Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Introduktion: Många kvinnor påverkas negativt av fysiska och psykiska besvär under sin menstruationscykel. Det råder idag stor kunskapsbrist om hur subkliniska menstruella besvär som kraftig menstruationssmärta, riklig menstruationsblödning, premenstruellt syndrom, premenstruellt dysforiskt syndrom, oregelbunden menstruation och menstruationsbortfall kan lindras utan att använda läkemedel. Fysisk aktivitet och kost har visats ge stora hälsoeffekter vid många sjukdomar och besvär och därför var syftet att undersöka om det även ger positiva hälsoeffekter vid menstruella besvär. Syfte: Syftet med litteraturstudien var att studera om fysisk aktivitet och kost kan minska fysiska och psykiska subkliniska menstruella besvär och därigenom ge ökat välmående. Metod: Sökt i Pubmed med sökorden subkliniska besvär i relation till fysisk aktivitet respektive kost hos fertila tränade och otränade kvinnor utan inverkan av hormonella preventivmedel. Resultat: Studien har visat vissa belägg för att fysisk aktivitet och kost kan lindra några subkliniska menstruella besvär. Premenstruellt syndrom (PMS) kan främst lindras genom lugna, meditativa aktiviteter. Vidare sågs god effekt på PMS av mindre men fler måltider med komplexa kolhydrater, samt intag av vitaminer och mineraler. Yoga har även visats minska menstruationssmärta, och allmän fysisk aktivitet har visat antydan till att förbättra menstruationens regelbundenhet. För att undvika oregelbunden menstruation eller menstruationsuppehåll behövs adekvat energiintag. Övriga subkliniska menstruella besvär saknade tydliga rekommendationer. Konklusion: Studien har visat att fysisk aktivitet och kost kan ha positiva effekter på vissa menstruella subkliniska besvär. För kvinnor med PMS verkar lugna, meditativa former av fysisk aktivitet kunna lindra syndromet. Yoga och fysisk aktivitet har även visats minska dysmenorré. Tillräckligt energiintag är essentiellt för att undvika oregelbunden och utebliven menstruation. Ytterligare studier behövs inom området för att säkerställa resultat och ge generella rekommendationer. / Background: Many women experience physical and psychological symptoms during their menstrual cycle. Research is scarce about how to ease subclinical menstrual disorders like dysmenorrhea, menorrhagia, premenstrual syndrome, premenstrual dysphoric syndrome, oligomenorrhea and amenorrhea without using medicines. Physical activity and diet is proved to have positive effects on several diseases and we therefore wanted to see if positive effects also could be seen on subclinical menstrual disorders. Aim: The aim of this study was to investigate if physical activity and diet could reduce physical and psychological subclinical menstrual disorders and lead to a better wellbeing. Method: Searching for subclinical menstrual disorders in relation to physical activity and diet in fertile, active and inactive women without the use of hormonal contraceptives was done using Pubmed. Results: The study has shown that physical activity and diet could reduce some of the problems associated with subclinical menstrual disorders. Premenstrual syndrome (PMS) could be eased through calm, meditative activities. Positive effects could be seen when eating more often but smaller meals containing complex carbohydrates and by taking additional vitamins and minerals. Yoga has been proved to reduce menstrual pain and there’s also an indication that physical activity could improve the regularity of the menstrual cycle. Adequate energy intake is needed to avoid oligomenorrhea and amenorrhea. No clear recommendations were found for the remaining subclinical menstrual disorders. Conclusion: The study has shown that physical activity and diet have positive effects on some subclinical menstrual disorders. Symptoms of PMS could be eased by calm, meditative activities. Yoga and physical activity have been shown to reduce dysmenorrhea. Adequate energy intake is essential to avoid oligomenorrhea and amenorrhea. Further research is needed to give general recommendations.

