The purpose of the study was to find out if children ages 4- 5 who were experiencing nighttime fears could be taught coping behaviors to decrease their fears. Five children and their parents participated in the study. A treatment package consisting of teaching the children brave self- statements, relaxation exercises, and the introduction of a token economy was used. Results indicate a reduction in fear behavior at post treatment, and further decreases in fear related measures at follow- up.

Domestic abuse is the number one cause of injury to women in the United States. Women and their children flee everyday to shelters to escape the abuse. Once inside the shelters, material resources are rendered so that the women can continue to lead lives outside the shelter and different therapies are employed so that the women can better understand the abuse and their options once leaving. A type of therapy used in other therapeutic forums, such as patients sexually abused as children, is dream analysis. This type of therapy has allowed formerly traumatized victims a safe space to uncover hidden traumas, acknowledge them and begin to write new scripts for their lives. The theoretical view behind this paper is that dream analysis could be a feminist tool of empowerment for women participating in domestic abuse therapy. As a researcher, I performed research at The Spring, Tampa Florida's only domestic abuse shelter for women and their children. During the research, I observed multiple domestic violence group therapy sessions, interviewed the facilitator of this group, and held personal interviews with five different women over a three month period. During these interviews, the women discussed in detail their lives, the abuse they sustained and their dreams surrounding the abuse. The women were asked to give interpretations of the meanings of their dreams, which are incorporated in the paper. Throughout the interviews, it was of vital importance that the battered women's standpoints were privileged and that they remained the experts of their own experiences. During this process, two points became clear: forgotten traumas resurfaced during dreamtime and the women understood they were "too good" for the abuse and should leave. It became clear that dream analysis could be a feminist tool of empowerment for this highly marginalized community.

Lucid Dreaming (LD) is defined as the phenomenon of becoming consciously aware of dreaming while still dreaming. In sleep laboratory experiments LD has been verified to occur during REM sleep stage by proficient lucid dreamers who have signaled while becoming lucid through specific pre-determined eye-movements. Using this method, (lucid) dreamed activity has been shown to correlate with both psychophysiological and neurophysiological responses to those observable if the same activity was to be performed during wakefulness. LD has also shown potential to be of therapeutic value, in reducing recurrent nightmare frequency. Recurrent nightmare sufferers engaging in Lucid Dreaming Treatment (LDT) show reduced nightmare frequency after treatment. As such, LDT has been suggested to be effective in the treatment of posttraumatic nightmares in Posttraumatic Stress Disorder (PTSD). The attitude and feeling of control provided by LDT has been shown to be fruitful also in fearful waking situations, indicating that LDT might be effective in disorders epitomized by fear.

<p>Lucid Dreaming (LD) is defined as the phenomenon of becoming consciously aware of dreaming while still dreaming. In sleep laboratory experiments LD has been verified to occur during REM sleep stage by proficient lucid dreamers who have signaled while becoming lucid through specific pre-determined eye-movements. Using this method, (lucid) dreamed activity has been shown to correlate with both psychophysiological and neurophysiological responses to those observable if the same activity was to be performed during wakefulness. LD has also shown potential to be of therapeutic value, in reducing recurrent nightmare frequency. Recurrent nightmare sufferers engaging in Lucid Dreaming Treatment (LDT) show reduced nightmare frequency after treatment. As such, LDT has been suggested to be effective in the treatment of posttraumatic nightmares in Posttraumatic Stress Disorder (PTSD). The attitude and feeling of control provided by LDT has been shown to be fruitful also in fearful waking situations, indicating that LDT might be effective in disorders epitomized by fear.</p>

