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Sexual dream and family relationships in frequent
sexual dreamers and healthy volunteers
Xu Shao, BSc, Chu Wang, BMed, Yanli Jia, BMed, Wei Wang, BMed, DSc
∗
Abstract
Early life family relationships affect the sexuality in adulthood, and these influences might be reflected in sexual dreams. The present
study was designed to investigate the exact associations between family relationships and sexual dream experience. We therefore
invited 62 frequent sexual dreamers (dreamers) and 104 healthy volunteers (controls) to answer the Sexual Dream Experience
Questionnaire (SDEQ) and the Family Relationship Questionnaire (FRQ). Compared to controls, dreamers scored higher on all SDEQ
factors and sexual dream frequency, higher on FRQ Paternal Abuse, and lower on FRQ General Attachment and Maternal Freedom
Release. In controls, Paternal Abuse was associated with Joyfulness, Maternal Dominance with Aversion, and Maternal Abuse with
dream frequency (–). In dreamers, Paternal Abuse was associated with Aversion, Bizarreness and dream frequency, and Maternal
Freedom Release with Aversion (–). In conclusion, there were pronounced associations between sexual dreams and family
relationships in frequent sexual dreamers. Paternal Abuse in particular was associated with sexual dream experience. Adverse family
relationships might induce frequent sexual dream occurrence, and family therapy or early intervention of Paternal Abuse might
alleviate the negative sexual dream experience.
Abbreviations: CI =confidence interval, DSM-5 =the Diagnostic and Statistical Manual of Mental Disorders, 5th ed, EMBU =the
Egna Minnen av. Barndoms Uppfostran, FRQ =the Family Relationship Questionnaire, MANOVA =multivariate analysis of variance,
MSE =mean square error, PBI =the parental bonding instrument, SDEQ =the Sexual Dream Experience Questionnaire.
Keywords: continuity hypothesis, family relationship, sexual behavior, sexual dream
1. Introduction
Sexual dream is one kind of typical dreams described in human.
More than 70% of people have experienced sexual dreams in
general population.
[1–3]
According to a Canadian study, sexual
experience was the second most-frequent themes in dream, after
the one of being chased or pursued.
[1]
Contents of sexual dreams
are mainly sexual intercourse, flirting, kissing or sexual
fantasies,
[4,5]
and negative ones such as aggression-involving
and rape.
[6]
Daily dreams are interpreted as reflections of one’s waking
states and concerns, and psychological variables according to the
continuity hypothesis.
[7,8]
Dreams did not simply depict waking-
life traits, but rather further elaborated the elements formed
during waking life.
[9,10]
Therefore, sexual dreams might manifest
an individual’s sexuality during waking time in general.
Investigators found that waking-life sexual fantasies were
direct-positively related to sexual dreams.
[11]
In a Canadian
university student sample, sexual interactions in dreams were
positively correlated with sexual fantasy, sexual daydreaming,
and orgasmic experience during waking time.
[6]
In female
participants, the realistic romantic problems including jealousy
and infidelity were reflected in sexual dreams.
[12]
In male
participants, Yu found that sexual behaviors only predicted part
of sexual dream contents, which revealed that sexual dreams
compensated for waking-state sexual behaviors.
[13]
Thus, recent
literature and the continuity theory suggest that sexual dreams
implicitly reflect people’s attitudes towards sexuality, sex-related
issues, or waking-state sexual behaviors, and fulfill individual’s
sexual desires which are not completely satisfied at waking-state.
Attitudes towards sexuality or sexual behaviors are affected by
multidimensional factors, such as endocrine hormone,
[14]
alcohol
consumption,
[15]
physical fitness,
[16]
mental state,
[17]
sexual
knowledge,
[18,19]
and religion.
[20]
Moreover, previous results
have indicated that family factors contribute to sexual attitudes
or behaviors.
[21,22]
For instance, familial intactness, close parent–
adolescent relationship, and parental monitoring were protective
factors from early sexual behaviors.
[23]
Parental communication
about sexual norms of love and respect was negatively associated
with the permissive sexual attitudes.
