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Kehr T, Haeyen S. Drawing your way out: Imagery rehearsal based art therapy (IR-AT) for post-traumatic nightmares in borderline personality disorder. J Clin Psychol 2024; 80:1015-1030. [PMID: 38193630 DOI: 10.1002/jclp.23638] [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] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024]
Abstract
Posttraumatic nightmares (PTN) are a frequent symptom after a traumatic event and often play part in the psychopathology of patients with borderline personality disorder (BPD). Imagery rehearsal therapy (IRT) currently offers the best evidence for an effective treatment to reduce PTNs, although high drop-out rates are common. Art therapy in IRT may counteract this, by its indirect, nonverbal, and often playful approach that helps to break through avoidance. This case study focusses on the perception of a patient with BPD in an art therapy based IRT treatment for patients with PTNs. It tells the story of Aurelia, a 40-year-old woman who, within this treatment, processes traumatic contents of her childhood like physical and sexual violence, but also current interactional problems that manifest themselves in her nightmares. Following the IR-AT treatment for PTNs Aurelia noticed a reduction in her nightmares, was less afraid of them and felt calmer towards her trauma. She expressed herself in the art medium and by this developed more self-efficacy. Her process resulted in an integration of the trauma and a perceived decrease in borderline symptoms. Future research can build on this basis to further explore the mechanisms and effects of IR-AT for PTNs.
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Affiliation(s)
- Timea Kehr
- LVR, Psychosomatic Medicine and Psychotraumatology, Cologne, Germany
| | - Suzanne Haeyen
- Academy of Health and Vitality, Research Group Arts & Psychomor Therapies in Health Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
- GGNet, Centre for Mental Health, Scelta, Expert Centre for Personality Disorders Apeldoorn, Warnsveld, The Netherlands
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2
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Reffi AN, Moore DA, Drake CL. Objective sleep disturbance in nightmares: is prolonged sleep onset latency a proxy for fear-of-sleep-related arousal? Sleep 2024; 47:zsae040. [PMID: 38353132 PMCID: PMC11009021 DOI: 10.1093/sleep/zsae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Affiliation(s)
- Anthony N Reffi
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - David A Moore
- Division of Acute Care Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI 48202, USA
- Division of Consultation Liaison Psychiatry, Department of Psychiatry and Behavioral Health, Henry Ford Hospital, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
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3
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Paquet C, Lenker KP, Calhoun SL, Bixler EO, Vgontzas AN, Fernandez-Mendoza J. Short-term stability and night-to-night variability of sleep parameters in nightmares comorbid with chronic insomnia Disorder across multiple nights of polysomnography. Sleep 2024; 47:zsae032. [PMID: 38300896 DOI: 10.1093/sleep/zsae032] [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] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/07/2024] [Indexed: 02/03/2024] Open
Abstract
STUDY OBJECTIVES The purpose of this study was to examine the degree of short-term stability of polysomnographic (PSG) measured sleep parameters and the overall differences between individuals with comorbid nightmares and insomnia compared to those with chronic insomnia disorder alone or good sleeping controls across four nights in the sleep lab. METHODS A total of 142 good sleeping controls, 126 chronic insomnia alone, and 24 comorbid insomnia/nightmare participants underwent four consecutive nights of 8-hour PSG recordings. Outcomes included sleep continuity, architecture, and REM-related parameters across nights one through four. Intraclass correlation coefficients with mixed-effect variances and repeated-measure analysis of covariance were used, respectively, to determine short-term stability as well as between-participants and time-by-group interaction effects. RESULTS Wake after sleep onset and stage 1 showed "poor stability" in the comorbid insomnia/nightmare group compared to "moderate stability" in the good sleeping controls and chronic insomnia alone group. Significant between-group effects (all ps < .05) showed that the comorbid insomnia/nightmare group took longer to fall asleep and had a greater first-night-effect in stage 1 compared to good sleeping controls and chronic insomnia alone group; in addition, the comorbid insomnia/nightmare and insomnia alone groups slept shorter, with fewer awakenings and REM periods, compared to the good sleeping controls. CONCLUSIONS Nightmares are associated with abnormal sleep above and beyond REM disruption, as sleep continuity was the primary aspect in which poor stability and group differences emerged. The greater inability to fall asleep and instability of sleep fragmentation in those with comorbid insomnia/nightmares compared to chronic insomnia alone may be attributed to the impact of presleep anticipatory anxiety and nightmare-related distress itself. CLINICAL TRIAL INFORMATION The data analyzed in this study does not come from any current or previous clinical trials. Therefore, there is no clinical trial information to report.
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Affiliation(s)
- Caitlin Paquet
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Edward O Bixler
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Department of Psychiatry and Behavioral Health, Sleep Research and Treatment Center, Penn State College of Medicine, Hershey, PA, USA
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4
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Ogden TH. Ontological Psychoanalysis in Clinical Practice. Psychoanal Q 2024; 93:13-31. [PMID: 38578260 DOI: 10.1080/00332828.2024.2314776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/06/2024]
Abstract
The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient's coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.
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5
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Zerr P, Adelhöfer N, Dresler M. The neuroscience of lucid dreaming: Past, present, future. Neuron 2024; 112:1040-1044. [PMID: 38574727 DOI: 10.1016/j.neuron.2024.03.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
Lucid dreaming allows conscious awareness and control of vivid dream states; however, its rarity and instability make neuroscientific experimentation challenging. Recent advances in wearable neurotechnology, large-scale collaborations, citizen neuroscience, and artificial intelligence increasingly facilitate the decoding of this intriguing phenomenon.
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Affiliation(s)
- Paul Zerr
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nico Adelhöfer
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
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6
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Thomas AM, Antony SP. Marine Antimicrobial Peptides: An Emerging Nightmare to the Life-Threatening Pathogens. Probiotics Antimicrob Proteins 2024; 16:552-578. [PMID: 37022565 DOI: 10.1007/s12602-023-10061-x] [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] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/07/2023]
Abstract
The emergence of multidrug-resistant pathogens due to improper usage of conventional antibiotics has created a global health crisis. Alternatives to antibiotics being an urgent need, the scientific community is forced to search for new antimicrobials. This exploration has led to the discovery of antimicrobial peptides, a group of small peptides occurring in different phyla such as Porifera, Cnidaria, Annelida, Arthropoda, Mollusca, Echinodermata, and Chordata, as a component of their innate immune system. The marine environment, possessing immense diversity of organisms, is undoubtedly one of the richest sources of unique potential antimicrobial peptides. The distinctiveness of marine antimicrobial peptides lies in their broad-spectrum activity, mechanism of action, less cytotoxicity, and high stability, which form the benchmark for developing a potential therapeutic. This review aims to (1) synthesise the available information on the distinctive antimicrobial peptides discovered from marine organisms, particularly over the last decade, and (2) discuss the distinctiveness of marine antimicrobial peptides and their prospects.
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Affiliation(s)
- Anne Maria Thomas
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi, Kerala, 682016, India
| | - Swapna P Antony
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi, Kerala, 682016, India.
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7
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Smith LE, Driggers EA. Science and the 'emancipation of the mind': dreams, the mind, and slavery. J Sleep Res 2024; 33:e13995. [PMID: 37555471 DOI: 10.1111/jsr.13995] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/21/2023] [Indexed: 08/10/2023]
Abstract
Dreams were a subject of interest to philosophers thinking about the connection between the mind and the body in the nineteenth century. Many scholars have pointed out that the mind and the body were intimately linked and affected each other. Although science was on its way to becoming more technical and numbers focused in its investigatory practices, medical students and other physician-philosophers investigated the nature of sleep and dreams. Medical students and advanced researchers speculated on the nature of consciousness and mused on where the mind travels to during the sleep processes. Other romantic figures like Dr Polydori speculated on the nature of sleep walking in their medical dissertations. Dreams also had a powerful moral and motivational component, as dreams and activities in dreams, drove people like Benjamin Rush to embrace abolition. Other promoters of abolition used the nature of dreams to discusses the dreadfulness and suffering of slavery.
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Affiliation(s)
| | - E Allen Driggers
- Department of History, Tennessee Technological University, Cookeville, USA
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8
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Gwyther MPD, Lenggenhager B, Windt JM, Aspell JE, Ciaunica A. Examining the association between depersonalisation traits and the bodily self in waking and dreaming. Sci Rep 2024; 14:6107. [PMID: 38480797 PMCID: PMC10937666 DOI: 10.1038/s41598-024-56119-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
Depersonalisation (DP) is characterized by fundamental alterations to the sense of self that include feelings of detachment and estrangement from one's body. We conducted an online study in healthy participants (n = 514) with DP traits to investigate and quantify the subjective experience of body and self during waking and dreaming, as the vast majority of previous studies focussed on waking experience only. Investigating dreams in people experiencing DP symptoms may help us understand whether the dream state is a 'spared space' where people can temporarily 'retrieve' their sense of self and sense of bodily presence. We found that higher DP traits-i.e. higher scores on the Cambridge Depersonalisation Scale (CDS)-were associated with more frequent dream experiences from an outside observer perspective (r = 0.28) and more frequent dream experiences of distinct bodily sensations (r = 0.23). We also found that people with higher CDS scores had more frequent dream experiences of altered bodily perception (r = 0.24), more frequent nightmares (r = 0.33) and higher dream recall (r = 0.17). CDS scores were negatively correlated with body boundary scores (r = - 0.31) in waking states and there was a negative association between CDS scores and the degree of trust in interoceptive signals (r = - 0.52). Our study elucidates the complex phenomenology of DP in relation to bodily selfhood during waking and dreaming and suggests avenues for potential therapeutic interventions in people with chronic depersonalisation (depersonalisation -derealisation disorder).