I uppsatsen behandlas musiken i ett avsnitt av realityserien Kitchen Nightmares. Ett antal tydliga musikaliska teman i avsnittet belyses. Instrumentering, narrativa funktioner och hur ljudstudenter tolkar dessa teman är de huvudsakliga frågeställningarna. Genom egna observationer, en intervju med en professionell kompositör för TV och film samt en fokusgrupp har frågeställningarna besvarats. De musikaliska teman som behandlas i uppsatsen varierar i karaktär, intensitet och instrumentering beroende på vad de vill förmedla. Ofta är det känslolägen som interpersonella konflikter och sorg som underbyggs av musiken men den har även funktioner som syftar till att belysa saker som etnisk härkomst och förlöjligande av personer som beter sig problematiskt. Vikten av tydlighet inom musik för TV och film behandlas och hur denna tydlighet framträder. Ljudstudenternas tolkningar av musiken beskrivs och sammantaget tyder resultatet på att de intentioner upphovsmännen haft med musikläggningen framgår tydligt hos dessa.

Posttraumatic Stress Disorder (PTSD) is a prevalent anxiety disorder that is debilitating to both veterans and civilians following one or more traumatic events. Sleep disturbances are hallmark features of PTSD. Sleep disturbances and PTSD remain two significant PTSD-related issues that continue to plague veterans returning from active duty, thereby preventing full reintegration into society. The same problem exists for civilians. This research was conducted as a previously collected pilot study data and a secondary data analysis. The purpose of the study consisted of: 1) examining the impact of treatment with Accelerated Resolution Therapy (ART) on symptoms of PTSD and sleep disturbances; 2) examining the relationships and treatment response among both subjective and objective measures of sleep function; and 3) comparing the relationship between PTSD and sleep disturbances among military versus civilians, including the effects of treatment with ART. The study represents one of only a few studies consisting of subjective measures of PTSD (PCL checklist) and sleep quality (Pittsburgh Quality Sleep Index (PSQI)), and objective measurement of sleep function by use of electroencephalography (EEG) testing and based on a 30-minute nap protocol. The aims of this study were to: 1) investigate the effects of ART on comorbid PTSD and sleep disturbances in U.S. veterans measured both subjectively (self-report) and objectively (sleep EEG data) from previously collected pilot study data; 2) assess the relationships between objective and subjective measures of sleep disturbances before and after treatment with ART for symptoms of PTSD in U.S. veterans from previously collected pilot study data; and 3) compare self-report PTSD and sleep disturbances symptoms between civilians and veterans before and after treatment with ART using a secondary analysis from two previously conducted studies. For Specific Aims 1 and 2, the methods consisted of previously collected pilot study data of 8 veterans who were treated with ART at the University of South Florida, College of Nursing. For Specific Aim 3, data were pooled from two completed studies of ART directed by Dr. Kevin Kip that included civilians (n=75) and veterans (n=50) who were treated for PTSD. Data analysis for Aim 1 included the use of paired t tests to compare PSQI score and each stage of sleep measured from qEEG (Delta, Theta, Alpha, Beta, Gamma) before and after treatment with ART. For Aim 2, Pearson correlation was used to assess the relationship between objective measurement of sleep disturbances and subjective sleep quality before and after ART. For Aim 3, multiple linear regression models were fit with PSQI (sleep) score as the dependent variable, PCL (PTSD) score as the primary independent variable, along with a main effect term for military status (civilian versus military) and an interaction term (military status * PCL score). Results for aims 1 and 2 showed the mean age of the sample to be 37.6 years, 87.5% male, 87.5% White (non-Hispanic), 87.5% had experienced prior combat, 50% had experienced 5 or more traumatic memories that impacted their lives, and 87.5% had previous treatment for PTSD. Sample mean scores were above established screening criteria for PTSD (PCL-M = 63.7), sleep disturbance (PSQI = 14.5), and Center for Epidemiologic Studies Depression Scale (CES-D = 28.9). For Aim 1, after treatment with ART, the mean score on the PSQI dropped 4.88 points, mean score on the PCL-M dropped -30.13 points, thereby indicating significant reductions in sleep dysfunction and symptoms of PTSD. Mean Delta 1.5-3.5 Hz waves increased pre/post by 299.89 (p=.032), and Theta 4-6.5 Hz waves increased pre/post mean by 83.07 (p<0.001), both indicative of improved sleep quality. Results for Aim 2 showed statistically significant strong inverse correlations between PSQI and Theta 1.5-3.5 Hz waves (r=-0.79) and PSQI and Alpha 8-11 Hz waves (r=-0.89) at baseline. Post-ART, non-significant trends were observed for higher PSQI scores and higher Beta (conscious, alert) waves. For Aim 3, mean age of military participants (n=50) was 41.9 years versus 40.4 years among civilians (n=75, p=.439). For the military cohort, 18% were female compared to 80% among civilians (p<0.001), with lower Hispanic ethnicity among military compared to civilian participants (12% vs. 27%, p=0.04). In multiple regression analysis, change in PCL score was a strong predictor of change in PSQI score, regardless of military status PCL. In summary, within the setting of PTSD, military participants tend to present with different traumatic exposures and worse sleep quality compared to civilian counterparts. In spite of these differences, the treatment protocol with ART demonstrated similar level of benefit (reduction in symptoms of PTSD and sleep disturbance) for both military and civilian personnel. Thus, nurses caring for individuals with PTSD, whether military or civilian, need to routinely assess sleep disturbances and initiate an open dialogue regarding these conditions. In return, nurses will be able to provide patients with resources to help them better understand and address these concerns, including after experiencing restless nights of sleep. Lastly, nurses should recognize the bi-directional temporal relationship between PTSD and sleep disturbances places. This places a premium on assessing these conditions collectively, rather than as discrete, independent clinical conditions.

