British journal of Clinical Psychology (1997),36, 377-386 Printed in Great Britain 377

0 1997 The British PsychologicalSociety

Nightmares, dreams, and schizotypy

Gordon Claridge*
UnivwsiQ of w o r d , Department of Eqertmental Psychology, South Parks Road, Oxford OX1 3 UD, UK

Ken Clark
Fair Mile Hoqital, Wallingford,Oxon

Caroline Davis
Graduate Programme in Evercise and Health Science, York University, Toronto, Canada

The theory that psychosis and dreaming share some common underlying mecha-
nism finds support in the observation that chronic nightmare sufferers are at
increased risk for psychopathology. We examined this connection in a large general
population sample, administering a battery of psychosis proneness and other per-
sonality scales, together with a nightmare distress scale; participants also answered
a single question on pleasurable mood associated with dreaming. In addition, they
completed the Bem Sex Role Inventory, to reinvestigate previously observed gender
differences in nightmare susceptibility. It was found that, among the psychosis
proneness scales, the best predictor of nightmare distress was STA, a mostly cogni-
tive measure of schizotypy; this was true even after allowing for a strong influence
in the data of general neuroticism. Other aspects of psychosis pr0neness-e.g.
anhedonia-were unrelated to nightmares. However, sex and sex role differences
did make a significant contribution, self-confessedfeminine females and masculine
males reporting, respectively, the highest and lowest nightmare distress. For schizo-
typy it was further shown that relationships were not confined to the nightmare
experience; high (STA) schizotypesalso sigdicantly more often reported enjoyable
dreaming. It was concluded that a utllfylngtheme explaining the data is the schizo-
type's greater imaginativeness,which can have both positive and negative expres-
sion in sleep and consciousness.

To say that insanity is a dream which has become real is no metaphor. The
phenomenology of the dream and of schizophrenia are almost identical ... uung,
1939).

In the above comment, one of his many references to the topic, Jung was articulating
a centuries-old theme. The possibility that madness is something akin to the inner
world of sleep has appeared in many guises: in art, poetry and other cultural forms,
as well as in the scientific literature, where it has regularly been proposed that schiz-
* Requests for reprints.
378 Gordon Claridge, Ken Ckark and Caroline Davis

ophrenia and dreaming share a common biology (Doty, 1989; Fischman, 1983;West,
1962). From the dream experience it is naturally the nightmare, with its negative
affect tone and threatening content, that finds special affinity with mental illness.
Here attention has been paid, not only to the question of a shared phenomenology
and biology, but also to whether the susceptibilityto nightmares bears on the risk for
psychotic disorder. Evidence suggesting that it does has come from a number of
sources; most directly from research on chronic nightmare sufferers who, in several
studies, have been found to show a greater incidence of schizophrenia spectrum dis-
orders and/or to score with a ‘psychotic’ profile on the MMPI (Kales, Soldatos,
Caldwell, Charney, Kales, Markel & Cadieux, 1980; Hartmann, Russ, Oldfield,
Sivan & Cooper, 1987; Hartmann, Russ, van der Kolk, Fake & Oldfield, 1981).
Work on these specially selected individuals has been supplemented by other
research on the characteristics of more general population samples. A recent large-
scale study that is particularly relevant here is a survey by Levin & Raulin (1991) of
some 600 participants administered four of the Chapmans’ psychosis proneness
scales. Three of these-perceptual aberration, intense ambivalence and somatic
symptoms-were positively and sigdicantly correlated with the reported frequency
of nightmares. (The fourth scale-physical anhedonia-was negatively related to
nightmare frequency.) Levin & Raulin discuss their findings from the point of view of
schizotypy as a disturbance of ego boundaries, which leads some individuals to
become overly attuned to and emotionally affected by their own internal state. This
interpretation is taken up again by Levin (1994) reporting on an even larger data set
(N = 3000+) in which greater nightmare frequencywas found to be associated with
several indices of dream sensitivity and affective disturbance within sleep and on
waking.
The notion of ‘boundaries’ quoted in the above studies is that developed in the
context of dream research by Hartmann (1991)who, starting from his own work on
the psychopathology of the nightmare, has elaborated it into a general theory of per-
sonality in which individuals are characterized by the relative permeability (the
‘thickness’or ‘thinness’) of the physiological and psychological boundaries that are
proposed to exist, both intra-psychically and between self and others. Notably, the
questionnaire constructed to measure the various facets of boundary permeability
has evident item overlap with some psychosis proneness scales and, according to
Hartmann (1991), does appear to be related to schizotypy as indexed by more con-
ventional psychometric instruments.
From the above evidence, then, there seems to be agreement that nightmare sus-
ceptibility is related to clinical and personality features of a broadly psychotic nature.
Even so, it could be, and has been, questioned (e.g. Bearden, 1994) whether the
associations revealed are unique to psychosis, or whether nightmares merely reflect
non-specific psychopathology and, in the personality domain, general neuroticism.
Interestingly, in reporting their original study of chronic mghtmare sufferers
Hartmann et al. (1981) make a special point of the fact that, despite a raised inci-
dence of psychiatric disorder, none of their participants developed an anxiety-based
condition of a neurotic type. It has also been reported that mghtmare frequency is
uncorrelated with self-rated anxiety (Wood & Bootzin, 1990).However, others have
 Nightmares, dreams, and schizotpy 379

