Sleep disturbances, for the purpose of this theoretical analysis, include a variety of problems with sleep that are discussed below. Variables Present in BPD and DRC Sleep Disturbances Each of these five variables is presented separately below.

This division was made on the basis of theoretical considerations no factor analyzes have been conducted yet. These variables, which we identified through an analysis of the scientific literature, can be divided into the following categories: (i) sleep disturbances (ii) dissociative symptoms (iii) negative dream content (iv) cognitive disturbances and (v) thin boundaries. This hypothesis is supported by the underlying assumption that there are groups of interrelated variables that are present in both DRC and BPD. We hypothesize that BPD subjects are highly predisposed to experience DRC. The aim of this paper is to provide an overview of the current knowledge of DRC in relation to features of BPD. The present theoretical analysis addresses the question of whether individuals with certain features of BPD may have difficulty distinguishing between dreams and reality. Borderline personality disorder affects between 1 and 5.9% of the general population ( Torgersen et al., 2001 Aragonés et al., 2011).ĭue to the complex psychopathology of BPD, numerous studies have examined different areas of functioning in individuals with this disorder. Moreover, persons with BPD often engage in self-destructive behaviors and are at significant risk of suicide. To qualify for this diagnosis, the person should, among other symptoms, make a frantic effort to avoid real or imaginary abandonment, experience a chronic feeling of emptiness or stress-related temporary paranoid symptoms, or exhibit severe dissociative symptoms. Research has found that there is a relationship between DRC and psychotic symptoms (e.g., Hempel et al., 2003), but the authors of the present paper have not been able to find any scientific studies on the relationship between DRC and borderline personality disorder (BPD).īPD is a pervasive pattern of instability of interpersonal relationships, self-image and affect, and marked impulsivity that begins by early adulthood and is present in a variety of contexts (DSM-V American Psychiatric Association, 2013, p. Although, only few studies on DRC in non-clinical populations have been conducted (e.g., Johnson et al., 1984 Mazzoni and Loftus, 1996 Rassin et al., 2001 Kemp et al., 2003), DRC has been investigated in specific groups, including narcolepsy patients ( Wamsley et al., 2014). The theoretical analysis on the basis of these findings suggests that people who suffer from BPD may be more susceptible to confusing dream content with actual waking events.ĭream-reality confusion (DRC) is a difficulty or inability to determine whether an event or experience occurred during the waking state or whether it was part of a dream. Thin boundaries: People with thin boundaries are more prone to DRC than people with thick boundaries, and people with BPD tend to have thin boundaries ( Hartmann, 2011).

Cognitive disturbances: Many BPD patients experience various cognitive disturbances, including problems with reality testing ( Fiqueierdo, 2006 Mosquera et al., 2011), which can foster DRC. Negative dream content: People with BPD have nightmares more often than other people ( Semiz et al., 2008) dreams that are more likely to be confused with reality tend to be more realistic and unpleasant, and are reflected in waking behavior ( Rassin et al., 2001). Dissociation: nearly two-thirds of people with BPD experience dissociative symptoms ( Korzekwa and Pain, 2009) and dissociative symptoms are correlated with a fantasy proneness both dissociative symptoms and fantasy proneness are related to DRC ( Giesbrecht and Merckelbach, 2006). Sleep disturbances: problems with sleep are found in 15–95.5% of people with BPD ( Hafizi, 2013), and unstable sleep and wake cycles, which occur in BPD ( Fleischer et al., 2012), are linked to DRC. Several variables related to this hypothesis were identified through a theoretical analysis of the scientific literature. It is hypothesized that people with BPD are more likely to experience DRC compared to people in non-clinical population. This paper presents an analysis of dream-reality confusion (DRC) in relation to the characteristics of borderline personality disorder (BPD), based on research findings and theoretical considerations. Unit of Sleep Psychology, Institute of Psychology, Jagiellonian University, Krakow, Poland.Dagna Skrzypińska and Barbara Szmigielska *

Warped reality disorder