The nightmare prevalence literature to date has largely focused on nightmare episode severity (i.e. frequency), with 8%-87% of individuals reporting these events in the past week to year. While this has helped to determine the prevalence of these events, focus on the episode severity alone is problematic because it means little is known about the actual prevalence of nightmare disorder. Moreover, focus on episode severity likely overestimates the actual prevalence of clinically significant nightmares while also obscuring clinically significant consequences of the disorder. Understanding the prevalence of nightmare disorder can help guide treatment planning and interventions. The present study recruited UNT undergraduates (N = 372; 351 analyzed) and managed all participant data using Research Electronic Data Capture (REDCap). The present study aimed to determine the prevalence of nightmare disorder, as stated in the DSM-5, to facilitate accurate characterization of the disorder. Additionally, as part of the secondary aim the influence of gender on nightmare disorder status and psychological wellbeing as measured by psychological and sleep outcome variables was examined. Finally, comparisons of individuals with DSM-5-defined nightmare disorder to those without the disorder were conducted on previously examined correlates (e.g., trauma symptoms, depression).

Une étude récente rapporte que des participants souffrant de cauchemars idiopathiques fréquents (CIF) produisaient plus d’erreurs de persévération sur une tâche de fluence verbale (TFV) que des participants contrôle (CTL) (Simor et al., 2012). Cela suggère une dysfonction exécutive chez les participants CIF, soutenant le modèle des cauchemars Affective Network Dysfunction (AND). Notre objectif était de reproduire cette trouvaille auprès d’une cohorte francophone. Des TFV lexicale et sémantique ont été administrées à 23 participants avec CIF et à 16 CTL. Contrairement aux attentes, le groupe CIF n’affichait pas plus de persévération (p=.87). L’absence de reproduction pourrait infirmer la suggestion d’une dysfonction exécutive liée au CIF, toutefois des différences méthodologiques entre les études et les complexités de la TFV peuvent jouer un rôle dans le décalage entre les études. Nous suggérons que l’étude future des déficits exécutifs liés aux CIF emploie des tâches neuropsychologiques non linguistiques empiriquement associées au sommeil paradoxal. / A recent study reported that individuals suffering from frequent idiopathic nightmares (NMs) produced more perseveration errors on a verbal fluency task (VFT) than did control participants (CTLs) (Simor et al., 2012). These findings suggest executive dysfunction in NM sufferers and support the Affective Network Dysfunction (AND) model relating NM production. We sought to replicate these results in a French speaking cohort. Lexical and semantic VFTs were administered to 23 participants with frequent NMs, and to 16 CTLs with few NMs. Contrary to expectations, groups did not exhibit more fluency perseveration errors (p=.87). Though failure to replicate may indicate that NM sufferers do not have an executive dysfunction, methodological differences between studies and challenges inherent to the use of the VFT may also play a role in the discrepancy between studies. Future study of executive deficits in NM participants should be measured by non linguistic-dependant neuropsychological tasks empirically linked to REM sleep.

