The Interplay Between Childhood Sexual Abuse, Self-Concept Clarity, and Dissociation: A Resilience-Based Perspective

BACKGROUND: Despite a robust consensus regarding the potentially negative implications of childhood sexual abuse (CSA), research investigating risk and protective factors-particularly among well-functioning young adults-is scant. Dissociation is one of the major maladaptive outcomes of CSA. Nevertheless, CSA explains only about 10% of the variance of dissociation. Possibly, this modest effect size is due to protective factors moderating the relation between CSA and dissociative symptoms. One such factor may be the extent to which one has succeeded in developing a clear and coherent sense of who they are. OBJECTIVE: We aimed to explore whether self-concept clarity (SCC) moderates the relationship between CSA and dissociation (Model 1), and an alternative hypothesis, whereby CSA may moderate the relationship between SCC and dissociation (Model 2). PARTICIPANTS AND SETTING: This was tested among 65 well-functioning young women drawn from an earlier study that intentionally oversampled CSA survivors. METHODS: We included data from survivors of CSA by a known perpetrator (n = 35) and women with no sexual trauma (n = 30). RESULTS: Findings were consistent with both Model 1 and Model 2, but only when depersonalization-derealization, namely detachment, was considered. Simple effects analyses revealed that CSA was related to depersonalization-derealization only under low SCC levels (Model 1), and SCC was negatively related to depersonalization-derealization only in the CSA group (Model 2). CONCLUSIONS: Findings suggest that SCC is a protective factor, buffering the association between CSA and detachment (depersonalization-derealization) symptoms. Clinical implications are discussed

Dreams of Teeth Falling Out: An Empirical Investigation of Physiological and Psychological Correlates

Teeth dreams (TD), i.e., dreams of teeth falling out or rotting, are one of the most common and universal typical dream themes, yet their source remains unknown and they have rarely been studied empirically. They are especially enigmatic as they do not readily fall under the rubric of the “continuity hypothesis”, i.e., dreams of current and salient waking-life experiences. The aim of the present study was to explore two possible hypotheses for the origin of TD; specifically, TD as incorporation of dental irritation into dreaming, and TD as a symbolic manifestation of psychological distress. Dream themes, dental irritation, psychological distress, and sleep quality were assessed among 210 undergraduates. TD were related to dental irritation (specifically, tension sensations in the teeth, gums, or jaws upon awakening), whereas other dream types were not. Conversely, TD were unrelated to psychological distress, whereas other dream types were (specifically, dreams of being smothered and dreams of falling). This disparity in the correlates of TD existed despite a small but significant relationship between psychological distress and dental irritation. Albeit preliminary, the present findings support the dental irritation hypothesis and do not support the symbolic hypothesis regarding the origins of TD. Research on TD portrays one path through which the mind may distort somatosensory stimuli and incorporate them into dreams as a vivid and emotionally salient image; these preliminary findings highlight the potential of studying TD in order to broaden our understanding of the cognitive mechanisms governing dream production

No Time Like the Present: Thinking About the Past and the Future Is Related to State Dissociation Among Individuals With High Levels of Psychopathological Symptoms

Several short-term pathways have been implicated in relation to dissociative experiences, among them are daily stress, sleepiness, and rumination. In addition, it has been claimed that mechanisms contributing to dissociative experiences may differ, according to specific psychopathological symptoms. Accordingly, this study had two aims. The first was to sample moment-to-moment increases or decreases in current stress, sleepiness, and rumination, in order to assess their temporal relations with state dissociation. Rumination was broken down to its basic two subcomponents: the negative value of the thoughts and thinking about the past (in comparison to present or future), in order to differentiate it from other repetitive thought patterns (e.g., worry). The second goal was to explore whether depression, anxiety, and obsessive–compulsive symptoms may moderate the links between the three mechanisms and specific state dissociation scales [specifically, depersonalization-derealization (DEP-DER) and absorption (ABS)]. Ninety-nine undergraduate students completed trait questionnaires and then answered state items four times a day for 4 days. These experience sampling data were analyzed using multilevel linear modeling (MLM) with Level 1 state measurements and Level 2 demographic and trait variables of the participants. Moments of stress, sleepiness, thinking about the past and negative thoughts were all associated both with state DEP-DER and with state ABS. Dissociation, negative thinking, stress, and sleepiness were positively associated with moments of thinking about the past and the future but inversely associated with moments of thinking about the present. Finally, in accordance with our expectations, the links between DEP-DER and hypothesized mechanisms were mostly moderated by depression and anxiety symptoms, whereas the links between ABS and hypothesized mechanisms were moderated mainly by obsessive–compulsive symptoms. Our findings are in accordance with literature on the efficacy of mindfulness as well as the maladaptive correlates of mind-wandering, as they suggest that dissociative detachment from one’s present occupation is associated with decreased well-being

Self-Reported Time in Bed and Sleep Quality in Association with Internalizing and Externalizing Symptoms in School-Age Youth

This study investigated the relationship between self-reported time in bed and sleep quality in association with self-reported internalizing and externalizing symptoms in a sample of 285 elementary school students (52% female) recruited from a rural Midwestern elementary school. Path models were used to estimate proposed associations, controlling for grade level and gender. Curvilinear associations were found between time in bed and anxiety, depressive symptoms, and irritability. Marginal curvilinear trends were found between time in bed and emotion dysregulation, reactive aggression, and proactive aggression. Sleep quality was negatively associated with anxiety, depressive symptoms, irritability, reactive aggression, and delinquency engagement. Gender and grade differences were found across models. Findings suggest that examining self-reported time in bed (both linear and quadratic) and sleep quality is important for understanding internalizing and externalizing symptoms associated with sleep in school-age youth. Incorporating self-reported sleep assessments into clinical practice and school-based evaluations may have implications for a child’s adjustment