[24]
In addition, family
functions such as the positive affective response, communicating,
problem solving, and behavioral controlling between family
members were associated with the knowledge and attitude
toward sexuality in adolescents.
[25]
On the contrary, adolescents’
bad attitude toward sexuality was related to the poor
interpersonal relationships with family members
[26]
; and indi-
viduals’self esteem and body image could be damaged by
Editor: Wen-Jun Tu.
The study was supported by a grant from the National Natural Science
Foundation of China (No. 81771475) to the correspondent author (Dr W Wang).
The authors have no conflicts of interest to disclose.
The datasets generated during and/or analyzed during the present study are
available from the corresponding author on reasonable request.
Department of Clinical Psychology and Psychiatry, School of Public Health,
Zhejiang University College of Medicine, Hangzhou, Zhejiang, China.
∗
Correspondence: Wei Wang, Department of Psychology, Norwegian University
of Science and Technology, Trondheim, Norway
(e-mail: wew@ntnu.no, drwangwei@zju.edu.cn).
Copyright ©2020 the Author(s). Published by Wolters Kluwer Health, Inc.
This is an open access article distributed under the Creative Commons
Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
How to cite this article: Shao X, Wang C, Jia Y, Wang W. Sexual dream and
family relationships in frequent sexual dreamers and healthy volunteers. Medicine
2020;99:36(e21981).
Received: 17 January 2020 / Received in final form: 24 July 2020 / Accepted: 30
July 2020
http://dx.doi.org/10.1097/MD.0000000000021981
Observational Study Medicine®
OPEN
1
paternal/maternal overprotection.
[27]
Besides, childhood mal-
treatment was negatively related to women’s sexual or relation-
ship satisfaction.
[28]
Early negative familial experiences were
strongly related to many kinds of sexual disorders,
[29]
and the
abnormal parent–child bonding and detachment in early life led
to deviant sexual fantasies in sexual offenders.
[30]
Therefore,
parent–child attachment, parental support, and parental encour-
agement might lead to individuals’positive sexual experiences in
later life, while parental overcontrol or abuse might lead to
emotionally negative ones. As daytime activities are reflected in
dreams, the sexual dream experience might be affected by family
relationships accordingly.
However, up to date, the exact relationship between family
factors and sexual dream experience is still unclear. One reason
for the literature scarce might be the inadequate quality of sexual
dream and family relationship measurements. Batteries such as
the Typical Dream Questionnaire
[31]
and the Dream Content
Questionnaire
[32]
have helped to describe the sexual activities or
thoughts in dreams, but they are not comprehensively structure-
validated. Comparatively, the Sexual Dream Experience Ques-
tionnaire
[33]
has been developed as a structure-validated measure
which covers four scales of Joyfulness, Aversion, Familiarity, and
Bizarreness, and a scale measuring sexual dream frequency. As to
the family relationship, questionnaires such as the Parental
Bonding Instrument (PBI)
[34]
and the Egna Minnen av. Barndoms
Uppfostran (EMBU)
[35]
were commonly used to measure
parental rearing experiences. But another instrument, the Family
Relationship Questionnaire (FRQ),
[36]
is structure-validated and
measures both positive and negative influences by either parent.
Therefore, SDEQ and FRQ might be used to elucidate the
relationships between sexual dream experience and family
relationships.
In the present study, we have invited both frequent sexual
dreamers and normal healthy volunteers to answer SDEQ and
FRQ. We have hypothesized that:
1. frequent sexual dreamers scored significantly higher on SDEQ
Joyfulness, lower on SDEQ Aversion or Bizarreness, higher on
FRQ General Attachment, Freedom Release or Encourage-
ment, and lower on FRQ Abuse or Dominance; and
2. in frequent sexual dreamers, General Attachment, Freedom
Release or Encouragement was associated with Joyfulness,
and Abuse or Dominance with Aversion or Bizarreness.
