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Hedderly T, Eccles C, Malik O, Abdulsatar F, Mitchell C, Owen T, Soffer-Dudek N, Grose C, Fernandez TV, Robinson S, Somer E. Intense Imagery Movements May Lead to Maladaptive Daydreaming: A Case Series and Literature Review. Mov Disord Clin Pract 2024. [PMID: 38533626 DOI: 10.1002/mdc3.14011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/11/2024] [Accepted: 02/06/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND This case series highlights the connection between childhood intense imagery movements (IIM) and adult-reported maladaptive daydreaming (MD). Motor stereotypies occur in typically developing children and also with co-occurring neurodevelopmental differences. A subgroup with complex motor stereotypies reports accompanying intense imagery, often enhanced by the movements. This phenomenon can persist into adulthood and, in some cases, will need active management to prevent significant distress and impairment. CASES Six adults, self-reporting maladaptive daydreaming associated with stereotypies, are presented to demonstrate the associations. LITERATURE REVIEW The clinical significance and function of IIM and MD are unclear, but several hypotheses are discussed, including the mechanism of emotional regulation through sensory seeking, as a process for processing childhood psychological trauma, as intrusive thoughts or images as part of a subtype of Obsessive Compulsive Disorder, or as a result of diverse attentional networks seen in neurodevelopmental disorders. CONCLUSIONS This paper highlights important connections between IIM and MD. Many adults with MD show a childhood origin of stereotypical movements. Whilst immersive daydreaming may provide creativity and emotional regulation, there is evidence of distress and impairment of function for some adults, leading to MD diagnoses. Recognizing this phenomenon is important for all neurologists and physicians working with stereotypical movements.
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Affiliation(s)
- Tammy Hedderly
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, School of Life Course Sciences (SoLCS), King's College London, London, UK
| | - Claire Eccles
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Osman Malik
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Farah Abdulsatar
- Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Clare Mitchell
- Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Tamsin Owen
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Claire Grose
- Tic and Neurodevelopmental Movements Service (TANDeM), Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Thomas V Fernandez
- Child Study Center and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sally Robinson
- Essex Child and Adolescent Mental Health Services, North East London NHS Foundation Trust, Rainham, UK
| | - Eli Somer
- Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
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Bregman-Hai N, Soffer-Dudek N. Posttraumatic symptoms and poor sleep are independent pathways to agency disruptions and dissociation: A longitudinal study with objective sleep assessment. J Psychopathol Clin Sci 2024; 133:192-207. [PMID: 38108801 DOI: 10.1037/abn0000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Dissociation and diminished sense of agency are experiential distortions of disintegration in the perception of self and action. Although one is often implied in the other, they are seldom studied together. Assessing their relationship and shared influences may allow for a more comprehensive and nuanced understanding of dissociative experiences. We aimed to examine their temporal (concurrent or directional) co-occurrence, and to elucidate their etiology, focusing on posttraumatic symptoms (PTS), poor sleep, and their hypothesized joint effect. N = 113 adults oversampled for the existence of trauma exposure history reported PTS and then, for a week, wore an actigraphic sleep monitor, reported subjective sleep quality each morning, and reported state dissociation (depersonalization, derealization, and absorption) and sense of agency four times each day. Data were analyzed using multilevel linear modeling. Higher state dissociation correlated with diminished state sense of agency, but only contemporaneously, not directionally. Both hypothesized etiological factors, namely, PTS (especially complex) and poor sleep (objective and subjective) predicted state dissociation and diminished state sense of agency, but psychological distress seemed to overshadow these main effects. However, robust interactive effects suggested that poor sleep predicted dissociation and disruptions in the sense of agency only among individuals with low PTS. These findings suggest that PTS and poor sleep quality are separate paths to dissociation and impaired sense of agency. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Noa Bregman-Hai
- Department of Psychology, Ben-Gurion University of the Negev
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Soffer-Dudek N, Oh H. Maladaptive daydreaming: A shortened assessment measure and its mental health correlates in a large United States sample. Compr Psychiatry 2024; 129:152441. [PMID: 38061294 DOI: 10.1016/j.comppsych.2023.152441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND AND AIMS Maladaptive Daydreaming (MD) is a suggested syndrome where individuals addictively engage in fanciful, narrative and emotional daydreaming for hours on end, often relying on stereotypical movements and music to facilitate the absorbed state. Many individuals suffering from MD to the point of clinically significant distress and functional impairment have advocated for its medicalization as a disorder. Maladaptive daydreamers exhibit high rates of psychopathology, but most studies were biased by self-selection. We developed a brief measure for efficient assessment of suspected MD and then administered it in a large non-selected US sample to gauge the significance of MD for public mental health. METHODS Two previous datasets were utilized to develop the 5-item measure, labeled the Maladaptive Daydreaming Short Form (MD-SF5). Then, a large survey was conducted using the Qualtrics panel, administering the MD-SF5 alongside several validated measures of mental health to a general sample of panelists (N = 2512, 84.6% females, age M = 39.74, SD = 18.53, Race/Ethnicity: 66.3% White, 14.7% Black, 9.3% Hispanic, and 9.7% Other). RESULTS The MD-SF5 showed good to excellent agreement with the existing measure. Generally, the new sample had high psychopathology rates. Suspected MD was associated with psychological distress, loneliness, psychotic experiences, heavy drinking, and suicidality. Notably, even after controlling for psychological distress, suspected maladaptive daydreamers were more than twice as likely to have recently attempted suicide (Odds Ratio = 2.44, 95% CI [1.44, 4.16], Wald = 10.86, p = .001). DISCUSSION AND CONCLUSIONS MD harbors public health significance and can be screened for with a short self-report tool. Thus, MD should be addressed by mental health practitioners.
