Schmid-Mühlbauer Gabriele, Reggiannini Laura, Treu Peter, Chae Woo Ri, Stamm Thomas
Klinikum Schloss Lütgenhof, Dassow, Germany.
Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany.
Front Psychol. 2024 Sep 2;15:1339734. doi: 10.3389/fpsyg.2024.1339734. eCollection 2024.
Emotions play an important role in the emergence, formation, and experience of dreams. The Central Image (CI) in a dream refers to the dream's dominant or underlying emotion, and it is the best-remembered part of a dream. Bipolar disorders are characterized by strong emotions, particularly during manic and depressive episodes. In these patients, dreams and CIs may serve as a helpful diagnostic and therapeutic tool. This study aims to evaluate the feasibility of the CI Method and to check for differences concerning dreams and CI emotions between healthy controls and patients with bipolar disorder.
Over a period of 3 weeks, 61 participants were asked to maintain a daily record of all dreams remembered. Dream reports were rated using the Central Image Method (CIM) by two independent, blinded raters. We assessed for interrater agreement on the CIM and for within and between group differences related to negative and positive CI emotions.
Mean agreement rates (weighted Cohen's kappa) for the CI emotion ratings could be classified as very good: For primary CI emotion ratings, the mean weighted Cohen's kappa was 0.99 (± 0.02), and for secondary CI emotions, it was 0.90 (± 0.17). Regarding the CI intensities, the mean agreement rate (Spearman's correlation) was also strong. Evaluation of differences within the groups showed that there were more negative CI emotions than positive CI emotions in healthy controls and currently depressive patients; however, in the latter, the difference was statistically not significant. Analyses of differences between groups indicated that patients who were currently depressed recorded more negative CI emotions in dreams than those who were euthymic or healthy controls.
The findings support the feasibility of the CIM. Our results might indicate different emotion regulation and defense mechanisms across bipolar disorder states, as reflected by the occurrence of negative and positive CI emotions.
情绪在梦的产生、形成和体验中起着重要作用。梦中的核心意象（CI）指的是梦的主导或潜在情绪，也是梦最容易被记住的部分。双相情感障碍的特征是强烈的情绪，尤其是在躁狂和抑郁发作期间。在这些患者中，梦和核心意象可能是一种有用的诊断和治疗工具。本研究旨在评估核心意象法的可行性，并检查健康对照组与双相情感障碍患者在梦和核心意象情绪方面的差异。
在3周的时间里，61名参与者被要求每天记录所有记住的梦。两名独立的、不知情的评分者使用核心意象法（CIM）对梦的报告进行评分。我们评估了评分者之间在核心意象法上的一致性，以及与消极和积极核心意象情绪相关的组内和组间差异。
核心意象情绪评分的平均一致率（加权科恩kappa系数）可归类为非常好：对于主要核心意象情绪评分，平均加权科恩kappa系数为0.99（±0.02），对于次要核心意象情绪，为0.90（±0.17）。关于核心意象强度，平均一致率（斯皮尔曼相关性）也很强。组内差异评估显示，健康对照组和当前抑郁患者中消极核心意象情绪多于积极核心意象情绪；然而，在后者中，差异无统计学意义。组间差异分析表明，当前抑郁的患者在梦中记录的消极核心意象情绪比心境正常者或健康对照组更多。
研究结果支持核心意象法的可行性。我们的结果可能表明，双相情感障碍不同状态下存在不同的情绪调节和防御机制，这反映在消极和积极核心意象情绪的出现上。