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Affiliation(s)
- Matt P D Gwyther
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK.
| | - Bigna Lenggenhager
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Jennifer M Windt
- Department of Philosophy, Monash University, Melbourne, Australia
- Monash Centre for Consciousness and Contemplative Studies, Melbourne, Australia
| | - Jane E Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Anna Ciaunica
- Centre for Philosophy of Science, University of Lisbon, Campo Grande, 1749-016, Lisbon, Portugal
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, UK
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9
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White RT, Armijo CJ, Elmaoued AA. Use of Terazosin to Treat Trauma-Related Nightmares After a Failed Trial of Prazosin. Prim Care Companion CNS Disord 2024; 26:23cr03638. [PMID: 38442072 DOI: 10.4088/pcc.23cr03638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Affiliation(s)
- Raechel T White
- University of South Florida Taneja College of Pharmacy, Tampa, Florida
| | - Caitlin J Armijo
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Amre A Elmaoued
- University of New Mexico College of Pharmacy, Albuquerque, New Mexico
- Corresponding Author: Amre Elmaoued, PharmD, 2600 Marble Avenue, Albuquerque, NM 87106
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10
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Loukola V, Tuominen J, Kirsilä S, Kyyhkynen A, Lahdenperä M, Parkkali L, Ranta E, Malinen E, Vanhanen S, Välimaa K, Olkoniemi H, Revonsuo A, Valli K. Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams. Conscious Cogn 2024; 119:103651. [PMID: 38335898 DOI: 10.1016/j.concog.2024.103651] [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] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/23/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.
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Affiliation(s)
- Ville Loukola
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland.
| | - Jarno Tuominen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Santeri Kirsilä
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Annimaaria Kyyhkynen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Maron Lahdenperä
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Lilja Parkkali
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Emilia Ranta
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Eveliina Malinen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Sanni Vanhanen
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Katariina Välimaa
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Henri Olkoniemi
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Division of Psychology, Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - Antti Revonsuo
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
| | - Katja Valli
- Department of Psychology and Speech-Language Pathology, and the Turku Brain and Mind Center, University of Turku, Turku, Finland; Department of Cognitive Neuroscience and Philosophy, University of Skövde, Skövde, Sweden
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11
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Larmo A. Was It Just a Dream? Aging and Dreaming the Psychoanalytic Process. Psychoanal Rev 2024; 111:37-46. [PMID: 38551661 DOI: 10.1521/prev.2024.111.1.37] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
By revisiting the last years of a long psychoanalytic treatment of a female patient, a psychoanalyst reflects on her own development as a clinician and on the changes in her experience of psychoanalytic generativity. An increasing ability to understand patient's shifts between creativity and destructiveness brings about a different understanding of the process of mourning, while the shared aging of the analytic dyad highlights the difficulty of ending an analysis that has become a way of life.
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Affiliation(s)
- Anneli Larmo
- Uudenmaankatu 11 B 15, 20500 Turku Finland, E-mail:
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12
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Abstract
Trauma-associated sleep disorder (TASD) is a recently described parasomnia that develops following a traumatic event. It consists of trauma-related nightmares, disruptive nocturnal behaviors, and autonomic disturbances, and shares similarities with post-traumatic stress disorder and rapid eye movement behavior disorder. The underlying pathophysiology of TASD and how it relates to other parasomnias are still not entirely understood; proposed treatment is similarly nebulous, with prazosin at the forefront along with management of comorbid sleep disorders. The purpose of this article is to characterize and highlight the clinical features of this condition.
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Affiliation(s)
- Daniel A Barone
- Weill Cornell Center for Sleep Medicine, Weill Cornell Medicine, New York-Presbyterian, 425 East 61st Street, 5th Floor, New York, NY 10065, USA.
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13
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El-Hourani M, Zadra A, Castellanos-Ryan N, Rioux C, Tremblay RE, Parent S, Séguin JR. Longitudinal Study of Early Adversity and Disturbing Dream Frequency: Moderating Role of Early Negative Emotionality. Res Child Adolesc Psychopathol 2024; 52:277-291. [PMID: 37589805 DOI: 10.1007/s10802-023-01109-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/18/2023]
Abstract
Although disturbing dreams are prevalent in youth and are associated with psychopathology, little is known about their developmental course and risk factors. We aimed to examine the association between early social environment and subsequent disturbing dream frequency across adolescence as moderated by early negative emotionality. Measures of children's early social environment and negative emotionality were collected from the mothers of 410 children (5-42 months old) and measures of disturbing dream frequency directly from the children (13-18 years old). Preliminary steps identified subgroups of families with distinct profiles of social environment using latent variable mixture modeling, and captured changes in disturbing dream frequency using latent growth modeling. Regression and moderation analyses were conducted to test the study objectives. Results showed that the diverse family patterns were best captured by two profiles reflecting adverse and positive social environments and that overall disturbing dream frequency decreased during adolescence. Moderation analyses showed that when early negative emotionality was higher, DD frequency was not only more elevated in an adverse environment, but lower in a positive environment. These results indicate that the development of disturbing dreams is most strongly associated with a combination of individual and environment factors. Our study adds to the literature by refining our conception of individual traits and disturbing dream development and has implications for the prevention of bad dreams, nightmares, and associated psychopathologies.
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Affiliation(s)
- Mira El-Hourani
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
| | - Antonio Zadra
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Natalie Castellanos-Ryan
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Charlie Rioux
- Department of Psychology, University of Oklahoma, Norman, Oklahoma, USA
| | - Richard E Tremblay
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Sophie Parent
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada
- School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
| | - Jean R Séguin
- Centre de Recherche du CHU Ste-Justine, Bureau B17.107; 3175 Chemin Côte Ste-Catherine, H3T 1C5, Montréal, Québec, Canada.
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada.
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14
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Naderifar N, Roohi E, Sharifi A, Jaafari N, Hashemian F. Therapeutic Effects of Tamsulosin in Nightmare Disorder: A Randomized, Double Blind, Placebo-Controlled, Cross-Over, Pilot Study. Drug Res (Stuttg) 2024; 74:53-59. [PMID: 38237637 DOI: 10.1055/a-2226-3604] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Nightmare disorder is associated with functional impairment, distress, and low quality of life; however, studies on pharmacotherapy of this debilitating disorder yielded mixed results. Prazosin, a non-selective α1 blocker is reported to be effective in treatment of post-traumatic stress disorder-related nightmares. We aimed at investigating therapeutic effects of tamsulosin which has higher affinity for blocking α1A and α1D adrenoceptors in treatment of nightmare disorder. A randomized, double blind, cross-over, placebo-controlled pilot study was conducted. Patients were randomly assigned to receive Tamsulosin 0.4 mg once daily or placebo for period of four weeks. Following a 2-week wash-out period, they were crossed over to the other group and received drug or placebo for duration of 4 additional weeks. Nightmare frequency and intensity measurements were carried out using Disturbing Dreams and Nightmares Severity Index (DDNSI). Blood pressure measurements were also performed. According to per protocol analysis, mean DDNSI scores decreased following administration of tamsulosin and a statistical trend towards significance was reported (p=0.065, d=0.236). Results of intention to treat analysis showed significant difference in DDNSI scores after drug use (p=0.030, d=0.651). Additionally, DDNSI scores dropped significantly following placebo use. However, intention to treat analysis showed no statistically significant difference pre and post placebo period (0.064, d=0.040). Tamsulosin may be effective in treatment of nightmare disorder. However, further larger clinical trials are recommended to clarify the effectiveness of tamsulosin and α1 subtypes in pharmacotherapy of nightmares.
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Affiliation(s)
- Negin Naderifar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Elnaz Roohi
- Department of Experimental Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, Canada
| | - Ali Sharifi
- Iranian Scientific Society of Clinical Hypnosis, Tehran, Iran
| | - Nemat Jaafari
- Université de Poitiers, Unité de recherche clinique centre Hospitalier Henri Laborit, CeRCA CNRS7295, Poitiers, France
| | - Farshad Hashemian
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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15
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Sultani G, Heinsch M, Wilson J, Pallas P, Tickner C, Kay-Lambkin F. 'Now I Have Dreams in Place of the Nightmares': An Updated Systematic Review of Post-Traumatic Growth Among Refugee Populations. Trauma Violence Abuse 2024; 25:795-812. [PMID: 37097092 PMCID: PMC10666490 DOI: 10.1177/15248380231163641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Trauma exposure places refugees at serious risk of developing mental health difficulties. However, research also recognizes that refugees can respond to trauma with psychological development and growth, commonly referred to as post-traumatic growth (PTG). An updated systematic review was conducted to investigate PTG across different refugee populations, including the processes that mediate this phenomenon, and the use of therapy in promoting PTG. A systematic search of CINAHL Complete, Proquest 5000, PsychINFO, Scopus, and Web of Science was performed to identify studies exploring PTG in refugee populations, published between June 2013 and November 2021. In all, 26 studies met the inclusion criteria for this review. Quantitative results reveal a positive correlation between PTG and religious commitment and coping, and the effectiveness of narrative and community-based interventions in facilitating PTG. Qualitative results facilitate insight into the complex ways refugees find meaning and strength after trauma through religion, comparison-based thinking, helping others, and storytelling. Findings highlight the need for future research and interventions to recognize the distinct PTG experiences of different refugee populations.