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Background: A recent epidemiological analysis on premenstrual dysphoric disorder (PMDD) in the community revealed increased rates of DSM-IV posttraumatic stress disorder (PTSD) among women suffering from PMDD. Aims: To explore whether this association is artifactual or might have important pathogenic implications. Methods: Data come from a prospective, longitudinal community survey of an original sample of N¼1488 women aged 14–24, who were followed-up over a period of 40 to 52 months. Diagnostic assessments are based on the Composite International Diagnostic Interview (CIDI) using the 12-month PMDD diagnostic module. Data were analyzed using logistic regressions (odds ratios) and a case-by-case review. Results: The age adjusted odds ratio between PTSD and threshold PMDD was 11.7 (3.0–46.2) at baseline. 10 women with full PTSD and at least subthreshold PMDD were identified at follow-up. Most reported an experience of abuse in childhood before the onset of PMDD. Some had experienced a life-threatening experience caused by physical attacks, or had witnessed traumatic events experienced by others. 3 women reported more than one traumatic event. Conclusions: A case-by-case review and logistic regression analyses suggest that women with traumatic events and PTSD have an increased risk for secondary PMDD. These observations call for more in-depth analyses in future research.

Introduktion: Kvinnorelaterade sjukdomar är underrepresenterade inom forskning, Premenstruellt syndrom (PMS) och premenstruellt dysforiskt syndrom (PMDS) är två av de. Premenstruella besvär orsakar konsekvenser för drabbade individer samt samhället i stort och är ett dolt folkhälsoproblem. Idag lider 75 procent av alla dessa kvinnor i fertilålder av någon grad av PMS och PMDS drabbar 3-5 procent av den kvinnliga befolkningen, vilket påverkar dessa individer psykiskt, fysiskt samt emotionellt. Mörkertalet är stort inom båda tillstånden då många kvinnor väljer att inte söka vård, till stor del på grund av rädslan för att inte bli tagen på allvar vilket resulterar i många odiagnostiserade individer. Syfte: Syftet med denna strukturerade litteraturstudie är att belysa den problematik kvinnor som lider av PMS eller PMDS ställs inför och hur det påverkar deras livskvalité. Metod: Metoden var att sammanställa tio stycken vetenskapliga artiklar till en litteraturstudie. Resultat: Resultatet belyser de symtom samt problematik som kvinnor upplever under PMS och PMDS. Upplevelsen är även att samhället samt sjukvården inte tar PMS och PMDS på allvar. Erfarenheter som framkommer är att de inte får det stöd som de önskas samt bristen på kunskap i samhället samt hos partnern. Slutsats: Kvinnor saknar förståelse samt hjälp för sin problematik från både samhället, sjukvården och partner. Den faktor som påverkar mest negativt är stress. Samhället har förutfattade meningar om PMS och PMDS som inte stämmer överens med verkligheten. Mer kunskap samt forskning är nödvändigt för att kunna ge dessa kvinnor rätt resurser till en god livskvalitet. / Introduction: Women-related diseases are underrepresented in research. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDS) are two of them. Premenstrual disorders cause consequences for affected individuals and society at large and are a hidden public health problem. In 2021, 75 percent of all women of childbearing age suffer from some degree of PMS and PMDS affects 3-5 percent. Manifestations of PMS and PMDS are mental, physical and emotional. There are a large percentage of unreported cases who experience PMS and PMDS, however, these women may choose not to seek care, due to the fear of not being taken seriously. Thus, many womenare undiagnosedand experience many difficulties, which affects theirachieving a good quality of life. Method: The method was to compile ten scientific articles for a literature study. Results: The results shed light on the symptoms and problems that women experience during PMS and PMDS. The results also show that society and healthcare professionals do not take PMS and PMDS seriously. Other aspects that emerge are that women do not receive the support they want due to lack of knowledge in society. Conclusion: Women lack understanding and help for reproductive problems from both society, healthcare professionals and partners. One factor that affects most negatively is stress. Society has preconceived notions about PMS and PMDS that do not correspond to reality. More knowledge and research are necessary to be able to give these women the right resources for a good quality of life.