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Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva 8410501, Israel.
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
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Soffer-Dudek N. Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice. Front Psychol 2023; 14:1132800. [PMID: 37051604 PMCID: PMC10084853 DOI: 10.3389/fpsyg.2023.1132800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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Pinus M, Lassri D, Rahamim O, Schiller M, Soffer-Dudek N, Shahar G. Identifying state self-criticism subscales within the Brief Symptoms Inventory: Analyses of data from Israeli young adults. Personality and Individual Differences 2023. [DOI: 10.1016/j.paid.2022.111989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Musetti A, Soffer-Dudek N, Imperato C, Schimmenti A, Franceschini C. Longitudinal associations between maladaptive daydreaming and psychological distress during the COVID-19 health crisis. J Behav Addict 2023; 12:288-294. [PMID: 36857029 DOI: 10.1556/2006.2023.00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/05/2023] [Accepted: 02/03/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND AND AIMS Maladaptive Daydreaming (MD) is a suggested syndrome where individuals become addicted to fantasizing vividly for hours on end at the expense of engaging in real-world relationships and functioning. MD can be seen as a behavioral addiction. However, a paucity of longitudinal research means that there is no empirical evidence confirming the stability of this alleged addiction. Moreover, the direction of its association with psychopathology is unclear. METHODS We examine, for the first time, long-term stability and longitudinal associations between MD, psychological distress (stress, anxiety, and depression symptoms) and COVID-19 related exposure. RESULTS Participants (N = 814) completed an online survey twice, with a lag of 13 months. A two-wave structural equation model demonstrated high MD stability and positive cross-lagged pathways from MD to psychological distress. COVID-19 related exposure was not a longitudinal predictor. DISCUSSION AND CONCLUSIONS MD is a stable condition and a risk factor for an increase in psychological distress.
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Affiliation(s)
- Alessandro Musetti
- 1Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Nirit Soffer-Dudek
- 2Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Chiara Imperato
- 1Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Adriano Schimmenti
- 3Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
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Lassri D, Bregman-Hai N, Soffer-Dudek N, Shahar G. The Interplay Between Childhood Sexual Abuse, Self-Concept Clarity, and Dissociation: A Resilience-Based Perspective. J Interpers Violence 2023; 38:2313-2336. [PMID: 35593092 PMCID: PMC9850382 DOI: 10.1177/08862605221101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social
Work and Social Welfare, The Hebrew University of
Jerusalem, Jerusalem, Israel
- Research Department of Clinical,
Educational and Health Psychology, UCL (University College
London), London, UK
| | - Noa Bregman-Hai
- Department of Psychology,
Ben-Gurion
University of the Negev, Beer-Sheva,
Israel
| | - Nirit Soffer-Dudek
- Department of Psychology,
Ben-Gurion
University of the Negev, Beer-Sheva,
Israel
| | - Golan Shahar
- Department of Psychology,
Ben-Gurion
University of the Negev, Beer-Sheva,
Israel
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Herscu O, Somer E, Federman A, Soffer-Dudek N. Mindfulness meditation and self-monitoring reduced maladaptive daydreaming symptoms: A randomized controlled trial of a brief self-guided web-based program. J Consult Clin Psychol 2023; 91:285-300. [PMID: 36634023 DOI: 10.1037/ccp0000790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Maladaptive daydreaming (MD) is a compulsive form of daydreaming that causes distress and functional impairment. We present the first treatment trial for MD. METHOD We tested the effectiveness of an eight-session internet-based self-help training for mindfulness and self-monitoring and compared three groups across three measurement points in time. A sample of 557 people was randomly assigned. A total of 353 participants (age M[SD] = 28.3[10.5], 76% female, 77% unmarried) completed our program: full-intervention group (n = 114, psychoeducation + motivation enhancement + mindfulness + self-monitoring), partial-intervention group (n = 125, identical excluding self-monitoring), and waiting-list group (n = 125, internet-based support as usual). RESULTS All MD measures assessing daydreaming pathology, daydreaming frequency, and life functioning showed significant improvement with a large effect size (ES) from