claimed that anxiety commonly does accompany the experience (Hersen, 1971),
while raised N scores have certainly been documented in nightmare sufferers
(Berquier & Ashton, 1992).The point at issue is whether increased anxietyheuroti-
cism is sigruficant in its own right; or whether its effect, if present, is secondary to that
of more primary psychotic traits. In this respect it should be noted that neuroticism
correlates quite highly with several of the commonly used psychosis proneness scales,
and that when included alongside them in factor analysis N helps to define at least
one of the major components of schizotypy (Claridge, McCreeq, Mason, Bentall,
Boyle, Slade & Popplewell, 1996). It is therefore clearly important to try to disen-
tangle what are likely to be separate but correlated influences of neurotic and psy-
chotic traits on nightmares.
The most commonly used way of measuring the severity of the nightmare experi-
ence is to record its frequency Belicki ( 1992), however, proposed that a better mea-
sure for exploring relations to personality and psychopathology is the degree of
distress surrounding the rughtmare, given that the emphasis of most research in the
area is on characterizing nightmare mflmkg. Belicki supports her argument with evi-
dence from her own work, showing that it was the emotional upset reported by par-
ticipants, rather than the incidence of nightmares per se, that was associated with
poor psychological adjustment and with scores on inventories such as Hartmann’s
Boundaries Questionnaire.
One of the very consistent observations in nightmare research is the marked sex
difference. To our knowledge, all investigatorswho have made the comparison report
susceptibility to be much greater in women, whether indexed as nightmare distress
(Belicki, 1992a) or frequency (Levin & Raulin, 1991), or whether examined in
chronic sufferers (Kales et al, 1980; Hartmann et al., 1981) or in less selected sam-
ples (Levin, 1994).The last author included the sex difference as a special part of his
study and raises an obvious difficulty in interpreting such findings, viz. that they
might merely reflect a greater female tendency to self-disclosureof emotional events.
As an alternative,Levin makes a proposal based on his account, referred to earlier, of
how nightmare differences in general arise, i.e. through a heightened sensitivity to
the dream experience as a whole. Quoting some evidence from his own data, he sug-
gests that women might be genuinely more hypersensitive in this respect. The inter-
pretation would find further support, he notes, in the demonstrably raised incidence
among women in the waking state of common forms of psychological disorder, such
as anxiety and depression.
A further facet of the topic of interest concerns the relationship between night-
mares and healthy dreaming, and the fact that these appear to have some common
underlying personality dynamics that can find expression in disparate kinds of sleep
disturbance. The theme recurs in various guises throughout the literature. Hartmann’s
(1991) theory-that nightmare sufferers are people with so-called thin mental
boundaries-also proposes that the enhanced sensitivity of such individuals will
show itself, under more favourable circumstances, as greater imaginativeness and,
possibly, creativity. In similar vein, Belicki (1992) has reported that nightmare dis-
tress is associated with the perceived richness of the normal dream experience and to
‘absorption’,as a measure of fantasy proneness.
380 Gordon Claridge, Ken Clark and Camline Davis
The same implied positive element in otherwise negatively construed dispositions
is also evident in some current formulations of schizotypy; these argue that psychot-
ic illness is only one among many possible outcomes for people of highly schizotypal
personality (Claridge, 1997; Claridge &Beech, 1995).More ego-syntonicmanifesta-
tions include profound mystical experiences (Jackson, 1997) and susceptibility to
such altered states of consciousness as out-of-the-body experiences (McCreery &
Claridge, 1995) and, possibly, lucid dreaming (Green & McCreery 1994). Further
links to this more adaptive side of schizotypy are also evident in the latter’s positive
relationshipto the personality dimension of ‘openness’(Mason & Claridge, in press),
a factor which, in turn,has reported connections to healthy dreaming (Bemstein &
Roberts, 1995).There is, in other words, strongly converging evidence that so-called
psychosis proneness relates to a range of sleep-related phenomena, positive as well as
negative.
The foregoing discussion has served to introduce three issues to be examined in
this paper. The first concerns the relationship between schizotypy and nightmares.
On the basis of previous work, it could be predicted that such an association would
exist; the main question was whether this is entirely or in part attributable to partici-
pant differences in neuroticism or whether schizotypy alone can account for the
results. The second question is about gender and extends previous research to
the study of differences in self-rated sex-role stereotyping; here it was tentatively
predicted that, irrespective of biological sex, the strength of the ntghtmare experi-
ence might vary according to participants’ weighting on masculine and feminine
traits. Thirdly, some data are reported testing the hypothesis that, in addition to
its association with nightmares, schizotypy would also predispose to more positive
dream experiences.

