Nightmares in Vietnam Veterans

Kramer, Milton; Schoen, Lawrence S.; Kinney, Lois

doi:10.1521/jaap.1.1987.15.1.67

Cited by 40 publications

(30 citation statements)

References 7 publications

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“…Such a possibility is consistent with the frequent observation that trauma-related nightmares intermix traumatic elements with elements of long-past fearful experiences (Hartmann, 1998b;Kramer et al, 1987). This phenomenon has been hypothesized to reflect some kind of adaptive assimilation or working through of a current trauma.…”

Section: Hippocampus: Mediator Of Fear Memory Contextsupporting

confidence: 83%

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

Levin

Nielsen

2007

Psychological Bulletin

527

557

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Nightmares are common, occurring weekly in 4%-10% of the population, and are associated with female gender, younger age, increased stress, psychopathology, and dispositional traits. Nightmare pathogenesis remains unexplained, as do differences between nontraumatic and posttraumatic nightmares (for those with or without posttraumatic stress disorder) and relations with waking functioning. No models adequately explain nightmares nor have they been reconciled with recent developments in cognitive neuroscience, fear acquisition, and emotional memory. The authors review the recent literature and propose a conceptual framework for understanding a spectrum of dysphoric dreaming. Central to this is the notion that variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity reflect the influence of both affect load, a consequence of daily variations in emotional pressure, and affect distress, a disposition to experience events with distressing, highly reactive emotions. In a cross-state, multilevel model of dream function and nightmare production, the authors integrate findings on emotional memory structures and the brain correlates of emotion.Keywords: nightmares, distress, neurophysiology of fear memory, posttraumatic stress disorder, psychopathology Nightmares are the most common form of disturbed dreaming. Vivid, with emotions escalating at times to the brink of terror, they are manifestations of the dramatic autonomic and cognitive fluctuations that can arise during rapid eye movement (REM) sleep and, under certain circumstances, during Stage 2 sleep. Nightmares can be simple and benign or so emotionally severe that they beg for comparison with psychotic episodes (C. Fisher, Byrne, Edwards, & Kahn, 1970;Hartmann, 1984;Sullivan, 1962). Occasional nightmares are almost ubiquitous in the general population. However, frequent distressing nightmares are more common than generally thought, affecting 4%-10% of individuals by conservative estimates. Nightmares are also extremely common following trauma exposure. Posttraumatic nightmares may depict traumarelated content and, in cases of chronic posttraumatic stress disorder (PTSD), may at times replicate the trauma with great distress (for review, see Mellman & Pigeon, 2005).There has been a proliferation of experimental work on posttraumatic and nontraumatic nightmares in the past 15 years, the vast majority of which has examined the psychopathological correlates of individuals with frequent nightmares. Furthermore, recent advances in neuroscience have greatly expanded our understanding of dreaming and related brain functions (Maquet, 2000;Maquet et al., 2000) as well as the pathogenic mechanisms implicated in fear conditioning and the development of PTSD (LeDoux, 2000;Ohman & Mineka, 2001). However, despite the clear implications of these developments for understanding nightmares, there are still no comprehensive models of nightmare etiology and no conceptual frameworks for understanding the link between posttraumatic and nontraumatic nightm...

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Section: Hippocampus: Mediator Of Fear Memory Contextsupporting

confidence: 83%

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

Levin

Nielsen

2007

Psychological Bulletin

527

557

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“…These dream contents typically failed to camou age the traumatic reality of the children's living environment. The lack of dream bizarreness is a hallmark of a failure to work through traumatic material, or to maintain good adjustment (Kaminer & Lavie, 1991;Kramer, Schoen, & Kinney, 1987).…”

Section: Dreams As Safeguarding Angels?mentioning

confidence: 99%

The Role of Dreams in Protecting Psychological Well-being in Traumatic Conditions

Punamäki

1998

International Journal of Behavioral Development

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The mental health function of dreaming was studied among Palestinian children and adolescents in a trauma group ( N= 268) and a comparison ( N= 144) group. The subjects were 6- to 15-year-old boys and girls, the mean age being 11.2± 2.64. They used a seven-day dream diary to record the dreams they could recall every morning. The results suggest that compensatory dreams could moderate between trauma and psychological symptoms. Traumatic events were not associated with psychological symptoms among children whose dreams were bizarre, vivid and active, and involved joyful feelings and happy endings. A mediating model suggested that exposure to traumatic events was associated with mundane persecution and unpleasant repetitious dreams. These dysfunctional dreams were, in turn, associated with poor psychological adjustment. The dynamics of mastery and compensation dreams in traumatic conditions are discussed.

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“…Close exploration of individual cases reveals a much richer fabric of factors at work. A paper by Kramer et al (1987) on nightmares in Vietnam veterans provides clear illustrations of how the selection of the particular aspect of combat experience that is focused on in nightmares may be determined by childhood experiences and difficulties, which may in turn be stirred up by problems in the patient's current life. "The Vietnam experience serves as a metaphor to express the difficulties."…”

Section: Abnormal Dreams and Nightmare Disorders 547mentioning

confidence: 99%

Abnormal dreams and nightmare disorders

Eiser

2011

Handbook of Clinical Neurology

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Nightmares in Vietnam Veterans

Cited by 40 publications

References 7 publications

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

Disturbed dreaming, posttraumatic stress disorder, and affect distress: A review and neurocognitive model.

The Role of Dreams in Protecting Psychological Well-being in Traumatic Conditions

Abnormal dreams and nightmare disorders

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