2. Materials and methods
2.1. Participants
We enrolled 104 healthy participants (controls: 38 women and
66 men; mean age, 22.19 years ±3.88 SD, age range, 18–35
years) who reported 1 to 3 times of clearly-remembered sexual
dreams annually, and 62 frequent sexual dreamers (dreamers: 22
women and 40 men; mean age, 23.19 ±5.07, age range, 18–39)
who reported no less than 3 times of sexual dreams monthly. All
participants were recruited from either host university, commu-
nity, or local psychiatric clinics. No differences of age (t=1.43,
P=.16, 95% confidence interval [CI]: 0.38–2.38) or gender
(x
2
=0.02, df =1, P=.89) were found between the two groups.
Participants had received basic education and had no difficulty
understanding or completing the test. They were also confirmed
not to have confounding factors such as schizophrenia,
schizoaffective disorder, prior history of head injury, alcohol
or tobacco abuse, psychoactive substance abuse, sexual dysfunc-
tion, paraphilic disorder, or any other medical condition
influencing sexual function via a semi-structured interview by
an experienced psychiatrist according to the Diagnostic and
Statistical Manual of Mental Disorders, 5th ed.
[37]
In addition,
participants were free from drug or alcohol, and from viewing
pornographic videos or movies, for at least 72 h prior to the test.
The study protocol was approved by the Medical Ethics
Committee of School of Public Health, Zhejiang University
and all participants gave their written informed consent.
2.2. Instruments
Participants were asked to complete the following questionnaires
in a quiet room.
1. The Sexual Dream Experience Questionnaire (SDEQ)
[33]
has
one item measuring the sexual dream frequency and 32 items
measuring four factors of dream experience (8 items each
factor): Joyfulness describing the happiness and satisfaction of
sexual dreams, Aversion the guilt, shame, fear, and discomfort
towards sexual dreams, Familiarity the normal scenes
appeared in sexual dreams, and Bizarreness the unusual
behaviors or thoughts in sexual dreams. Participants were
asked to rate the items using the Likert type scale (1-very
unlike me, 2-moderately unlike me, 3-somewhat unlike and
like me, 4-moderately like me, and 5-very like me). The
internal alphas of each SDEQ factor in the present study were
shown in Table 1.
2. The Family Relationship Questionnaire (FRQ)
[36]
is designed
to evaluate the core features of the experienced family
relationships up to 16 years old. It has 43 items including
General Attachment (5 items; describing children’s affection-
ate dependence on family members), Paternal/Maternal
Encouragement (5 items each; describing the positive
incentives, harmonic environment and spiritual/material needs
offered by parents), Paternal/Maternal Abuse (5 items each;
describing the physical or psychological maltreatment and
criticism from parents), Paternal/Maternal Freedom Release
(5 items each; describing the autonomy of decision-making or
daily behavior given by parents), and Paternal/Maternal
Dominance (4 items each; describing the parental authority in
family affairs). Each FRQ item was rated using the same 5-
point Likert scale as in SDEQ. The internal alphas of each
FRQ factor in the present study were also shown in Table 1.
2.3. Data analyses and statistics
Data analyses were conducted using Statistical Product and
Service Solutions for windows (SPSS, version 19.0, IBM,
Armonk, NY). Multivariate analysis of variance (MANOVA)
was applied to the 4 SDEQ or 9 FRQ factors in two groups. The
independent Student ttest was also employed to look for the
potential group differences. The annual sexual dream frequency
was also analyzed by the ttest. Cohen’s d was calculated for each
comparison to show the effect size. The partial correlation test of
SDEQ (including dream frequency) and FRQ factors was applied
in each group. Given the proven effect of age and gender on
sexual dreams,
[38,39]
we controlled age and gender as covariates
in the partial correlation test to rule out their possible influences.
Moreover, multiple linear regression analysis (stepwise method
and adjusted for age and gender) was employed respectively in
Shao et al. Medicine (2020) 99:36 Medicine
2
each group to search for the relationships between SDEQ and
FRQ factors, taking FRQ factors as potential predictors for
SDEQ ones. A Pvalue <.05 was considered to be significant. In
order to avoid the chances of Type I error, the absolute value of
coefficient larger than 0.25 was considered as significant for
correlation, and the absolute beta value larger than 0.25 for
prediction.
