Rêves dysphoriques et rêves récurrents chez les enfants et les adolescents : corrélats psychosociaux et implications cliniques

Cette thèse vise à étudier les liens entre les rêves dysphoriques (p. ex. : cauchemars et mauvais rêves), les rêves récurrents et l’ajustement psychosocial chez les enfants et les adolescents. Elle comporte un article présentant une recension des écrits ainsi que quatre articles empiriques. Le premier article présente une recension des études ayant investigué les rêves dysphoriques chez les enfants et les adolescents, avec une attention particulière portée sur leur prévalence, leurs corrélats ainsi que les options de traitement. Cette revue de la littérature permet de constater que plus de la moitié des jeunes rapportent des rêves dysphoriques. Même s’ils touchent beaucoup de jeunes, les rêves dysphoriques ne sont pas pour autant insignifiants. En effet, les enfants et les adolescents ayant des rêves dysphoriques ont aussi plus de problèmes reliés au sommeil et plus de problèmes au niveau de leur ajustement psychosocial. Finalement, l’article relève quelques recherches sur les traitements des rêves dysphoriques chez les jeunes qui offrent des résultats prometteurs. Le deuxième article vise à examiner les liens entre les rêves dysphoriques et diverses variables d’ajustement psychosocial en prenant en compte certaines limites méthodologiques d’études précédentes dans le domaine (et mises de l’avant dans l’article 1). De plus, il examine le possible lien modérateur de l’émotivité négative (traduction libre de « emotional negativity ») entre les rêves dysphoriques et l’ajustement psychosocial. Les résultats de cette étude montrent que les rêves dysphoriques sont liés à certains troubles intériorisés et que l’émotivité négative modère le lien entre les rêves dysphoriques et les troubles extériorisés. Le troisième article s’attarde aux rêves récurrents chez les enfants et les adolescents, phénomène très peu étudié à ce jour. Plus précisément, la prévalence et la fréquence des rêves récurrents chez les jeunes âgés entre 11 et 14 ans sont répertoriées et leur contenu, thématiques et tonalité émotionnelle sont examinés. Cet article démontre que les rêves récurrents touchent environ un tiers des jeunes et que leur contenu est principalement négatif. Le quatrième article vise à déterminer si, comme chez les adultes, les rêves récurrents chez les enfants sont associés à un déficit dans l’ajustement psychosocial. Les résultats montrent que les rêves récurrents sont liés à l’agressivité réactive chez les garçons, mais qu’ils ne sont pas liés à des variables d’ajustement psychosocial chez les filles. Le cinquième et dernier article a comme but de déterminer si, comme démontré chez les adultes, les rêves dysphoriques sont associés aux idéations suicidaires chez les préadolescents et d’explorer la possibilité que les rêves récurrents soient eux aussi liés aux idéations suicidaires. Les résultats démontrent que les rêves dysphoriques ainsi que les rêves récurrents sont liés aux pensées suicidaires chez des préadolescents de 12 et 13 ans. Suite à ces cinq articles, les résultats ainsi que les conclusions qui en découlent sont intégrés à la littérature existante sur les rêves, leurs significations au plan théorique et clinique sont explorées, et des études futures sont proposées.The aim of this thesis was to investigate the associations between dysphoric dreams (e.g., bad dreams and nightmares), recurrent dreams, and psychosocial adjustment in a population of children and young adolescents. It is comprised of one review article and four empirical articles. The first article is a literature review of studies having investigated dysphoric dreams in children and adolescents, with a focus on their prevalence, correlates and treatments. This review shows that more than half of children and adolescents experience dysphoric dreams. Even if having such negative dreams is common in these populations, dysohoric dreams are not without significance. In fact children with dysphoric dreams have more sleep problems, and more psychosocial difficulties than those who do not report dysphoric dreams. Finally, this article shows that there exist promising treatment options for disturbing dreams. The second article aimed to investigate the relationship between dysphoric dreams and a range of variables measuring psychosocial adjustment while taking into account key methodological shortcomings of previous studies in the field (and highlighted in the first article). In addition, the study examined the possible moderator role of emotional negativity in the relation between dysphoric dreams and psychosocial adjustment. Results show that the presence of dysphoric dreams is associated with internalizing difficulties and that emotional negativity moderates the relation between dysphoric dreams and externalizing difficulties. The third article examines the content of recurrent dreams reported by children and young adolescents, a largely neglected question to date. Specifically, the study reports on the prevalence, thematic content and emotional valence of recurrent dreams reported by children between 11 and 15 years old. This article shows that approximately one third of children report having had a recurrent dreams in the past year and that the majority of these dreams are negatively toned. The fourth article aimed to determine if, as shown in adult populations, the presence of recurrent dreams in children is associated to impoverished psychosocial adjustment. Results show that recurrent dreams are associated to reactive aggression in boys but that they show no evident relation to indices of psychosocial adjustment among girls. The fifth and final article examines the question of whether or not the presence of dysphoric and recurrent dreams in children is associated to suicidal ideation, as shown to be the case in recent studies of adult populations. This study reveals that the occurrence of recurrent as well as dysphoric dreams shows an association with suicidal ideation in 12 and 13 year old children. Following these five articles, the results and conclusions drawn from this body of work are integrated into the existing literature, their theoretical as well as clinical implications explored, and future studies proposed

Association between recurrent dreams, disturbing dreams and suicidal ideation in adolescents

Disturbing dreams and recurrent dreams have both been linked to a wide range of psychological difficulties in children. There is growing evidence that the experience of frequent disturbing dreams is associated with suicidal ideation in adults but studies in young adolescents have been limited and the results inconsistent. In addition, the possible relationship between suicidal ideation and recurrent dreams has yet to be studied. We thus investigated the relation between disturbing dreams, recurrent dreams and suicidal ideation in a sample of young adolescents. Self-report measures of disturbing dream frequency, recurrent dream frequency, and suicidal ideation were collected at age 12 years and again at age 13 years from 170 children from a prospective population-based birth cohort. While the rate of disturbing dreams and recurrent dreams dropped between ages 12 and 13, the rate of self-reported suicidal ideation increased between the ages of 12 and 13 years. Analyses taking sex and age into account revealed that young adolescents who reported having had suicidal thoughts over the past year had significantly greater frequencies of disturbing dreams and of recurrent dreams than adolescents who had not thought about suicide. These findings highlight the potential clinical value of assessing disturbing and recurrent dreams as part of the screening process for suicidal ideation in young adolescents

The content of recurrent dreams in young adolescents

Studies on children’s recurrent dreams have been largely anecdotal and based on adults’ recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15 years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future researc

Soluble CD86 is a costimulatory molecule for human T lymphocytes

International audienceCD86 is an important costimulatory molecule for the priming and activation of naive and memory T cells, respectively. Here, we show that soluble CD86 is detected in human serum. Soluble CD86 is produced by resting monocytes and results from an alternatively spliced transcript (CD86deltaTM) characterized by deletion of the transmembrane domain. Recombinant CD86deltaTM binds to CD28 and CTLA-4 and induces the activation of T cells after stimulation with anti-CD3 mAb. CD86deltaTM also induces IFNgamma production by virus-specific CD8+ memory human T cells stimulated with the Flu M1 peptide. The concentrations of soluble CD86 found in human serum are sufficient to induce biological activity. Soluble CD86 molecule, therefore, appears to be a functional costimulatory molecule playing a potentially important role in immune surveillance