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Hein V. Es gab einen Grund für ihre wiederkehrenden Albträume. MMW Fortschr Med 2024; 166:34. [PMID: 38261201 DOI: 10.1007/s15006-023-3522-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Affiliation(s)
- Volkmar Hein
- Facharzt für Allgemeinmedizin, Facharzt für Chirurgie, 59755, Arnsberg, Deutschland
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Abstract
The frequent appearance of newly learned information in dreams suggests that dream content is influenced by memory consolidation. Many studies have tested this hypothesis by asking whether dreaming about a learning task is associated with improved memory, but results have been inconsistent. We conducted a meta-analysis to determine the strength of the association between learning-related dreams and post-sleep memory improvement. We searched the literature for studies that (1) trained participants on a pre-sleep learning task and then tested their memory after sleep, and (2) associated post-sleep memory improvement with the extent to which dreams incorporated learning task content. Sixteen studies qualified for inclusion, which together reported 45 effects. Integrating across effects, we report a strong and statistically significant association between task-related dreaming and memory performance (SMD = 0.51 [95% CI 0.28, 0.74], p < 0.001). Among studies using polysomnography, this relationship was statistically significant for dreams collected from non-rapid eye movement (NREM) sleep (n = 10) but not for dreams collected from rapid eye movement (REM) sleep (n = 12). There was a significant association between dreaming and memory for all types of learning tasks studied. This meta-analysis provides further evidence that dreaming about a learning task is associated with improved memory performance, suggesting that dream content may be an indication of memory consolidation. Furthermore, we report preliminary evidence that the relationship between dreaming and memory may be stronger in NREM sleep compared to REM.
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Affiliation(s)
- Lauren Hudachek
- Furman University Department of Psychology and Program in Neuroscience, Greenville, SC, 29613, USA
| | - Erin J Wamsley
- Furman University Department of Psychology and Program in Neuroscience, Greenville, SC, 29613, USA
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Ataei S, Dresler M, Schoch SF. The prospects of open science practices and large-scale collaborations for dream research. Sleep 2023; 46:zsad139. [PMID: 37170861 PMCID: PMC10710988 DOI: 10.1093/sleep/zsad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Indexed: 05/13/2023] Open
Affiliation(s)
- Somayeh Ataei
- Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sarah F Schoch
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Center of Competence Sleep and Health Zurich, University of Zurich, Zurich, Switzerland
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Pavlova I, Rogowska AM. Exposure to war, war nightmares, insomnia, and war-related posttraumatic stress disorder: A network analysis among university students during the war in Ukraine. J Affect Disord 2023; 342:148-156. [PMID: 37690539 DOI: 10.1016/j.jad.2023.09.003] [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: 02/24/2023] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Little is known about the prevalence and associations between war-related variables among Ukrainians during the Russian invasion. The present study assesses the prevalence and associations between exposure to war (EW), nightmares of war (NW), insomnia, and war-related post-traumatic stress disorder (WPTSD) among university students from Ukraine. METHODS During the war, an online cross-sectional study was performed among university students (N = 1072) from western Ukraine. Newly developed questions evaluated EW and NW, while insomnia was measured using Athens Insomnia Scale (AIS), and for assessing war-related PTSD symptoms, we adopted an abbreviated six-item PTSD checklist (PCL-6). The associations between exposure to war, nightmares of war, and symptoms of insomnia and PTSD were examined using network analysis (NA). RESULTS Among university students, 98 % declared exposure to war, 86 % dreamed nightmares of war, 49 % experienced insomnia symptoms, and 27 % presented symptoms of PTSD. A network analysis found that war-related PTSD has a central and the greatest impact on the frequency of war nightmares and the severity of insomnia symptoms. LIMITATIONS Self-report measurements were applied to a gender-unbalanced sample of university students from the western regions of Ukraine, so it would be inappropriate to generalize to the population directly affected by the war. CONCLUSIONS War-related PTSD symptoms had the most significant impact on the other variables. Therefore, war-related PTSD should be a priority in treatment among university students in Ukraine. However, multidisciplinary integrative intervention programs that treat nightmares, insomnia, and PTSD, can be the most effective.
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Affiliation(s)
- Iuliia Pavlova
- Theory and Methods of Physical Culture Department, Lviv State University of Physical Culture, Lviv, Ukraine
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20
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Inci S, Karakaya D. The Nightmare of Aneurysm Surgery: Intraoperative Rupture. World Neurosurg 2023; 180:70. [PMID: 37741327 DOI: 10.1016/j.wneu.2023.09.039] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
Intraoperative rupture is the most important complication of aneurysm surgery1-5 and occurs in 3 different stages: premature (before dissection), dissection, and clipping.5 We present a video of premature rupture and its management (Video 1). A 45-year-old patient presented with subarachnoid hemorrhage originating from a dorsal internal carotid artery (ICA) aneurysm of the communicating segment. Due to our sufficient experience, we preferred direct clipping in this case. The Sylvian fissure could only be partially opened due to excessive adhesions. During retraction of the frontal lobe, severe bleeding occurred. This was a premature rupture since neither the aneurysm nor the ICA had yet been seen. While aspirating the bleeding just over the rupture site with the left hand, the ICA was explored with the right hand and a temporary clip was placed. The bleeding continued, though it decreased. The aneurysm dome was rapidly explored with 1 hand, and a pilot clip was placed on the dome to stop the bleeding. Immediately afterwards, the aneurysm neck was dissected and clipped parallel to the ICA with a sideward clip. The temporary clip and pilot clip were removed. The temporary occlusion time was 7 minutes and 40 seconds. Postoperative angiogram confirmed complete aneurysm occlusion. The patient discharged with normal neurologic examination. In the literature review including 10,540 cases,1 the mean incidence of IOR is 16.6%. Therefore every neurosurgeon should be prepared for this important complication and know its management well. This case reminds us once again the golden rule of aneurysm surgery: proximal control first.
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Affiliation(s)
- Servet Inci
- Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey.
| | - Dicle Karakaya
- Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey
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Jin ZT, Hodel RGJ, Ma DK, Wang H, Liu GN, Ren C, Ge BJ, Fan Q, Jin SH, Xu C, Wu J, Liu BB. Nightmare or delight: Taxonomic circumscription meets reticulate evolution in the phylogenomic era. Mol Phylogenet Evol 2023; 189:107914. [PMID: 37666378 DOI: 10.1016/j.ympev.2023.107914] [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] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023]
Abstract
Phylogenetic studies in the phylogenomics era have demonstrated that reticulate evolution greatly impedes the accuracy of phylogenetic inference, and consequently can obscure taxonomic treatments. However, the systematics community lacks a broadly applicable strategy for taxonomic delimitation in groups characterized by pervasive reticulate evolution. The red-fruit genus, Stranvaesia, provides an ideal model to examine the influence of reticulation on generic circumscription, particularly where hybridization and allopolyploidy dominate the evolutionary history. In this study, we conducted phylogenomic analyses integrating data from hundreds of single-copy nuclear (SCN) genes and plastomes, and interrogated nuclear paralogs to clarify the inter/intra-generic relationship of Stranvaesia and its allies in the framework of Maleae. Analyses of phylogenomic discord and phylogenetic networks showed that allopolyploidization and introgression promoted the origin and diversification of the Stranvaesia clade, a conclusion further bolstered by cytonuclear and gene tree discordance. With a well-inferred phylogenetic backbone, we propose an updated generic delimitation of Stranvaesia and introduce a new genus, Weniomeles. This new genus is distinguished by its purple-black fruits, thorns trunk and/or branches, and a distinctive fruit core anatomy characterized by multilocular separated by a layer of sclereids and a cluster of sclereids at the top of the locules. Through this study, we highlight a broadly-applicable workflow that underscores the significance of reticulate evolution analyses in shaping taxonomic revisions from phylogenomic data.
