Lesson 23: Dissociative and Sleep Disorders

Lucid dream

You are aware that you’re dreaming (may be able to control what you do)

Vivid dream

Very clear dream you can remember in great detail

Sleep-wake cycle

Daily rhythmic activity 24-hour cycle in many organisms

Sleep paralysis

Happens during REM sleep when falling asleep or awakening, may include hallucinations of danger

Sleep deprivation

Lack of restorative sleep over a period that causes physical or psychiatric symptoms that affect task abilities

Dissociation

A disruption or a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

Happens about 1-3% of general population, more risk for OCD, PTSD, borderline BD, schizophrenia.

More prevalent in people with a proneness to fantasy, which doesn’t give as much support for past trauma being the case.

State Dissociation

Viewed as a transient symptom (lasts few minutes to hours)

Trait Dissociation

Viewed as an integral aspect of personality

Dissociative amnesia

Extensive forgetting typically associated with highly aversive events (not remembering past abuse bc the mind blocks it out)

Dissociative fugue

Short-lived reversible amnesia for personal identity, involving unplanned travel or wandering (not separate disorder, but feature some- not all- cases of dissociative amnesia

Depersonalization/Derealization

Feeling as though you are an outside observer of your own body

Dissociative Identity Disorder

Experiencing two or more distinct identities that recurrently take control of your behavior

REM behavior disorder

REM sleep (dreaming), but for some reason your muscles can act out. This can be very dangerous to spouse, roommates, others

Nightmares (more common in children, they spend more time in REM sleep)

Night Terrors

Rare in adults but happen more in younger children. Deep sleep, but you can walk/talk. Don’t realize you are asleep.

Sleepwalking (or somnambulism)

Occurring during deep sleep. Often acting out some task. Hereditary component.

Insomnia

Inability to fall asleep, stay asleep, get good quality sleep

Sleep Apnea

Stop breathing for 10 seconds or longer during sleep (CPAP is helpful).

5-25% of adults have this (many are not diagnosed)

Associated with poor sleep quality, obesity, heart problems, and depression

Narcolepsy

Kind of sleep seizure where you suddenly slip into REM sleep. Excessive daytime sleepiness, can happen anywhere, any time of day, which can be extremely dangerous

Cataplexy (sudden loss of muscle tone)

Manifest content

Dream is actual content/meaning, taken literally

Freud’s view of dreaming

Dreams are wish-fulfillment, based on past conflicts and events, seen as symbols

Activation-Synthesis Hypothesis

Activation and synthesis of sensation in the pons and areas of the brain. A different kind of thinking, less realistic because frontal lobes shut down in dreams

Activation-Information-Mode (AIM) Model

Dreams organize info from past few days

The post-traumatic model

Says dissociation is caused by trauma, especially childhood abuse. People dissociate to escape painful memories or feelings. Evidence for this is that many people with dissociative disorders also have trauma or PTSD. A weakness is that a lot of studies use self-reports, so they cannot fully prove trauma causes dissociation.

The sleep-dissociation model

Says dissociation is linked to sleep problems, like nightmares, sleep deprivation, and dream-like experiences. Studies show that lack of sleep can increase dissociation, and better sleep can reduce symptoms. A weakness is that dissociation may also cause sleep problems, so the connection goes both ways.