Daniella David

Dreams in the Acute Aftermath of Trauma and Their Relationship to PTSD

Dreams following trauma have been suggested to aid emotional adaptation, yet trauma-related nightmares are a diagnostic symptom of Posttraumatic Stress Disorder (PTSD). There is little published data relating dreams to PTSD soon after trauma. We assessed dreams and PTSD in 60 injured patients after life-threatening events and obtained follow-up assessments in 39 of these participants 6 weeks later. Ten of 21 dream reports from morning diaries were rated and described as similar to the recent traumatic event. The participants reporting these distressing “trauma dreams” had more severe concurrent PTSD symptoms than those reporting other categories of dreams and had more severe initial and follow-up PTSD than those without dream recall. These findings along with our preliminary longitudinal observations relating changes in dream patterns to outcome, suggest a relationship of dream characteristics and early adaptive versus maladaptive patterns of processing traumatic memory.

Cognitive Functioning and the Early Development of PTSD

Cross-sectional studies of chronic PTSD reveal deficits in verbal memory. We studied cognitive functioning and its relationship to current and subsequent PTSD severity during an early phase of trauma response. Thirty-eight participants with traumatic injuries and only posttrauma incident psychopathology were evaluated shortly after admission to a Level I Trauma Center. Neuropsychological measures were obtained at baseline and assessment of PTSD and other psychiatric disorders was conducted at baseline and follow-up, 6 weeks later. Significant negative correlations were found for follow-up PTSD severity with delayed recall and retroactive interference. These relationships were not significant for, and were independent of, baseline PTSD severity. Relative deficits in select areas of verbal memory after a trauma may confer greater risk for developing PTSD.