Bakgrund: Kvinnor i fertil ålder drabbas i olika omfattning av premenstruella besvär i form av fysiska och psykiska symtom under perioden mellan ägglossning och mens. Forskning visar att menstruationsrelaterade frågor är underrepresenterade och det förekommer negativa uppfattningar om den menstruerande och premenstruerande kvinnan som svag och sjuk. ​​Sjuksköterskan har ett ansvar att bedriva en vård som främjar hälsa och lindrar lidande. Ökad kunskap och förståelse för erfarenheter av att leva med premenstruella besvär kan bidra till att sjuksköterskan kan vara ett bättre stöd för dessa kvinnor.  Syfte: Syftet var att beskriva kvinnors erfarenheter av premenstruella besvär​.   Metod: En allmän litteraturöversikt har gjorts med tio vetenskapliga artiklar hämtade från databaserna CINAHL och PubMed. Nio artiklar var kvalitativa och en artikel var mixad metod.  Resultat: ​I resultatet identifierades tre huvudteman: Påverkan på kvinnors vardag och arbetsliv till följd av premenstruella besvär, Hur kvinnor hanterar premenstruella besvär, Kvinnors erfarenheter av bemötande och attityder kring premenstruella besvär varav sista temat har två subteman: Bemötande från vården och Mäns och samhällets attityd.​  Slutsats: Kvinnors erfarenheter av premenstruella besvär påverkade dem såväl fysiskt som psykiskt och hade en inverkan på både vardag- och arbetsliv. Kvinnor upplevde att samhällets syn och mäns attityd kring premenstruella besvär var negativ och att det saknades kunskap och förståelse inom vården. Det framkom olika sätt att hantera sina besvär på och många sökte stöd och förståelse hos andra kvinnor. Erfarenheterna som beskrevs av kvinnorna kan ge sjuksköterskan kunskap och vara en bra grund för hur hon ska ge stöd och bemöta kvinnor med premenstruella besvär. / Background: ​Women in fertile age describe varying degrees of premenstrual discomfort in the form of physical and psychological symptoms during the period between ovulation and menstruation. Research shows that menstruation-related issues are underrepresented in general and there are negative perceptions of the menstruating and premenstruating woman as being weak and sick. The nurse has a responsibility to provide care that promotes health and alleviates suffering. Increased knowledge and understanding the experience of living with premenstrual discomfort can contribute to the nurse being better able to support these women.​  Aim: The aim was to describe women´s experiences of premenstrual discomfort​.  Method: A general literature review has been made with ten scientific articles taken from the databases CINAHL and PubMed. Nine articles were qualitative and one article was mixed method.​  Results: In the result three main themes were identified: Impact on women's private and professional lives as a result of premenstrual discomfort, How women deal with premenstrual discomfort, Women's experiences of treatment and attitudes around premenstrual discomfort, the last theme of which has two subthemes: Treatment from health care and Men's and society's attitude.  Conclusion: Women's experiences of premenstrual discomfort affected them both physically and psychologically and had an impact on both their private and professional lives. Women felt that society's view and men's attitude towards premenstrual discomfort were negative and that there was a lack of knowledge and understanding in healthcare. Different ways of dealing with their premenstrual discomfort emerged and many sought support and understanding from other women. The experiences described by the women can give the nurse knowledge and be a good basis for how the nurse should provide support and respond to women with premenstrual discomfort.

