The Relationship between Neuroticism, Nightmare Characteristics and Suffering in respect to PTSD Psychopathology

Sonja Protić; Robert-Jacek Gorzka; Helge Höllmer; Lutz Wittmann

doi:10.19090/pp.v17i3.2505

Authors

Sonja Protić Evangelische Hochschule Darmstadt, University of Applied Science, Germany https://orcid.org/0000-0003-0703-6826
Robert-Jacek Gorzka Department of Applied Military and Operational Psychology, Military Police Command, Hanover, Germany https://orcid.org/0009-0004-4831-345X
Helge Höllmer Bundeswehr Hospital Hamburg, Center for Mental Health, Germany https://orcid.org/0000-0002-6706-9470
Lutz Wittmann International Psychoanalytic University Berlin, Germany https://orcid.org/0009-0005-8792-2634

DOI:

https://doi.org/10.19090/pp.v17i3.2505

Keywords:

neuroticism, PTSD, nightmare characteristics, suffering

Abstract

Introduction: The role of neuroticism in the relationship between nightmare characteristics (e.g., frequency and replicativity), and nightmare-related suffering, i.e., nightmare-related distress and impairment after awaking, is still to be explored.

Methods: In a sample of 346 soldiers (mean age 33.95 years, 13.9% females) who experienced at least one traumatic event (47.0% having a formal clinical diagnosis of PTSD), we tested the contributions of neuroticisms and PTSD symptomatology in predicting nightmare characteristics, as well as their moderating effects on the relationship between variables reflecting nightmare characteristics and suffering.

Results: Results showed no significant effect of neuroticism on nightmare frequency and replicativity beyond PTSD symptomatology, while its contribution to nightmare-related suffering was only partially explained by PTSD symptomatology. However, in the subsample of soldiers with PTSD diagnosis, neuroticism showed no significant effects beyond PTSD symptom severity and replicativity. Furthermore, no moderating effects of neuroticism or PTSD symptom severity on the relationship between nightmare characteristics and nightmare-related suffering in traumatized soldiers were found.

Discussion: These results confirm the predictive role of neuroticism on PTSD symptom severity and nightmare-related suffering but not nightmare frequency and replicativity. Furthermore, neuroticism and PTSD symptom severity did not contribute to higher vulnerability to nightmare suffering, in traumatized people who experience frequent and replicative nightmares.

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References

Abdel-Khalek, A. M. (2016). Reported nightmares and trait anxiety among arab children, adolescents and adults. Journal of Sleep Disorders Therapy, 5(248), 2167-0277. http://dx.doi.org/10.4172/2167-0277.1000248 DOI: https://doi.org/10.4172/2167-0277.1000248

American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. DOI: https://doi.org/10.1176/appi.books.9780890425596

Belicki, K. (1992). Nightmare frequency versus nightmare distress: Relations to psychopathology and cognitive style. Journal of Abnormal Psychology, 101(3), 592–597. https://doi.org/10.1037/0021-843X.101.3.592 DOI: https://doi.org/10.1037//0021-843X.101.3.592

Blagrove, M., Farmer, L., & Williams, E. (2004). The relationship of nightmare frequency and nightmare distress to well‐being. Journal of sleep research, 13(2), 129-136. https://doi.org/10.1111/j.1365-2869.2004.00394.x DOI: https://doi.org/10.1111/j.1365-2869.2004.00394.x

Böckermann, M., Gieselmann, A., & Pietrowsky, R. (2014). What does nightmare distress mean? Factorial structure and psychometric properties of the Nightmare Distress Questionnaire (NDQ). Dreaming, 24(4), 279–289. https://doi.org/10.1037/a0037749 DOI: https://doi.org/10.1037/a0037749

Borkenau, P., & Ostendorf, F. (2008). NEO-Fünf-Faktoren-Inventar nach Costa und McCrae. Bern: Hogrefe.

