, aged between 12 and 18 years, from 23 regions, whose average age was 16.12 (±1.44) years, with 48.8% being male. While the chi-square test and t-test were used for analyzing demographic data and continuous variables, respectively, mediation analysis was used to explore the mechanism of experiencing aggression on suicide risk. The respondents' sleep quality, nightmare distress, daytime sleepiness, fatigue, and suicide risk were assessed using the Pittsburgh Sleep Quality Index (PSQI), Nightmare Distress Questionnaire-Chinese version (NDQ-CV), Chinese Adolescent Daytime Sleepiness Scale (CADSS), Multidimensional Fatigue Inventory (MFI-20), and the suicide risk module of the Mini-International Neuropsychiatric Interview (MINI), respectively. Four items were used to assess adolescents' experiences with aggression. RESULTS: Of the respondents, 42% reported experiencing aggression by others, especially parental physical maltreatment. Furthermore, 26.9% of adolescents in school, and in particular, 31.8% in senior high school experienced insomnia symptoms. Adolescents who reported experiences of aggression had more severe insomnia symptoms, nightmare distress, fatigue, and a higher risk of suicide when compared with those who did not (all ps < 0.001). Insomnia symptoms, nightmare distress, and fatigue all mediated the relationship between aggression and suicide risk, and there was a chain of mediating effects between these factors [for total indirect effect ß = 1.1512, 95% CI (0.9671 to 1.3426), direct effect ß = 0.4934, 95% CI (0.1978 to 0.7891), and total effect ß = 1.6446, 95% CI (1.3479 to 1.9414)]. CONCLUSIONS: Our findings indicate that among adolescents, experiencing aggression is associated with an increased suicide risk. In addition to the direct effect of aggression on suicide risk, insomnia, nightmare distress, and fatigue mediate the relationship between aggression and suicide risk. More attention should be paid to adolescents experiencing aggression, and interventions should be implemented and strengthened.

Aggressiveness in the dreams of drug-naïve and clonazepam-treated patients with isolated REM sleep behavior disorder.

BACKGROUND: Although aggressive dream content is considered a distinctive feature of REM Sleep Behavior Disorder (RBD) and patients often report violent dreams during medical interviews, nonviolent behaviors (eating, drinking, urinating) and pleasant actions (e.g laughing, singing, dancing) or simply elemental, jerky limb movements are frequently observed during video-polysomnography. As a first-line pharmacological treatment, clonazepam has been shown to reduce motor symptoms during REM sleep, but its effect on dream content remains unclear. Here, we aimed to prospectively assess the dream content of individuals with drug-naïve isolated RBD (iRBD) and iRBD patients treated with clonazepam. METHODS: Thirteen (12 Male, 1 Female; age 65.38 ± 10.95) iRBD patients treated with clonazepam (iRBD-T), eleven (9 M, 2 F; age 68.90 ± 6.8) drug-naïve patients (iRBD-NT) and twelve (8 M, 1 F; age 63.33 ± 12.88) healthy control subjects of comparable age kept a dream diary over a 3-week period. Dream content analysis was conducted according to the Hall and Van de Castle method (HVdC). The Threat Simulation Scale (TSS) was employed to assess the frequency of threatening contents. RESULTS: A total of 214 dream reports were collected. No significant differences were found in the frequency of threatening dream contents between the iRBD subsamples and healthy control subjects (p = 0.732). The HVdC analysis detected higher levels of Friendliness in iRBD patients compared to the control group (p = 0.036). Increased levels of Aggressiveness were only observed when differentiating dreams in which dream enactment behaviors (DEB) were present compared to dreams without DEBs, both in the iRBD-T group (p = 0.007) and the iRBD-NT group (p = 0.012). CONCLUSION: Our study shows no difference in the frequency of violent or threatening dreams in drug-naïve iRBD patients, clonazepam-treated iRBD patients and healthy control individuals. Aggressiveness is more frequent when DEBs are reported, suggesting motor disinhibition could require sufficiently dramatic and emotionally intense dreams, independent of clonazepam treatment.

Characteristics of Posttraumatic Nightmares and Their Relationship to PTSD Severity Among Combat Veterans With PTSD and Hazardous Alcohol Use.

