Tidsskrift for Norsk psykologforening, Dec 1, 2022
Erfaringene til deltakerne viste at intendert virkning av behandling ikke alltid stemmer med oppl... more Erfaringene til deltakerne viste at intendert virkning av behandling ikke alltid stemmer med opplevd virkning. Denne studien av behandlingsmetoden Basal eksponeringsterapi (BET) viser at deltakernes erfaringer er viktig for videre utvikling, og at ved å lytte til pasientene kan man skaffe ny kunnskap og forbedre praksis.
The modulation of our brains' neural A circuitry by ongoing life experience __ _.__ __ ("... more The modulation of our brains' neural A circuitry by ongoing life experience __ _.__ __ ("neuronal plasticity") remains an excit---ing and intensely studied topic. Such ex------perience-based changes in neuronal struc_ _ _ ture and function underlie the critical _ -_ . _ . adaptive processes of learning and mem_ ory formation. Current research seeks to -_ _-. understand these phenomena at numer(-_-_ous levels of analysis, including genetics, __-_ --molecular biology, biochemistry, cell biology, developmental biology, neurobiol.---ogy, cognitive neuroscience, psychology, and even philosophy. Over the last decade, _ _ _ it has become increasingly clear that the ..-_-, processes of learning and memory consol_ idation and integration can occur over extended periods of time, measured in Fig. 1. Sample texture discr days or even years (1-4). At the same with a rotated letter ("T" or "L time, evidence has continued to build a horizontal row or a vertical supporting an important role for sleep in diagonal bars in a row in the i at least some aspects of these processes the upper left(refs. 5-8, but see ref. 9). A complete understanding of the role of slow and sleep-dependent mechanisms in these seen even 12 h after trair phenomena will require the concerted apoccurs during this periot plication of tools from all these fields of such sleep, improvemen research. In this issue of PNAS, Schwartz additional days and nig et al. (10) use a visual texture discriminaabsence of additional tr tion task (TDT) to demonstrate how eleBut when subjects are sl gantly functional magnetic resonance imfirst night after training aging (fMRI) studies can contribute to provement is prevente this field. bar). In addition, ove In the TDT, originally described by ments correlates with Karni and Sagi (11), subjects evaluate both deep, slow wave sl stimuli similar to those in Fig. 1 by in the night and REM identifying both a central fixation letter
Electroconvulsive treatment (ECT) often is described as particularly effective with severe depres... more Electroconvulsive treatment (ECT) often is described as particularly effective with severe depression. We argue that available placebo-controlled evidence does not support this contention, instead showing marginal effects of ECT at treatment end and the absence of positive long term effects. In contrast, the literature on neuropsychological effects suggests that ECT weakens cognitive functions, in particular memory, for weeks or months in most participants. Neurophysiologically, ECT lowers the regional activation level and slows down neural firing in the frontal and temporal lobes (deceleration). ECT also blocks long term potentiation necessary for memory formation, and it activates the hypothalamus-pituitary-adrenal stress axis. The frontotemporal deceleration following ECT empirically is associated with changes in the patients’ behavior viewed as «therapeutic response» by clinicians, such as improved appetite and sleep. Increased «doses» of ECT are associated with a stronger «therapeutic response» as well as with gradually increased neurophysiological deficits and memory problems. It may appear that the response to ECT seen in the clinic reflects the neurophysiological deficits that the treatment incurs, indicating a violation of the Hippocratic oath – first, do no harm.
The Maltreatment and Abuse Chronology of Exposure scale (MACE) trauma questionnaire Background: A... more The Maltreatment and Abuse Chronology of Exposure scale (MACE) trauma questionnaire Background: A 55-item Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale was recently developed. For clinicians to apply MACE, they need to perceive the instrument as acceptable to patients and useful. We investigated clinicians’ experiences and views of the acceptability, usefulness and application of MACE. Method: Twenty-three clinicians recorded their perceptions of how unpleasant it was for 84 adult patients to complete MACE, 20 clinicians answered a survey about MACE, and eight clinicians attended focus group interviews to detail their experiences and views. Results: According to the clinicians, the MACE form was sufficiently self-explanatory to function as a questionnaire. Clinicians considered MACE as emotionally tolerable for most patients. They reported that some patients had strong negative reactions but that these patients did not regret participating. The ...
Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Resea... more Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Research into the mechanisms underlying these relationships has focused, productively, on psychological processes, including cognition, attachment and dissociation. In 2001, the traumagenic neurodevelopmental model sought to integrate biological and psychological research by highlighting the similarities between the structural and functional abnormalities in the brains of abused children and adults diagnosed with
The suicide risk in psychotic disorders is highest in the early phases of illness. Studies have t... more The suicide risk in psychotic disorders is highest in the early phases of illness. Studies have typically focused on suicidality from treatment start rather than actual onset of psychosis. This study explored the prevalence and characteristics of suicidality in patients with a first episode of psychosis (FEP) in two time intervals: 1) prior to study entry and 2) explicitly in the period of untreated psychosis. Method: One hundred seventy FEP-patients were interviewed as soon as possible after treatment start. The interview included assessments of diagnoses, suicidality, symptoms, substance use, and premorbid functioning. Results: Nearly 26% of the patients attempted suicide prior to study entry and 14% made suicide attempts during the period of untreated psychosis. Of the patients who had been suicidal (i.e. experienced suicidal ideation or attempts), 70% were suicidal during the period of untreated psychosis. Suicide attempts prior to study entry were associated with female gender, more depressive episodes, younger age at psychosis onset, and history of alcohol disorder. Suicide attempts during untreated psychosis were also associated with more depressive episodes and younger age at illness onset, in addition to drug use the last six months and longer duration of untreated psychosis (DUP). Conclusion: The prevalence of suicidality before and in the early phases of FEP is high, especially during untreated psychosis. As prolonged DUP is associated with suicide attempts during the period of untreated psychosis, reducing the DUP could have the effect of reducing the prevalence of suicide attempts in patients with FEP.
This study tested the two main neurocognitive models of dreaming by using cognitive data elicited... more This study tested the two main neurocognitive models of dreaming by using cognitive data elicited from REM sleep in normals and narcoleptics. The two models were the "activation-only" view which holds that, in the context of sleep, overall activation of the brain is sufficient for consciousness to proceed in the manner of dreaming (e.g., Antrobus, 1991; Foulkes, 1993; Vogel, 1978); and the Activation, Input source, Modulation (AIM model), which predicts that not only brain activation level but also neurochemical modulatory systems exert widespread effects upon dreaming (Hobson & McCarley, 1977; Hobson, Pace-Schott, & Stickgold, 2000). Mental activity was studied in nocturnal REM in 15 narcoleptics and 9 normal healthy persons and in REM at the onset of daytime naps and nighttime sleep (SOREM) in narcoleptics. The study was performed in the subjects' homes, using instrumental awakenings and ambulatory polysomnographic techniques, and focused upon visual vividness, mentation report length, improbable and discontinuous bizarre features, and reflective consciousness. Within each subject group, most cognitive variables tended to fluctuate in line with expected variations in circadian activation level. When comparing the cognitive variables between the two groups, reflective consciousness was clearly highest in narcoleptics, whereas improbabilities and discontinuities were lower, with mentation report length and visual vividness differing less between the groups. These findings are consistent with the AIM model of sleep mentation, but not with the activation-only model.
A subset of people with severe mental health conditions feels they are on the verge of losing con... more A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They have been encountered at a specialized inpatient ward offering exposurebased therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety (ECa). We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature-annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects.
Abstract Theoretical and empirical work is needed to adapt psychotherapy to psychosis. The articl... more Abstract Theoretical and empirical work is needed to adapt psychotherapy to psychosis. The article introduces dialogue therapy (DT), a philosophical-ethical, humanistic, and dialogue-oriented individual psychotherapy model for schizophrenia and other severe psychosis. Rather than introducing novel methods, DT offers a unified approach, including flexible methodology derived from existing psychotherapy traditions that focuses on difficulties of emotion, relation, identity, and self-regulation that are characteristic in psychosis. The patient is included to participate fully in the dialogue with her/his subjective voice. The therapist is aware, authentically committed, respectful, and takes seriously all forms of utterances. DT invites the patient to a collaborative process, where she/he is acknowledged as a co-researcher in a continuous search for a cure. Crucial in the therapeutic interaction is to collaborate in generating a breakthrough to split off the psychotic symptoms. The context of DT, therapeutic interactions, and specific methods of how to carry out this psychotherapy are outlined in the article. Not applying psychotherapy in the treatment of psychosis might endanger the development of emotions and self-regulation, social competences, and healthy functioning.
