Relationship between drug dreams, affect and craving during early recovery from drug dependence
This thesis is an investigation of the drug dreams (DD) phenomenon in relation to the affect and craving of individuals in withdrawal or early recovery from drug dependence. Dream journals were used by 86 participants over the course of their five weeks treatment program to record their daily affect, craving, dreaming occurrences as well as drug dream content. The data were analysed using mostly mixed modelling methods, and a dream content analysis was also performed. DD were associated with higher levels of negative affect (p < .001) and craving (p < .001) while positive affect showed only little variations in relation to the type of dream experienced (drug dream, regular dream, no dream) during the night. These significant associations between craving, affect and DD were replicated in the female only analysis but not in the male one. The incidence of drug dreams did not decrease in the 5 weeks of the study (p = 7.06). Cocaine/crack users reported a higher incidence of DD (p = .03) than the other drug groups (opiates and alcohol). Nicotine patch users for their part experienced more DD than non-users during treatment (p = .03). DD content that involved active drug use had a larger impact on affect than DD with passive content (p < .05). The presence of fear (p < .001), distress (p < .05) and nervousness (p < .001) in DD moreover produced higher levels of negative affect when compared to DD without such content. These results support the hypothesis that DD can act similarly to drug conditioned stimuli to elevate craving and negative affect in abstaining individuals. Given the role of negative affect and craving on continued drug use and relapse, these results support the implementation of psychological and pharmacological interventions aimed at altering the impact of DD on individuals in recovery.