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Is there a dissociative process in sleepwalking and night terrors?
D Hartman1, A H Crisp, P Sedgwick
1Department of Psychiatry, St George's Hospital Medical School, London, UK.
Postgraduate Medical Journal
|March 27, 2001
Summary
Sleepwalking and night terrors are rarely linked to major psychological trauma in adults. While trauma can influence attack content, most patients show no dissociation during wakefulness.
Area of Science:
- Psychiatry
- Sleep Medicine
- Psychology
Background:
- The hypothesis that sleepwalking and night terrors stem from a protective dissociative mechanism is debated.
- This mechanism is proposed to activate during sleep when facing intolerable impulses, feelings, or memories, leading to motoric or affective episodes with amnesia.
Observation:
- A study of 22 adult patients with sleepwalking/night terrors found only six had a history of major psychological trauma.
- The majority of patients experienced vivid, dream-like behaviors related to escaping attacks.
- Dissociation Questionnaire (DIS-Q) scores were generally normal, though higher in the trauma subgroup.
Findings:
- A minority of adult sleepwalking/night terror patients report significant psychological trauma.
- In trauma cases, the trauma content influences the attacks, but symptoms manifest as sleepwalking/night terrors, not REM sleep nightmares.
- Patients without trauma history showed no clinical or DIS-Q evidence of dissociation during wakefulness.
Implications:
- The findings suggest psychological trauma is not a primary cause for most adult sleepwalking/night terror cases.
- The study highlights that dissociation may operate exclusively during sleep in some individuals.
- Further research is needed to understand the specific mechanisms in patients without a clear trauma history.
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