The Dream as a Model for Psychosis: An Experimental Approach Using Bizarreness as a Cognitive Marker

Abstract

Many previous observers have reported some qualitative similarities between the normal mental state of dreaming and the abnormal mental state of psychosis. Recent psychological, tomographic, electrophysiological, and neurochemical data appear to confirm the functional similarities between these 2 states. In this study, the hypothesis of the dreaming brain as a neurobiological model for psychosis was tested by focusing on cognitive bizarreness, a distinctive property of the dreaming mental state defined by discontinuities and incongruities in the dream plot, thoughts, and feelings. Cognitive bizarreness was measured in written reports of dreams and in verbal reports of waking fantasies in 30 schizophrenics and 30 normal controls. Seven pictures of the Thematic Apperception Test (TAT) were administered as a stimulus to elicit waking fantasies, and all participating subjects were asked to record their dreams upon awakening. A total of 420 waking fantasies plus 244 dream reports were collected to quantify the bizarreness features in the dream and waking state of both subject groups. Two-way analysis of covariance for repeated measures showed that cognitive bizarreness was significantly lower in the TAT stories of normal subjects than in those of schizophrenics and in the dream reports of both groups. The differences between the 2 groups indicated that, under experimental conditions, the waking cognition of schizophrenic subjects shares a common degree of formal cognitive bizarreness with the dream reports of both normal controls and schizophrenics. Though very preliminary, these results support the hypothesis that the dreaming brain could be a useful experimental model for psychosis.

What links schizophrenia and dreaming? Common phenomenological and neurobiological features of schizophrenia and REM sleep.

“…In addition to the above described common features of schizophrenia and dreaming, research on cognitive bizarreness conducted by Scarone and colleagues [29] supports the hypothesis that due to similarities between these two states, a dreaming brain may be a useful model for this disease. The level of cognitive bizarreness, defined as discontinuity and incongruity of dream perception and cognition is comparable in both non-clinical subjects, and ones suffering from schizophrenia.…”

“…The level of cognitive bizarreness, defined as discontinuity and incongruity of dream perception and cognition is comparable in both non-clinical subjects, and ones suffering from schizophrenia. A comparison of stories from the Thematic Apperception Test obtained from both patients and non-clinical subjects revealed that although the level of cognitive bizarreness is significantly higher in the former than in the latter, it still oscillates at a level similar to that which occurs in dreams [29]. Therefore, it seems that while bizarreness constitutes a kind of cognitive model for dreaming mental state (for both clinical and non-clinical populations), it is still present as a characteristic feature of waking cognitive organization in schizophrenia.…”

“…Once lucid dreaming is left out of the analysis we can see that what characterizes both states is not only a loss of autonomy in relation to mental Archives of Psychiatry and Psychotherapy, 2013; 2 : [29][30][31][32][33][34][35] content, but also a lack of insight [7]. These are some of the defining conditions of dreams [7].…”

“…Archives of Psychiatry and Psychotherapy, 2013; 2 : [29][30][31][32][33][34][35] Glutamate hypothesis assumes that hypofunction of the NMDA receptor may contribute to the patophysiology of schizophrenia [38]. There is also a dysfunction in glutamate level in REM sleep stage.…”

In your wildest dreams: the language and psychological features of dreams

“…Beginning with Freud and Jung, researchers have drawn similarities between dreaming and psychosis. These similarities range from phenomenological to neurobiological, qualitatively manifested as a loosening of associations, incongruity and bizarreness of personal experience, and distortion of time and space parameters (Scarone et al, 2008). Reviewing the content of our 25-topic solution, we see no reason to interpret the clustering of words within any given topic as incongruous nor do we detect support for the content to be evaluated as "bizarre" (Hobson et al, 1987).…”