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Affiliation(s)
- Ze-Tao Jin
- College of Horticulture, State Key Laboratory of Crop Genetics & Germplasm Enhancement and Utilization, Nanjing Agricultural University, Nanjing, Jiangsu 210095, China; State Key Laboratory of Plant Diversity and Specialty Crops / State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China; China National Botanical Garden, Beijing 100093, China
| | - Richard G J Hodel
- Department of Botany, National Museum of Natural History, Smithsonian Institution, Washington, DC 20013-7012, USA
| | - Dai-Kun Ma
- State Key Laboratory of Plant Diversity and Specialty Crops / State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China; China National Botanical Garden, Beijing 100093, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hui Wang
- State Key Laboratory of Plant Diversity and Specialty Crops / State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China; China National Botanical Garden, Beijing 100093, China; College of Forestry and Biotechnology, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang 311300, China
| | | | - Chen Ren
- Key Laboratory of Plant Resources Conservation and Sustainable Utilization & Guangdong Provincial Key Laboratory of Applied Botany, South China Botanical Garden, Chinese Academy of Sciences, Guangzhou, Guangdong 510650, China
| | - Bin-Jie Ge
- Eastern China Conservation Center for Wild Endangered Plant Resources, Shanghai Chenshan Botanical Garden, Shanghai 201602, China
| | - Qiang Fan
- State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510275, China
| | - Shui-Hu Jin
- College of Forestry and Biotechnology, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang 311300, China
| | - Chao Xu
- State Key Laboratory of Plant Diversity and Specialty Crops / State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China; China National Botanical Garden, Beijing 100093, China
| | - Jun Wu
- College of Horticulture, State Key Laboratory of Crop Genetics & Germplasm Enhancement and Utilization, Nanjing Agricultural University, Nanjing, Jiangsu 210095, China
| | - Bin-Bin Liu
- State Key Laboratory of Plant Diversity and Specialty Crops / State Key Laboratory of Systematic and Evolutionary Botany, Institute of Botany, Chinese Academy of Sciences, Beijing 100093, China; China National Botanical Garden, Beijing 100093, China.
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Eichinger J, Zimmermann B, Elger B, McLennan S, Filges I, Koné I. 'It's a nightmare': informed consent in paediatric genome-wide sequencing. A qualitative expert interview study from Germany and Switzerland. Eur J Hum Genet 2023; 31:1398-1406. [PMID: 37773517 PMCID: PMC10689462 DOI: 10.1038/s41431-023-01468-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Abstract
The use of genome-wide sequencing (GWS) in paediatrics has added complexity to informed consent (IC) and pretest counselling because of the vast number and interpretation of potential findings, and their implications. However, empirical data from continental Europe on these issues remains limited. This study therefore aimed to explore the experiences and views of medical geneticists working with children in Germany and Switzerland regarding the challenges of obtaining valid IC in paediatric GWS. Qualitative interviews with 20 medical geneticists were analysed employing reflexive thematic analysis. In the interviews, many medical geneticists questioned the validity of parents' IC due to the enormous amount of relevant information given and the variety and complexity of the possible test outcomes. Key barriers identified included familial implications, administrative challenges and struggles with non-directiveness. Medical geneticists' suggestions for improvement included increasing the number of genetics professionals and better information material, which is crucial as GWS becomes a diagnostic standard in the early care pathways of children. An adjustment of aspirations from still existing ideal of traditional fully IC to appropriate IC seems to be needed. Such a more realistic and ethically sound adaptation of the requirements for IC can lead to better 'informedness' and improve the validity of the consent. This might also help reduce the moral distress for the medical geneticists involved.
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Affiliation(s)
- Johanna Eichinger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
| | - Bettina Zimmermann
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Institute of Philosophy & Multidisciplinary Center for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Bernice Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Center for Legal Medicine (CURML), University of Geneva, Geneva, Switzerland
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Isabel Filges
- Medical Genetics, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Insa Koné
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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23
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Tran L, Brodeur M. Midodrine-Induced Nightmares in the Treatment of Orthostatic Hypotension: A Case Report. Sr Care Pharm 2023; 38:501-505. [PMID: 38041226 DOI: 10.4140/tcp.n.2023.501] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Background Midodrine was the first medication approved by the Food and Drug Administration (FDA) for the treatment of orthostatic hypotension. Pharmacologically, midodrine is a peripheral selective alpha-1-adrenergic agonist that can improve standing, sitting, and supine systolic blood pressure. Common side effects include bradycardia, supine hypertension, and paresthesia. A novel side effect of midodrine-induced nightmares has been reported in our patient. To our knowledge, this is the first reported case of midodrine-induced nightmares. Objective To investigate and report a clinically significant and unique drug adverse event of midodrine in the treatment of orthostatic hypotension. Case Presentation This report describes a case of persistent nightmares associated with midodrine use in an 83-year-old male who experienced frequent syncope episodes treated with midodrine for orthostatic hypotension (OH). After the initiation of midodrine, the patient complained of increased nightmares, which quickly led to his refusal of the medication, despite the initial improvements in his blood pressure. The timing of administration included an evening dose at 21:00. This novel adverse event of midodrine-induced nightmares will be highlighted and explored in this case report. Conclusion This case demonstrated a unique adverse event of nightmares caused by midodrine. It is hypothesized that autonomic dysfunction plays a role and further investigations should be conducted to confirm this theory. We hope that our case report highlights the importance of careful consideration when prescribing midodrine in older people with orthostatic hypotension.
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Affiliation(s)
- Lara Tran
- Albany College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Albany, New York
| | - Michael Brodeur
- Albany College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Albany, New York
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24
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Clarke AJ. Commentary on Eichinger J, Zimmermann B, Elger B, McLennan S, Filges I, Koné I. 2023. 'It's a nightmare': informed consent in paediatric genome-wide sequencing. A qualitative expert interview study from Germany and Switzerland. Eur J Hum Genet 2023; 31:1348-1349. [PMID: 37950048 PMCID: PMC10689423 DOI: 10.1038/s41431-023-01490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
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Gallo FT, Spiousas I, Herrero NL, Godoy D, Tommasel A, Gasca-Rolin M, Ramele R, Gleiser PM, Forcato C. Structural differences between non-lucid dreams, lucid dreams and out-of-body experience reports assessed by graph analysis. Sci Rep 2023; 13:19579. [PMID: 37949978 PMCID: PMC10638299 DOI: 10.1038/s41598-023-46817-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
Dreaming is a complex phenomenon that occurs during sleep, involving various conscious dream experiences. Lucid dreams (LDs) involve heightened awareness within the dream environment, while out-of-body experiences (OBEs) involve the sensation of being outside one's physical body. OBEs occur during sleep paralysis (SP), where voluntary movements are inhibited during sleep/wake transitions while remaining aware of the surroundings. The relationship between LDs and OBEs is debated, with some viewing them as distinct phenomena and others considering them different manifestations of the same underlying experience. This study aimed to characterize non-lucid dreams, LDs, and OBEs by analyzing dream reports' structural properties. OBE reports displayed a condensed and interconnected network structure compared to non-lucid dreams and LDs. Additionally, OBE reports exhibited a specialized network structure, with specific nodes playing a more central role. These findings suggest that OBE dreams may have a more coherent and unified narrative, with certain nodes being pivotal in the network structure.
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Affiliation(s)
- Francisco T Gallo
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico de Buenos Aires (ITBA), Iguazú 341, (1437) Capital Federal, Buenos Aires, Argentina.
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425) Capital Federal, Buenos Aires, Argentina.