Breslau, N., & Schultz, L. (2013). Neuroticism and post-traumatic stress disorder: a prospective investigation. Psychological medicine, 43(8), 1697-1702. https://doi.org/10.1017/S0033291712002632 DOI: https://doi.org/10.1017/S0033291712002632

Chivers, L., & Blagrove, M. (1999). Nightmare frequency, personality and acute psychopathology. Personality and Individual Differences, 27(5), 843-851. https://doi.org/10.1016/S0191-8869(99)00033-1 DOI: https://doi.org/10.1016/S0191-8869(99)00033-1

Cohen, Jacob (1988). Statistical Power Analysis for the Behavioral Sciences. Routledge.

Costa Jr, P. T., & McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: is the bark worse than the bite?. Journal of personality, 55(2), 299-316. https://doi.org/10.1111/j.1467-6494.1987.tb00438.x DOI: https://doi.org/10.1111/j.1467-6494.1987.tb00438.x

Cox, B. J., MacPherson, P. S., Enns, M. W., & McWilliams, L. A. (2004). Neuroticism and self-criticism associated with post-traumatic stress disorder in a nationally representative sample. Behaviour research and therapy, 42(1), 105-114. https://doi.org/10.1016/S0005-7967(03)00105-0 DOI: https://doi.org/10.1016/S0005-7967(03)00105-0

Davis, J. L., Byrd, P., Rhudy, J. L., & Wright, D. C. (2007). Characteristics of chronic nightmares in a trauma-exposed treatment-seeking sample. Dreaming, 17(4), 187–198. https://doi.org/10.1037/1053-0797.17.4.187 DOI: https://doi.org/10.1037/1053-0797.17.4.187

de Dassel, T., Wittmann, L., Protic, S., Höllmer, H., & Gorzka, R. J. (2018). Association of post-traumatic nightmares and psychopathology in a military sample. Psychological Trauma: Theory, Research, Practice, and Policy, 10(4), 475–481. https://doi.org/10.1037/tra0000319 DOI: https://doi.org/10.1037/tra0000319

Engelhard, I. M., van den Hout, M. A., & Kindt, M. (2003). The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: A prospective study. Personality and individual differences, 35(2), 381-388. https://doi.org/10.1016/S0191-8869(02)00200-3 DOI: https://doi.org/10.1016/S0191-8869(02)00200-3

Foa, E. B. (1995). Posttraumatic Stress Diagnostic Scale Manual. Minneapolis: National Computer Systems.

Freese, F., Wiese, M., Knaust, T., Schredl, M., Schulz, H., De Dassel, T., Gorzka, R.-J., Höllmer, H., & Wittmann, L. (2018). Comparison of symptomatic and idiopathic nightmares in patients with different mental disorders. International Journal of Dream Research, 11(1), 1-5. https://doi.org/10.11588/ijodr.2018.1.38712

Gieselmann, A., Ait Aoudia, M., Carr, M., Germain, A., Gorzka, R., Holzinger, B., ... & Nadorff, M. R. (2019). Aetiology and treatment of nightmare disorder: State of the art and future perspectives. Journal of sleep research, 28(4), e12820. https://doi.org/10.1111/jsr.12820 DOI: https://doi.org/10.1111/jsr.12820

Gorzka, R-J., Rebling, K., Höllmer, H., Schulz, H., Knaust, T., Protić, S., Schredl, M., Wittmann, L. (2019). Psychometric evaluation of the Hamburg Nightmare Questionnaire (HAFB). European Journal of Psychotraumatology (ZEPT), 10(1), 1592393. doi: https://doi.org/10.1080/20008198.2019.1592393 DOI: https://doi.org/10.1080/20008198.2019.1592393

Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford publications.