baseline to posttreatment in both intervention groups, whereas the wait-list group showed no significant improvement, MD: F(3, 349) = 35.76, p < .0001, η² = 0.24; frequency: F(3, 349) = 32.06, p < .001, η² = 0.22; functioning: F(3, 349) = 20.43, p < .001, η² = 0.15. Mindfulness with self-monitoring training for MD was superior to mindfulness alone in the short term, but they both were equally efficient in the long term. Both interventions were superior to relying on internet-based support forums only. The clinically significant improvement rate of mindfulness with self-monitoring training was 24%, while the reliable improvement rate reached 39%. At the 6-month follow-up, achievements were maintained. CONCLUSIONS A brief internet-based intervention program comprising mindfulness meditation and self-monitoring facilitated recovery or improvement in many individuals with MD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Soffer-Dudek N, Theodor-Katz N. Maladaptive Daydreaming: Epidemiological Data on a Newly Identified Syndrome. Front Psychiatry 2022; 13:871041. [PMID: 35573338 PMCID: PMC9091653 DOI: 10.3389/fpsyt.2022.871041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Maladaptive Daydreaming (MD) is a recently identified psychological disorder, characterized by excessively and addictively engaging in vivid, narrative, intensely emotional fantasy activity, at times with the aid of music and/or repetitive movements, causing distress and functional impairment. Over 100,000 self-diagnosed individuals are active online and thousands of them have been researched; yet there are no studies using clinical interviews on large, systematic general (non-MD) samples, to assess the estimated prevalence of this suggested disorder, and establish norms for its main psychometric tool. METHODS Four independent Israeli samples (three student samples, and one sample representing the general Jewish-Israeli population; total N = 1,023) self-reported MD. In two samples, those exceeding the cutoff score for suspected MD were invited for a structured clinical interview. RESULTS The skewness of most items of the 16-item Maladaptive Daydreaming Scale (MDS-16) supports the notion of MD as a binary construct rather than a normally distributed trait. In the community sample, 4.2% exceeded the cutoff for suspected MD. Rates were higher when focusing on the young adult age group or student samples (5.5-8.5%), suggesting a likely age effect. Following clinical interviews, only 60% of interviewed respondents met criteria for diagnosis, suggesting a true point-prevalence of 2.5% in the Israeli-Jewish population. CONCLUSIONS This is the first systematic clinical evaluation of the prevalence of MD. In an Israeli sample, a point-prevalence of 2.5% was found, like several other internalizing psychiatric syndromes. This result, along with the Non-normal nature of item distribution, both support the validity of MD as a psychological disorder, which should be considered as a potential addition to future psychiatric diagnostic manuals.
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Affiliation(s)
- Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nitzan Theodor-Katz
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Somer E, Cardeña E, Catelan RF, Soffer-Dudek N. Reality shifting: psychological features of an emergent online daydreaming culture. Curr Psychol 2021; 42:1-13. [PMID: 34744401 PMCID: PMC8556810 DOI: 10.1007/s12144-021-02439-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
Reality shifting (RS) is a trendy mental activity that emerged abruptly following the flare-up of the COVID-19 pandemic in 2020 and seems to be practiced mainly by members of the post-millennial generation. RS, described as the experience of being able to transcend one's physical confines and visit alternate, mostly fictional, universes, is discussed by many on Internet platforms. One RS forum boasts over 40,000 members and RS clips on some social media platforms have been viewed over 1.7 billion times. The experience of shifting is reportedly facilitated by specific induction methods involving relaxation, concentration of attention, and autosuggestion. Some practitioners report a strong sense of presence in their desired realities, reified by some who believe in the concrete reality of the alternate world they shift to. One of the most popular alternate universes involves environments adopted from the Harry Potter book and film series. We describe the phenomenology of RS as reported online and then compare it to related phenomena such as hypnosis, tulpamancy, dissociation, immersive and maladaptive daydreaming, and lucid dreaming. We propose a theoretical model of interactive factors giving rise to RS, and conclude that it is an important, uninvestigated emerging phenomenon and propose future research directions.
