Nightmares, Bad Dreams, and Emotion Dysregulation:A Review and New Neurocognitive Model of Dreaming

摘要

Nightmares--vivid, emotionally dysphoricdreams—are quite common and are associated with abroad range of psychiatric conditions. However, the originof such dreams remains largely unexplained, and therehave been no attempts to reconcile repetitive traumaticnightmares with nontraumatic nightmares, dysphoricdreams that do not awaken the dreamer, or with morenormative dreams. Based on recent research in cognitiveneuroscience, sleep physiology, fear conditioning, andemotional-memory regulation, we propose a multilevelneurocognitive model that unites waking and sleeping as aconceptual framework for understanding a wide spectrumof disturbed dreaming. We propose that normal dreamingserves a fear-extinction function and that nightmaresreflect failures in emotion regulation. We further suggestthat nightmares occur as a result of two processes that weterm affect load—a consequence of daily variations inemotional pressures—and affect distress—a disposition toexperience events with high levels of negative emotionalreactivity.