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Wang X, Soondrum T, Dai L. Neuroticism affects nightmare distress through rumination. Sleep Breath 2024:10.1007/s11325-024-03135-9. [PMID: 39150590 DOI: 10.1007/s11325-024-03135-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 07/17/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND/AIMS The role of neuroticism in predicting nightmare distress have been highlighted, and negative coping style may contribute to this relationship, but how these variables interact is limited. The present study aimed to explore how neuroticism and ruminative response contribute to producing nightmare distress, and to explore whether sex influences this relationship. METHODS We recruited 758 university students, aged an average of 19.07. A moderated mediation model was built to examine the relationships among neuroticism, rumination, and nightmare distress (measured by dream anxiety scale), and explore whether sex could affect this relationship, using the SPSS PROCESS 3.5 macro. RESULTS The moderated mediation analyses results showed that ruminative response-depression related can significantly partially mediate the relationship between neuroticism and dream anxiety (β = 0.32), dream anxiety-sleep-related disturbances (β = 0.11) and dream anxiety-daytime dysfunctions (β = 0.21). However, the moderating effects of sex were not significant in all path from neuroticism to dream anxiety. CONCLUSION The study provides a novel architecture on the underlying psychological mechanisms of neuroticism and nightmare distress. This interplay is assumed to be facilitated by ruminations, suggesting that interventions for individuals who suffer from nightmares may focus on their repetitive negative response strategies, especially in people with high neuroticism, irrespective of sex differences.
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Affiliation(s)
- Xiang Wang
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, China.
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.
- Douglas Research Centre, 6875 LaSalle Blvd, Montréal, QC, H4H 1R3, Canada.
| | | | - Lisha Dai
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China
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Chaaya R, Jiang C, Meng R, Zhu Y, Obeid S, Dagher D, Hallit R, Malaeb D, Dabbous M, Sakr F, Fekih-Romdhane F, Hallit S. Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents. BMC Psychiatry 2024; 24:553. [PMID: 39123135 PMCID: PMC11311914 DOI: 10.1186/s12888-024-05989-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV). METHODS A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8). RESULTS The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity. CONCLUSION In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context.
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Affiliation(s)
- Roni Chaaya
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
- Pediatric Health Care Section, Women and Children's Hospital of Ningbo University, Ningbo, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China.
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, 311121, China.
| | - Yihong Zhu
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Dina Dagher
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame Des Secours, University Hospital Center, Postal Code 3, Byblos, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Schredl M. Seeking help for nightmares: Associated personality factors. J Sleep Res 2024; 33:e13972. [PMID: 37345305 DOI: 10.1111/jsr.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
Research indicated that patients suffering from nightmares are often undertreated. One reason for this gap is that nightmare sufferers themselves often have not sought professional help for their nightmares, and-if they did-it was not very helpful. The current study aimed at studying trait factors (personality, harm avoidance) in relation to the persons considering seeking professional help. In a population-sample of 1108 persons (712 women, 396 men) with a mean age of 50.55 ± 14.22 years, it was also found that only some of the persons who have problems with nightmares even considered seeking professional help as an option. As expected and after controlling for effects of nightmare frequency, persons with high harm avoidance and high introversion were more likely not seeking help for their problems with nightmares. The associations with low education, low agreeableness and low conscientiousness with considering seeking professional help might point to the fear of stigmatisation in nightmare sufferers. Interestingly, the association between harm avoidance and "Considering seeking professional help" was even stronger in the subsample of frequent nightmare sufferers (once a week or more often). Future efforts should aim at findings new ways to offer adequate help for nightmares and increase the knowledge about nightmare treatment in healthcare professionals.
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Affiliation(s)
- Michael Schredl
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Campo Redondo M, Andrade G. Nightmare experiences and perceived ethnic discrimination amongst female university students in the United Arab Emirates: a cross-sectional study. J Sleep Res 2024:e14148. [PMID: 38233953 DOI: 10.1111/jsr.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
Perceived ethnic discrimination is known to be associated with anxiety and depression, and in turn, anxiety and depression are known to be associated with nightmare frequency and distress. This elicits a question: is perceived ethnic discrimination associated with nightmare frequency and distress? In this study, 179 female university students from the United Arab Emirates were assessed to answer that question. Results showed that while anxiety and depression were related to nightmare experiences, perceived ethnic discrimination was a stronger predictor of nightmare experiences. We posit two explanations for this finding: one based on psychoanalytical insights, and the other based on the Disposition-Stress model with neurobiological correlates. No significant differences were found across ethnicity when it comes to nightmare experiences or perceived ethnic discrimination. This is an encouraging sign of optimal societal integration in the United Arab Emirates.
