Emotion dysregulation mediates the relationship between nightmares and psychotic experiences: results from a student population
Umair Akram, Maria Gardani, Kamila R. Irvine, Sarah Allen, Antonia Ypsilanti, Lambros Lazuras, Jennifer Drabble, Jodie C. Stevenson, Asha Akram
Schizophrenia June 1, 2020 DOI: 10.1038/s41537-020-0103-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 1,273 |
| Population | University students from UK universities |
| Topics | Dreaming |
| Keywords | Dream Mediation Psychosis Arousal Clinical psychology Distress Association psychology Psychotherapist |
| Citations | 31 |
| Key findings | Psychotic experiences were significantly more prevalent in students reporting nightmares, and this association was mediated by emotion regulation difficulties. |
Abstract
Abstract Sleep disruption is commonly associated with psychotic experiences. While sparse, the literature to date highlights nightmares and related distress as prominent risk factors for psychosis in students. We aimed to further explore the relationship between specific nightmare symptoms and psychotic experiences in university students while examining the mediating role of emotion dysregulation. A sample ( N = 1273) of student respondents from UK universities completed measures of psychotic experiences, nightmare disorder symptomology and emotion dysregulation. Psychotic experiences were significantly more prevalent in students reporting nightmares ( n = 757) relative to those who did not ( n = 516). Hierarchical linear regression analysis showed that psychotic experiences were significantly associated (Adjusted R 2 = 32.4%) with perceived nightmare intensity, consequences and resulting awakenings, and with emotion regulation difficulties. Furthermore, multiple mediation analysis showed that the association between psychotic experiences and nightmare factors was mediated by emotion regulation difficulties. Adaptive regulation of dream content during rapid eye-movement sleep has previously been demonstrated to attenuate surges in affective arousal by controlling the intensity and variability of emotional content. Difficulties in emotion regulation may partially explain the experience of more intense and disruptive nightmares among individuals with psychotic experiences. Emotion regulation may represent an important control mechanism that safeguards dream content and sleep quality.
Comparable studies
Other cross-sectional and survey studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States | 2011 | Observational cross-sectional survey | n = 583 |
| Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... | 2010 | Cross-sectional survey with subsequent clinical evaluation (two-phase design) | n = 8,558 |
| Factors of home dream recall: a structural equation model Adults (general population sample) | 2003 | Cross-sectional survey with structural equation modeling | n = 444 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults | 2011 | Cross-sectional survey | n = 919 |
Citations in the library
Cited by 6
- Evaluating the Relationship Between Emotion Regulation, Mood and Distressing Dreams Using Daily Sleep Diary Reports in Trauma Survivors Journal of Sleep Research April 3, 2025
- Psychological and sociological characteristics of students suffering from nightmares Medical alphabet January 11, 2023
- Sleep and psychosis: An integrative review of conceptual and neurophysiological associations. Progress in Neuro-Psychopharmacology and Biological Psychiatry August 14, 2026
- Associations between frequent nightmares, nightmare distress and depressive symptoms in adolescent psychiatric patients. Sleep Medicine March 1, 2023
- Schizotypy unfolding into the night? Schizotypal traits and daytime psychotic-like experiences predict negative and salient dreams. Schizophrenia Research June 10, 2022
and 1 more in the library
Cites 6
- Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Sleep 2002
- Nightmares in Patients with Psychosis: The Relation with Sleep, Psychotic, Affective, and Cognitive Symptoms The Canadian Journal of Psychiatry August 1, 2015
- Cognitive and emotional processes during dreaming: a neuroimaging view. Consciousness and Cognition December 2011
- Replication and expansion of "Best Practice Guide for the Treatment of Nightmare Disorder in Adults". Journal of Clinical Sleep Medicine October 1, 2011
- Gender differences in nightmare frequency: a meta-analysis. Sleep Medicine Reviews April 1, 2011
and 1 more in the library