Dreaming in Bipolar Disorders – Feasibility of the Central Image Method: A Prospective Controlled Trial
Frontiers in Psychology September 2, 2024 Gabriele Schmid‐Mühlbauer, Laura Reggiannini, Peter Treu et al.
Emotions shape the content and experience of dreams, and the Central Image (CI)—the dominant emotion in a dream—may be especially revealing in bipolar disorder, where mood swings are extreme. Over three weeks, 61 participants kept daily dream diaries, and two independent raters used the Central Image Method to classify dream emotions. Inter-rater agreement was very high: weighted Cohen's kappa averaged 0.99 for primary and 0.90 for secondary CI emotions. Healthy controls and currently depressed patients both reported more negative than positive CI emotions, though the difference was not statistically significant in the depressed group. Currently depressed patients recorded more negative CI emotions than euthymic patients or healthy controls. The findings suggest the method is feasible and may reflect different emotion regulation and defense mechanisms across bipolar states.