1178 Emotional Dream Content of Acute Trauma Patients: Associations with Interpersonal Violence, Nightmares, and PTSD
Greg Mahr, Anthony N Reffi, Lily Jankowiak, David Moore, Christopher L Drake
Sleep May 19, 2025 DOI: 10.1093/sleep/zsaf090.1178 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 88 |
| Population | Patients hospitalized within one week following traumatic injury (mean age 39.53 years, 67.0% male, 67.0% Black); 43 recalled a dream since hospitalization |
| Duration | Approximately one-month post-trauma follow-up |
| Measures | Affective Neuroscience Dream Rating Scale |
| Topics | Dreaming PTSD |
| Key findings | Dreams recalled after traumatic injury were rated as more negative than positive in emotional tone. More negatively toned dreams were associated with hospitalization for interpersonal violence and more severe acute stress symptoms, and prospectively predicted trauma-related nightmares, nightmare distress, night terrors, and PTSD status about one month later; patients who screened positive for PTSD had more negative dreams than those who did not. |
Abstract
Abstract:
Introduction: Dreams are involved in the processing of emotions and can serve as markers of emotional distress. The authors developed a rating scale for affect in dreams and applied it to an acute trauma population.
Methods: We recruited 88 patients hospitalized within one week following traumatic injury (Mage = 39.53 ± 14.31 years, 67.0% male, 67.0% Black). Patients who recalled a dream since hospitalization recorded their dream (n = 43). An independent rater scored the dreams using a novel 33-item Affective Neuroscience Dream Rating Scale to indicate the presence of fear, rage, grief, seeking, care, play, and lust. We quantified the emotional valence of dreams by summing positive (seeking + care + play + lust) and negative emotions (fear + rage + grief) and explored their associations with interpersonal violence and clinical outcomes approximately one-month post-trauma.
Results: The emotional valence of dreams across all patients was significantly more negative (M = 4.84 ± 2.91) than positive (M = 1.26 ± 1.16), p <.001. Experiencing negatively toned dreams was associated with increased odds of being hospitalized for interpersonal violence (OR = 1.45, p =.014, 95% CI = 1.08 – 1.96) and more severe acute stress symptoms (β = 0.36, p =.021), regardless of sex. Reporting more negatively toned dreams during hospitalization prospectively predicted risk for trauma-related nightmares one month later (OR = 1.73, p =.045, 95% CI = 1.01 – 2.97), adjusting for time, and was prospectively associated with increased nightmare distress (r =.70, p <.001), night terrors (r =.37, p =.042), and PTSD status (r =.44, p =.033). The dreams of patients who went on to screen positive for PTSD one month after trauma were significantly more negative (M = 5.99) than patients without PTSD (M = 3.70), p =.038, ηp2 = 19, indicating a large effect.
Conclusion: Negative affective tone in dreams immediately after trauma predicted subsequent nightmares and future PTSD and can provide a potential tool for assessing PTSD risk in acute trauma patients. Support (if any): Funding for A.N.R. was provided from the NIMH (K23MH134032).
Comparable studies
Other observational and cohort studies on PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder Women with chronic PTSD secondary to sexual assault | 2008 | Observational cohort | n = 6 |
| An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Treatment-seeking veterans, current serving military members, and emergency service... | 2017 | Observational study using ambulatory polysomnography | n = 35 |
| Increased Mastery Elements Associated With Imagery Rehearsal Treatment for Nightmares in Sexual Assault Survivors With PTSD. Female sexual assault survivors with chronic nightmares | 2004 | Observational cohort | n = 44 |
| Posttraumatic stress symptoms following near-death experiences. Persons who report near-death experiences and those who came close to death without NDEs | 2001 | Observational study | |
| Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD | 2018 | Retrospective review | n = 37 |