Abstract

Background: Nightmare experience is associated with a broad spectrum of psychopathology, however, there lacks a structure-validated questionnaire to measure the effects of nightmare contents on the physical, psychological and behavioral aspects. Methods: Based on the clinical manifestation and previous documentation, we have designed a matrix of 95 items to measure the nightmare contents, plus one item to measure the nightmare frequency, and trialed them in 160 male and 161 female Chinese university students who have had a life-long nightmare experience. Results: After both exploratory and confirmatory factor analyses, we have found four factors regarding the nightmare experience, namely Physical Effect, Negative Emotion, Meaning Interpretation and Horrible Stimulation. The fit of 20-item model (five top-loading items each factor) has proven to be the best structure. Together with an item measuring frequency, the model, called Nightmare Experience Questionnaire (NEQ), was retained for further analyses. The nightmare frequency was positively correlated with all the four NEQ factors, and women scored significantly higher on NEQ Negative Emotion and Meaning Interpretation factors than men did. Conclusion: The NEQ might help to understand some psychiatric disorders, especially those with the awaking emotional deregulation in women.

Highlights

  • Nightmares are repeated occurrences of extended, extremely dysphoric, and well-remembered dreams usually involving efforts to avoid threats to survival, security, or physical integrity, and usually being accompanied by fear or panic which results in immediate awakening [1]

  • The frequent nightmares are prevalent in 16.7% patients with schizophrenia [8], 17.5% depression [8,9], 25% substance or alcohol abuse [10,11], 49% borderline personality disorder [12,13], 57% dissociative disorder [14,15], and 90% post-traumatic stress disorder (PTSD) [16]

  • Answers to the 95 items measuring the nightmare experience were entered into a principal component analysis first

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Summary

Introduction

Nightmares are repeated occurrences of extended, extremely dysphoric, and well-remembered dreams usually involving efforts to avoid threats to survival, security, or physical integrity, and usually being accompanied by fear or panic which results in immediate awakening [1]. The frequent nightmares happen in anxiety and bipolar disorders [17,18] They are even considered as a hallmark of PTSD [3,9], since they are connected with a broad range of traumatic events, such as combat exposure, traffic accident, crime victimization, rape, and natural disaster [20,21,22,23]. The frequent nightmares in early adolescence predict the onset of anxiety symptoms five years later [18], and increase the suicidal tendency in patients with major depression, borderline personality disorder, and dissociative disorder [24,25]. Nightmare experience is associated with a broad spectrum of psychopathology, there lacks a structure-validated questionnaire to measure the effects of nightmare contents on the physical, psychological and behavioral aspects

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