| | - Ignacio Spiousas
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425) Capital Federal, Buenos Aires, Argentina
- Sensorimotor Dynamics Lab (LDSM), Universidad Nacional de Quilmes, Bernal, Argentina
- Laboratorio Interdisciplinario del Tiempo y la Experiencia (LITERA), Universidad de San Andrés, Victoria, Argentina
| | - Nerea L Herrero
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico de Buenos Aires (ITBA), Iguazú 341, (1437) Capital Federal, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425) Capital Federal, Buenos Aires, Argentina
| | - Daniela Godoy
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425) Capital Federal, Buenos Aires, Argentina
- Instituto Superior de Ingeniería de Software Tandil (CONICET/UNCPBA), Tandil, Bs. As., Argentina
| | - Antonela Tommasel
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425) Capital Federal, Buenos Aires, Argentina
- Instituto Superior de Ingeniería de Software Tandil (CONICET/UNCPBA), Tandil, Bs. As., Argentina
| | - Miguel Gasca-Rolin
- Asociación Internacional de Onironautas, Carmelo Betore Bergua 2 Casa 6 9C, 50014, Zaragoza, Spain
| | - Rodrigo Ramele
- Centro de Inteligencia Computacional, Instituto Tecnológico de Buenos Aires (ITBA), Iguazú 341, (1437) Capital Federal, Buenos Aires, Argentina
| | - Pablo M Gleiser
- Laboratorio de Neurociencia de Sistemas Complejos, Departamento de Ciencias de la Vida, Instituto Tecnológico de Buenos Aires (ITBA), Iguazú 341, (1437) Capital Federal, Buenos Aires, Argentina
| | - Cecilia Forcato
- Laboratorio de Sueño y Memoria, Departamento de Ciencias de la Vida, Instituto Tecnológico de Buenos Aires (ITBA), Iguazú 341, (1437) Capital Federal, Buenos Aires, Argentina
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Krakow B. Sleep breathing at the intersection of nightmares and cardiovascular risk. Sleep 2023; 46:zsad171. [PMID: 37436923 DOI: 10.1093/sleep/zsad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Affiliation(s)
- Barry Krakow
- Sleep and Human Health Institute, Sleep Research, Savannah, GA, USA
- Gateway Behavioral Health, Psychiatry Residency Training Program, Savannah, GA, USA
- Mercer University School of Medicine, Psychiatry and Behavioral Health, Savannah, GA, USA
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27
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Ulmer CS, Taylor KA, Campbell AA, Sherwood A, Wu JQ, Beckham JC, Hoerle JM, Augustine AV. Response to letter to the editor: sleep breathing at the intersection of nightmares and cardiovascular risk. Sleep 2023; 46:zsad221. [PMID: 37748436 DOI: 10.1093/sleep/zsad221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Affiliation(s)
- Christi S Ulmer
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kenneth A Taylor
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC, USA
| | | | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jade Q Wu
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Veterans Affairs VA Mid-Atlantic MIRECC Workgroup, Durham, NC, USA
| | - Jeffrey M Hoerle
- Veterans Affairs VA Mid-Atlantic MIRECC Workgroup, Durham, NC, USA
| | - Ann V Augustine
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs (VA) Healthcare System, Durham, NC, USA
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28
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Rosamaria L, Michela F, Emma B, Ana M, Bruno P, Philippe D, Bérangère D, Raffaele F, Monica P, Franck D, Maria Livia F. Strained face during sleep in multiple system atrophy: not just a bad dream. Sleep 2023; 46:zsad180. [PMID: 37463431 DOI: 10.1093/sleep/zsad180] [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] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/08/2023] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Patients with Parkinson's disease and multiple system atrophy may be subject to sleep state dissociation. Motivated by the fortuitous observation of prominent facial muscle activity during video-polysomnography in patients with multiple system atrophy, we assessed facial motor activity and chin muscle tone during sleep in multiple system atrophy compared to Parkinson's disease and controls. METHODS A sleep expert blinded to pathology and sleep stage retrospectively analyzed facial activity in 62 video-polysomnography (11 multiple system atrophy, 38 Parkinson's disease, and 13 controls). Facial movements were classified into six categories: "Eyes closing/opening," "Eyebrows frowning," "Raising eyebrows," "Smiling," "Other mouth movements," and "Strained face," an expression involving both the superior and inferior parts of the face. Chin electromyography activity was quantified during Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep using the atonia index, a validated algorithm. RESULTS Multiple system atrophy patients had an increased number of all facial movements compared to controls during NREM. "Strained face" was significantly more frequent in multiple system atrophy compared to Parkinson's disease, even after adjusting for the presence of REM sleep behavior disorder (RBD). Atonia index was lower in multiple system atrophy compared to controls and Parkinson's disease during REM and NREM sleep. This difference remained significant compared to Parkinson's disease in NREM sleep during N1 and N2 after adjusting for the presence of RBD. CONCLUSIONS Facial movements during sleep are frequent in multiple system atrophy, "strained face" appears to be a hallmark of this condition. The presence of increased facial activity and elevated muscle tone during all stages of sleep in multiple system atrophy may be a manifestation of sleep state dissociation, reflecting more severe neurodegeneration.
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Affiliation(s)
- Lecca Rosamaria
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Figorilli Michela
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Bouniol Emma
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Marques Ana
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Pereira Bruno
- Biostatistics Unit, Department of Clinical Research and Innovation Direction (DRCI), CHU Clermont-Ferrand, France
| | - Derost Philippe
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Debilly Bérangère
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Ferri Raffaele
- Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute - IRCCS, Troina, Italy
| | - Puligheddu Monica
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Durif Franck
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Fantini Maria Livia
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
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29
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Schuffelen J, Maurer LF, Lorenz N, Rötger A, Pietrowsky R, Gieselmann A. The clinical effects of digital cognitive behavioral therapy for insomnia in a heterogenous study sample: results from a randomized controlled trial. Sleep 2023; 46:zsad184. [PMID: 37428712 PMCID: PMC10636251 DOI: 10.1093/sleep/zsad184] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/20/2023] [Indexed: 07/12/2023] Open
Abstract
STUDY OBJECTIVES Numerous studies worldwide have reported the beneficial effects of digital cognitive behavioral therapy for insomnia (dCBT-I). However, few focus on real-world study samples that reflect people in regular care. To test whether dCBT-I is suitable within German regular care, we designed a randomized controlled trial recruiting a heterogenous insomnia population. METHODS Participants aged ≥18 who met the criteria for insomnia disorder were randomized to 8-weeks dCBT-I + care-as-usual (CAU) or they were set on a waitlist + CAU. The intervention group was followed-up at 6- and 12-months. The primary outcome was self-reported insomnia severity, assessed with the Insomnia Severity Index (ISI) at 8-weeks post-randomization. A one-way ANCOVA with baseline score as a covariate was fitted to determine group differences. Secondary outcomes included measures of daytime functioning, quality of life, depression, anxiety, dreams, and nightmares. RESULTS Of the N = 238 participants (67.6% female), age range 19-81 years, n = 118 were randomized to dCBT-I and n = 120 to the control group. At posttreatment, the use of dCBT-I was associated with a large reduction in the ISI (Diffadj = -7.60) in comparison to WLC (d = -2.08). This clinical improvement was also reflected in responder and remission rates. Treatment effects were also observed for daytime functioning, quality of life, symptoms of depression and anxiety (ds = 0.26-1.02) and at long-term follow-up (intervention group only; ds = 0.18-1.65). No effects were found for dream and nightmare frequency. CONCLUSIONS This study showed that dCBT-I reduces insomnia symptoms and improves daytime functioning in a heterogenous insomnia population in Germany with sustained long-term treatment effects in the intervention group. Our results underscore the potential of digital health applications, their suitability within regular care, and their role in facilitating widespread implementation of CBT-I as a first-line treatment for insomnia.
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Affiliation(s)
- Jennifer Schuffelen
- Heinrich Heine University Düsseldorf, Institute of Experimental Psychology, Department of Clinical Psychology, GermanyGermany
| | | | - Noah Lorenz
- mementor DE GmbH, Department of Science, Germany
| | | | - Reinhard Pietrowsky
- Heinrich Heine University Düsseldorf, Institute of Experimental Psychology, Department of Clinical Psychology, GermanyGermany
| | - Annika Gieselmann
- Heinrich Heine University Düsseldorf, Institute of Experimental Psychology, Department of Clinical Psychology, GermanyGermany
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30
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Agrawal M, Chandra PS. Major Vessel Injury During Surgery - A Neurosurgeon's Nightmare. Neurol India 2023; 71:1130-1131. [PMID: 38174445 DOI: 10.4103/0028-3886.391336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Mohit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, India
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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31
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Riepl M. Compounded "Monster Spray" for Nighttime Terrors: A Case Report. Int J Pharm Compd 2023; 27:446-448. [PMID: 38100660] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Among the challenges most difficult to treat in the spectrum of pediatric anxieties are severe, persistent nighttime terrors (e.g., anticipating or "perceiving" the presence of monsters or other creatures under the bed or in the closet, nightmares) that disrupt a child's sleep, impact his or her overall adjustment, negatively affect the quality of family life, and may eventually require clinical assessment and intervention. This article describes a compounded preparation that has proven successful in combatting such fears and enabling the recovery of children so afflicted.
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Affiliation(s)
- Mike Riepl
- Retired Compounding Pharmacist, Bismarck, North Dakota.
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32
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Batin S, Ekinci Y, Gürbüz K. The Nightmare of Calcaneus: Gustilo-Anderson Type IIIB Fractures. J Am Podiatr Med Assoc 2023; 113:21-179. [PMID: 38175701 DOI: 10.7547/21-179] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND The aim of this study was to share the clinical results of open calcaneus fractures, which are extremely rare and have become the fearful nightmare of orthopedic surgeons. METHODS Between June of 2014 and June of 2020, of 196 patients with the diagnosis of calcaneus fracture, Gustilo-Anderson type IIIB, 17 patients (11 men and six women; mean age, 36.2 ± 4.6 years; range, 22-56 years) under prospective follow-up were retrospectively screened and included in the study. Patients were recorded in terms of classification of fracture, mechanism of injury, comorbidities, surgical progress, complications, and associated orthopedic and nonorthopedic injuries. Functional clinical results and quality of life of the patients were evaluated at the 6-month follow-up with the American Orthopedic Foot and Ankle Society score and the 36-Item Short Form Health Survey questionnaire. RESULTS The most common etiologic factor was work-related injuries, with 29.4%. Although triple arthrodesis surgery was performed in three cases because of pseudoarthrosis, amputation was performed in one case because of deep infection. The most common soft-tissue defect was located at the medial aspect of the foot, which was commonly reconstructed with the used of reverse flow island sural flap. The average total American Orthopedic Foot and Ankle Society hindfoot score was 51.6 (range, 48-74) and similarly, physical component, pain, and social parameters on the 36-Item Short Form Health Survey were statistically significant compared to Turkish population normal scores. CONCLUSIONS A long and laborious process is required for both the patient and the surgeon in the treatment of open calcaneal fractures. However, it is possible to obtain good results with soft-tissue reconstructions.
