The Menninger Clinic, Houston, TX 77035, USA.
The Menninger Clinic, Houston, TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA; University of Houston Downtown, Houston, TX 77002, USA.
J Affect Disord. 2024 Apr 15;351:179-183. doi: 10.1016/j.jad.2024.01.244. Epub 2024 Jan 28.
Emotional processing and regulation of affect are often impaired in psychiatric patients. Nightmares could be considered a manifestation of problems with this process. In the present study, we examined how depression, anxiety and suicidal risk related to difficulties in emotion regulation and nightmares over the course of inpatient treatment. We also explored whether emotion regulation problems moderated the relationship between changes in depression, anxiety, and suicide risk to changes in nightmares from admission to discharge.
The present study included 1215 adults admitted to an inpatient psychiatric hospital ranging from 18 to 87 years of age (M = 37.18, SD = 16.14). Mood symptoms, emotion regulation difficulties, nightmares and suicide risk were assessed at admission and discharge. Moderation analyses were calculated using Model 1 of the PROCESS Macro (Hayes, 2013).
Moderation analyses showed the associations between depression and nightmares (b = 0.25, p < .001) and suicide and nightmares (b = 0.34, p < .001) were strongest when patients had high levels of emotion regulation difficulties. Emotion regulation difficulties did not, however, moderate the relationship between anxiety and nightmares. Furthermore, improvement in depression and nightmares was significantly related to improvement in emotion regulation difficulties.
The homogeneity of the sample limits the generalizability of the results. Furthermore, the use of self-report measures, especially sleep related assessments, can bias the data more than objective measures.
These findings provide clinical implications when treating psychiatric patients such as a need for emotion regulation skills building.
情感处理和情感调节在精神科患者中常常受损。噩梦可以被认为是这一过程出现问题的表现。在本研究中，我们考察了抑郁、焦虑和自杀风险如何与住院治疗过程中的情绪调节困难和噩梦相关。我们还探讨了情绪调节问题是否调节了抑郁、焦虑和自杀风险的变化与入院至出院期间噩梦变化之间的关系。
本研究纳入了 1215 名年龄在 18 至 87 岁之间（M=37.18，SD=16.14）的成年住院精神科患者。在入院和出院时评估了情绪症状、情绪调节困难、噩梦和自杀风险。使用 PROCESS Macro（Hayes，2013）的模型 1 进行了调节分析。
调节分析表明，当患者的情绪调节困难程度较高时，抑郁与噩梦（b=0.25，p<.001）和自杀与噩梦（b=0.34，p<.001）之间的关联最强。然而，情绪调节困难并没有调节焦虑与噩梦之间的关系。此外，抑郁和噩梦的改善与情绪调节困难的改善显著相关。
样本的同质性限制了结果的普遍性。此外，使用自我报告的措施，尤其是与睡眠相关的评估，可能会比客观测量更偏向于数据。
这些发现为治疗精神科患者提供了临床意义，例如需要进行情绪调节技能培养。