Method

Participants
The sample consisted of 204 participants (117 females and 87 males) ranging in age from 14 to 51 years
(women, mean age = 23.3; men, mean age = 24.7). The majority (187) were recruited in Canada, in
part from a university and in part from a general community population; the remaining 17 were British
undergraduates.

Measures and procedure

Participants were administered a series of paper-and-penciltests, forming part of a larger inquj. into
dreams and tllgtmares which included the collection of qualitative data, not considered here. In about
half the cases subjects completed the questionnairesin the c o m e of their participation in a laboratory
experiment on cognitive performance, the data for which will be published elsewhere. The measures
used in the present study were as follows:

Nightmare Dktreu. Devised by Belicki (19926), this consists of 13 items in which individuals
rate on five-point scales the degee of emotional upset engendered by their nightmares.
 Nightmares, dreams, and schizoopy 381

Dream question. The participant’s enjoyment in dreaming was assessed with the single ques-
tion, ‘Have you had periods when your dreams were so pleasant that you looked forward to
going to sleep?’

STllN. This is a composite four-scale ‘psychosis proneness’ inventory constructed by the

authors from existing questionnaires. Two of the scales-Schizotypal Personality (STA) and
Borderline Personality (STB)-are taken directly from Claridge and Rawlings’ STQ ques-
tionnaire (Claridge & Broks, 1984). The other two are Physical Anhedonia (PhA)and Social
Anhedonia (SoA), as modified versions of the equivalent scales published by Chapman,
Chapman & Raulin (1976). Here the wording of the items was slightly altered in order to
replace the original ‘true’rfalse’with a ‘yes’rno’mode of endorsement, in line with the STQ.
To produce the STAN, the items from the four scales described were intermingled with one
another and with those from the Lie (L)scale of the Eysenck Personality Questionnaire; this
was done in a pseudo-random order, so as to avoid unwanted sequencing of questions.

Eysenck Personality Questionnaire. This was administered with the Lie items deleted and
scored to give the two measures of interest, viz. Neuroticism (N), and Psychoticism (P)
(Eysenck & Eysenck, 1975).

BEM Sex Role Inventory. This was administered and scored in its standard form (Bem, 1973)
to give T-score measures of masculinity (BEMM) and femininity (BEMF).Again using Bem’s
norms and guidelines, participants were also allocated to one of four categories-masculine,
feminine, androgynous or undifferentiated-according to whether one or both of their mas-
culine and feminine ratings fell above or below the combined maldfemale median. Here,
androgynous indicated that both scores were above, and undifferentiated that both scores
were below, the median.

Results

Descriptives for all of the data are shown in Table 1. The only point to be noted
here is that examination of the distributions for the various measures indicated
that the nightmare distress (ND) scores were positively skewed. This was corrected
with a square root transformation and the scores in that form used in all subsequent
calculations.
Examining ND scores for the effects of age showed this to have no influence, the
correlation being virtually zero. There was, however, a marked sex difference,
women having sigdicantlyhigher distress scores than men (t(202)= 3.75,~ < .001).
This result was partly paralleled in the relationships between ND and the two BEM
variables. Although the masculinity score was unrelated ( Y = .05), femininity was

Table 1. Means and SDs for questionnaire scales (N = 204)

STA STB SoA PhA N P ND BEMF BEMM

Mean 17.21 7.00 9.77 14.66 11.37 4.25 11.62 51.13 50.63
SD 7.13 3.71 5.40 7.69 5.43 2.73 8.70 11.15 10.22
382 Gordon Clatidge, Ken Clark and Camline Davis
positively and signrficantlycorrelated with ND (r(202)= .25,p < .001). These gen-
der and sex role effectsare considered again later.
Table 2 shows the matrix of correlations for ND and the personality measures,
across the total group. Among the psychosis proneness scales, the only slgniscant
correlationswith ND were for the STQ, especially STA The other notable result was
the sigHlficantpositive correlationbetween ND and Neuroticism, which, in turn,was
significantly related to STA (and STB).