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Affiliation(s)
| | - Etzel Cardeña
- Present Address: CERCAP, Department of Psychology, Lund University, Lund, Sweden
| | - Ramiro Figueiredo Catelan
- Present Address: Center for Maladaptive Daydreaming and Emotion Dysregulation Research, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Vannikov-Lugassi M, Shalev H, Soffer-Dudek N. From brooding to detachment: Rumination longitudinally predicts an increase in depersonalization and derealisation. Psychol Psychother 2021; 94 Suppl 2:321-338. [PMID: 32333727 DOI: 10.1111/papt.12279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 03/31/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Depersonalization-derealization (DEP-DER) is a dissociative experience which is related to psychopathology and distress. Yet, the aetiological factors leading to DEP-DER are not sufficiently clear. In this study, we suggest rumination as one possible antecedent. Thus, the goal of the study was to explore the longitudinal relationship between rumination and DEP-DER. DESIGN Longitudinal self-report study; mixed clinical and community sample. METHODS The study was conducted on 98 participants, 49 of them were diagnosed with depression, anxiety disorders, or obsessive-compulsive disorder, and the other 49 were healthy, matched community controls. The participants underwent a structured clinical interview and completed a battery of questionnaires. Then, the participants completed the same battery again once a month, for five additional assessment points (6 months in total). The data were analysed using multilevel linear modelling with time-lag analysis. RESULTS We found that levels of rumination and DEP-DER increased and decreased simultaneously, meaning that on assessments in which people reported that they tended to ruminate, they also reported higher levels of DEP-DER symptoms. In addition, we found support for a unidirectional association, consistent with our theoretical hypothesis. Specifically, rumination levels on a certain month longitudinally predicted a higher likeliness for reporting DEP-DER on the following month, even when controlling for the contemporaneous relationship. Conversely, DEP-DER symptoms did not longitudinally predict increased rumination. CONCLUSIONS These findings suggest that rumination may be an antecedent of DEP-DER, but not vice versa. Possible mechanisms to explain this link are discussed. PRACTITIONER POINTS Rumination and DEP-DER oscillate together over time; additionally, rumination predicts a longitudinal increase in DEP-DER. Clinicians noticing ruminative thought followed by decreased emotionality should distinguish between an authentic decrease of distress versus detachment. The findings provide one possible explanation for the frequency of DEP-DER symptoms in anxiety and depressive disorders. Poor sleep quality and emotion regulation difficulties should be explored as potential mediators explaining this link.
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Affiliation(s)
| | - Hadar Shalev
- Ben-Gurion University of the Negev, Be'er-Sheva, Israel.,Soroka Medical Center, Be'er Sheva, Israel
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Salomon-Small G, Somer E, Harel-Schwarzmann M, Soffer-Dudek N. Maladaptive Daydreaming and Obsessive-Compulsive Symptoms: A confirmatory and exploratory investigation of shared mechanisms. J Psychiatr Res 2021; 136:343-350. [PMID: 33636690 DOI: 10.1016/j.jpsychires.2021.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/17/2020] [Accepted: 02/08/2021] [Indexed: 11/18/2022]
Abstract
Maladaptive Daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning. There is a high comorbidity of MD with Obsessive-Compulsive Spectrum Symptoms (OCSS), yet the mechanisms responsible for this relationship are still unclear. The present study set out to explore the relationship between MD and OCSS by: (1) examining dissociation, trauma, sense of control, and mind-wandering as potential mediators; (2) exploring whether MD is more strongly related to obsessions or compulsions; and (3) identifying patterns of specific obsessions and/or compulsions common in an MD sample. A group of 510 participants with self-identified MD completed a battery of online questionnaires. Dissociation and sense of control significantly mediated the MD-OCSS association. MD was moderately related to both obsessions and compulsions but was significantly more strongly related to the former. Frequently endorsed obsessions and compulsions among MD participants included checking and repetition compulsions, intrusive obsessions, and body-related obsessions and compulsions. We conclude that dissociative mechanisms, including dissociative absorption, play a major role in the relationship between MD and OCSS and may lead to consequent checking when transitioning back to reality, altered embodiment, intrusive images, and thoughts, and an impaired sense of mental control. Clinicians working with OCSS should be aware of the possible role of MD in the development or maintenance of symptoms. Future work should develop useful interventions for this type of shared psychopathology.