BACKGROUND Suicide prevention is a core task in mental health services. Our objective was to dete... more BACKGROUND Suicide prevention is a core task in mental health services. Our objective was to determine whether Collaborative Assessment and Management of Suicidality (CAMS) reduced suicidal thoughts and behaviors and mental health distress more effectively than treatment as usual (TAU) in a heterogeneous patient population within specialized mental health care services. METHODS In this observer-blinded pragmatic randomized controlled trial participants who scored 13 or above on Beck's Scale for Suicide Ideation-Current (BSSI-C) were included from seven in- and outpatient units. Primary outcome was suicidal ideation (BSSI-C). Secondary outcomes were mental health distress measured by the Outcome Questionnaire-45, and suicidal behaviors measured by the Suicide Attempt Self-Injury Count. Patients were assessed at baseline and after 6 and 12 months. RESULTS The final intent-to-treat analyses included 78 participants (mean age 35.9 years, SD = 14.5, 41 females). The majority were depressed (65%), had a secondary diagnosis (73%) and 32% suffered from borderline personality disorder or borderline traits. After 6 months, CAMS participants reported lower levels of suicidal ideation compared to TAU (β = -4.29, 95% CI = -8.32 to -0.27, p = .036). Larger changes in mental health distress were observed for CAMS participants after 6 months (β = -11.87, 95% CI = -22.99 to -0.76, p = .036) and 12 months (β = -13.70, 95% CI = -24.88 to -2.51, p = .017). LIMITATIONS The modest sample size rendered the trial unable to detect small between-group differences. CONCLUSIONS CAMS reduced suicidal ideation and mental health distress more efficiently than TAU in a heterogeneous patient population within specialized care.
A long noted hypothesis is that mechanisms of dreaming play a role in psychotic hallucinations. O... more A long noted hypothesis is that mechanisms of dreaming play a role in psychotic hallucinations. One challenge for this hypothesis is that while psychotic hallucinations primarily are auditory, dreaming most characteristically is visual. At the same time, previous studies have not explicitly examined auditory impressions in dreaming. Here, we mapped the prevalence and characteristics of auditory impressions in 130 dreams reported after spontaneous awakenings from sleep in 13 normal, healthy people. We instructed participants to report any dream they could recall and to pay particular attention to possible auditory impressions. The participants reported auditory impressions in 93.9% of their dreams on average. The most prevalent auditory type was other people speaking (83.9% of participants' dreams), followed by the dreamer speaking (60.0%), and other types of sounds (e.g. music, 33.1%). Of altogether 407 instances of auditory impressions in the 130 dreams, auditory quality was judged comparable to waking in 46.4%, indeterminate in 50.6%, and absent or only thought-like in 2.9%. The results suggest that also internally generated auditory (verbal) sensations are a central component of dreaming, typically occurring several times every night in normal, healthy people.
To collect and analyze reports of mental activity across sleep/wake states. Mentation reports wer... more To collect and analyze reports of mental activity across sleep/wake states. Mentation reports were collected in a longitudinal design by combining our Nightcap sleep monitor with daytime experience sampling techniques. Reports were collected over 14 days and nights from active and quiet wake, after instrumental awakenings at sleep onset, and after both spontaneous and instrumental awakenings from REM and NREM sleep. All reports were collected in the normal home, work and school environments of the subjects. Subjects included 8 male and 8 female undergraduate students (19-26 years of age). N/A. A total of 1,748 reports, averaging 109 per subject, were collected from active wake across the day (n=894), from quiet wake in the pre-sleep onset period (n=58), from sleep onset (n=280), and from later REM (n=269) and nonREM (n=247) awakenings. Median report lengths varied more than 2-fold, in the order REM > active wake > quiet wake > NREM = sleep onset. The extended protocol allow...
