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Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents

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Abstract

Purpose

Nightmares are common, especially in pediatric populations and psychiatric patients. Nightmares are associated with daytime distress and negative health outcomes. The data on the prevalence and psychopathological profiles of nightmares in Chinese adolescents are limited. This study examined age and gender differences in nightmare frequency and associated psychopathological problems in a large sample of Chinese adolescents.

Methods

A total of 11,831 adolescent students (mean age = 14.9, 12–18 years) participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort. Participants completed a self-administered questionnaire to report their nightmare frequency, trait anger, hopelessness, and multiple domains of behavioral/emotional problems. Univariate and multivariate analyses were performed to examine psychopathological problems in relation to nightmare frequency.

Results

Of the sample, 45.2% reported having nightmares at least once in the past month and 7.9% at least once/week. Girls reported more frequent nightmares than boys. Nightmare frequency significantly declined with age for both boys and girls. Mean scores on trait anger, hopelessness, attention, internalizing problems, and externalizing problems significantly increased with nightmare frequency. Frequent nightmares (at least once/week) were significantly associated with 2–4-fold increased likelihood of behavioral/emotional problems after adjusting for adolescent and family covariates.

Conclusion

Nightmares are prevalent in Chinese adolescents. Frequent nightmares are associated with multiple domains of psychopathological problems. Assessment and intervention of frequent nightmares should be incorporated into routine clinical practice and mental health services in adolescents.

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Data available upon request.

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Acknowledgements

The authors would like to thank staff members at Yanggu County Center for Disease Control and Prevention, Lijin County Center for Disease Control and Prevention, and Zoucheng City Center for Disease Control and Prevention, Shandong Province, China, and all participating class teachers for their help with data collection and all students for their voluntarily participating in the study.

Funding

This work was funded in part for data collection by National Natural Science Foundation of China (Grant number 81573233; Recipient Dr. Cun-Xian Jia).

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Authors and Affiliations

  1. Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Xianchen Liu

  2. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China

    Zhen-Zhen Liu, Bao-Peng Liu & Cun-Xian Jia

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  1. Xianchen Liu
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  2. Zhen-Zhen Liu
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  3. Bao-Peng Liu
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  4. Cun-Xian Jia
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Contributions

Dr. Xianchen Liu conceptualized the study, performed data analysis, and drafted the manuscript. Drs. Zhen-Zhen Liu and Bao-Peng Liu collected data, managed data, and reviewed and revised the manuscript. Dr. Cun-Xian Jia contributed to the study design, supervised data collection and data management, and reviewed and revised the manuscript.

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Correspondence to Xianchen Liu.

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Liu, X., Liu, ZZ., Liu, BP. et al. Nightmare frequency and psychopathological problems in a large sample of Chinese adolescents. Soc Psychiatry Psychiatr Epidemiol 57, 805–816 (2022). https://doi.org/10.1007/s00127-022-02224-y

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  • DOI: https://doi.org/10.1007/s00127-022-02224-y

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