The Relationship between Psychotic Experiences, Nightmares and Emotion Dysregulation: Results from a Student Population

Background: Sleep-disruption is commonly associated with psychotic experiences. Whilst sparse, the literature to date highlights nightmares and related distress as prominent risk factors for psychosis in students. We aimed to further explore the relationship between specific nightmare symptoms and psychotic experiences in university students whilst examining the mediating role of emotion dysregulation. Method: A sample (N=1273) of students respondents from UK Universities completed measures of psychotic experiences, nightmare disorder symptomology, and emotion dysregulation. Findings: Hierarchical linear regression analysis showed that psychotic experiences were significantly associated (Adjusted R2 = 32.4%) with perceived nightmare intensity, consequences and resulting awakenings, and with emotion regulation difficulties. Furthermore, multiple mediation analysis showed that the association between psychotic experiences and nightmare factors was mediated by emotion regulation difficulties. Interpretation: Adaptive regulation of dream content during rapid eye-movement sleep has previously been demonstrated to attenuate surges in affective arousal by controlling the intensity and variability of emotional content. Deficits in emotion regulation may partially explain the experience of more intense and disruptive nightmares amongst individuals with psychotic experiences. Emotion regulation may represent an important control mechanism that safeguards dream content and sleep quality. Funding Statement: The authors stated: "No funding received." Declaration of Interests: No conflicts of interest declared in relation to this paper. Ethics Approval Statement: The study was approved by the Sheffield Hallam University Research Ethics Committee, and all participants provided online informed consent.