Att få barn är en stor livsstilsförändring som kan komma med många utmaningar. Att amma sitt barn anses ofta som en självklarhet och det talas om amningens många fördelar. Däremot talas det sällan om svårigheter som kan uppkomma i samband med amning. Amningsångest och dysforisk mjölkutdrivningsreflex är ett relativt okänt tillstånd vilket kan leda till onödigt lidande för de ammande mödrarna. Syftet med studien var att beskriva mödrars upplevelser och erfarenheter av amningsångest och dysforisk mjölkutdrivningsreflex. Det är en kvalitativ studie med induktiv ansats. Data samlades in genom blogginlägg, kommentarer och publicerade intervjuer där mödrar beskrivit sina upplevelser. Insamlad data analyserades med en kvalitativ innehållsanalys som resulterade i två kategorier: Okunskap om amningssvårigheter hos ammande mödrar och Okunskap om amningssvårigheter hos vårdpersonal. Kategorierna bildade temat: Mödrars behov av förståelse, bekräftelse och hjälp i den postnatala vården. Utifrån denna studie kan vårdpersonal som möter ammande mödrar få förståelse för och kunskap om hur mödrar upplever sin amningsångest och dysforiska mjölkutdrivningsreflex, och även att mödrarna själva kan få kunskap om att det är ett tillstånd som existerar. Studien kan ligga till grund för kunskapsspridning om amningsångest och dysforisk mjölkutdrivningsreflex och resultera i att mödrar upplever mindre ensamhet och lidande. / Having a baby is a lifestyle change that can come with challenges. Breastfeeding is often taken for granted and the many benefits are often talked about. However, it rarely talks about difficulties that can arise. Breastfeeding anxiety and dysphoric milk ejection reflex is a relatively unknown condition which can lead to unnecessary suffering for breastfeeding mothers. The purpose of the study was to describe mothers' experiences of breastfeeding anxiety and dysphoric milk ejection reflex. It is a qualitative study with an inductive approach. Data was collected through blogposts, comments and published interviews where mothers described their experiences. Data were analyzed with a qualitative analysis that resulted in two categories: Ignorance of breastfeeding difficulties in nursing mothers and Ignorance of breastfeeding difficulties in healthcare personnel. The categories formed the theme: Mothers' need for understanding, confirmation and help in postnatal care. Based on this study, healthcare professionals can gain understanding and knowledge of how mothers experience their breastfeeding anxiety and dysphoric milk ejection reflex, but also the mothers themselves gain knowledge that it is a condition that exists. The study can spread knowledge about breastfeeding anxiety and dysphoric milk drive reflex, which can result in mothers experiencing less loneliness and suffering.

Bakgrund: Premenstruell dysforisk störning (PMDS) är en allvarlig form av premenstruellt syndrom (PMS) som drabbar 3–8% av kvinnor i reproduktiv ålder. Emotionell dysreglering är kardinalsymptom för PMDS. Orsaken är ännu ej är helt klarlagd, men troligen råder hormonell överkänslighet i centrala nervsystemet. Identifikation, bemötande och omvårdnad från hälso- och sjukvårdspersonal är avgörande för bibehållen livskvalitet. Syfte: Syftet är att undersöka kvinnors upplevelser av premenstruell dysforisk störning. Metod: Litteraturöversikt med kvalitativ metod och induktiv ansats. Artikelsökningen gjordes i databaserna MEDLINE, CINAHL och PsycInfo. Tolv artiklar från år 2006–2022 inkluderades i resultatet. Fribergs dataanalysmodell användes. Resultat: I resultatet framkom två huvudteman; Begränsningar till följd av PMDS samt försök att hantera PMDS, vilka underbyggdes av sex subteman. Slutsats: Till följd av PMDS upplevdes sociala, känslomässiga, utbildnings- och yrkesmässiga begränsningar. Kvinnor försökte hantera livet med PMDS på olika sätt. Vikten av att såväl kvinnor själva som hälso- och sjukvårdspersonal besitter kunskap om PMDS var avgörande för att undvika onödigt lidande och försämrad livskvalité. / Background: Premenstrual Dysphoric Disorder (PMDD) is a severe type of Premenstrual Syndrome (PMS) affecting 3–8% of women at reproductive age. Emotional dysregulation is the primary symptom for PMDD. The cause is not yet entirely confirmed but probably it is due to hormonal oversensitivity in the central nervous system. Health professionals' identification, respond and nursing is crucial in order to substantiate women's perceived quality of life. Aim: The aim is to describe women’s experiences of premenstrual dysphoric disorder. Method: A literature review with qualitative method and inductive research approach. The result was based on twelve articles from year 2006-2022 which underwent examination according to templates from Friberg’s analysis model. Result: Two main themes were identified as Limitations due to PMDD and women’s ways of handling the life with PMDD. Those were supported by 6 sub-themes. Conclusion: Social, emotional, educational and work-related limitations due to PMDD were presented along with women´s different ways of trying to handle their life with PMDD. It was found highly important that both women themselves and health professionals have knowledge about PMDD in order to avoid unnecessary suffering and negatively affected quality of life.

