Dreams in the acute aftermath of trauma and their relationship to PTSD

Abstract

Dreams following trauma have been suggested to aid emotional adaptation, yet trauma‐related nightmares are a diagnostic symptom of Posttraumatic Stress Disorder (PTSD). There is little published data relating dreams to PTSD soon after trauma. We assessed dreams and PTSD in 60 injured patients after life‐threatening events and obtained follow‐up assessments in 39 of these participants 6 weeks later. Ten of 21 dream reports from morning diaries were rated and described as similar to the recent traumatic event. The participants reporting these distressing “trauma dreams” had more severe concurrent PTSD symptoms than those reporting other categories of dreams and had more severe initial and follow‐up PTSD than those without dream recall. These findings along with our preliminary longitudinal observations relating changes in dream patterns to outcome, suggest a relationship of dream characteristics and early adaptive versus maladaptive patterns of processing traumatic memory.

Posttraumatic nightmares and psychopathology in children after road traffic accidents

“…Generally, nightmares six months postaccident were not cross-sectionally related to depression scores. These findings reinforce previous evidence from adult road traffic accident survivors that replicative posttraumatic nightmares indicate pathological elaboration of traumatic experiences (Mellman, David, Bustamante, Torres, & Fins, 2001). The specific relation of different types of nightmares should be replicated based on a larger sample in a longitudinal design.…”

Sleep and Anxiety Disorders

“…Nightmares and insomnia are also common in the early aftermath of trauma especially among those who are developing PTSD (39)(40)(41)(42). Furthermore sleep disruption leads to fatigue and irritability which are daytime symptoms of PTSD.…”

“…The trauma exposed group who did not subsequently develop PTSD, either did not recall dreaming or reported dreams that did not depict actual memories, although some represented threatening scenarios. The authors theorized that dreams with highly replicative content represent a failure of adaptive emotional memory processing that is a normal function of REM sleep and dreaming (42).…”

Conceptual Problems with the DSM‐IV Criteria for Posttraumatic Stress Disorder

“…Mellman and his colleagues have been among the few investigators who have asked trauma patients to record their reexperiencing symptoms (nightmares) prospectively (Esposito, Benitez, Barza, & Mellman, 1999;Mellman, David, Bustamante, Torres, & Fins, 2001). They found that many of the recorded distressing dreams were related to trauma, and a minority were experienced as replicas of the trauma.…”