Dreaming correlates of alexithymia among sleep-disordered patients.

Abstract

Increasing evidence supports the clinical view that alexithymia is associated with disturbed dreaming. However, a consistent, replicable pattern of relationships between alexithymia and different dreaming components has not yet been identified. Groups of sleep-disordered outpatients (N 580; 46.0 13.2 years) and nonclinical controls (N 145; 22.9 4.2 years) were administered the Toronto Alexithymia Scale (TAS-20) and a 14-item Dreaming Questionnaire. Sleep diagnoses were assessed from polysomnography and clinical histories following the American Academy of Sleep Medicine classification system. The Dreaming Questionnaire was reduced by principal-components analysis to a 3-factor solution that distinguishes nightmare distress, dream recall, and dream meaning items. Factor coefficients were correlated with TAS total score and TAS subscales while age was controlled as a covariate. TAS total score was found to correlate positively with nightmare distress and negatively with dream recall for both clinical and nonclinical groups and for both men and women considered separately. TAS total score also correlated negatively with dream meaning for nonclinical participants. TAS subscales were differentially correlated with the 3 dream factors: difficulty identifying feelings (DIF) with increased nightmare distress, difficulty describing feelings (DDF) with decreased dream recall and externally oriented thinking (EOT) with decreased dream meaning. With some exceptions, these patterns were obtained independently for clinical and nonclinical groups and for men and women within these groups. Findings suggest a consistent and replicable pattern of relationships between alexithymia and dreaming components that implicates processes regulating emotion during both wakefulness and dreaming, for example, affect distress, expressive anxiety, and openness to experience.