Table 2. product moment correlations for &mare distress and personality scales (N= 204)

STA STB N P PhA SoA

ND .51*** .38*** .39*** .10 -. 16" .02
STA - .70*** .57*** .16* -. 16* .16
STB - .58*** .29** .02 .20
N - .02 .04 .23
P - .25** .24**
PhA - .33***
*p < .05; **p c.01; ***p < .001.

In order to establish which combination of variables optimally predicted ND,

stepwise regression procedures were used with the maximum R2improvement option
(SAS,1985).' AU psychosis proneness scales, as well as N, BEMF and BEMM, were
entered as independent variables into the model. Results indicated that the best pre-
dictor of ND was the combination of STA, BEMF and sex. None of the other inde-
pendent variables reached statistical significance after controlling for these three
variables. Following this analysis, the model was modified to include all pairwise
interaction terms among STA, BEMF and sex along with the main effects. In no case
was the interaction sqpdicant, so these terms were dropped. Table 3 presents details
of the final regression model.
The combined genderhex role effects on ND were then further examined, with
the data rearranged according to the four BEM categories. This is illustrated graphi-
cally in Fig. 1where it can be seen that mean ND scores are ordered much as expect-
ed from the previous analysis. Overall, women reported more ntghtmare distress;
but, irrespective of gender, feminine traits also had an influence, as revealed in the
larger ND scores of individuals-male and female-fabg into the feminine and
androgynous categories, both of which shared a high BEMF score. This combined
additive effect of gender and sex role meant that the high and low extremes of night-
mare distress were occupied by, respectively, very feminine women and very mascu-
line men. Other combinationswere ranged in between, with the two undifferentiated
subgroups (both with below-median BEMF scores) being low on ND, relative to

'This method begins by finding the one-variablemodel which produces the highest R2.Then a second variable that
yields the greatest increase in R2is added. Once the two-variablemodel is obtained, each of the variables in the
model is compared with each variable not in the model. The 'best' two-variablemodel is the one with the greatest
Rz. Another variable is then added, and this process is repeated.
 Nightmares, dreams, and schizotypy 383
Table 3. Stepwise regression analysis with &mare distress as the dependent variable

Parameter Incremental
Variable estimate SE F(HJ P R2

Intercept 1.70 0.49

STA 0.09 0.01 60.93 .ooo 1 .28
Sex (male) -0.53 0.16 10.97 .0011 .05
BEMF 0.02 0.007 6.12 .0143 .03
R2 = .36.
Note. Testing the full model with aJl of the variables entered resulted in only a modest increase in R2 to
.38. Significance values for these other variables, listed in the order in which they were entered by the
MaxR procedure, were as follows: N = .lo; STB = .22; SoA = .33; P = .40; PhA = .52; BEMM =
.68.

most other members of their own sex. Tested with one-wayANOVA, the data shown
in Fig. 1 proved to be signrficant (F(7,195) = 3.585,~ < .001).Pairwise compar-
isons showed the sflcant effects (p < .05) to lie in the lower ND scores of
masculine and undifferentiated males, compared with androgynous men and with
feminine, androgynous and masculine women.
Finally,participants’ responses to the dream question were examined in relation to
the other variables. Both STQ scales were found to correlate sgndicantly and posi-
tively with an affirmative reply to the question: .28 for STA and .22 for STB (p < .01,

0
e 0
arn 3.6 0
rn
g 3.4 - 0
Y
0
0
a 3.2 - 0

3-
Y
i
I 2.8 -
m
f 2.6 -
0 .

2.4 ! I I 1 I I I I 1

Undif Marc Andr Fern Undif Marc Andr Fern

MALES FEMALES

F i m 1. Diagram showing mean nightmare distress (transformed) scores for four BEM categories in
males and in females.
384 Gordon Ckaridge, Ken Ckark and Caroline Davis
d.f. = 202 in both cases). Of the other personalityvariables only one-physical anhe-
donia+orrelated with the item, and did so negatively (-.24,p c .01, d.f. 202).A
small, but significant, positive correlation (. 17,p c .05, d.f. = 202) was also found
with ND; indicating a slight tendency for nightmare sufferers also to report more
positive dream experiences.

