The relationship of nightmare frequency and nightmare distress to well-being MARKBLAGROVE,LAURAFARMERandELVIRAWILLIAMS Department of Psychology, University of Wales Swansea, Swansea, UK Accepted in revised form 10 March 2004; received 19 November 2003 SUMMARY Nightmares can be defined as very disturbing dreams, the events or emotions of which cause the dreamer to wake up. In contrast, unpleasant dreams can be defined in terms of a negative emotional rating of a dream, irrespective of whether or not the emotions or events of the dream woke the dreamer. This study addresses whether frequency of unpleasantdreamsisabetterindexoflowwell-beingthanisfrequencyofnightmares.A total of 147 participants reported their nightmare frequency retrospectively and then kept a log of all dreams, including nightmares, for 2 weeks, and rated each dream for pleasantness/unpleasantness. Anxiety, depression, neuroticism, and acute stress were found to be associated with nightmare distress (ND) (the trait-like general level of distress in waking-life caused by having nightmares) and prospective frequency of unpleasant dreams, and less so with the mean emotional tone of all dreams, or retrospective or prospective nightmare frequency. Correlations between low well-being and retrospective nightmare frequency became insignificant when trait ND was controlled for, but correlations with prospective unpleasant dream frequency were maintained. The reporting of nightmares may thus be confounded and modulated by trait ND: such confounding does not occur for the reporting of unpleasant dreams in general. Thus there may be attributional components to deciding that one has been awoken by a dream, which can affect estimated nightmare frequency and its relationship with well-being. Underestimation of nightmare frequency by the retro- spective questionnaire compared with logs was found to be a function of mean dream unpleasantness and ND. keywords definition of nightmares, nightmare distress, nightmare frequency, psychopathology, well-being INTRODUCTION Ithasoftenbeensuggestedthatnightmaresmaybeindicativeof an underlying psychopathology or current lack of emotional well-being, but there is considerable conflict on this in the literature. Frequency of nightmares has been related to high scores on the neurotic and psychotic scales of the Minnesota MultiphasicPersonalityInventory(MMPI)(Kales et al.,1980), and with global, mainly neurotic psychopathology (Berquier and Ashton, 1992). Lang and O’Connor (1984) found neurot- icism correlated significantly with nightmare frequency (r ¼ 0.26)andintensity(r ¼ 0.23),suchlowcorrelationsbeing typical in this field. However, Hartmann et al. (1981, 1987) found no association between frequent nightmares and MMPI neuroticism, and Chivers and Blagrove (1999) found no significant correlation between neuroticism on the Eysenck Personality Questionnaire (EPQ) and prospective nightmare frequency as assessed by a log. Nightmare frequency has also been associated with state anxiety (Ko¨the and Pietrowsky, 2001), mood and anxiety disorders (Ohayon et al., 1997) and incidence of suicide, anxiety, depressed mood and symptoms of life stress (Tans- kanen et al., 2001). However, whereas Levin (1998) found that subjects having at least one nightmare per week had signifi- cantly greater trait anxiety and schizotypy than controls, there were only trends for higher state anxiety and depression. In addition,inalongitudinalstudy,CellucciandLawrence(1978) foundstateanxietycorrelatedsignificantlywithinsubjectswith Correspondence: Mark Blagrove PhD, Department of Psychology, University of Wales Swansea, Swansea SA2 8PP, UK. Tel.: +44 1792 295586; fax: +44 1792 295679; e-mail: m.t.blagrove@swansea.ac.uk J. Sleep Res. (2004) 13, 129–136 Ó 2004 European Sleep Research Society 129