3. Results
There were significant differences on SDEQ scale scores between
the two groups (Pillai’s Trace =0.14, Wilks’l=0.86, Hotelling’s
Trace =0.16, F[4, 161]=6.43, P<.001, partial h
2
=0.14).
Dreamers scored significantly higher than controls did on the
Joyfulness (t=3.20, P=.002), Aversion (t=2.01, P=.05),
Familiarity (t=2.91, P=.004), Bizarreness (t=3.46, P=.001),
and dream frequency (t=10.35, P<.001). Meanwhile, there
were significant differences of FRQ scores between the two
groups (Pillai’s Trace =0.11, Wilks’l=0.89, Hotelling’s Trace=
0.12, F[9, 156]=2.15, P=.03, partial h
2
=0.11). Dreamers
scored significantly higher than controls did on the Paternal
Abuse (t=2.28, P=.03), but lower on General Attachment (t=
2.45, P=.02) and Maternal Freedom Release (t=2.03, P=.04)
(Table 1).
In controls, Paternal Abuse (r=.27, P=.01) was correlated
with joyfulness, and maternal dominance (r=.27, P=.01) with
Aversion. In Dreamers, Paternal Abuse (r=.28, P=.03) and
Maternal Freedom Release (r=.32, P=.01) were correlated
with Aversion, Paternal Abuse (r=.46, P<.001) with Bizarre-
ness, and Paternal Abuse (r=.34, P=.01) with dream frequency
(Table 2).
Considering the prediction of SDEQ factors by the FRQ
factors, adjusted R
2
were ranged from 0.07 to 0.22 in controls,
and from 0.10 to 0.22 in dreamers. In controls, maternal abuse
(b=0.28; t=2.99, P=.003) predicted dream frequency (F[1,
102]=8.94, mean square error (MSE) =4.76, P=.003; adjusted
R
2
=0.07). While in dreamers, Maternal Freedom Release (b=
0.30; t=2.53, P=.01) predicted the aversion (F[2, 59] =7.19,
MSE=222.16, P=.002; adjusted R
2
=0.17), Paternal Abuse
(b=0.49; t=4.29, P<.001) predicted the Bizarreness (F[1, 60] =
18.43, MSE =299.95, P<.001; adjusted R
2
=0.22), and Paternal
Abuse (b=0.33; t=2.73, P=.01) also predicted dream frequency
Table 2
Partial correlation (adjusted for age and gender) between the Sexual Dream Experience Questionnaire and the Family Relationship
Questionnaire in frequent sexual dreamers (Dreamers, n =62) and healthy volunteers (Controls, n =104).
Dreamers Controls
FRQ Joyfulness Aversion Familiarity Bizarreness Frequency Joyfulness Aversion Familiarity Bizarreness Frequency
General Attachment 0.11 0.11 0.20 0.01 0.04 0.00 0.02 0.09 0.07 0.03
Paternal Encouragement 0.15 0.08 0.12 0.12 0.03 0.07 0.20
∗
0.17 0.04 0.06
Paternal Abuse 0.21 0.28
∗
0.11 0.46
∗
0.34
∗
0.27
∗
0.12 0.11 0.15 0.25
∗
Paternal Freedom Release 0.16 0.18 0.08 0.05 0.03 0.06 0.04 0.13 0.01 0.02
Paternal Dominance 0.24 0.22 0.15 0.11 0.01 0.03 0.03 0.02 0.00 0.14
Maternal Encouragement 0.03 0.01 0.04 0.11 0.01 0.15 0.17 0.13 0.01 0.11
Maternal Abuse 0.07 0.01 0.12 0.14 0.01 0.09 0.16 0.13 0.13 0.25
∗
Maternal Freedom Release 0.03 0.32
∗
0.06 0.18 0.17 0.04 0.01 0.01 0.03 0.02
Maternal Dominance 0.09 0.06 0.01 0.07 0.02 0.25
∗
0.27
∗
0.04 0.19 0.05
FRQ =the Family Relationship Questionnaire.
∗
P<.05; absolute value of coefficient larger than 0.25 was bolded for clarity.