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Affiliation(s)
- Sabri Batin
- *Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Yakup Ekinci
- *Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Kaan Gürbüz
- *Kayseri City Education and Research Hospital, Kayseri, Turkey
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33
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Konkoly KR, Picard-Deland C, Morris D, Mallett R. Dreaming outside the Box: Evidence for Memory Abstraction in REM Sleep. J Neurosci 2023; 43:6952-6953. [PMID: 37852785 PMCID: PMC10586531 DOI: 10.1523/jneurosci.1374-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/05/2023] [Accepted: 08/13/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Karen R Konkoly
- Department of Psychology, Northwestern University, Evanston, Illinois 60208
| | - Claudia Picard-Deland
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, H4J 1C5, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Quebec, H3T 1J4, Canada
| | - Daniel Morris
- Department of Psychology, Northwestern University, Evanston, Illinois 60208
| | - Remington Mallett
- Department of Psychology, Northwestern University, Evanston, Illinois 60208
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34
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Sebastiani L, Barcaro U, Paradisi P, Frumento P, Faraguna U. Morning naps architecture and mentation recall complexity. J Sleep Res 2023; 32:e13915. [PMID: 37139546 DOI: 10.1111/jsr.13915] [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] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
Mentation reports were collected after spontaneous awakenings from morning naps in 18 healthy participants, and associations between sleep stages duration and complexity of recalled mentation were investigated. Participants were continuously recorded with polysomnography and allowed to sleep for a maximum of 2 hr. Mentation reports were classified according to both their complexity (1-6 scale) and their perceived timing of occurrence (Recent or Previous Mentation with respect to the final awakening). The results showed a good level of mentation recall, including different types of mentation with lab-related stimuli. N1 + N2 duration was positively related to the complexity of Previous Mentation recall, while rapid eye movement sleep duration was negatively related. This suggests that the recall of complex mentation, such as dreaming with a plot, occurring far from awakening may depend on the length of N1 + N2. However, the duration of sleep stages did not predict the complexity of Recent Mentation recall. Nevertheless, 80% of participants who recalled Recent Mentation had a rapid eye movement sleep episode. Half of the participants reported incorporating lab-related stimuli in their mentation, which positively correlated with both N1 + N2 and rapid eye movement duration. In conclusion, nap sleep architecture is informative about the complexity of dreams perceived as having occurred early during the sleep episode, but not about those perceived as recent.
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Affiliation(s)
- Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI-CNR), Pisa, Italy
| | - Umberto Barcaro
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI-CNR), Pisa, Italy
| | - Paolo Paradisi
- Institute of Information Science and Technologies "Alessandro Faedo" (ISTI-CNR), Pisa, Italy
- BCAM-Basque Center for Applied Mathematics, Bilbao, Spain
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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35
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Zhuang YY, Wang LL, Song TH, Dietch JR, Wang TT, Qi M, Liu JM, Zhou SJ, Chen JX. Reliability and validity of the Chinese version of the Nightmare disorder index in adolescents. Stress Health 2023; 39:894-901. [PMID: 36719632 PMCID: PMC10387496 DOI: 10.1002/smi.3228] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/05/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
The Nightmare Disorder Index Questionnaire (NDI) was developed to measure the impact of nightmares. The purpose of this study was to investigate the psychometric properties of NDI among Chinese adolescents. This study investigated the validity and internal consistency of the Nightmare Disorder Index Chinese (NDI-CV) among 6014 Chinese adolescents who completed the NDI-CV, Nightmare Distress Questionnaire-Chinese Version (NDQ-CV), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Chinese Adolescent Daytime Sleepiness Scale (CADSS), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). In addition, we investigated the test-retest reliability of the NDI-CV among 423 adolescents who completed a retest of the NDI-CV after a 2-week interval. Finally, NDI-CV demonstrated good psychometric properties in a sample of Chinese adolescents (Cronbach's α coefficient of 0.876), and the 95% confidence interval for the 2-week retest correlation coefficient was 0.675-0.977 (p < 0.001).
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Affiliation(s)
- Yun-Yue Zhuang
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Tian-He Song
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Jessica R. Dietch
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | | | - Meng Qi
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Jin-Meng Liu
- 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
| | - Jing-Xu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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36
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Miller KE, So CJ, Brownlow JA, Woodward SH, Gehrman PR. Neighborhood disadvantage is associated with sleep disturbance in a sample of trauma-exposed Veterans. Sleep Health 2023; 9:634-637. [PMID: 37532605 DOI: 10.1016/j.sleh.2023.06.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES This study examined associations among neighborhood disadvantage, all-night respiratory sinus arrhythmia, fear of sleep, nightmare frequency, and sleep duration in a sample of trauma-exposed Veterans. METHODS Participants completed baseline assessments and slept on a mattress actigraphy system for seven nights. Neighborhood disadvantage was assessed with the Area Deprivation Index, a census-based socioeconomic index. Differences between the least and most disadvantaged groups on the sleep variables were analyzed. RESULTS Data were available from 37 Veterans. Residing in neighborhoods with greater disadvantage was associated with elevated fear of sleep and reduced sleep-period respiratory sinus arrhythmia. No significant differences were observed for nightmare frequency or sleep duration. A regression confirmed that neighborhood context had a significant effect on respiratory sinus arrhythmia, after controlling for other baseline sleep variables. CONCLUSIONS In this sample of Veterans, sleep context may increase hypervigilance in turn serving as a mechanism by which trauma-induced sleep disruptions are maintained.
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Affiliation(s)
- Katherine E Miller
- Mental Illness Research, Education, and Clinical Center, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.
| | - Christine J So
- Mental Illness Research, Education, and Clinical Center, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Janeese A Brownlow
- Department of Psychology, Delaware State University, Dover, Delaware, USA
| | - Steven H Woodward
- National Center for PTSD D&T Division, VA Palo Alto Healthcare System, Palo Alto, California, USA
| | - Philip R Gehrman
- Mental Illness Research, Education, and Clinical Center, Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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37
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Abstract
Nightmares can be a distressing symptom in patients living with serious illness. Prazosin, a selective alpha-1 adrenergic antagonist, has been suggested to treat nightmares, with most data supporting its use in post-traumatic stress disorder (PTSD). We present the case of a 60-year-old woman with metastatic breast cancer who experienced healthcare-associated nightmares following hospitalisation. She did not meet diagnostic criteria for PTSD. Atypical antipsychotics and benzodiazepines were ineffective in controlling her nightmares, resulting in referral to our outpatient palliative medicine clinic. Prazosin was initiated alongside interdisciplinary psychosocial support, resulting in rapid resolution of her nightmares. To our knowledge, this is the first case to report on use of prazosin to manage nightmares in the outpatient palliative medicine setting.
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Affiliation(s)
- Wil Santivasi
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Erin Taylor
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - April Christensen
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jacob Strand
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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38
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Abstract
Effective emergency nurse-patient (EN) communication and ENs' communication with other healthcare workers have implications for patient outcomes. Effective EN-patient communication informs and empowers patients. This study sought to better understand ENs frontstage and backstage interactions in a metropolitan emergency department (ED). The researcher engaged in participant observation of 15 different ENs' healthcare interactions with patients and other healthcare workers in the ED for a total of 47 hours and 30 minutes. Iterative analysis of field notes builds reveal two key observations. First, frontstage and backstage spaces are fluid in nature, where healthcare workers simultaneously engage in backstage and frontstage communication regardless of physical space or audience. Second, frontstage communication processes can be categorized into three groups: information seeking and sharing, informally attending to patients and rapport building, and acting out of character. Further, a novel type of front stage interaction, "acting out of character" is conceptualized as when ENs act in ways that are inconsistent with their typical role when communicating with a patient. Implications for health communication practice and theorizing are discussed.
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Affiliation(s)
- Sydney O'Shay
- Department of Communication Studies & Philosophy, Utah State University
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39
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Kültür Y, Nuri Tütüncü M, Ulutaş S. Using e-scooters: An easy way to get home or a nightmare? An orthopedic perspective on e-scooter accidents. ULUS TRAVMA ACIL CER 2023; 29:1158-1166. [PMID: 37791439 PMCID: PMC10644078 DOI: 10.14744/tjtes.2023.35848] [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] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/02/2023] [Accepted: 08/02/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The percentage of e-scooter use quickly escalated in our community due to its convenience, low cost, and eases of use. The number of accidents causing high-energy traumas has also increased. This study aims to describe the demographic char-acteristics and fracture patterns of patients admitted to the emergency department following an e-scooter accident and to identify common, correctable factors that increased the likelihood of accidents. METHODS Between January 2022 and August 2022, 43 patients (20 females and 23 males) who were admitted to the emergency department after an e-scooter accident and developed extremity fractures were included. The patients were divided into 2 groups those treated surgically and conservatively. Parameters such as the time of the accident, education level of the user, alcohol use, e-scooter malfunction, and compliance with traffic rules were evaluated. RESULTS Accidents that led to treatment by surgery mostly occurred between 11 pm and 7 am. Surgically treated patients were mostly high school graduates. Alcohol use and recreational scooter use rates were statistically higher in the operated patients when compared to patients who were treated conservatively. The number of patients who reported a malfunction in the e-scooter was significantly lower in the operated group than in the conservative group. The rates of accidents due to non-compliance with traffic laws, driving at full speed of the e-scooter, use on the driveway, and presence of wet ground at the time of the accident were higher in the surgically treated patient group. Surgically treated patients also had a higher rate of being 1st time e-scooter users. CONCLUSION Although governments have introduced many regulations regarding e-scooter use, the current situation seems insufficient in solving the problem. E-scooter users should be further educated about the associated risks. Authorities should tighten their supervision of scooter rental companies and drivers. Nighttime usage conditions should be reviewed, and the use of alcohol should be controlled. The use of helmets should be mandatory. If such regulations are tightened, accident rates can be reduced or high-energy impacts from existing accidents can be avoided. The results suggest that experienced, slow, non-alcoholic, and rule-abiding drivers require less operative treatment. This article will hopefully raise awareness and improve e-scooter regulations.