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Affiliation(s)
- Gabrielle Salomon-Small
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Eli Somer
- School of Social Work, University of Haifa, Haifa, Israel.
| | | | - Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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13
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Buchnik-Daniely Y, Vannikov-Lugassi M, Shalev H, Soffer-Dudek N. The path to dissociative experiences: A direct comparison of different etiological models. Clin Psychol Psychother 2021; 28:1091-1102. [PMID: 33527536 DOI: 10.1002/cpp.2559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 01/24/2021] [Indexed: 12/15/2022]
Abstract
Severe dissociation is trauma-related, but a range of dissociative experiences are also prevalent in clinical populations that are not necessarily trauma-based (e.g., depression, anxiety disorders, and obsessive-compulsive disorders). These remain poorly understood as the dominant etiological model for dissociation relies on trauma. Importantly, dissociation in such samples predicts poor prognosis and high drop-out rates. We set out to better understand the aetiology of dissociative experiences in a mixed clinical (anxiety and depression) and community sample by exploring between- and within-subjects effects of two domains: psychological distress or negative affectivity (operationalized as anxiety and depression symptoms), and poor sleep quality, including disturbed dreaming. The idea that negative affectivity triggers dissociation (Distress Model) is inspired by the trauma model. The idea that poor sleep and unusual dreaming underlie dissociation (Sleep Model) has been suggested as a competing theory. We examined both models by exploring which domains oscillate alongside dissociative experiences. N = 98 adults, half of them diagnosed with depression and anxiety and half community controls, underwent a structured clinical interview and completed questionnaires monthly for 6 months. Support was found for both models in that each domain had a unique explanatory contribution. Distress evinced consistent effects that could not be explained by sleep or dreaming, both between individuals and across time. Oscillations in dissociation across months, when taking psychological distress into account, were better explained by unusual dreaming than traditional sleep quality measures. These findings cannot be generalized to highly-traumatized samples. A complex, integrated etiological model for dissociative experiences is warranted.
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Affiliation(s)
| | | | - Hadar Shalev
- Department of Psychiatry, Soroka Medical Center, Beer-sheva, Israel
| | - Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beer-sheva, Israel
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Soffer-Dudek N, Somer E, Abu-Rayya HM, Metin B, Schimmenti A. Different cultures, similar daydream addiction? An examination of the cross-cultural measurement equivalence of the Maladaptive Daydreaming Scale. J Behav Addict 2020; 9:1056-1067. [PMID: 33141115 PMCID: PMC8969720 DOI: 10.1556/2006.2020.00080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/02/2020] [Accepted: 10/11/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND AIMS Maladaptive Daydreaming (MD) is a proposed mental disorder, in which absorption in rich, narrative fantasy becomes addictive and compulsive, resulting in emotional, social, vocational, or academic dysfunction. Most studies on MD were carried out on aggregated international samples, using translated versions of the Maladaptive Daydreaming Scale (MDS-16). However, it is unknown whether the properties of MD are affected by culture. Thus, we investigated the cross-cultural measurement invariance of the MDS-16. METHODS We recruited both individuals self-identified as suffering from MD and non-clinical community participants from four countries: the USA, Italy, Turkey, and the UK (N = 1,081). RESULTS Configural invariance was shown, suggesting that the hypothesized four-factor structure of the MDS-16 (including Yearning, Impairment, Kinesthesia, and Music) holds across cultures. Metric invariance was shown for Impairment, Kinesthesia, and Music, but not for Yearning, suggesting that the psychological meaning of the latter factor may be understood differently across cultures. Scalar invariance was not found, as MD levels were higher in the USA and UK, probably due to the over-representation of English-speaking members of MD communities, who volunteered for the study. DISCUSSION AND CONCLUSIONS We conclude that the urge to be absorbed in daydreaming and the fantasies' comforting and addictive properties may have different meanings across countries, but the interference of MD to one's daily life and its obstruction of long-term goals may be the central defining factor of MD.