Table 1
Internal alphas (N =166) and scale scores (mean ±SD) of the Sexual Dream Experience Questionnaire and the Family Relationship
Questionnaire in frequent sexual dreamers (Dreamers, n =62) and healthy volunteers (Controls, n =104).
Internal alphas Dreamers Controls 95% confidence interval Cohen’sd
SDEQ
Joyfulness 0.88 21.56 ±7.95
∗
17.83 ±6.85 1.43–6.04 0.51
Aversion 0.82 14.31 ±6.10
∗
12.54 ±4.27 0.02–3.52 0.35
Familiarity 0.74 26.00 ±5.68
∗
23.18 ±6.23 0.91–4.73 0.47
Bizarreness 0.74 12.16 ±4.57
∗
9.91 ±2.98 0.96–3.54 0.62
Frequency 38.76 ±27.97
∗
2.01 ±0.76 29.65–43.85 2.15
FRQ
General Attachment 0.67 15.60 ±3.84
∗
17.20 ±4.22 2.90 to 0.31 0.39
Paternal Encouragement 0.82 11.95 ±5.13 13.39 ±4.91 3.03 to 0.14 0.29
Paternal Abuse 0.83 9.19 ±4.58
∗
7.64 ±3.60 0.20–2.90 0.39
Paternal Freedom Release 0.86 17.02 ±5.39 18.56 ±4.56 3.09 to 0.01 0.32
Paternal Dominance 0.69 11.71 ±4.25 10.94 ±3.81 0.49 to 2.03 0.19
Maternal Encouragement 0.71 15.63±4.60 16.03 ±3.91 1.72 to 0.92 0.10
Maternal Abuse 0.79 8.47 ±3.32 7.42 ±3.77 0.10 to 2.19 0.29
Maternal Freedom Release 0.83 17.63 ±4.73
∗
19.02 ±3.97 2.74 to 0.04 0.33
Maternal Dominance 0.69 11.56 ±3.69 10.47 ±3.87 0.11 to 2.30 0.29
FRQ =the Family Relationship Questionnaire, SDEQ =the Sexual Dream Experience Questionnaire.
∗
P<.05 vs control group.
Shao et al. Medicine (2020) 99:36 www.md-journal.com
3
(F[1, 60]=7.45, MSE =5270.13, P=.01; adjusted R
2
=.10)
(Table 3).
4. Discussion
To the best of our knowledge, it is the first comprehensive study
addressing associations between family relationships and sexual
dream experience in frequent sexual dreamers. Compared to
healthy volunteers, frequent sexual dreamers scored higher on all
SDEQ factors including dream frequency, higher on FRQ
Paternal Abuse, and lower on FRQ General Attachment and
Maternal Freedom Release, which partly confirmed our first
hypothesis. Paternal Abuse and Maternal Freedom Release
significantly predicted some sexual dream experience factors in
frequent sexual dreamers, which also partly accorded with our
second hypothesis.
Generally, sexual pleasure or emotional satisfaction during sexual
dreams was frequently reported by men
[13]
and women.
[40]
There
arealsosomecultural-specific differences on sexuality, for instance,
East-Asian people tended to have higher sexual guilt than their
Western counterparts.
[41,42]
Therefore, our Chinese dreamers might
have averse feelings during waking time due to the conservative sex
values despite that they might have pleasant sexual dreams. These
explained our results that dreamersscoredhigheronbothJoyfulness
and Aversion factors. In addition, dreamers had higher Familiarity,
which was in line with that these individuals were familiar with
persons involved in sexual dreams.
[6]
Previous results have also
demonstrated that bizarreness enhanced recall of dream contents,
[43]
which might account for the higher Bizarreness in our dreamers who
also had frequent dream recalls.
Dreamers scored lower on General Attachment in our study,
which agreed with that individuals with insecure interpersonal
attachment were likely to report dreams.
[44]
Frequent dreamers
also had higher Paternal Abuse, which could be explained by that
physical abuse by fathers increased adolescents’level of
internalizing behavior problems
[45]
and that these problems
increased dream recalls.
[46]
Moreover, our dreamers scored lower
on Maternal Freedom Release, which might be due to that
mothers communicated with children more often than fathers
about sex and mothers promoted sexual abstinence.
