Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder
Article first published online: 13 FEB 2008
© 2008 The Authors
Psychiatry and Clinical Neurosciences
Volume 62, Issue 1, pages 48–55, February 2008
How to Cite
Semiz, U. B., Basoglu, C., Ebrinc, S. and Cetin, M. (2008), Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder. Psychiatry and Clinical Neurosciences, 62: 48–55. doi: 10.1111/j.1440-1819.2007.01789.x
- Issue published online: 13 FEB 2008
- Article first published online: 13 FEB 2008
- Received 19 March 2007; revised 1 August 2007; accepted 10 August 2007.
- borderline personality disorder;
- childhood trauma;
Aims: The aims of the present study were to examine the rate of nightmare disorder (ND) and to determine the levels of dream anxiety and subjective sleep quality in patients with borderline personality disorder (BPD). Another aim was to determine whether dream anxiety was associated with childhood trauma, dissociative experiences, and subjective sleep disturbance in BPD patients. Finally, the hypothesis as to whether BPD patients with ND exhibited a more severe clinical profile than those without ND, was also tested.
Methods: A total of 88 borderline patients and 100 age- and sex-matched healthy control subjects were assessed using the Structured Clinical Interview for DSM-III-R Personality Disorders, Structured Clinical Interview for DSM-IV Axis I Disorders, Van Dream Anxiety Scale, Pittsburgh Sleep Quality Index, Dissociative Experiences Scale, and Traumatic Experiences Checklist. Subjects with codiagnoses that could affect sleep were not included.
Results: BPD patients suffered a significantly greater rate of nightmares, elevated levels of dream anxiety, and disturbed sleep quality than did controls. In the borderline group, heightened dream anxiety was correlated with higher rates of early traumatic experiences and dissociative symptoms, and impaired sleep quality. Furthermore, borderline patients with ND exhibited greater psychopathology as compared to those without ND in terms of several clinical characteristics.
Conclusions: The present study provides support for a strong association between BPD, distressing nightmares, and subjective sleep quality. Recognition and management of dream and sleep disturbances in BPD patients might lead to improvements in their global clinical picture.