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Affiliation(s)
- Yiğit Kültür
- Department of Orthopedics and Traumatology, Yeni Yuzyil University, Gaziosmanpasa Hospital, İstanbul-Türkiye
| | - Mehmed Nuri Tütüncü
- Department of Orthopedics and Traumatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul-Türkiye
| | - Suat Ulutaş
- Department of Orthopedics and Traumatology, Taksim Training and Research Hospital, İstanbul-Türkiye
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40
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Biondi A, Lo Rito M. Commentary: Redo of aortic root surgery: Tackling the nightmare successfully. J Thorac Cardiovasc Surg 2023; 166:726-727. [PMID: 34749940 DOI: 10.1016/j.jtcvs.2021.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Andrea Biondi
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Mauro Lo Rito
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy.
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Spangler PT, Sim W. Working with dreams and nightmares: A review of the research evidence. Psychotherapy (Chic) 2023; 60:383-395. [PMID: 37104805 DOI: 10.1037/pst0000484] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
In this article, we describe methods for working with dreams and nightmares in individual psychotherapy, provide clinical examples, and review research evidence of immediate and distal outcomes of each method. An original meta-analysis of eight studies using the cognitive-experiential dream model with 514 clients showed moderate effect sizes for session depth and insight gains. In the nightmare treatment literature, a previous meta-analysis of 13 studies with 511 clients showed moderate to large effects in reducing nightmare frequency and small to moderate effects in decreasing sleep disturbance for imagery rehearsal therapy and exposure, relaxation, and rescripting therapy. Limitations of the current meta-analysis of cognitive-experiential dreamwork and of the reviewed research on nightmare methods are described. Training implications and therapeutic practice recommendations are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Wonjin Sim
- Department of Psychology, Towson University
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42
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Hill CE, Norcross JC. Skills and methods that work in psychotherapy: Observations and conclusions from the special issue. Psychotherapy (Chic) 2023; 60:407-416. [PMID: 37036683 DOI: 10.1037/pst0000487] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
We draw recommendations and conclusions from the articles presented in this special issue and the companion special section in Psychotherapy Research on evidence-based therapist skills and methods. For distal (end-of-treatment) outcome, 10 skills/methods were judged to be demonstrably effective (affirmation/validation, paradoxical interventions, homework, routine outcome monitoring, strength-based methods, emotional regulation, imagery rehearsal therapy and exposure relaxation and rescripting therapy for nightmares, meditation/mindfulness/acceptance, behavioral activation, cognitive restructuring) and four were probably effective (rupture repair, role induction, collaborative assessment methods, chairwork). For intermediate (postsession or midtreatment) outcome, one method was judged to be demonstrably effective (cognitive-experiential dreamwork) and two methods probably effective (paradoxical interventions, homework). For immediate (in-session) outcomes, five skills/methods were judged to be probably effective (in-dialog silences, extended silences, role induction, strength-based methods, and emotion regulation). For the rest of the immediate, intermediate, or distal outcomes for skills/methods, there was either no or insufficient research available upon which to base judgments. Possible harmful effects, diversity considerations, and research limitations are summarized. The article ends with training implications, therapeutic practices, and the formal conclusions of the interorganizational Task Force on Psychotherapy Skills and Methods that Work. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Clara E Hill
- Department of Psychology, University of Maryland
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43
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Saguin E, Hulot LJ, Roseau JB, Metlaine A, Paul F, Nicolas F, Sipahimalani LG, Leger D, Gomez-Merino D, Chennaoui M. Translation, Cross-Cultural Adaptation and Preliminary Validation of a French Version of the Trauma-Related Nightmare Survey (TRNS-FR) in a PTSD Veteran Population. Mil Med 2023; 188:3182-3190. [PMID: 35472134 PMCID: PMC10464873 DOI: 10.1093/milmed/usac107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In the military population, trauma-related nightmares (TRNs) are highly associated with deployments and combat-related events. Trauma-related nightmares are also correlated with severity, treatment resistance, and chronicity of Post-Traumatic Stress Disorder (PTSD). However, to date, no specific measure of TRNs has been validated for use in the French language. This study aimed to translate and culturally adapt the English version of the Trauma-Related Nightmare Survey into French and to evaluate the psychometric properties of the translation on veterans. MATERIALS AND METHODS After the translation and cultural adaptation process, we evaluated the reliability and validity of the French version of the questionnaire (TRNS-FR) in a population of veterans suffering from PTSD with nightmare complaints (n = 56 patients for test-retest and n = 60 for internal consistency), recruited from five French military hospitals. RESULTS Analyses demonstrated that TRNS-FR has good test-retest reliability (r = 0.59) and good internal consistency with PTSD symptoms, insomnia symptoms, and subjective sleep parameters assessed at home. This questionnaire provides a rapid and comprehensive assessment of sleep disturbance and a specific description of TRNs in the population of veterans with severe PTSD. Our results allowed us to propose a valid and reliable French adaptation of the questionnaire. CONCLUSION Because sleep disturbances and TRNs require specific therapeutic management, the psychometric qualities of TRNS-FR make it a tool of choice for assessing TRNs in future clinical research settings.
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Affiliation(s)
- Emeric Saguin
- Psychiatric Department, Begin Military Teaching Hospital, Saint-Mandé 94160, France
- VIFASOM (Vigilance Fatigue Sommeil et Santé Publique) EA 7330, Université de Paris, Paris 75005, France
| | | | - Jean-Baptiste Roseau
- Pneumology and Sleep Medicine Department, Clermont-Tonnerre Military Teaching Hospital, Brest 29240, France
| | - Arnaud Metlaine
- Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP, Paris 75004, France
| | - Frédéric Paul
- Psychiatric Department, Laveran Military Teaching Hospital, Marseille 13384, France
| | - Florian Nicolas
- Psychiatric Department, Sainte-Anne Military Teaching Hospital, Toulon 83800, France
| | | | - Damien Leger
- VIFASOM (Vigilance Fatigue Sommeil et Santé Publique) EA 7330, Université de Paris, Paris 75005, France
- Centre du Sommeil et de la Vigilance, Hôtel-Dieu, APHP, Paris 75004, France
| | - Danielle Gomez-Merino
- VIFASOM (Vigilance Fatigue Sommeil et Santé Publique) EA 7330, Université de Paris, Paris 75005, France
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge 91220, France
| | - Mounir Chennaoui
- VIFASOM (Vigilance Fatigue Sommeil et Santé Publique) EA 7330, Université de Paris, Paris 75005, France
- French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge 91220, France
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44
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Huber P, Huc M, Jeansoulin L, Osnim Kota-Mamah A, Melro Costa M, Guenat LJ, Carnesecchi S, Vacher G. Sommeil éclairé : un cauchemar pour le cœur et le métabolisme. Rev Med Suisse 2023; 19:1476-1477. [PMID: 37589584 DOI: 10.53738/revmed.2023.19.837.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Priscilla Huber
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Marius Huc
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Lilian Jeansoulin
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Aurélie Osnim Kota-Mamah
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Marcia Melro Costa
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Léa J Guenat
- Bachelor en sciences biomédicales, Faculté de médecine, Centre médical universitaire, 1211 Genève 4
| | - Stéphanie Carnesecchi
- Département de pathologie et immunologie, Centre médical universitaire, 1211 Genève 4
| | - Gaëlle Vacher
- Laboratoire de biopharmacie, Institut des sciences pharmaceutiques de Suisse occidentale, 1205 Genève 4
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45
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Cox RC, Brown SL, Chalmers BN, Scott LN. Examining sleep disturbance components as near-term predictors of suicide ideation in daily life. Psychiatry Res 2023; 326:115323. [PMID: 37392522 PMCID: PMC10527974 DOI: 10.1016/j.psychres.2023.115323] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023]
Abstract
Suicide ideation emerges and fluctuates over short timeframes (minutes, hours, days); however, near-term predictors of such fluctuations have not been well-elucidated. Sleep disturbance is a distal suicide risk factor, but less work has examined whether daily sleep disturbance predicts near-term changes in suicide ideation. We examined subjective sleep disturbance components as predictors of passive and active suicide ideation at the within-person (i.e., day-to-day changes within individuals relative to their own mean) and between-persons (individual differences relative to the sample mean) levels. A transdiagnostic sample of 102 at-risk young adults ages 18-35 completed a 21-day ecological momentary assessment protocol, during which they reported on sleep and passive and active suicide ideation. At the within-persons level, nightmares, sleep quality, and wake after sleep onset predicted passive suicide ideation, and sleep quality and wake after sleep onset predicted active suicide ideation. At the between-persons level, nightmares, sleep onset latency, and sleep quality were associated with passive suicide ideation, and sleep onset latency was associated with active suicide ideation. In contrast, suicide ideation did not predict subsequent sleep at the within-person level. Specific sleep disturbance components are near-term predictors of intraindividual increases in suicide ideation and may hold promise for suicide prevention and intervention.