Tidsskrift for Norsk psykologforening, Dec 1, 2022
Erfaringene til deltakerne viste at intendert virkning av behandling ikke alltid stemmer med oppl... more Erfaringene til deltakerne viste at intendert virkning av behandling ikke alltid stemmer med opplevd virkning. Denne studien av behandlingsmetoden Basal eksponeringsterapi (BET) viser at deltakernes erfaringer er viktig for videre utvikling, og at ved å lytte til pasientene kan man skaffe ny kunnskap og forbedre praksis.
The modulation of our brains' neural A circuitry by ongoing life experience __ _.__ __ ("... more The modulation of our brains' neural A circuitry by ongoing life experience __ _.__ __ ("neuronal plasticity") remains an excit---ing and intensely studied topic. Such ex------perience-based changes in neuronal struc_ _ _ ture and function underlie the critical _ -_ . _ . adaptive processes of learning and mem_ ory formation. Current research seeks to -_ _-. understand these phenomena at numer(-_-_ous levels of analysis, including genetics, __-_ --molecular biology, biochemistry, cell biology, developmental biology, neurobiol.---ogy, cognitive neuroscience, psychology, and even philosophy. Over the last decade, _ _ _ it has become increasingly clear that the ..-_-, processes of learning and memory consol_ idation and integration can occur over extended periods of time, measured in Fig. 1. Sample texture discr days or even years (1-4). At the same with a rotated letter ("T" or "L time, evidence has continued to build a horizontal row or a vertical supporting an important role for sleep in diagonal bars in a row in the i at least some aspects of these processes the upper left(refs. 5-8, but see ref. 9). A complete understanding of the role of slow and sleep-dependent mechanisms in these seen even 12 h after trair phenomena will require the concerted apoccurs during this periot plication of tools from all these fields of such sleep, improvemen research. In this issue of PNAS, Schwartz additional days and nig et al. (10) use a visual texture discriminaabsence of additional tr tion task (TDT) to demonstrate how eleBut when subjects are sl gantly functional magnetic resonance imfirst night after training aging (fMRI) studies can contribute to provement is prevente this field. bar). In addition, ove In the TDT, originally described by ments correlates with Karni and Sagi (11), subjects evaluate both deep, slow wave sl stimuli similar to those in Fig. 1 by in the night and REM identifying both a central fixation letter
Electroconvulsive treatment (ECT) often is described as particularly effective with severe depres... more Electroconvulsive treatment (ECT) often is described as particularly effective with severe depression. We argue that available placebo-controlled evidence does not support this contention, instead showing marginal effects of ECT at treatment end and the absence of positive long term effects. In contrast, the literature on neuropsychological effects suggests that ECT weakens cognitive functions, in particular memory, for weeks or months in most participants. Neurophysiologically, ECT lowers the regional activation level and slows down neural firing in the frontal and temporal lobes (deceleration). ECT also blocks long term potentiation necessary for memory formation, and it activates the hypothalamus-pituitary-adrenal stress axis. The frontotemporal deceleration following ECT empirically is associated with changes in the patients’ behavior viewed as «therapeutic response» by clinicians, such as improved appetite and sleep. Increased «doses» of ECT are associated with a stronger «therapeutic response» as well as with gradually increased neurophysiological deficits and memory problems. It may appear that the response to ECT seen in the clinic reflects the neurophysiological deficits that the treatment incurs, indicating a violation of the Hippocratic oath – first, do no harm.
The Maltreatment and Abuse Chronology of Exposure scale (MACE) trauma questionnaire Background: A... more The Maltreatment and Abuse Chronology of Exposure scale (MACE) trauma questionnaire Background: A 55-item Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale was recently developed. For clinicians to apply MACE, they need to perceive the instrument as acceptable to patients and useful. We investigated clinicians’ experiences and views of the acceptability, usefulness and application of MACE. Method: Twenty-three clinicians recorded their perceptions of how unpleasant it was for 84 adult patients to complete MACE, 20 clinicians answered a survey about MACE, and eight clinicians attended focus group interviews to detail their experiences and views. Results: According to the clinicians, the MACE form was sufficiently self-explanatory to function as a questionnaire. Clinicians considered MACE as emotionally tolerable for most patients. They reported that some patients had strong negative reactions but that these patients did not regret participating. The ...
Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Resea... more Evidence that childhood adversities are risk factors for psychosis has accumulated rapidly. Research into the mechanisms underlying these relationships has focused, productively, on psychological processes, including cognition, attachment and dissociation. In 2001, the traumagenic neurodevelopmental model sought to integrate biological and psychological research by highlighting the similarities between the structural and functional abnormalities in the brains of abused children and adults diagnosed with
The suicide risk in psychotic disorders is highest in the early phases of illness. Studies have t... more The suicide risk in psychotic disorders is highest in the early phases of illness. Studies have typically focused on suicidality from treatment start rather than actual onset of psychosis. This study explored the prevalence and characteristics of suicidality in patients with a first episode of psychosis (FEP) in two time intervals: 1) prior to study entry and 2) explicitly in the period of untreated psychosis. Method: One hundred seventy FEP-patients were interviewed as soon as possible after treatment start. The interview included assessments of diagnoses, suicidality, symptoms, substance use, and premorbid functioning. Results: Nearly 26% of the patients attempted suicide prior to study entry and 14% made suicide attempts during the period of untreated psychosis. Of the patients who had been suicidal (i.e. experienced suicidal ideation or attempts), 70% were suicidal during the period of untreated psychosis. Suicide attempts prior to study entry were associated with female gender, more depressive episodes, younger age at psychosis onset, and history of alcohol disorder. Suicide attempts during untreated psychosis were also associated with more depressive episodes and younger age at illness onset, in addition to drug use the last six months and longer duration of untreated psychosis (DUP). Conclusion: The prevalence of suicidality before and in the early phases of FEP is high, especially during untreated psychosis. As prolonged DUP is associated with suicide attempts during the period of untreated psychosis, reducing the DUP could have the effect of reducing the prevalence of suicide attempts in patients with FEP.
This study tested the two main neurocognitive models of dreaming by using cognitive data elicited... more This study tested the two main neurocognitive models of dreaming by using cognitive data elicited from REM sleep in normals and narcoleptics. The two models were the "activation-only" view which holds that, in the context of sleep, overall activation of the brain is sufficient for consciousness to proceed in the manner of dreaming (e.g., Antrobus, 1991; Foulkes, 1993; Vogel, 1978); and the Activation, Input source, Modulation (AIM model), which predicts that not only brain activation level but also neurochemical modulatory systems exert widespread effects upon dreaming (Hobson & McCarley, 1977; Hobson, Pace-Schott, & Stickgold, 2000). Mental activity was studied in nocturnal REM in 15 narcoleptics and 9 normal healthy persons and in REM at the onset of daytime naps and nighttime sleep (SOREM) in narcoleptics. The study was performed in the subjects' homes, using instrumental awakenings and ambulatory polysomnographic techniques, and focused upon visual vividness, mentation report length, improbable and discontinuous bizarre features, and reflective consciousness. Within each subject group, most cognitive variables tended to fluctuate in line with expected variations in circadian activation level. When comparing the cognitive variables between the two groups, reflective consciousness was clearly highest in narcoleptics, whereas improbabilities and discontinuities were lower, with mentation report length and visual vividness differing less between the groups. These findings are consistent with the AIM model of sleep mentation, but not with the activation-only model.
A subset of people with severe mental health conditions feels they are on the verge of losing con... more A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They have been encountered at a specialized inpatient ward offering exposurebased therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety (ECa). We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature-annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects.
Abstract Theoretical and empirical work is needed to adapt psychotherapy to psychosis. The articl... more Abstract Theoretical and empirical work is needed to adapt psychotherapy to psychosis. The article introduces dialogue therapy (DT), a philosophical-ethical, humanistic, and dialogue-oriented individual psychotherapy model for schizophrenia and other severe psychosis. Rather than introducing novel methods, DT offers a unified approach, including flexible methodology derived from existing psychotherapy traditions that focuses on difficulties of emotion, relation, identity, and self-regulation that are characteristic in psychosis. The patient is included to participate fully in the dialogue with her/his subjective voice. The therapist is aware, authentically committed, respectful, and takes seriously all forms of utterances. DT invites the patient to a collaborative process, where she/he is acknowledged as a co-researcher in a continuous search for a cure. Crucial in the therapeutic interaction is to collaborate in generating a breakthrough to split off the psychotic symptoms. The context of DT, therapeutic interactions, and specific methods of how to carry out this psychotherapy are outlined in the article. Not applying psychotherapy in the treatment of psychosis might endanger the development of emotions and self-regulation, social competences, and healthy functioning.