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Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Israel,Corresponding author.
| | - Eli Somer
- School of Social Work, University of Haifa, Israel
| | - Hisham M. Abu-Rayya
- School of Social Work, University of Haifa, Israel,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Barış Metin
- Faculty of Medicine, Üsküdar University, Turkey
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Soffer-Dudek N. Are Lucid Dreams Good for Us? Are We Asking the Right Question? A Call for Caution in Lucid Dream Research. Front Neurosci 2020; 13:1423. [PMID: 32038133 PMCID: PMC6993576 DOI: 10.3389/fnins.2019.01423] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/16/2019] [Indexed: 02/03/2023] Open
Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Bregman-Hai N, Kessler Y, Soffer-Dudek N. Who wrote that? Automaticity and reduced sense of agency in individuals prone to dissociative absorption. Conscious Cogn 2019; 78:102861. [PMID: 31887532 DOI: 10.1016/j.concog.2019.102861] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 12/29/2022]
Abstract
Dissociative absorption (DA) is a tendency to become completely immersed in a stimulus while neglecting to attend to one's surroundings. Theoretically, DA implies automatic functioning in areas that are outside the focus of attention. This study examined whether high absorbers indeed act more automatically, i.e., with decreased meta-consciousness for, and therefore poor memory of, their own actions, along with reduced sense of agency (SoA). High and low absorbers (N = 63) performed three DA-promoting tasks: choice-reaction time (CRT), Tetris, and free writing. Participants were tested on memory of task details and self-reported their state SoA. As hypothesized, trait DA was correlated with impaired autobiographical memory for self-generated writing. However, DA was not related to episodic memory disruptions in externally-generated content tasks (Tetris, CRT). In most tasks, DA was associated with decreased SoA. Absorbers' specific difficulty in identifying self-generated content suggests that their memory failures stem from reduced accessibility to self-actions and intentions.
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Affiliation(s)
- Noa Bregman-Hai
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Yoav Kessler
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Israel.
| | - Nirit Soffer-Dudek
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
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Vannikov-Lugassi M, Soffer-Dudek N. 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. Front Psychol 2018; 9:2465. [PMID: 30581402 PMCID: PMC6292924 DOI: 10.3389/fpsyg.2018.02465] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/21/2018] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Miriam Vannikov-Lugassi
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
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Rozen N, Soffer-Dudek N. Dreams of Teeth Falling Out: An Empirical Investigation of Physiological and Psychological Correlates. Front Psychol 2018; 9:1812. [PMID: 30319507 PMCID: PMC6168631 DOI: 10.3389/fpsyg.2018.01812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/06/2018] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Naama Rozen
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beersheba, Israel
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Soffer-Dudek N. Dissociative absorption, mind-wandering, and attention-deficit symptoms: Associations with obsessive-compulsive symptoms. Br J Clin Psychol 2018; 58:51-69. [DOI: 10.1111/bjc.12186] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory; Department of Psychology; Ben-Gurion University of the Negev; Beer-Sheva Israel
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Vannikov-Lugassi M, Soffer-Dudek N. Rumination and dissociation: The mediating role of poor sleep quality and presleep cognitions. Psychology of Consciousness: Theory, Research, and Practice 2018. [DOI: 10.1037/cns0000128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Aviram L, Soffer-Dudek N. Lucid Dreaming: Intensity, But Not Frequency, Is Inversely Related to Psychopathology. Front Psychol 2018; 9:384. [PMID: 29623062 PMCID: PMC5875414 DOI: 10.3389/fpsyg.2018.00384] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/08/2018] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
| | - Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Soffer-Dudek N, Somer E. Trapped in a Daydream: Daily Elevations in Maladaptive Daydreaming Are Associated With Daily Psychopathological Symptoms. Front Psychiatry 2018; 9:194. [PMID: 29867613 PMCID: PMC5962718 DOI: 10.3389/fpsyt.2018.00194] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 04/25/2018] [Indexed: 01/22/2023] Open
Abstract
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.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eli Somer
- School of Social Work, University of Haifa, Haifa, Israel