[47,48]
While
individuals’idea of sexuality was suppressed, it might be
persistent in dreams instead.
[49]
In our controls, Paternal Abuse was associated with Joyfulness,
which might be due to that healthy individuals had positive sex-
related self-cognition, and this cognition offset the negative
influence of abuse on sexual functioning and satisfaction.
[50]
Besides, Maternal Dominance was associated with Aversion,
which was in line with that maternal psychological control was
related to anxiety through adolescent emotional dysregula-
tion,
[51]
and that anxiety led to negative dream affect.
[52]
Furthermore, Maternal Abuse was negatively associated with
dream frequency, which accorded with that maternal abuse
longitudinally predicted adolescents’depressive symptoms in
early adulthood,
[53]
and that depression was linked with the loss
of sexual interest or arousal.
[54]
In our dreamers, Paternal Abuse was associated with Aversion,
Bizarreness, and dream frequency. Previous studies showed that
paternal physical abuse predicted adolescent sexual victimiza-
tion.
[55]
Sexual abuse increased psychosocial problems
[56]
and
sexual aversion,
[57]
and victims had increased compulsive sexual
activities in spite of their traumatic belief that sex was bad.
[58]
Based on the continuity hypothesis, these waking-state cognitions
might extend to dreams, and our dreamers might recognize their
highly-recurrent sexual dreams repulsive and weird. In addition,
Maternal Freedom Release was negatively associated with
Aversion, which agreed with that adolescents talked about sex
more often with their mothers
[48]
and that the parental support
was related to sexual satisfaction.
[59]
However, there were several design flaws in the present study.
First, sample sizes of two groups were relatively small, and the
current results need to be replicated with larger samples,
especially of frequent sexual dreamers. Secondly, participants’
daytime sexual behaviors or attitudes were not recorded, which
might help explain our results. Thirdly, our study design was
cross-sectional, and a longitudinal design might further detail the
family relationship involvement in sexual dreams. Notwithstand-
ing, we have found the enhanced sexual dream experience and
adverse parent–child relationships in frequent sexual dreamers.
Especially, Paternal Abuse was a robust predictor of unpleasant
but frequent dream experience.
Parent-child issues, especially sex-related ones, in early family
life could influence individual’s later-life sexuality reflected in
sexual dreams. Therefore, family therapy and especially early life
intervention of father–child relationship to reduce the negative
affect of frequent sexual dreams.
Acknowledgments
The authors thank Dr Hongying Fan for helping the data-
analyses of this study.
Table 3
Stepwise multiple linear regression predicting the Sexual Dream Experience Questionnaire factors (including dream frequency) with the
Family Relationship Questionnaire factors (adjusted for age and gender) in frequent sexual dreamers (Dreamers, n =62) and healthy
volunteers (Controls, n =104).
Dreamers Controls
Adjusted R
2
b(B, SE), predictors Adjusted R
2
b(B, SE), predictors
Joyfulness ––0.22 0.21 (0.41, 0.17) paternal abuse
∗
0.19 (0.33, 0.16) maternal dominance
∗
Aversion 0.17 0.30 (0.38, 0.15) maternal freedom release
∗
0.09 0.21 (0.18, 0.08) paternal encouragement
∗
0.25 (0.28, 0.10) maternal dominance
∗
Familiarity ––––
Bizarreness 0.22 0.49 (0.49, 0.11) paternal abuse
∗
––
Frequency 0.10 0.33 (2.03, 0.74) paternal abuse
∗
0.07 0.28 (0.06, 0.02) maternal abuse
∗
∗
P<.05. B =unstandardized coefficient; SE =standard error; jbjs>0.25 were bolded for clarity.
Shao et al. Medicine (2020) 99:36 Medicine
4
Author contributions
Conceptualization: Wei Wang.
Data curation: Xu Shao, Chu Wang, Yanli Jia.
Formal analysis: Xu Shao.
Methodology: Wei Wang.
Project administration and supervision: Wei Wang
Writing –original draft: Xu Shao, Wei Wang.
Writing –review & editing: Xu Shao, Wei Wang.
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