Sleep-amount differentially affects fear-processing neural circuitry in pediatric anxiety: A preliminary fMRI investigation

Insufficient sleep, as well as the incidence of anxiety disorders, both peak during adolescence. While both conditions present perturbations in fear-processing-related neurocircuitry, it is unknown whether these neurofunctional alterations directly link anxiety and compromised sleep in adolescents. Fourteen anxious adolescents (AAs) and 19 healthy adolescents (HAs) were compared on a measure of sleep amount and neural responses to negatively valenced faces during fMRI. Group differences in neural response to negative faces emerged in the dorsal anterior cingulate cortex (dACC) and the hippocampus. In both regions, correlation of sleep amount with BOLD activation was positive in AAs, but negative in HAs. Follow-up psychophysiological interaction (PPI) analyses indicated positive connectivity between dACC and dorsomedial prefrontal cortex, and between hippocampus and insula. This connectivity was correlated negatively with sleep amount in AAs, but positively in HAs. In conclusion, the presence of clinical anxiety modulated the effects of sleep-amount on neural reactivity to negative faces differently among this group of adolescents, which may contribute to different clinical significance and outcomes of sleep disturbances in healthy adolescents and patients with anxiety disorders

Arousal in Nocturnal Consciousness: How Dream- and Sleep-Experiences May Inform Us of Poor Sleep Quality, Stress, and Psychopathology

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

Trapped in a Daydream: Daily Elevations in Maladaptive Daydreaming Are Associated With Daily Psychopathological Symptoms

Background: Maladaptive Daydreaming (MD) characterizes individuals who engage in vivid, fanciful daydreaming for hours on end, neglecting real-life relationships and responsibilities, resulting in clinical distress and functional impairment. Sufferers have embraced the term MD in cyber-communities devoted to this problem because it seemed to uniquely fit their experience and since existing diagnostic labels and their therapies seemed inadequate. However, scientific research in the field has been scarce, relying on cross-sectional or case study designs. Existing knowledge on MD suggests the involvement of dissociative and obsessive-compulsive symptoms, as well as positive reinforcement comparable to processes in addiction disorders. The present study aimed to rigorously explore factors that accompany MD employing a longitudinal daily-diary design, hypothesizing that temporal increases in MD will associate concurrently with, and will temporally precede, other symptoms and emotional changes. In addition, we aimed to explore which symptoms may act as precursors to increases in MD, in order to identify possible mechanisms bringing about daydreaming in these individuals.Methods: In a sample of 77 self-diagnosed individuals with MD we assessed relevant daily symptoms for 14 days, including MD, depression, general anxiety, social anxiety, obsessive-compulsive symptoms, and dissociation, as well as positive and negative emotion.Results: Increases in MD were strongly related to concurrent increases in all other symptoms and negative emotion, and to decreased positive emotion. Obsessive-compulsive symptoms, dissociation, and negative emotion also temporally followed MD. Obsessive-compulsive symptoms were the only consistent temporal antecedent of MD.Conclusions: MD and obsessive-compulsive symptoms coincided in what seems to be a vicious cycle; understanding possible shared mechanisms between these symptoms may inform our understanding of the etiology of MD. For example, Serotonin levels may possibly be involved in the development or maintenance of this condition. The findings may also provide clues as to potentially beneficial interventions for treating MD. For example, perhaps utilizing response prevention techniques may be useful for curbing or intercepting unwanted daydreaming. Future studies on MD should address its compulsory nature

Lucid Dreaming: Intensity, But Not Frequency, Is Inversely Related to Psychopathology

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

Data_Sheet_1_Trapped in a Daydream: Daily Elevations in Maladaptive Daydreaming Are Associated With Daily Psychopathological Symptoms.DOCX

<p>Background: Maladaptive Daydreaming (MD) characterizes individuals who engage in vivid, fanciful daydreaming for hours on end, neglecting real-life relationships and responsibilities, resulting in clinical distress and functional impairment. Sufferers have embraced the term MD in cyber-communities devoted to this problem because it seemed to uniquely fit their experience and since existing diagnostic labels and their therapies seemed inadequate. However, scientific research in the field has been scarce, relying on cross-sectional or case study designs. Existing knowledge on MD suggests the involvement of dissociative and obsessive-compulsive symptoms, as well as positive reinforcement comparable to processes in addiction disorders. The present study aimed to rigorously explore factors that accompany MD employing a longitudinal daily-diary design, hypothesizing that temporal increases in MD will associate concurrently with, and will temporally precede, other symptoms and emotional changes. In addition, we aimed to explore which symptoms may act as precursors to increases in MD, in order to identify possible mechanisms bringing about daydreaming in these individuals.</p><p>Methods: In a sample of 77 self-diagnosed individuals with MD we assessed relevant daily symptoms for 14 days, including MD, depression, general anxiety, social anxiety, obsessive-compulsive symptoms, and dissociation, as well as positive and negative emotion.</p><p>Results: Increases in MD were strongly related to concurrent increases in all other symptoms and negative emotion, and to decreased positive emotion. Obsessive-compulsive symptoms, dissociation, and negative emotion also temporally followed MD. Obsessive-compulsive symptoms were the only consistent temporal antecedent of MD.</p><p>Conclusions: MD and obsessive-compulsive symptoms coincided in what seems to be a vicious cycle; understanding possible shared mechanisms between these symptoms may inform our understanding of the etiology of MD. For example, Serotonin levels may possibly be involved in the development or maintenance of this condition. The findings may also provide clues as to potentially beneficial interventions for treating MD. For example, perhaps utilizing response prevention techniques may be useful for curbing or intercepting unwanted daydreaming. Future studies on MD should address its compulsory nature.</p

Table_1.docx

<p>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.</p