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Somer E, Soffer-Dudek N, Ross CA, Halpern N. Maladaptive daydreaming: Proposed diagnostic criteria and their assessment with a structured clinical interview. Psychology of Consciousness: Theory, Research, and Practice 2017. [DOI: 10.1037/cns0000114] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Soffer-Dudek N. Arousal in Nocturnal Consciousness: How Dream- and Sleep-Experiences May Inform Us of Poor Sleep Quality, Stress, and Psychopathology. Front Psychol 2017; 8:733. [PMID: 28539902 PMCID: PMC5423938 DOI: 10.3389/fpsyg.2017.00733] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/24/2017] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Nirit Soffer-Dudek
- Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the NegevBeer-Sheva, Israel
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Soffer-Dudek N, Shelef L, Oz I, Levkovsky A, Erlich I, Gordon S. Absorbed in sleep: Dissociative absorption as a predictor of sleepiness following sleep deprivation in two high-functioning samples. Conscious Cogn 2017; 48:161-170. [DOI: 10.1016/j.concog.2016.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 12/29/2022]
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Soffer-Dudek N. Daily Elevations in Dissociative Absorption and Depersonalization in a Nonclinical Sample Are Related to Daily Stress and Psychopathological Symptoms. Psychiatry 2017; 80:265-278. [PMID: 29087250 DOI: 10.1080/00332747.2016.1247622] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
OBJECTIVE Dissociative experiences are associated with several psychopathological symptoms and are a hindrance to therapeutic gain. Depersonalization-derealization (DEP-DER) is positively associated with stress and anxiety, while absorption and imaginative involvement (ABS), a tendency for total, immersed attention, is commonly referred to as nonpathological dissociation, although it is positively associated with obsessive-compulsive (OC) symptoms. Previous studies in the field have been mainly cross-sectional. The present study aimed to examine these associations rigorously and attempted to determine directionality between dissociation and distress. METHOD The current study employed both variable-centered (cross-sectional) and person-centered (longitudinal, within-subjects) analyses of the associations of DEP-DER and ABS with distress. Undergraduate students (N = 184) completed trait questionnaires on dissociation, stress, anxiety, depression, and OC symptoms, and n = 78 also completed questionnaires assessing the same constructs daily for 14 days. Multiple regression and multilevel modeling analyses were conducted. RESULTS In the cross-sectional phase, DEP-DER was uniquely positively related to anxiety and OC symptoms, and ABS was uniquely positively related to OC symptoms. In the daily diary phase, increases in DEP-DER were related to increases in anxiety, depression, OC symptoms, and stress, while increases in ABS were related to increases in OC symptoms and stress. In addition, time-lag analysis showed that ABS tended to temporally precede OC. CONCLUSIONS ABS foretold increases in OC symptoms, at least in this nonclinical sample. Future studies on clinical samples should explore whether ABS should be referred to as "nonpathological" and its possible role in the development or maintenance of clinical-level OCD.
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Soffer-Dudek N. Sleep-related experiences longitudinally predict elevation in psychopathological distress in young adult Israelis exposed to terrorism. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2015.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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De Marcas GS, Soffer-Dudek N, Dollberg S, Bar-Haim Y, Sadeh A. Reactivity and sleep in infants: a longitudinal objective assessment. Monogr Soc Res Child Dev 2015; 80:49-69. [PMID: 25704735 DOI: 10.1111/mono.12144] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sleep patterns and temperament in the first year of life are closely related. However, research utilizing objective, rather than subjective measurements of sleep and temperament is scarce and results are inconsistent. In addition, a relative lack of longitudinal data prevents inference of causality between the two constructs. In this study, infant sleep was objectively assessed among 95 infants at 3, 6, and 12 months-of-age with an actigraph in the home setting. Reactivity to sound, light, and touch, a specific aspect of temperament, was behaviorally assessed at 3 and 6 months, both during sleep (at home) and during waking (at the laboratory). Expected maturational trends were recorded in sleep, with a temporal increase in sleep efficiency and percent of motionless sleep. Quadratic (i.e., inverse U shape) relations were found, especially among girls, when predicting change in sleep by reactivity thresholds, suggesting that both hyposensitive and hypersensitive infants are at risk for poor sleep quality. These are the first research findings suggesting that low reactivity in infancy might be associated with compromised sleep quality. The observed nonlinear effects may account for null or inconsistent results in previous studies that explored only linear associations between temperament and sleep. Future studies should address both extremes of the temperament continuum when exploring relations with sleep patterns.
