Mental Health Literacy Buffers the Association Between Nightmare Distress and Psychotic-Like Experiences Among College Students.

Background: Nightmares may lead to psychotic-like experiences (PLEs). The present study aimed to examine the potential moderating and mediating effects of mental health literacy (MHL) on the association between nightmare distress (ND) and PLEs among Chinese college students.

Methods: A total of 4000 college students who have had nightmares in the past year were assessed using the Chinese version of the nightmare distress questionnaire (NDQ-CV), mental health knowledge questionnaire (MHKQ), 15-item positive subscale of the community assessment of psychic experiences (CAPE-P15), 2-item insomnia questionnaire, 2-item patient health questionnaire (PHQ-2), and a self-compiled sample characteristics questionnaire.

Results: Greater ND and lower MHL were associated with an elevated risk of PLEs among college students when adjusting for sample characteristics, insomnia and depressive symptoms. Moderation analysis indicated that MHL buffers the association between ND and PLEs, such that a higher level of MHL attenuates the positive effect of ND on PLEs to a greater extent.

Conclusions: These findings strongly stressed the urgent need for early intervention in college students with ND. Strategies should prioritise treating ND and enhancing MHL, as these may be effective approaches to preventing and reducing PLEs.