Discussion and conclusions

The study reported here usefully extends previous research and offers reasonably
definitive answers to the three questions that the paper set out to answer.
The issue of main interest in the research was the specificity of schizotypy’sinflu-
ence on the strength of the nightmare experience. This actually resolved itself in two
questions. The first concerned the relative degree of association with ‘schizotypy’in
the narrow sense-defined by the, largely cognitive, items of the STA scale-as com-
pared with measures of other aspects of psychosis proneness. The second question
asked whether if any relations with nightmares were found, could they be explained
as simply due to general neuroticism, rather than to something uniquely ‘psychotic’?
The results on both counts were clear: the STA was the only major psychosis prone-
ness scale positively related to nightmare distress and was also its biggest single pre-
dictor. This was true even after controlling for N, which otherwise had a strong
influence throughout the data. Our interpretation draws upon an idea, presented
elsewhere in more general form (Claridge& Davis, in preparation), to the effect that
N has a hierarchical relationship to other factors. Neuroticism can be considered a
very broad dimension that correlates with, but subsumes, a range of more specific,
clinically relevant personality features. Further analysis of the personality dynamics
involved in particular forms of psychopathology then requires that attention is paid
to more causally distinct subcomponents of N, selected according to the clinical
problem being studied. In the present case schizotypy proved to be the theoretically
pertinent choice.
The marked difference we observed between men and women in their nightmare
experience replicates the findings of other workers. Our own data go further and
suggest that, irrespective of biological sex and the tendency for females in general to
report more nightmare distress, the latter also increases as a function of self-evaluat-
ed feminine traits. Indeed, mean nightmare scores were much the same for several
combinations of sex and BEM category The extremes were only particularly defined
where individuals perceived themselves as conforming to their own sex stereotype,
‘masculine’males reporting very low and ‘feminine‘ females very high nightmare dis-
tress. Exceptional here were undifferentiated males who, despite their low BEM
masculinity rating, had the lowest ND scores. This perhaps suggests that, among
men at least, the tendency to report nightmare distress is as much influenced by
rejecting ‘feminine’characteristics as by strongly endorsing ‘masculine’ones.
The finding that highly schizotypal individuals also actively enjoyed their normal
dreaming confirms our supposition that ‘psychosisproneness’ is a too restrictive view
of the subject matter. It is more informative to construe schizotypy as an essentially
 Nightmares, dreams, and schizoopy 385

neutral personality characteristic, which includes among its cognitive features the
tendency towards a wide range of unusual perceptual experiences and thought styles.
A frequently quoted mediator of such effects is a relative reduction in so-called ‘cog-
nitive inhibition’ (Claridge & Beech, 1995), an account that draws heavily upon the
explanation of schizophrenic cognition, as caused by a failure to limit the contents of
consciousness (Frith, 1979). Logically the phenomenology of such ‘leaked’ experi-
ence is just as likely to be pleasant and ego-syntonic as disintegrative and negative in
emotional tone; healthy dreaming and the nightmare could therefore be regarded as
sleep-related examples of these contrasting psychological conditions.
Although we have set the discussion here in the context of schizotypy research,
similar ideas have been articulated under several other headings: in Hartmann’s
(1991) ‘boundarypermeability’ theory and the concept of ‘openness’ (McCrae, 1994),
both already mentioned; in Thalbourne’s notion of ‘transliminality’(Thalbourne &
Delin, 1994);and as ‘skinlessness’,a descriptor for highly emotionally attuned indi-
viduals at risk for psychopathology (Anthony, 1987). Like schizotypy theory, all of
these formulations include, among the positive expression of the traits described,
some degree of enhanced creativity. It was this connection that partly inspired the
present research, following some biographical analyses of the personalities of a group
of eminent writers who had suffered psychotic illness (Claridge, Watkins & Pryor,
1990).A striking feature many of these individuals shared was a marked tendency to
suffer from nightmares, sometimes of ho-g intensity. These appeared to form
part of a complex of attributes and experiences, of common origin, also manifest in
the writers’ emotional skinlessness and great imaginativeness. Creative thought,
intermittent mental illness, unusual experiences by day or night: these all seemed,
and seem, to be as one. The theme was captured as well as any by the earliest of our
subjects of study-Thomas Hoccleve, a contemporaryof Chaucer-who, in describ-
ing his own condition, wrote piteously of his ‘Troubly dremes, drempt al in wakynge’.

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Received 31 December 1995, revised version received 1 July 1996