Le trouble comportemental en sommeil paradoxal (TCSP) est caractérisé par des rêves intenses et une perte de l’atonie musculaire normalement présente au cours du sommeil paradoxal qui permet l’apparition de comportements oniriques isomorphiques au contenu des rêves. Quelques chercheurs ont étudié le contenu des rêves des patients atteints du TCSP, plusieurs ont trouvé une plus grande présence de thèmes menaçants et agressifs, d’autres ont obtenu des résultats plus mitigés. Ces études comportent des failles méthodologiques importantes, comme l’absence d’un groupe contrôle ou l’inclusion de patients consommant une médication psychoactive. La présence de rêves à caractère dysphorique a été associée, dans d’autres populations, à une psychopathologie marquée et à des difficultés émotionnelles, et cette association, quoiqu’inexplorée pourrait aussi être présente chez patients ayant un TCSP. La raison pour laquelle ces patients font des rêves plus dysphoriques est encore largement inconnue, de même qu’une partie des mécanismes qui génèrent les comportements oniriques. Le but du premier article de cette thèse était de mesurer l’alexithymie et la détresse des cauchemars chez les patients atteints du TCSP par rapport à des contrôles. Les résultats indiquent que les patients souffrent davantage d’alexithymie, et particulièrement d’une difficulté à identifier leurs émotions et qu’elle corrélait avec la détresse due aux cauchemars. Le second article estimait, à l'aide d'un questionnaire validé, la présence de rêves, la diversité des thèmes des rêves chez les patients et examinait leurs thèmes au cours de leur vie. Les patients rapportaient beaucoup plus de cauchemars et plus de thèmes à caractère menaçant, comme des agressions, des catastrophes, et des rêves où le rêveur a peu de contrôle. Le troisième article avait pour objectif de clarifier les écarts dans les résultats des études sur les rêves des patients, c'est-à-dire déterminer si l'agressivité rapportée par ces patients est vraiment une différence au niveau du contenu des rêves, ou s'il s'agit plutôt d'un problème dû à la détresse liée aux rêves. Un second objectif était de mesurer le degré de corrélation entre les comportements à l’éveil, comme les comportements miroirs, et les comportements oniriques chez les patients. L’article démontre que les patients ressentaient une plus grande détresse à l'éveil en lien avec leurs expériences oniriques et que leurs rêves étaient plus dysphoriques et contenaient plus d'anxiété. De plus, leurs résultats au questionnaire de comportements miroirs corrélaient avec la sévérité de leurs comportements oniriques, ce qui suggère que le système de neurones miroirs pourrait avoir une influence sur les manifestations de ces comportements chez les patients. Globalement, ces résultats suggèrent que des difficultés au niveau de la régulation émotionnelle pourraient expliquer à la fois les symptômes émotionnels à l’éveil et les difficultés nocturnes des patients. Nous suggérons qu'un déficit au niveau des régions régulatrices frontales pourrait être à la base des différentes difficultés éprouvées par les patients. De plus, il est possible que des anomalies au niveau du système de neurones miroirs aient à la fois un impact sur la capacité des patients à réguler leurs émotions, mais aussi sur les manifestations de comportements oniriques. / REM sleep behavior disorder (RBD) is a parasomnia characterized by vivid dreams and loss of muscle atonia usually present during REM sleep that allows the appearance of dream-enacting behaviors that are isomorphic to dream content. Several studies have examined the content of RBD patients’ dreams, many found a greater presence of threatening and aggressive themes, others obtained mixed results. Most studies had significant methodological shortcomings, such as a lack of a control group or the inclusion of patients taking psychoactive medication. Still, the presence of dysphoric dreams is associated with marked psychopathology and emotional regulation problems. Moreover, the reason why RBD patients have dysphoric dreams is largely unexplored, just as parts of the processes that generate the dream-enacting behaviors. The goal of the first article of this thesis was to measure alexithymia and nightmare distress among RBD patients compared to a control group. The results indicate that RBD patients suffer more from alexithymia, especially a greater difficulty in identifying their emotions and that this difficulty correlated with nightmare distress. The second article examined, using a validated questionnaire, the lifetime prevalences of patients’ typical dream themes, and estimated the presence of their dreams, nightmares and dream theme diversity. RBD patients reported significantly more nightmares than controls and more menacing themes, such as assaults, disasters, and where the dreamer lacks control. The third article was intended to clarify discrepancies in the results of studies on RBD dreams, that is, if the aggressiveness reported by patients is really a difference in dream content or rather a problem related to dream distress. A second objective was to measure the degree of correlations between waking-state behaviors such as mirror behaviors, and dream-enacting behaviours in RBD patients. RBD patients were found to have more dysphoric dreams, containing more anxiety. They were also feeling greater distress in reaction to their dream experiences than did controls. Moreover, their results on the mirror behavior questionnaire correlated with the severity of their dream-enacting behaviors, suggesting that the mirror neuron system could have an influence in the formation of these behaviors. Overall, these findings suggest that difficulties in emotional regulation could explain both patients’ daytime emotional symptoms (alexithymia, nightmare distress, depression, anxiety, fewer mirror behaviors) and nocturnal difficulties (nightmares and dysphoric dreams, threats in dreams). We suggest that a deficit in frontal regulatory regions could be the base of the different challenges faced by patients. More specifically, it is possible that abnormalities in the mirror neuron system have an impact on both patients' ability to regulate their emotions and the manifestation of dream-enacting behaviors.