Hu, Lt., Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equotation Modeling, 6: 1–55. https://doi.org/10.1080/10705519909540118 DOI: https://doi.org/10.1080/10705519909540118

Köthe, M., & Pietrowsky, R. (2001). Behavioral effects of nightmares and their correlations to personality patterns. Dreaming, 11, 43–52. DOI: https://doi.org/10.1023/A:1009468517557

Lawrence, J. W., & Fauerbach, J. A. (2003). Personality, coping, chronic stress, social support and PTSD symptoms among adult burn survivors: a path analysis. The Journal of burn care & rehabilitation, 24(1), 63-72. https://doi.org/10.1097/00004630-200301000-00016 DOI: https://doi.org/10.1097/00004630-200301000-00016

Levin, R., & Fireman, G. (2002). Nightmare prevalence, nightmare distress, and self-reported psychological disturbance. Sleep, 25, 205–212. https://doi.org/10.1093/sleep/25.2.205 DOI: https://doi.org/10.1093/sleep/25.2.205

Levin, R., & Nielsen, T. A. (2007). Disturbed dreaming, post-traumatic stress disorder, and affect distress: A review and neurocognitive model. Psychological Bulletin, 133(3), 482–528. https://doi.org/10.1037/0033-2909.133.3.482 DOI: https://doi.org/10.1037/0033-2909.133.3.482

Levin, R., Fireman, G., Spendlove, S., & Pope, A. (2011). The relative contribution of affect load and affect distress as predictors of disturbed dreaming. Behavioral sleep medicine, 9(3), 173-183. https://doi.org/10.1080/15402002.2011.583905 DOI: https://doi.org/10.1080/15402002.2011.583905

Maercker, A., & Schützwohl, M. (1998). Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version (IES-R) [Assessment of post-traumatic stress reactions: The Impact of Event Scale-Revised (IES-R)]. Diagnostica, 44(3), 130–141. DOI: https://doi.org/10.1037/t55092-000

Mellman, T. A., David, D., Bustamante, V., Torres, J., & Fins, A. (2001). Dreams in the acute aftermath of trauma and their relationship to PTSD. Journal of Traumatic Stress, 14(1), 241-247. DOI: https://doi.org/10.1023/A:1007812321136

Miró, E., & Martínez, M. P. (2005). Affective and Personality Characteristics in Function of Nightmare Prevalence, Nightmare Distress, and Interference Due to Nightmares. Dreaming, 15(2), 89–105. https://doi.org/10.1037/1053-0797.15.2.89 DOI: https://doi.org/10.1037/1053-0797.15.2.89

Munezawa, T., Kaneita, Y., Osaki, Y., Kanda, H., Ohtsu, T., Suzuki, H., ... & Ohida, T. (2011). Nightmare and sleep paralysis among Japanese adolescents: a nationwide representative survey. Sleep Medicine, 12(1), 56-64. https://doi.org/10.1016/j.sleep.2010.04.015 DOI: https://doi.org/10.1016/j.sleep.2010.04.015

Ogle, C. M., Siegler, I. C., Beckham, J. C., & Rubin, D. C. (2017). Neuroticism increases PTSD symptom severity by amplifying the emotionality, rehearsal, and centrality of trauma memories. Journal of Personality, 85(5), 702-715. https://doi.org/10.1111/jopy.12278 DOI: https://doi.org/10.1111/jopy.12278

Prado P.H., Korelo, J. C., Mantovani, D. (2010). On the practice of allowing correlated residuals among indicators in structural equation models. In Lance, C. E., Lance, C. E., & Vandenberg, R. J. (eds.). Statistical and methodological myths and urban legends (pp. 213-236). Routledge. DOI: https://doi.org/10.4324/9780203867266-16

Roberts, J., & Lennings, C. J. (2006). Personality, psychopathology and nightmares in young people. Personality and Individual Differences, 41(4), 733-744. https://doi.org/10.1016/j.paid.2006.03.010 DOI: https://doi.org/10.1016/j.paid.2006.03.010

Sandman, N., Valli, K., Kronholm, E., Ollila, H. M., Revonsuo, A., Laatikainen, T., & Paunio, T. (2013). Nightmares: prevalence among the Finnish general adult population and war veterans during 1972-2007. Sleep, 36(7), 1041-1050. https://doi.org/10.5665/sleep.2806 DOI: https://doi.org/10.5665/sleep.2806

Schneider, T. R. (2004). The role of neuroticism on psychological and physiological stress responses. Journal of Experimental Social Psychology, 40(6), 795-804. https://doi.org/10.1016/j.jesp.2004.04.005 DOI: https://doi.org/10.1016/j.jesp.2004.04.005

Schredl, M. (2003). Continuity between waking and dreaming: A proposal for a mathematical model. Sleep and Hypnosis, 5, 38-52.

