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ORIGINAL RESEARCH article

Front. Psychol.
Sec. Emotion Science
Volume 15 - 2024 | doi: 10.3389/fpsyg.2024.1339734

Dreaming in Bipolar Disorders: Feasibility of the Central Image Method. A Prospective Controlled Trial

Provisionally accepted
  • 1 Clinic Schloss Lütgenhof, Dassow, Germany
  • 2 Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Baden-Wurttemberg, Germany
  • 3 International Psychoanalytic University Berlin, Berlin, Germany
  • 4 Department of Psychiatry and Neurosciences, Charité University Medicine Berlin, Berlin, Baden-Württemberg, Germany
  • 5 DZPG, German Center for Mental Health, partner site Berlin, Berlin, Germany
  • 6 Berlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
  • 7 Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany

The final, formatted version of the article will be published soon.

    Background: 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. The aims of this study are 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.Methods: Over a period of three weeks, 61 participants were asked to maintain a daily record of all dreams remembered. Dream reports were rated using the Cental 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.Results: Mean agreement rates (weighted Cohen's Kappa) for the CI emotion ratings could be classified as very good: For primary CI emotion ratings, mean weighted Cohen's Kappa was 0.99 (± 0.02), and for secondary CI emotions 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 compared to 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 defence mechanisms across bipolar disorder states, as reflected by the occurrence of negative and positive CI emotions.

    Keywords: emotion, dream, Bipolar Disorder, prospective controlled trial, Central Image Method

    Received: 16 Nov 2023; Accepted: 12 Jun 2024.

    Copyright: © 2024 Schmid-Mühlbauer, Reggiannini, Treu, Chae and Stamm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Thomas Stamm, Clinic Schloss Lütgenhof, Dassow, Germany

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