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Lutz Wittmann

Publications and source records attributed to Lutz Wittmann.

6 recordsLinked to original sources

Dreaming in posttraumatic stress disorder: A critical review of phenomenology, psychophysiology and treatment.

This review summarizes the available knowledge on the phenomenology of posttraumatic dreams. Posttraumatic nightmares are reported by up to 70% of individuals suffering from posttraumatic stress disorder (PTSD). An extensive review of polysomnographic studies suggests that neither this high incidence nor the occurrence of posttraumatic nightmares throughout the sleep cycle can be explained by altered REM sleep parameters. The assumption that a reduction of dream recall may serve as a coping mechanism in PTSD patients is questionable. About 50% of posttraumatic dreams comprise exact replications of the traumatic events. Therefore dreams in PTSD do not have stereotypical content. Data characterizing non-replicative posttraumatic dreams and indicating a change in dream content over time must be considered preliminary. Occurrence of posttraumatic dreams is associated with psychopathological developments. Imagery Rehearsal Therapy has repeatedly been proven to be a valuable tool in treating patients suffering from posttraumatic dream disturbance. A deeper knowledge of posttraumatic dreams is essential for any theory of PTSD as well as for a better understanding of the overall function of dreaming.

Adult↗

Low predictive power of peritraumatic dissociation for PTSD symptoms in accident survivors.

To test the predictive power of peritraumatic dissociation for the development of psychopathology, the authors assessed symptoms of peritraumatic dissociation (Peritraumatic Dissociative Experiences Questionnaire; PDEQ), posttraumatic stress disorder (Clinician-Administered PTSD Scale; CAPS), anxiety and depression (Hospital Anxiety and Depression Scale; HADS) in a sample of 214 accident victims 5 days postaccident (T1). Six months later (T2), CAPS and HADS were administered again. Acute stress disorder (ASD) and PTSD symptom levels were surprisingly low. In sequential regression analyses, initial reexperiencing and hyperarousal significantly predicted PTSD symptom level (T2) over several possibly confounding variables controlled for. Peritraumatic dissociation explained less than 3% of variance. For PTSD scores, 38% overall variance explanation was obtained; the variance for HADS scores was low. Possible explanations for the low-predictive power of peritraumatic dissociation for posttraumatic psychopathology in the sample are discussed.

Accidents↗

Coping with serious accidental injury: a one-year follow-up study.

BACKGROUND: The aim of this study was to analyze changes of coping strategies in severely injured accident victims over time and to compare patients with high and low posttraumatic stress disorder (PTSD) symptom levels with regard to their coping patterns and accident-related cognitions. METHODS: 106 consecutive patients with severe accidental injuries admitted to a trauma surgery intensive care unit (ICU) were assessed within 1 month after the trauma and 6 and 12 months later. Assessments included a clinical interview, the Freiburg Questionnaire of Coping with Illness, the patients' accident-related cognitions, the Clinician-Administered PTSD Scale, the 90-item revised Symptom Checklist (SCL-90-R), and the Sense of Coherence Questionnaire (SOC). Patients who met the criteria for either full or subsyndromal PTSD at least once over the observation period (36 subjects; 34.0%) were assigned to a highly symptomatic group (HSG), the remainder (70 subjects; 66.0%) to a less symptomatic group. RESULTS: Overall, active problem-focused coping was predominant immediately after the accident and declined over time, with a stronger decrease in the HSG. Patients in the HSG scored higher on the SCL Global Severity Index and lower on the SOC. The patients' subjective appraisal of accident severity was higher in the HSG, whereas there was no group difference with regard to accident-related variables such as type of accident, injury severity and mild to moderate traumatic brain injury. CONCLUSIONS: Active problem-focused coping, although utilized most frequently and often regarded as protective, might be an inadequate strategy in face of acute stress following a severe accident. Clinicians should not expect their patients to cope very actively in the acute ICU phase. In the subsequent rehabilitation, active coping seems to be more adaptive.

Accidents↗

Psychological and psychosocial interventions after attempted suicide: an overview of treatment studies.

A literature search was conducted to collect randomized controlled studies evaluating the outcome of psychological and psychosocial interventions after attempted suicide and deliberate self-harm. Twenty-five studies meeting the inclusion criteria were identified. The studies are grouped according to the psychological approach chosen for the intervention. They are discussed with regard to both the various therapeutic strategies and models used, and the repetition of self-harming behavior as the main outcome.

Humans↗

Typical dreams: stability and gender differences.

Although the variability of dream content is large, typical dream themes that occur quite often and are reported by many people can be identified (e.g., being chased, falling, flying, failing an examination, being unable to find a toilet or restroom). The present study is an investigation of the stability of the rank order of the dream themes and of gender differences in the content of dreams. The authors administered A. L. Zadra and T. A. Nielsen's (1997) Typical Dream Questionnaire to 444 participants. The findings indicated that most of the 55 dream themes occurred at least once in most of the participants' lifetimes. In addition, the correlation coefficients for the rank order of the themes were very high; that is, the relative frequencies were stable. The gender differences in the present study were in line with content analytic findings; for example, men reported dreams about physical aggression more often than did women. Overall, previous research and the present data indicate that available research results of the measurement of typical dream themes are reliable and valid. The question of the meaning of these themes or the relationship between typical dream contents and waking life experiences, however, has not yet been answered and is open to future research.

Adult↗

Factors of home dream recall: a structural equation model.

Previous research has indicated that personality factors such as openness to experience, creativity, visual memory, attitude toward dreams, and sleep behavior is related to home dream recall frequency (DRF). However, a study investigating all areas simultaneously within one sample in order to determine the percentage of variance explained by all variables and to take intercorrelations between the influencing factors into account has not been performed till now. The present study with 444 participants fills this gap. Using several indicators for each of the variables mentioned above, a structural equation model was tested. Although the model fit was satisfying, the four factors which were significantly related to DRF: personality (openness to experience, thin boundaries, absorption), creativity, nocturnal awakenings, and attitude toward dreams, explained only 8.4% of the total variance. As this value is considerably lower than those of studies investigating a single influencing factor and using similar measurement instruments in similar samples, one might speculate about possible expectancy effects in these previous studies, an effect which has been demonstrated for DRF in the laboratory setting. In addition, the small percentage of explained variance of each single factors (<3%) may indicate that other, in this study unmeasured, variables such as sleep duration (state aspect), introspection, and cognitive functioning immediately upon awakening (sleep inertia) show substantial covariance with the interindividual differences in DRF. Future studies should focus on longitudinal aspects in order to differentiate between state versus trait factors (although methodologic issues, e.g. the effect of the measurement technique on DRF itself, have to be clarified) and investigate additional variables which might be associated with DRF (see above).

Attitude↗