Bien que les rêves dysphoriques, comme les mauvais rêves et les cauchemars, surviennent du moins occasionnellement chez la majorité des adultes, les facteurs impliqués dans l’occurrence de ces rêves, d’une nuit à l’autre, demeurent incertains. Par le biais d’un devis prospectif multiniveaux, nous avons étudié l’impact interactif des facteurs d’état et de trait sur l’occurrence de rêves dysphoriques d’une nuit à l’autre. Nous avons également exploré dans quelle mesure le contenu affectif et négatif des rêves de tous les jours était affecté par les mêmes facteurs. Des femmes adultes ont complété des mesures de trait de personnalité et de psychopathologie suivies de jusqu’à quatre semaines de journaux quotidiens de rêves et d’anxiété avant le coucher, ainsi que d’inventaires hebdomadaires de stress perçu. En contrôlant pour le rappel de rêve, une hausse hebdomadaire du stress perçu a significativement augmenté la probabilité d’avoir un rêve dysphorique une nuit donnée, alors que la psychopathologie a modéré positivement cette relation. Ces résultats suggèrent que les femmes adultes ayant un niveau plus élevé de psychopathologie seraient particulièrement sensibles au stress quotidien et donc plus susceptibles de faire des mauvais rêves ou cauchemars les nuits suivantes. Les analyses ont aussi révélé des effets positifs différentiels des variables d’état et de trait sur le contenu émotionnel et négatif des rêves de tous les jours. Ces résultats concordent avec le modèle neurocognitif des rêves dysphoriques proposé récemment et l’hypothèse de continuité des rêves. Les implications de cette étude et des recommandations futures sont émises. / Although disturbing dreams, such as bad dreams and nightmares, are experienced at least occasionally by a majority of adults, the factors involved in the night-by-night occurrence of these dreams remain unclear. Using a prospective design and multilevel modeling, we investigated the interactive impact of state and trait factors on the nightly occurrence of disturbing dreams. We further explored the extent to which emotionally intense and negative everyday dream content was affected by the same variables. Adult women completed measures of personality and psychopathology followed by up to four weeks of daily dream logs, daily pre-sleep anxiety logs, and weekly perceived stress inventories. After controlling for dream recall, upsurges in weekly perceived stress significantly increased the likelihood of having a disturbing dream on a given night, whereas psychopathology positively moderated that relationship. These results suggest that adult women reporting higher levels of psychopathology are particularly sensitive to everyday stress and thus more likely to experience bad dreams or nightmares on subsequent nights. Analyses also revealed differential positive effects of state and trait variables on the emotional and negative content of everyday dreams. These findings are in line with a recently proposed neurocognitive model of disturbed dreaming and the continuity hypothesis of dreaming. The implications of this study and future recommendations are emitted.

