Interoceptive Awareness and Dream Themes

Interoceptive awareness was assessed using the Turkish adaptation of the Multidimensional Assessment of Interoceptive Awareness, Version 2. The original MAIA-2 contains 37 items and eight dimensions. In the Turkish validation study, five original items were removed, producing a 32-item, six-factor solution comprising Emotional Awareness, Attention Regulation, Body Listening, Not-Distracting, Trusting, and Not-Worrying. Items are rated from 0 ("never") to 5 ("always"). Each dimension score was calculated as the mean of its constituent items after applying the direction of scoring specified for the administered form. Higher scores indicate a greater level of the tendency represented by the corresponding dimension.

The Dream Themes Scale (DTS) is a 29-item Turkish self-report measure assessing the frequency of themes in recalled dreams. Items are rated from 0 ("never") to 4 ("always"). The total score ranges from 0 to 116, with higher scores indicating more frequent endorsement of the assessed dream themes. The original development study identified five correlated dimensions: Negative Themes, Anxiety Themes, Fear Themes, Effects of Waking-Life Experiences, and Frustration Themes. The DTS total score was prespecified as the primary outcome and was used as a descriptive composite reflecting the overall frequency of endorsed dream themes across five related domains. The five DTS subscales were additionally examined as secondary outcomes to evaluate whether the observed associations were domain-specific.

Alexithymic characteristics were assessed with the 20-item Toronto Alexithymia Scale and its Turkish adaptation. Total scores range from 20 to 100, with higher values indicating greater alexithymic characteristics. Somatic symptom burden during the preceding four weeks was assessed using the 15-item Patient Health Questionnaire and the Turkish PHQ-SADS validation. Items are rated from 0 to 2 and summed to produce a total score ranging from 0 to 30. Higher scores indicate greater somatic symptom burden. Subjective sleep quality during the preceding month was measured using the Pittsburgh Sleep Quality Index and its Turkish adaptation. Seven component scores are summed to produce a global score ranging from 0 to 21, with higher scores indicating poorer subjective sleep quality.