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Soffer-Dudek N. Dissociation and dissociative mechanisms in panic disorder, obsessive–compulsive disorder, and depression: A review and heuristic framework. ACTA ACUST UNITED AC 2014. [DOI: 10.1037/cns0000023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lassri D, Soffer-Dudek N, Lerman SF, Rudich Z, Shahar G. Self-Criticism Confers Vulnerability to Psychopathology in the Face of Perceived Stress Related to Missile Attacks: Three Longitudinal Studies. Int J Cogn Ther 2013. [DOI: 10.1521/ijct.2013.6.3.221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Soffer-Dudek N, Shahar G. Daily stress interacts with trait dissociation to predict sleep-related experiences in young adults. J Abnorm Psychol 2011; 120:719-29. [PMID: 21443286 DOI: 10.1037/a0022941] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Building on the previously documented effects of stress and dissociation on sleep and dreaming, we examined their interactive role in general sleep-related experiences (GSEs; e.g., nightmares, falling dreams, hypnagogic hallucinations; see Watson, 2001). Stress, sleep quality, and GSEs were assessed daily for 14 days among young adults. Baseline assessment included life stress, sleep quality, psychopathology, dissociation, and related dimensions. Multilevel analyses indicated that daily stress brings about GSEs among highly dissociative young adults. Additionally, baseline trait dissociation predicted within-subject elevation in GSEs when daily stress was high. Flawed sleep-wake transitions, previously linked to dissociation and sleep-related experiences, might account for this effect.
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Affiliation(s)
- Nirit Soffer-Dudek
- Stress & Personality Lab, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
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Soffer-Dudek N, Sadeh A, Dahl RE, Rosenblat-Stein S. Poor sleep quality predicts deficient emotion information processing over time in early adolescence. Sleep 2011; 34:1499-508. [PMID: 22043121 DOI: 10.5665/sleep.1386] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES There is deepening understanding of the effects of sleep on emotional information processing. Emotion information processing is a key aspect of social competence, which undergoes important maturational and developmental changes in adolescence; however, most research in this area has focused on adults. Our aim was to test the links between sleep and emotion information processing during early adolescence. DESIGN Sleep and facial information processing were assessed objectively during 3 assessment waves, separated by 1-year lags. SETTING Data were obtained in natural environments-sleep was assessed in home settings, and facial information processing was assessed at school. PARTICIPANTS 94 healthy children (53 girls, 41 boys), aged 10 years at Time 1. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Facial information processing was tested under neutral (gender identification) and emotional (emotional expression identification) conditions. Sleep was assessed in home settings using actigraphy for 7 nights at each assessment wave. Waking > 5 min was considered a night awakening. Using multilevel modeling, elevated night awakenings and decreased sleep efficiency significantly predicted poor performance only in the emotional information processing condition (e.g., b = -1.79, SD = 0.52, confidence interval: lower boundary = -2.82, upper boundary = -0.076, t(416.94) = -3.42, P = 0.001). CONCLUSIONS Poor sleep quality is associated with compromised emotional information processing during early adolescence, a sensitive period in socio-emotional development.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Adler Center for Research in Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Tel Aviv, Israel
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Abstract
The relationship between resilience and lucid dreams, which involves awareness of the experience of dreaming, was examined in 79 Israeli young adults. Psychological distress and lucid dreams 3 years prior to exposure to terrorism, and exposure levels and psychological distress 1 week following exposure, were assessed. Both indirect exposure through media and perceived stress predicted an increase in distress during the 3-year interval under low, but not high, levels of lucid dreams. Possible mechanisms are discussed.
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Affiliation(s)
- Nirit Soffer-Dudek
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
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Abstract
General sleep-related experiences (Watson, 2001), including special dream states such as elevated dream recall, nightmares, hypnagogic hallucinations, flying dreams, and waking dreams, have been shown to be associated with life stress and psychopathological distress (Soffer-Dudek & Shahar, 2009). In this study, we attempted to examine these associations within the context of terror-related stress. In the week following operation Oferet Yetzuka in Israel, ninety-one participants filled out questionnaires concerning sleep experiences, psychopathological distress, and degree of exposure to terror. These participants were part of a larger study conducted three years earlier (Soffer-Dudek & Shahar, 2009). General sleep experiences (GSEs) were positively correlated to exposure to terror through media, a link that was mediated through psychopathological symptoms. Surprisingly, GSEs were negatively correlated with physical exposure variables. We suggest that GSEs may be related to a ruminative coping style (i.e., not "letting go," both by day and by night).
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Affiliation(s)
- Nirit Soffer-Dudek
- Stress & Personality (StreP) Lab, Department of Behavioral Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
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Soffer-Dudek N, Shahar G. What are sleep-related experiences? Associations with transliminality, psychological distress, and life stress. Conscious Cogn 2009; 18:891-904. [DOI: 10.1016/j.concog.2008.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 07/15/2008] [Accepted: 07/21/2008] [Indexed: 11/25/2022]
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