BACKGROUND Suicide prevention is a core task in mental health services. Our objective was to dete... more BACKGROUND Suicide prevention is a core task in mental health services. Our objective was to determine whether Collaborative Assessment and Management of Suicidality (CAMS) reduced suicidal thoughts and behaviors and mental health distress more effectively than treatment as usual (TAU) in a heterogeneous patient population within specialized mental health care services. METHODS In this observer-blinded pragmatic randomized controlled trial participants who scored 13 or above on Beck's Scale for Suicide Ideation-Current (BSSI-C) were included from seven in- and outpatient units. Primary outcome was suicidal ideation (BSSI-C). Secondary outcomes were mental health distress measured by the Outcome Questionnaire-45, and suicidal behaviors measured by the Suicide Attempt Self-Injury Count. Patients were assessed at baseline and after 6 and 12 months. RESULTS The final intent-to-treat analyses included 78 participants (mean age 35.9 years, SD = 14.5, 41 females). The majority were depressed (65%), had a secondary diagnosis (73%) and 32% suffered from borderline personality disorder or borderline traits. After 6 months, CAMS participants reported lower levels of suicidal ideation compared to TAU (β = -4.29, 95% CI = -8.32 to -0.27, p = .036). Larger changes in mental health distress were observed for CAMS participants after 6 months (β = -11.87, 95% CI = -22.99 to -0.76, p = .036) and 12 months (β = -13.70, 95% CI = -24.88 to -2.51, p = .017). LIMITATIONS The modest sample size rendered the trial unable to detect small between-group differences. CONCLUSIONS CAMS reduced suicidal ideation and mental health distress more efficiently than TAU in a heterogeneous patient population within specialized care.
A long noted hypothesis is that mechanisms of dreaming play a role in psychotic hallucinations. O... more A long noted hypothesis is that mechanisms of dreaming play a role in psychotic hallucinations. One challenge for this hypothesis is that while psychotic hallucinations primarily are auditory, dreaming most characteristically is visual. At the same time, previous studies have not explicitly examined auditory impressions in dreaming. Here, we mapped the prevalence and characteristics of auditory impressions in 130 dreams reported after spontaneous awakenings from sleep in 13 normal, healthy people. We instructed participants to report any dream they could recall and to pay particular attention to possible auditory impressions. The participants reported auditory impressions in 93.9% of their dreams on average. The most prevalent auditory type was other people speaking (83.9% of participants' dreams), followed by the dreamer speaking (60.0%), and other types of sounds (e.g. music, 33.1%). Of altogether 407 instances of auditory impressions in the 130 dreams, auditory quality was judged comparable to waking in 46.4%, indeterminate in 50.6%, and absent or only thought-like in 2.9%. The results suggest that also internally generated auditory (verbal) sensations are a central component of dreaming, typically occurring several times every night in normal, healthy people.
To collect and analyze reports of mental activity across sleep/wake states. Mentation reports wer... more To collect and analyze reports of mental activity across sleep/wake states. Mentation reports were collected in a longitudinal design by combining our Nightcap sleep monitor with daytime experience sampling techniques. Reports were collected over 14 days and nights from active and quiet wake, after instrumental awakenings at sleep onset, and after both spontaneous and instrumental awakenings from REM and NREM sleep. All reports were collected in the normal home, work and school environments of the subjects. Subjects included 8 male and 8 female undergraduate students (19-26 years of age). N/A. A total of 1,748 reports, averaging 109 per subject, were collected from active wake across the day (n=894), from quiet wake in the pre-sleep onset period (n=58), from sleep onset (n=280), and from later REM (n=269) and nonREM (n=247) awakenings. Median report lengths varied more than 2-fold, in the order REM > active wake > quiet wake > NREM = sleep onset. The extended protocol allow...
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