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Affiliation(s)
- Rebecca C Cox
- Department of Integrative Physiology, University of Colorado Boulder, USA; Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Sarah L Brown
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Brittany N Chalmers
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Lori N Scott
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA.
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46
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Moore BA, Brager A, Judkins J, Mysliwiec V. Nightmare disorder in active-duty US military personnel. Sleep Health 2023; 9:283-287. [PMID: 36774213 DOI: 10.1016/j.sleh.2022.12.001] [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] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 11/29/2022] [Accepted: 12/22/2022] [Indexed: 02/11/2023]
Abstract
STUDY OBJECTIVES Military personnel experience high rates of traumatic experiences. Despite this, few studies have examined the presence of nightmare disorder in military personnel. The primary aim of this study was to examine diagnoses of nightmare disorder across the 4 largest branches of the active-duty US military. DESIGN & PARTICIPANTS Data and service branch densities used to derive the expected rates of diagnoses of nightmare disorder were drawn from the Defense Medical Epidemiology Database. The branches examined included all active-duty services members in the US Army, Navy, Marine Corps, and Air Force, who served between 2016 and 2021. Single-sample chi-square goodness of fit tests were conducted to examine within-variable differences for military relevant variables. RESULTS Between 2016 and 2019, the incidence rates of nightmare disorder (per 10,000 service members) in the US Department of Defense ranged from 11.3 in 2016 to a low of 6.9 in 2018. Service members who were classified as non-white, female, over the age of 35, married, in the Army, and/or a noncommissioned officer, were diagnosed at greater rates relative to their representation in the military population (p < .001). CONCLUSION Our findings of higher than expected rates of nightmare disorder in older, senior service members as well as those in the Army align with the known precipitant of nightmares, and trauma. However, the reason for the finding that female and Black service members have higher than expected rates is not readily apparent.
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Affiliation(s)
- Brian A Moore
- Department of Psychological Science, Kennesaw State University, Kennesaw, Georgia, USA.
| | - Allison Brager
- Marketing & Engagement Brigade, United States Army Recruiting Command, Fort Knox, Kentucky
| | - Jason Judkins
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Vincent Mysliwiec
- Department of Psychiatry and Behavioral Health, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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47
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Cunningham TJ. The next step in understanding the function of dreams. Sleep 2023; 46:zsad010. [PMID: 36656722 PMCID: PMC10091084 DOI: 10.1093/sleep/zsad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Indexed: 01/20/2023] Open
Affiliation(s)
- Tony J Cunningham
- Center for Sleep and Cognition, Psychiatry Department, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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48
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Picard-Deland C, Konkoly K, Raider R, Paller KA, Nielsen T, Pigeon WR, Carr M. The memory sources of dreams: serial awakenings across sleep stages and time of night. Sleep 2023; 46:zsac292. [PMID: 36462190 PMCID: PMC10091095 DOI: 10.1093/sleep/zsac292] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/27/2022] [Indexed: 12/05/2022] Open
Abstract
Memories of waking-life events are incorporated into dreams, but their incorporation is not uniform across a night of sleep. This study aimed to elucidate ways in which such memory sources vary by sleep stage and time of night. Twenty healthy participants (11 F; 24.1 ± 5.7 years) spent a night in the laboratory and were awakened for dream collection approximately 12 times spread across early, middle, and late periods of sleep, while covering all stages of sleep (N1, N2, N3, REM). In the morning, participants identified and dated associated memories of waking-life events for each dream report, when possible. The incorporation of recent memory sources in dreams was more frequent in N1 and REM than in other sleep stages. The incorporation of distant memories from over a week ago, semantic memories not traceable to a single event, and anticipated future events remained stable throughout sleep. In contrast, the relative proportions of recent versus distant memory sources changed across the night, independently of sleep stage, with late-night dreams in all stages having relatively less recent and more remote memory sources than dreams earlier in the night. Qualitatively, dreams tended to repeat similar themes across the night and in different sleep stages. The present findings clarify the temporal course of memory incorporations in dreams, highlighting a specific connection between time of night and the temporal remoteness of memories. We discuss how dream content may, at least in part, reflect the mechanisms of sleep-dependent memory consolidation.
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Affiliation(s)
| | - Karen Konkoly
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Rachel Raider
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Ken A Paller
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Tore Nielsen
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Wilfred R Pigeon
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Carr
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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49
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Seiler A, Pelz S, Wolfensberger F, Hertler C, Schettle M, Schlögl M, Peng-Keller S, Blum D. [End-of-Life Dreams and Visions]. Praxis (Bern 1994) 2023; 112:297-303. [PMID: 37042410 DOI: 10.1024/1661-8157/a004020] [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] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
End-of-Life Dreams and Visions Abstract: End-of life dreams and visions (ELDVs) or so-called death bed phenomena are transcendent experiences at the end of life that can be visual, auditory and/or kinesthetic, and often include visions of (deceased) loved ones, close friends or perceptions of places, travels, bright lights, or music. ELDVs typically occur weeks to hours prior to death and may comfort the dying and prepare spiritually for the end of life. Such experiences are frequently reported by dying individuals, the prevalence varying between 30 and 80%, but in the clinical context ELDVs are usually neglected, but interpreted and treated as pathological changes in the brain that result in, and from, delirium. This article tries to enlighten the occurrence, the contents and meanings of ELDVs in dying persons as opposed to delirium and night dreams using findings from the literature and from clinical observations. Implications of these conclusions for palliative care and the therapeutic relevance of ELDVs when taking care of dying individuals and their loved ones will also be discussed.
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Affiliation(s)
- Annina Seiler
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
| | - Stefan Pelz
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
| | - Fanny Wolfensberger
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
| | - Caroline Hertler
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
| | - Markus Schettle
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
| | - Mathias Schlögl
- Klinik für Geriatrie, Barmelweid, Schweiz
- Universitäre Klinik für Akutgeriatrie, Stadtspital Waid, Zürich, Schweiz
| | | | - David Blum
- Klinik für Radio-Onkologie, Kompetenzzentrum Palliative Care, Universitätsspital Zürich, Zürich, Schweiz
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50
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Vincent N, Dirkse D, Giannouli E, McQuarrie A. Transdiagnostic cognitive behavioral therapy for nightmares and parasomnias. J Clin Sleep Med 2023; 19:499-509. [PMID: 36468650 PMCID: PMC9978420 DOI: 10.5664/jcsm.10374] [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] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES This pilot study determined whether transdiagnostic cognitive behavioral therapy for parasomnias (CBTp) reduces parasomnia and activity levels during sleep in a sample of adult sleep clinic outpatients. A secondary objective was to assess whether treatment produces improvements in daytime fatigue/sleepiness, perceived cognition, mood, and depression/anxiety/stress, as well as functional impairment in work and leisure activities. METHODS This was a randomized controlled trial with CBTp and self-monitoring control conditions. Participants were 19 adults with a DSM 5 parasomnia disorder who received individual CBTp virtually from their homes. CBTp consisted of psychoeducation, sleep hygiene and safety instructions, relaxation training, parasomnia techniques, and relapse prevention in a 6-week manualized, structured program. RESULTS Using a repeated measures analysis of variance model, and relative to a self-monitoring control condition, results showed that CBTp produced statistically significant improvements in parasomnia frequency, severity, nocturnal activity, and sleep efficiency. There was a trend toward reduced sleep-onset latency and improved work and social adjustment. Of treated participants, 100% rated themselves as improved at study conclusion. CONCLUSIONS Implications of these findings are that cognitive behavioral interventions for parasomnias are effective in lessening parasomnias. More investigation into this type of treatment is warranted. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Impact of Cognitive Behavioral Therapy on Parasomnias; URL: https://clinicaltrials.gov/ct2/show/NCT04633668; Identifier: NCT04633668. CITATION Vincent N, Dirkse D, Giannouli E, McQuarrie A. Transdiagnostic cognitive behavioral therapy for nightmares and parasomnias. J Clin Sleep Med. 2023;19(3):499-509.
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Affiliation(s)
- Norah Vincent
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dale Dirkse
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Eleni Giannouli
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amanda McQuarrie
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
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