{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:48:09Z","timestamp":1791157689300,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"906","license":[{"start":{"date-parts":[[2001,4,1]],"date-time":"2001-04-01T00:00:00Z","timestamp":986083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The enduring and contentious hypothesis that sleepwalking and night terrors are symptomatic of a protective dissociative mechanism is examined. This is mobilised when intolerable impulses, feelings and memories escape, within sleep, the diminished control of mental defence mechanisms. They then erupt but in a limited motoric or affective form with restricted awareness and subsequent amnesia for the event. It has also been suggested that such processes are more likely when the patient has a history of major psychological trauma. In a group of 22 adult patients, referred to a tertiary sleep disorders service with possible sleepwalking\/night terrors, diagnosis was confirmed both clinically and polysomnographically, and only six patients had a history of such trauma. More commonly these described sleepwalking\/night terrors are associated with vivid dream-like experiences or behaviour related to flight from attack. Two such cases, suggestive of a dissociative process, are described in more detail.<\/jats:p>\n               <jats:p>The results of this study are presented largely on account of the negative findings. Scores on the dissociation questionnaire (DIS-Q) were normal, although generally higher in the small \u201ctrauma\u201d subgroup. These were similar to scores characterising individuals with post-traumatic stress disorder. This \u201ctrauma\u201d group also scored particularly highly on the anxiety,phobic, and depression scales of the Crown-Crisp experiential index. In contrast the \u201cno trauma\u201d group scored more specifically highly on the anxiety scale, along with major trends to high depressionand hysteria scale scores. Two cases are presented which illustrate exceptional occurrence of later onset of sleepwalking\/night terrors with accompanying post-traumatic symptoms during wakefulness. It is concluded that a history of major psychological trauma exists in only a minority of adult patients presenting with sleepwalking\/night terror syndrome. In this subgroup trauma appears to dictate the subsequent content of the attacks. However, the symptoms express themselves within the form of the sleepwalking\/night terror syndrome rather than as rapid eye movement sleep related nightmares. The main group of subjects with the syndrome and with no history of major psychological trauma show no clinical or DIS-Q evidence of dissociation during wakefulness. The proposition that, within the character structure of this group, the mechanism still operates but exclusively within sleep remains a possibility.<\/jats:p>","DOI":"10.1136\/pmj.77.906.244","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:38:40Z","timestamp":1027766320000},"page":"244-249","source":"Crossref","is-referenced-by-count":62,"title":["Is there a dissociative process in sleepwalking and night terrors?"],"prefix":"10.1093","volume":"77","author":[{"given":"D","family":"Hartman","sequence":"first","affiliation":[{"name":"Department of Psychiatry, St George\u2019s Hospital Medical School , London, and South West London and St George\u2019s Mental Health NHS Trust, Sleep Laboratory, Atkinson Morley\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A H","family":"Crisp","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, St George\u2019s Hospital Medical School , London, and South West London and St George\u2019s Mental Health NHS Trust, Sleep Laboratory, Atkinson Morley\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Sedgwick","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, St George\u2019s Hospital Medical School , London, and South West London and St George\u2019s Mental Health NHS Trust, Sleep Laboratory, Atkinson Morley\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Borrow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, St George\u2019s Hospital Medical School , London, and South West London and St George\u2019s Mental Health NHS Trust, Sleep Laboratory, Atkinson Morley\u2019s Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2001,4,1]]},"reference":[{"key":"2023042612394057700_B1","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1126\/science.159.3819.1070","article-title":"Sleep disorders: disorders of arousal?","volume":"159","author":"Broughton","year":"1968","journal-title":"Science"},{"key":"2023042612394057700_B2","volume-title":"Diagnostic and statistical manual of mental disorders.","author":"American Psychiatric Association","year":"1994","edition":"4th"},{"key":"2023042612394057700_B3","doi-asserted-by":"crossref","first-page":"465","DOI":"10.3928\/0048-5713-19870701-09","article-title":"Parasomnias: sleepwalking, night terrors, and nightmares.","volume":"17","author":"Vela-Bueno","year":"1987","journal-title":"Psychiatry