De nombreux cliniciens œuvrant en périnatalité constatent que l’activité onirique est plus foisonnante et perturbée durant la grossesse. Certains croient d’ailleurs que le caractère plus vif, réaliste et marquant des rêves de cette période permette aux femmes d’avoir une plus grande accessibilité à leur monde intrapsychique, ce qui faciliterait la résolution d’enjeux relationnels laissés jusqu’alors en suspens. D’autres avancent aussi que les rêves permettent aux futures mères d’intérioriser leur rôle maternel grâce au développement de représentations mentales ayant trait, entre autres, à la future relation mère-bébé. Or, bien que ces notions soient fortement ancrées dans la littérature clinique, elles demeurent, en revanche, peu étudiées sur le plan empirique. Le premier objectif de cette thèse visait à offrir une meilleure description de l’activité onirique au troisième trimestre (≥26 semaines) d’une première grossesse, incluant le rappel onirique, la prévalence des rêves dysphoriques et le contenu des rêves. Nos résultats montrent pour la première fois que, lorsqu’ils sont collectés prospectivement, les rêves des femmes enceintes ne sont pas plus fréquents, mais ils sont nettement plus perturbés (article 1) et globalement plus négatifs (article 2) que ceux d’un groupe témoin constitué de femmes non enceintes et sans enfant. Le deuxième article montre aussi que, sur le plan thématique, les rêves de la grossesse incorporent, en plus des préoccupations typiques de cette période, des images de la femme en relation avec un enfant. Les processus plus généraux de la formation d’imageries oniriques, tels que le développement de la trame narrative et la valence des interactions entre personnages, se montrent quant à eux similaires entre les femmes enceintes et non enceintes. Le deuxième objectif de cette thèse visait à évaluer le rôle prédictif des rêves de la grossesse dans l’adaptation psychologique à la maternité, via l’étude de caractéristiques oniriques affectives et représentationnelles bien spécifiques (article 3). Nous montrons pour la première fois que les rêves qui dépeignent négativement la rêveuse et ceux qui incorporent la relation de la rêveuse avec sa propre mère prédisent indépendamment, et au-delà des symptômes dépressifs prénataux, l’adaptation de la femme aux chamboulements affectifs et relationnels que suscite la venue d’un premier enfant. Les résultats de cette thèse appuient l’hypothèse de la continuité onirique, qui stipule que les préoccupations de l’éveil transparaissent dans les rêves. Ce travail s’inscrit également dans la lignée des conceptions théoriques voulant que les rêves occupent une fonction adaptative pour l’équilibre psychologique. / According to many perinatal health care professionals, dreams are more frequent and disturbed during pregnancy. Some suggest that in being more vivid, realistic and impactful than during any other period of life, pregnancy dreams might increase women’s awareness to their intrapsychic world and therefore facilitate the resolution of past relational issues. Other clinicians suggest that dreams during pregnancy might help women to integrate their maternal role through the elaboration of various mental representations, such as the future mother-baby relationship. While these notions have been frequently mentioned in the clinical literature, empirical evidence is lacking. The first objective of this thesis was to provide a better description of changes occurring in the dreams of the third trimester (≥26 weeks) of a first pregnancy, using measures of dream recall, dysphoric dreams prevalence, and dream content. Our results show—for the first time—that when pregnant women’s dreams are prospectively collected, they are not more frequent, but they are more disturbed (study 1) and generally more dysphoric (study 2) than non-pregnant women’s dreams. The second study also reveals that during pregnancy, dreams do not only express typical concerns of pregnant women, but they also depict the elaboration of representations of the woman’s relationship with her unborn child. However, more general dream attributes, such as development of the dream’s narrative and interactions between dream characters, are similar between pregnant and non-pregnant women. The second objective of this thesis was to assess the predictive role of pregnancy dreams in the psychological adaptation to motherhood through the evaluation of specific affective and representational characteristics (study 3). Our results show for the first time that more frequent masochistic dreams and dreams about mother-daughter relationships predict independently, and above and beyond prenatal depression symptoms, better maternal adaptation to affective and relational changes concurrent with the arrival of a new baby. The results of this thesis thus support the view that dreams are continuous with emotionally important waking life concerns. The work also supports theoretical conceptions suggesting that dreams have an adaptive function in maintaining psychological equilibrium.