ABSTRACT: Although nightmares are known to predict the clinical course of posttraumatic stress disorder (PTSD), research on the relationship between specific nightmare characteristics and PTSD severity is sparse. This study conducted a secondary analysis to explore how five nightmare characteristics are cross-sectionally related to PTSD severity in 76 combat veterans with PTSD and at-risk alcohol use. Consistent with emotional processing theory, we hypothesized that more replicative, threatening, realistic, and easily recalled nightmares would be associated with more severe PTSD, whereas those with greater symbolism would predict lower PTSD severity. Nightmares narratives were audio-recorded and rated by multiple coders. Multiple analyses of variance explored the relationship between nightmare characteristics and PTSD clinical indicators. Most nightmares were realistic, easily recalled, and involved significant threat. Greater realism and replication were associated with greater PTSD severity. Realistic and replicative nightmares may be markers of more severe PTSD and may indicate that less emotional processing of the trauma has occurred.

Nightmares mediate the association between traumatic event exposure and suicidal ideation in frontline medical workers exposed to COVID-19.

BACKGROUND: Trauma experience increases the risk of suicidal ideation, but little is known about potentially psychological mechanisms underlying this relationship. This study aims to examine the relationship between coronavirus disease 2019 (COVID-19)-related traumatic event (CTE) exposure and suicidal ideation among hospital workers, and identify mediating roles of sleep disturbances in this relationship. METHODS: Workers in seven designated hospitals in Wuhan, China, were invited to participate in an online survey from May 27, 2020, to July 31, 2020. Participants completed a self-report questionnaire to evaluate demographic characteristics, level of CTE exposures, nightmare frequency, insomnia severity, symptoms of depression and anxiety, and suicidal ideation. A series of correlation analyses were performed, and a mediation model was generated to examine correlations between CTE exposure, sleep disturbances, and suicidal ideation. RESULTS: A total of 16,220 hospital workers were included in the final analysis, 13.3% of them reported suicidal ideation in the past month. CTE exposure was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling potential confounders, nightmares but not insomnia, depression, or anxiety were shown to be independent risk factors for suicidal ideation. Pathway analyses showed that the relationship between CTE exposure and suicidal ideation was fully mediated by nightmares (proportion mediated 66.4%) after adjusting for demographic characteristics and psychological confounders. LIMITATIONS: Cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS: CTE exposure increases risk of hospital workers' suicidal ideation that is mediated by nightmares, suggesting nightmares intervention might be considered as a component when developing suicide prevention strategies.

Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents.

PURPOSE: Nightmares are common, especially in pediatric populations and psychiatric patients. Nightmares are associated with daytime distress and negative health outcomes. The data on the prevalence and psychopathological profiles of nightmares in Chinese adolescents are limited. This study examined age and gender differences in nightmare frequency and associated psychopathological problems in a large sample of Chinese adolescents. METHODS: A total of 11,831 adolescent students (mean age = 14.9, 12-18 years) participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort. Participants completed a self-administered questionnaire to report their nightmare frequency, trait anger, hopelessness, and multiple domains of behavioral/emotional problems. Univariate and multivariate analyses were performed to examine psychopathological problems in relation to nightmare frequency. RESULTS: Of the sample, 45.2% reported having nightmares at least once in the past month and 7.9% at least once/week. Girls reported more frequent nightmares than boys. Nightmare frequency significantly declined with age for both boys and girls. Mean scores on trait anger, hopelessness, attention, internalizing problems, and externalizing problems significantly increased with nightmare frequency. Frequent nightmares (at least once/week) were significantly associated with 2-4-fold increased likelihood of behavioral/emotional problems after adjusting for adolescent and family covariates. CONCLUSION: Nightmares are prevalent in Chinese adolescents. Frequent nightmares are associated with multiple domains of psychopathological problems. Assessment and intervention of frequent nightmares should be incorporated into routine clinical practice and mental health services in adolescents.

Dream Interpretation from a Cognitive and Cultural Evolutionary Perspective: The Case of Oneiromancy in Traditional China.

Why did people across the world and throughout history believe that dreams can foretell what will occur in the future? In this paper, I attempt to answer this question within a cultural evolutionary framework by emphasizing the cognitive aspect of dream interpretation; namely, the fact that dreams were often viewed as significant and interpretable has to do with various psychological and social factors that influence how people obtain and process information regarding the validity of dream interpretation as a technique. Through a comprehensive analysis of a large dataset of dream occurrences in the official Chinese historical records, I argue that the ubiquity and persistence of dream interpretation have a strong empirical component (predictively accurate dream cases), which is particularly vulnerable to transmission errors and biases. The overwhelmingly successful records of dream prediction in transmitted texts, I suggest, is largely due to the fabrication and retrospective inference of past dreams, as well as the under-reporting of predictive failures. These "positive data" then reinforce individuals' confidence in the predictive power of dreams. I finally show a potential decline of the popularity of dream interpretation in traditional China and offer a few suggestive explanations drawing on the unique characteristics of oneiromancy compared to other divination techniques.