Annals"},{"key":"2023042612394057700_B4","first-page":"65","article-title":"REM sleep behaviour disorder.","volume":"145","author":"Schenck","year":"1988","journal-title":"Am J Psychiatry"},{"key":"2023042612394057700_B5","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1176\/ajp.141.2.187","article-title":"Nightmares and trauma: a comparison of nightmares after combat with lifelong nightmares in veterans.","volume":"141","author":"Van der Kolk","year":"1984","journal-title":"Am J Psychiatry"},{"key":"2023042612394057700_B6","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1176\/ajp.144.3.344","article-title":"Long-term effects of extreme situational stress on sleep and dreaming.","volume":"144","author":"Hefez","year":"1987","journal-title":"Am J Psychiatry"},{"key":"2023042612394057700_B7","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1176\/ajp.146.12.1530","article-title":"Pierre Janet and the breakdown of adaptation in psychological trauma.","volume":"146","author":"Van der Kolk","year":"1989","journal-title":"Am J Psychiatry"},{"key":"2023042612394057700_B8","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1192\/bjp.137.2.111","article-title":"Hereditary factors in sleepwalking and night terrors.","volume":"137","author":"Kales","year":"1980","journal-title":"Br J Psychiatry"},{"key":"2023042612394057700_B9","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/00005053-197403000-00002","article-title":"A psychophysiological study of nightmares and night terrors. III. Mental content and recall of stage 4 night terrors.","volume":"158","author":"Fisher","year":"1974","journal-title":"J Nerv Ment Dis"},{"key":"2023042612394057700_B10","first-page":"483","article-title":"Sleepwalking and the traumatic experience.","volume":"63","author":"Calogeras","year":"1982","journal-title":"Int J Psychoanal"},{"key":"2023042612394057700_B11","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1001\/archpsyc.1963.01720160090012","article-title":"Somnambulism. Its clinical significance and dynamic meaning in late adolescence and adulthood.","volume":"9","author":"Sours","year":"1963","journal-title":"Arch Gen Psychiatry"},{"key":"2023042612394057700_B12","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1136\/bmj.300.6721.360","article-title":"Sleepwalking, night terrors, and consciousness.","volume":"300","author":"Crisp","year":"1990","journal-title":"BMJ"},{"key":"2023042612394057700_B13","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1136\/pgmj.72.852.599","article-title":"The sleepwalking\/night terror syndrome in adults.","volume":"72","author":"Crisp","year":"1996","journal-title":"Postgrad Med J"},{"key":"2023042612394057700_B14","volume-title":"Dissociative experiences, trauma and hypnosis.","author":"Vanderlinden","year":"1993"},{"key":"2023042612394057700_B15","volume-title":"Manual of the Crown-Crisp experiential index.","author":"Crown","year":"1979"},{"key":"2023042612394057700_B16","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1176\/ajp.147.7.887","article-title":"Dissociative symptoms in relation to childhood physical and sexual abuse.","volume":"147","author":"Chu","year":"1990","journal-title":"Am J Psychiatry"},{"key":"2023042612394057700_B17","first-page":"287","article-title":"Revising the differential diagnosis of the parasomnias in DSM-IIIR.","volume":"12","author":"Ross","year":"1989","journal-title":"Sleep"},{"key":"2023042612394057700_B18","first-page":"121","article-title":"Night terrors\u2014sleepwalking: personality characteristics.","volume":"11","author":"Hartmann","year":"1982","journal-title":"Sleep Research"},{"key":"2023042612394057700_B19","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1176\/appi.psychotherapy.1982.36.3.399","article-title":"Psychotherapy with night terror patients.","volume":"36","author":"Kales","year":"1982","journal-title":"Am J Psychother"},{"key":"2023042612394057700_B20","first-page":"194","article-title":"Dissociative disorders presenting as somnambulism. Polysomnographic, video and clinical documentation (8 cases).","volume":"2","author":"Schenck","year":"1989","journal-title":"Dissociation"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/77\/906\/244\/50042020\/postgradmedj-77-244.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/77\/906\/244\/50042020\/postgradmedj-77-244.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T12:41:32Z","timestamp":1682512892000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/77\/906\/244\/7039738"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,4,1]]},"references-count":20,"journal-issue":{"issue":"906","published-online":{"date-parts":[[2001,4,1]]},"published-print":{"date-parts":[[2001,4,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pmj.77.906.244","relation":{},"ISSN":["1469-0756","0032-5473"],"issn-type":[{"value":"1469-0756","type":"electronic"},{"value":"0032-5473","type":"print"}],"subject":[],"published-other":{"date-parts":[[2001,4]]},"published":{"date-parts":[[2001,4,1]]}}}