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Faccini J, Joshi V, Del-Monte J. Nightmares, interoceptive sensibility and nociception: An exploratory study in a general population. Sleep Med 2023; 112:209-215. [PMID: 37918138 DOI: 10.1016/j.sleep.2023.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/01/2023] [Accepted: 09/30/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Nightmares are dysphoric dreams present in both clinical and non-clinical populations. Physiological activity underlies their emotional reactivity. Therefore, the objective of this study was to investigate the role of interoceptive processes (interoceptive sensibility and nociception) in nightmares in the general population. METHOD 542 French participants were recruited from the general population to complete an online survey. Interoceptive sensibility, nociception, nightmare frequency and nightmare distress were assessed through online scales and questionnaires. Network analysis, regression and mediation analyses were conducted to assess the relationship between these variables. RESULTS The results showed the existence of associations between certain dimensions of interoceptive sensibility, nociception, nightmare frequency and nightmare distress. The regression analysis highlighted the involvement of interoceptive dimensions in predicting the nightmare distress score. Mediation analysis highlighted that nociception was a mediating variable in the relationship between nightmare frequency and nightmare distress. CONCLUSION This study provides initial evidence in favour of the involvement of interoceptive processes in the understanding of nightmares. These results offer a new window of understanding the etiology of nightmares but also present the interest to target interoceptive processes in the management of nightmares.
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Affiliation(s)
- Julie Faccini
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France.
| | - Vrutti Joshi
- University of Nîmes, LPS Laboratory, Aix-Marseille University, France
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Zhang LG, Cheng LF, Wang TT, Wang LL, Zhou SJ, Luo YH, Chen JX. Chain mediating effect of insomnia, depression, and anxiety on the relationship between nightmares and cognitive deficits in adolescents. J Affect Disord 2023; 322:2-8. [PMID: 36343783 DOI: 10.1016/j.jad.2022.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- Li-Gang Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ling-Fei Cheng
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ting-Ting Wang
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shuang-Jiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Yan-Hong Luo
- School of Mental Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Jing-Xu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China.
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Gan Y, Wang R, Li J, Wang X, Fan H. The Relationship between Nightmare Experience and Athletes' Personality Traits and Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12900. [PMID: 36232198 PMCID: PMC9566163 DOI: 10.3390/ijerph191912900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/02/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Frequent nightmare behavior or deep nightmare experiences may harm the physical and mental health and performance of athletes. This study explores the nightmare experiences of athletes, and includes non-athletes with similar experiences for comparison. METHODS The Nightmare Experience Questionnaire (NEQ); Zuckerman-Kuhlman-Aluja Personality Questionnaire, Shortened Form (ZKA-PQ/SF); and Self-Rating Anxiety Scale (SAS) were used. The subjects were 187 athletes (mean age = 20.44 years, SD = 0.85; 91 females, 96 males) and 90 non-athletes (mean age = 20.34 years, SD = 1.65; 52 females, 38 males) who reported having nightmares. RESULTS A total of 87 athletes (46.5%) reported having nightmare experiences. The athlete nightmare group scored significantly higher in neuroticism than the non-nightmare group, and their anxiety scores were significantly higher than those of non-athletes, who scored higher in aggressiveness, neuroticism, and sensation seeking. Moreover, anxiety, neuroticism, and sensation seeking positively predicted athletes' nightmare experiences. CONCLUSIONS Personality traits and anxiety levels can be effectively applied to predict athletes' nightmare experiences.
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Liu X, Liu ZZ, Liu BP, Jia CX. Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 2022; 57:805-816. [PMID: 35064282 DOI: 10.1007/s00127-022-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Liu X, Liu L, Yang Y, Liu ZZ, Jia CX. Psychometric properties of the Chinese version of nightmare distress questionnaire (NDQ-CV) in adolescents. Sleep Med 2021; 79:94-100. [PMID: 33485261 DOI: 10.1016/j.sleep.2021.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 12/29/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Nightmare Distress Questionnaire (NDQ) is the most common scale used to measure nightmare distress for its satisfactory psychometric properties. This study assessed the psychometric properties of the Chinese version of NDQ (NDQ-CV) in a large sample of adolescents. METHODS The NDQ-CV consists of 14 items (12 original NDQ items, 1 modified NDQ item and 1 new item) to assess waking distress associated with nightmares. Each item is rated on a 5-point scale from 1 = Never to 5 = Always. Subjects used for psychometric assessment of the NDQ-CV were 11,831 participants of the Shandong Adolescent Behavior and Health Cohort in China. Participants completed the NDQ-CV and a structured questionnaire to assess nightmare frequency, sleep, anxiety/depression, and academic performance. RESULTS The NDQ-CV score ranged from 14 to 70 (M = 22.5, SD = 8.7). Internal consistency reliability coefficient was 0.90. Both exploratory and confirmatory factor analyses yielded 2 dominant factors defined as nightmare general distress (10 items) and daytime reality perception (4 items). The NDQ-CV score was significantly correlated with short nocturnal sleep duration, anxiety/depression, insomnia, daytime sleepiness, and poor academic performance. Furthermore, NDQ-CV significantly predicted depressive symptoms 1 year later. STUDY LIMITATIONS All data were self-reported. CONCLUSIONS The NDQ-CV appears to be a simple, reliable, and valid scale for assessing nightmare distresses in Chinese adolescents. Further studies are warranted to test the reliability and validity of the NDQ-CV with adult samples.
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Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA and Kelin Health Research, Montgomery, NJ, USA.
| | - Lu Liu
- Department of Educational Psychology and Learning Systems, Florida State University, USA
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, USA
| | - Zhen-Zhen Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China
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