Mental suffering costs the society amounts of money every year due to sick leave, suicide and general production loss. Posttraumatic stress disorder (PTSD) is one of the conditions that can affect anyone who has experienced a traumatic event.  This thesis examines the positive experiences and limitations of the treatment form Imagery rehearsal therapy for war veterans’ post-traumatic nightmares. The results show that this treatment reduces post-trauma nightmares both in frequency and in intensity. It also improves the quality of sleep and reduces PTSD- and depression symptoms. However, veterans with multiple traumas as a basis for their PTSD may need more sessions of imagery rehearsal therapy. The results also indicate that the treatment also can show positive results in the reduction of the nightmare frequency and intensity in individuals who suffer from other types of traumatic nightmares than the war veterans had. / Psykiskt lidande kostar samhället stora summor årligen genom sjukskrivningar, självmord och allmänt produktionsbortfall. Posttraumatiskt stressyndrom (PTSD) är ett av dessa sjukdomstillstånd och kan drabba vem som helst som upplevt en traumatisk händelse. Detta examensarbete undersöker de positiva erfarenheterna av och begränsningarna hos behandlingsformen imagery rehearsal therapy vid posttraumatiska mardrömmar hos krigsveteraner. Resultatet visar att denna behandlingsform minskar posttraumatiska mardrömmar både i frekvens och i intensitet. Den förbättrar även sömnkvalitén, samt minskar PTSD-och depressionssymptom. Dock, så kankrigsveteraner med flera trauman som grund för deras PTSD behöva fler sessioner av imagery rehearsal therapy. Resultaten visar också att behandlingen även kan visa positiva resultat i minskning av mardrömmars frekvens och intensitet hos individer som lider av andra typer av traumatiska mardrömmar än de krigsveteranerna hade.