During the second wave of the COVID-19 pandemic, people reported lower dream recall, fewer nightmares, less frequent lucid dreams, and reduced emotional intensity in dreams compared to the first wave. Dreams during the second wave had a more negative tone. Changes in dream frequency between the two waves were linked to post-traumatic growth, sleep-related PTSD symptoms, and sleep quality. Emotional features of dreams correlated with pandemic-related factors such as job changes, forced quarantine, having infected relatives or friends, and seeking mental health help. The findings partly support the continuity hypothesis, which links dream content to waking experiences.
Clinical psychology and psychotherapy face a paradigm shift toward more individualized, mechanism-oriented, and transdiagnostic approaches. Recent umbrella reviews show that both psychotherapies and pharmacotherapies for adult mental disorders have only minor effect sizes when only the best studies are considered, with small differences between them and few extra benefits from combining them. New challenges include integrating psychedelic-assisted therapy, using neuroimaging to define psychopathology based on shared neurobiological mechanisms rather than traditional diagnostic categories, expanding digital and mHealth interventions, and applying the biopsychosocial model more effectively in clinical practice. The field must move from disorder-specific protocols to dimensional, person-centered care that combines neuroscience with psychosocial formulation.
During the COVID-19 lockdown, a large Italian sample reported more frequent nightmares and dreams compared to a population-based sample. Predictors of high dream recall included young age, female gender, not having children, and sleep duration. High nightmare frequency was predicted by young age, female gender, changes in napping, sleep duration, intrasleep wakefulness, sleep problem index, anxiety, and depression. Higher emotional features of dream activity occurred in workers who stopped working, people with relatives or friends infected by or who died from COVID-19, and those who changed sleep habits. These findings support the continuity hypothesis linking daily experiences to sleep mentation and the arousal-retrieval model linking poor sleep to nightmares.