Among 389 Italian adults, stress emerged as the most central element in a web of connections linking worry, anxiety and depression, according to a study published in BMC Psychology. People who reported more worry and more depressive symptoms also tended to report more negative dreams, a pattern consistent with the idea that waking concerns carry over into sleep.
Dreams have long been associated with people’s emotional lives. The continuity hypothesis of dreaming proposes that concerns and feelings from waking life can continue into sleep and influence dream experiences. For example, people under pressure may dream about threatening or emotionally intense events.
However, it is difficult to determine how different dream experiences relate to different forms of distress. A person may remember dreams frequently without finding them upsetting, while another person may rarely recall dreams but feel strongly affected by the dreams they do remember. Research on dreams and research on worry, which has been linked to poorer sleep, have also largely been conducted separately.
Vittorio Lenzo of the University of Catania in Italy led a team investigating these relationships. The researchers surveyed 389 Italian-speaking adults recruited through university mailing lists, social media and online blogs. Participants were 18 to 64 years old, with an average age of about 24, and the sample included 330 women, 50 men and nine non-binary participants.
Participants completed an online survey containing three questionnaires. The Mannheim Dream Questionnaire asked how often people recalled their dreams, how emotionally intense their dreams were, how positive or negative their dreams usually felt, how often dreams affected their daytime mood and how often they told other people about their dreams. Each of these features was measured with a single question.
The Penn State Worry Questionnaire measured pathological worry, meaning persistent and difficult-to-control thoughts about possible future problems. Participants also completed the Depression Anxiety Stress Scale, which measures symptoms related to depression, anxiety and stress.
Lenzo and colleagues then used network analysis. In this type of analysis, each psychological feature is treated as a point in a network, and the connections between points represent how strongly two features are related after accounting for all the others. This approach can show which variables are most strongly linked to the rest of the network.
On average, participants reported high levels of worry, enough to be considered clinically elevated compared with normative data. Depression, anxiety and stress formed a closely connected cluster, with the strongest connection between anxiety and stress. Worry was most strongly associated with stress and only weakly with anxiety and depression, which the authors suggest may reflect worry’s role in sustaining prolonged tension.
Within the dream measures, people who recalled their dreams more often were also more likely to tell others about them, the strongest connection in the entire network. Frequent dream recall was moderately associated with more emotionally intense dreams, which were in turn linked with the feeling that dreams affected daytime mood.
The links between dreams and distress were weaker. People whose dreams tended to be more negative in tone reported more depressive symptoms and more worry, and people who felt their dreams affected their daytime mood reported more anxiety. The authors note that this pattern fits the continuity hypothesis, since people who worry a great deal may carry that vigilance into sleep.
Stress was the most central variable in the overall network, meaning it had the strongest total connections to the other variables, while depression, dream recall and dream intensity were among the least central. Dream emotional tone had what researchers call a negative expected influence, meaning its connections to the rest of the network ran mostly in the opposite direction from those of distress.
The authors concluded that “dream experiences are integrated components of a dynamic system of emotional functioning.” They suggest that more positive dream experiences might help dampen distress, while stress may amplify it. They also propose that worry and depression could lead to more negative dreams, which might in turn feed next-day anxiety, though both ideas require testing in studies that follow people over time.
There are a few things to keep in mind. Because the data were collected at a single point in time, the study cannot show whether dreams influence distress, whether distress shapes dreams, or both. The participants were a convenience sample of mostly young women recruited online, which limits how far the findings can be generalized.
All information was self-reported, and dream experiences depend on people’s memories, which may introduce bias. Each dream feature was measured with a single question, the connections between dreams and distress were small, and while the network was generally stable when tested using repeated statistical resampling, some individual connections were less certain.
The study, “Dream experiences and psychological distress: a network analysis of pathological worry, depression, anxiety, and stress,” was authored by Vittorio Lenzo, Chiara Fioretti, Alessandro Musetti, Raffaele De Luca Picione, Christian Franceschini, Patrizia Strano, Maria C. Quattropani and Alberto Sardella.