Tracking Potentiating States of Dissociation: An Intensive Clinical Case Study of Sleep, Daydreaming, Mood, and Depersonalization/Derealization.
Giulia Poerio, Stephen Kellett, Peter Totterdell
Frontiers in Psychology August 17, 2016 DOI: 10.3389/fpsyg.2016.01231 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study (intensive N=1 experience-sampling study) Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | One individual meeting diagnostic criteria for depersonalization/derealization disorder |
| Duration | 40 days, with ratings six times daily |
| Topics | Dreaming |
| Keywords | Dissociation Sleep Emotion Depersonalization Daydreaming Mindwandering Clinical case study Experience-sampling methodology |
| Key findings | Daydreaming was reported on 45% of occasions and significantly predicted greater dissociation, particularly when daydreams were repetitive and negative rather than fanciful, with depression and anxiety mediating this relationship. Better sleep quality, but not duration, negatively predicted daily dissociation and depression but not anxiety. The authors propose that daydreaming occurrence and content may act as potentiating states for in-the-moment dissociation. |
Abstract
This study examined in real time the role of sleep and daydreaming as potentiating states for subsequent dissociation in depersonalization/derealization disorder (DDD). Research and theory suggests that dissociation may be exacerbated and maintained by a labile sleep-wake cycle in which "dream-like" mentation intrudes into waking life and fuels dissociative symptoms. We explore and extend this idea by examining the state of daydreaming in dissociation. Daydreaming is a state of consciousness between dreaming and waking cognition that involves stimulus-independent and task-unrelated mentation. We report the results of a unique intensive N = 1 study with an individual meeting diagnostic criteria for DDD. Using experience-sampling methodology, the participant rated (six times daily for 40 days) current daydreaming, mood, and dissociative symptoms. At the start of each day sleep quality and duration was also rated. Daydreaming was reported on 45% of occasions and significantly predicted greater dissociation, in particular when daydreams were repetitive and negative (but not fanciful) in content. These relationships were mediated by feelings of depression and anxiety. Sleep quality but not duration was a negative predictor of daily dissociation and also negatively predicted depression but not anxiety. Findings offer initial evidence that the occurrence and content of daydreams may act as potentiating states for heightened, in the moment, dissociation. The treatment implications of targeting sleep and daydreaming for dissociative disorders are discussed.
Comparable studies
Other case reports and case series on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lucid Dreaming as a Learnable Skill: A Case Study The author | 1980 | Case study | n = 1 |
| Lucid Dreaming as a Treatment for Recurrent Nightmares People with recurrent nightmares | 2010 | Case study | n = 5 |
| Treating Chronic Nightmares of Sexual Assault Survivors with an Intellectual Disability – Two Descriptive Case Studies Adults with learning disabilities suffering from post-traumatic nightmares | 2006 | Case study | n = 2 |
| Lucid dreaming: Correspondence between dreamed and actual events in one subject during rem sleep A lucid dreamer | 1984 | Case study | n = 1 |
| Lucid dreaming treatment for nightmares: A series of cases. Participants with nightmares | 2003 | Case series | n = 8 |
Citations in the library
Cited by 5
- Terror and bliss? Commonalities and distinctions between sleep paralysis, lucid dreaming, and their associations with waking life experiences Journal of Sleep Research July 27, 2016
- Associations between exploding head syndrome and measures of sleep quality and experiences, dissociation, and well-being Sleep December 13, 2018
- Trait dissociation as a predictor of induced dissociation by ketamine or esketamine in treatment-resistant depression: Secondary analysis from a randomized controlled trial. Journal of Psychiatric Research May 8, 2021
- Dissociative episodes and concurrent heart rate in patients with PTSD - An ecological momentary assessment. Psychiatry Research 2025
- No Time Like the Present: Thinking About the Past and the Future Is Related to State Dissociation Among Individuals With High Levels of Psychopathological Symptoms. Frontiers in Psychology 2018
Cites 15
- Measurement of dissociative states with the Clinician‐Administered Dissociative States Scale (CADSS) Journal of Traumatic Stress 1998
- Not all minds that wander are lost: the importance of a balanced perspective on the mind-wandering state Frontiers in Psychology 2013
- Dreaming as mind wandering: evidence from functional neuroimaging and first-person content reports. Frontiers in Human Neuroscience 2013
- Shaped by the Past: The Default Mode Network Supports Cognition that Is Independent of Immediate Perceptual Input PLoS One June 30, 2015
- Terror and bliss? Commonalities and distinctions between sleep paralysis, lucid dreaming, and their associations with waking life experiences Journal of Sleep Research July 27, 2016
and 10 more in the library