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SUMMARYSuppressing unwanted thoughts can lead to an increased occurrence of the suppressed thought in dreams. This is explainable by the ironic control theory, which theorizes why the suppression of thoughts might make them more persistent. The present study examined the influence of thought suppression on dream rebound, dream distress, general psychiatric symptomatology, depression, sleep quality and perceived stress. Thirty healthy participants (good sleepers) were investigated over a period of 1 week. Half were instructed to suppress an unwanted thought 5 min prior to sleep, whereas the other half were allowed to think of anything at all. Dream content was assessed through a dream diary. Independent raters assessed whether or not the dreams were related to the suppressed target thought. The results demonstrated increased target-related dreams and a tendency to have more distressing dreams in the suppression condition. Moreover, the data imply that thought suppression may lead to significantly increased general psychiatric symptomatology. No significant effects were found for the other secondary outcomes. IN TROD UCTI ONSuppressing unpleasant thoughts can be tempting, as associated negative emotions may be avoided. However, ironic control theory (Wegner et al., 1987) proposes that suppressing thoughts leads to an increased occurrence of the suppressed content in waking states. According to Wegner et al. (2004), the interplay of two processes is responsible for this effect: first, a conscious operating process that is responsible for mental deflection by concentrating on content other than the target thought, and secondly, an unconscious monitoring process that controls for unwanted thoughts or intrusions, in order to test whether the operating process is needed. The operating process requires greater cognitive capacity. As soon as capacity is reduced, for example by cognitive demands (or sleep), the operating process is 'weakened' and unwanted thoughts become more accessible, because the monitoring process continues its activity.Previous studies on psychology students found that any attempted suppression of unwanted thoughts prior to sleep leads to increased dreaming about that target; the so-called dream rebound effect (Schmidt and Gendolla, 2008;Taylor and Bryant, 2007;Wegner et al., 2004). This implies that ironic control theory might be applicable to explain the occurrence of bad dreams or nightmares. A recent study on first-year psychology students showed that suppression-induced dream rebound prior to sleep can even be enhanced by cognitive load, such as learning a nine-digit number (Bryant et al., 2011). In accord with the ironic control theory, these findings suggest that cognitive load weakens the operating process and unwanted content becomes more accessible.There is convergent evidence to support the dream rebound effect and the proposal that thought suppression leads to increased occurrence of the suppressed content in dreams. For example, patients with insomnia report having insomnia-related dream...

<b><i>Introduction:</i></b> Both imagery rescripting and imaginal exposure have been proven to be effective in the treatment of chronic nightmares when compared to a waitlist condition. Little is known about their comparative efficacy and their efficacy compared to an active control. <b><i>Objective:</i></b> The aims of this study were to compare the two treatments to one another and to positive imagery as an active control, and to explore covariates of the treatment effect. <b><i>Methods:</i></b> In this single-blinded randomized controlled trial, 96 patients with nightmare disorder (idiopathic nightmares) from an outpatient clinic were randomly assigned to a single individual treatment session of rescripting, exposure, or positive imagery and 4 weeks of practice at home. The primary outcome was nightmare distress, and the secondary outcomes were nightmare frequency, nightmare effects, self-efficacy, and general psychopathology. <b><i>Results:</i></b> Nightmare distress was reduced in all groups (imagery rescripting: Cohen’s <i>d</i> = –1.04, imaginal exposure: <i>d</i> = –0.68, positive imagery: <i>d</i> = –0.57), as were nightmare frequency, nightmare effects, and psychopathology. Self-efficacy was enhanced. No differential treatment effects were found on any primary or secondary measure. Treatment gains were not associated with demographic or disorder characteristics, baseline values, treatment credibility, or the number of practice sessions. <b><i>Conclusions:</i></b> Even short nightmare treatments are effective regardless of personal characteristics, and different interventions produce similar results. Future research should aim to clarify the mechanisms of action. Health care should make more use of these powerful and easy-to-administer nightmare treatments.

The Nightmare Effects Survey (NES) and the Nightmare Frequency Questionnaire (NFQ), 2 widely used questionnaires in nightmare research, were translated into German and tested in a sample of 86 adult chronic nightmare sufferers. Participants completed the questionnaires together with measures of nightmare-and sleep-related factors and psychopathology and kept a nightmare diary for 3 weeks. Psychometric properties were determined: The German NES showed high internal consistency (Cronbach's ␣ ϭ .898) and split-half reliability (r ϭ .889) and a unifactorial structure (46.33% variance explained). The German NFQ and the prospective nightmare diary yielded similar frequencies for nights with nightmares, a significantly higher value for number of nightmares in the diary, and correlations of .621 and .570 between measures of nights with nightmares and number of nightmares, respectively. The 2 scores of the German NFQ were highly intercorrelated (r ϭ .838). Correlations with related constructs were insignificant or low for the German NFQ (between r ϭ .09 and r ϭ .28) and medium for the German NES (between r ϭ .27 and r ϭ .59). The German NFQ and NES proved to be reliable, useful, and efficient to quantify nightmares and their effects. The findings demonstrate the questionnaires' construct validity and support theories that differentiate between nightmare frequency, nightmare effects, and nightmare distress. German

An increasing number of children are conceived using assisted reproduction technologies (ART), but little is known about the long-term risk in terms of mental health outcomes. All twin and singleton children conceived via ART and born in 1995 were sampled from the Danish in vitro fertilization registry and matched to four spontaneously conceived (SC) children. The children were followed-up at the age of 3, 7, 14 and 18 years in the Danish Psychiatric Central Research Registry, to estimate the prevalence of all possible psychiatric diagnoses; dimensional aspects of psychopathology were assessed at the age of 14 years, using the Child Behavior Checklist (CBCL). The study included 858 ART children and 3436 SC children. ART and SC children were not clinically distinguishable on either the categorical measures of psychopathology at the age of 3, 7, 14 and 18 years, or on CBCL scale scores at the age of 14 years. The findings remained nonsignificant after controlling for sample differences. This large, prospective, nationwide cohort study provides evidence to support that ART exposure does not increase the risk of adverse mental health outcomes considered as a whole, while power was limited to discard an effect of ART on specific mental health disorders.

Theoretischer Hintergrund: Chronische Alpträume stellen eine weit verbreitete Schlafstörung dar, welche einen hohen Leidensdruck hervorruft. Als besonders wirksam in der Behandlung gilt die Imagery Rehearsal Therapy (IRT). Selbsthilfeprogramme stellen hierbei eine effektive, ökonomische Behandlungsoption dar. Fragestellung: Die vorliegende Pilotstudie untersucht die Wirksamkeit einer neuen, IRT-basierten, angeleiteten Selbsthilfe. Methode: 10 Patienten mit chronischen Alpträumen wurden im Rahmen von 4 face-to-face-Sitzungen vor Intervention (T1) sowie 4 Wochen (T2) und 3 Monate (T3) danach hinsichtlich Alptraumhäufigkeit sowie verschiedener psychosozialer Parameter untersucht. Ergebnisse: Die Alptraumhäufigkeit reduzierte sich innerhalb von 4 Wochen signifikant (T1-T2; Effektstärke: 1,0). Dieser Effekt blieb über 3 Monate stabil (T1-T3; Effektstärke: 1,26). Zudem reduzierten sich signifikant Depressions-, Angst- und Anspannungsparameter sowie das Stresserleben. Schlussfolgerung: Das deutschsprachige Selbsthilfemanual könnte eine wirksame Behandlungsmöglichkeit zur Reduktion von Alpträumen darstellen.

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