Dream content and intrusive thoughts in Obsessive-Compulsive Disorder.

The continuity between dreaming and waking consciousness remains unclear. In this study, people with obsessive-compulsive disorder (OCD) and healthy controls provided waking fantasy narratives using a shortened Thematic Apperception Test and kept dream diaries. Analysis of obsessive and compulsive themes in both dream and waking reports showed no differences between the two groups in the density of these themes. However, for both groups, obsessive and compulsive themes were significantly more frequent in dream reports than in waking narratives. Among OCD patients, dream obsession and compulsion scores did not correlate with their Y-BOCS symptom scores. These results support the discontinuity hypothesis, suggesting that ruminative thought patterns are interrupted during dreaming.

Study at a glance

Abstract

Although central to any exhaustive theory of human subjectivity, the relationship between dream and waking consciousness remains uncertain. Some findings suggest that dream consciousness can be influenced by severe disorders of thought content. The suppression of unwanted thoughts has been shown to influence dream content in healthy individuals. In order to better define this phenomenon, we evaluated the persistence of obsessive/compulsive themes across the dream and waking cognition of OCD patients and in a control group of healthy subjects. Participants were administered a shortened version of the Thematic Apperception Test to produce a waking fantasy narration, and were trained to keep a dream diary. Dream and waking narrative contents were analyzed in order to recognize obsessive/compulsive themes, and to calculate Mean Dream Obsession/Compulsion (MDO, MDC) and Mean TAT Obsession/Compulsion (MTO, MTC) parameters. No differences were found between the two populations in terms of MDO, MDC, MTO, nor MTC. Density of obsessive and compulsive themes were significantly higher in dream reports than in waking narratives for both groups. No correlation was observed between MDO/MDC scores and Y-BOCS obsession/compulsion scores in the OCD group. These findings strengthen the discontinuity hypothesis, suggesting that ruminative aspects of cognition are somehow interrupted during dream activity.