Schredl, M. (2003). Effects of state and trait factors on nightmare frequency. European archives of psychiatry and clinical neuroscience, 253(5), 241-247. doi: https://doi.org/10.1007/s00406-003-0438-1 DOI: https://doi.org/10.1007/s00406-003-0438-1

Schredl, M. (2010). Nightmare frequency and nightmare topics in a representative German sample. European archives of psychiatry and clinical neuroscience, 260(8), 565-570. https://doi.org/10.1007/s00406-010-0112-3 DOI: https://doi.org/10.1007/s00406-010-0112-3

Schredl, M., & Goeritz, A. S. (2019). Nightmare frequency and nightmare distress: Socio-demographic and personality factors. Sleep Science, 12(3), 178-184. https://dx.doi.org/10.5935%2F1984-0063.20190080 DOI: https://doi.org/10.5935/1984-0063.20190080

Schredl, M., Landgraf, C., & Zeiler, O. (2003). Nightmare frequency, nightmare distress and neuroticism. North American Journal of Psychology, 5, 345–350.

Schredl, M., Schäfer, G., Hofmann, F., & Jacob, S. (1999). Dream content and personality: Thick vs. thin boundaries. Dreaming, 9, 257–263. DOI: https://doi.org/10.1023/A:1021336103535

Schreuder, B. J. N., Igreja, V., van Dijk, J., & Kleijn, W. (2001). Intrusive re-experiencing of chronic strife or war. Advances in Psychiatric Treatment, 7(2), 102-108. https://doi.org/10.1192/apt.7.2.102 DOI: https://doi.org/10.1192/apt.7.2.102

Steele, M., Germain, A., & Campbell, J. S. (2017). Mediation and moderation of the relationship between combat experiences and post-traumatic stress symptoms in active duty military personnel. Military medicine, 182(5-6), e1632-e1639. https://doi.org/10.7205/MILMED-D-16-00169 DOI: https://doi.org/10.7205/MILMED-D-16-00169

Steil, R., & Ehlers, A. (2000). Posttraumatische Diagnoseskala. Jena: Universität Jena

Swart, M. L., Van Schagen, A. M., Lancee, J., & Van Den Bout, J. (2013). Prevalence of nightmare disorder in psychiatric outpatients. Psychotherapy and psychosomatics, 82(4), 267-268. https://doi.org/10.1159/000343590 DOI: https://doi.org/10.1159/000343590

Wittmann, L., Schredl, M., & Kramer, M. (2007). Dreaming in post-traumatic stress disorder: A critical review of phenomenology, psychophysiology and treatment. Psychotherapy and psychosomatics, 76(1), 25-39. https://doi.org/10.1159/000096362 DOI: https://doi.org/10.1159/000096362

Wittmann, L., Zehnder, D., Schredl, M., Jenni, O. G., & Landolt, M. A. (2010). Post-traumatic nightmares and psychopathology in children after road traffic accidents. Journal of Traumatic Stress, 23(2), 232-239. https://doi.org/10.1002/jts.20514 DOI: https://doi.org/10.1002/jts.20514

Wood, J. M., & Bootzin, R. R. (1990). The prevalence of nightmares and their independence from anxiety. Journal of Abnormal Psychology, 99(1), 64-–68. https://doi.org/10.1037/0021-843X.99.1.64 DOI: https://doi.org/10.1037//0021-843X.99.1.64

World Health Organization. (2004). ICD-10 : international statistical classification of diseases and related health problems / World Health Organization. Geneva: World Health Organization