Twelve-month follow-up: Comparative efficacy of cognitive therapy, behavior therapy, and cognitive behavior therapy for patients with insomnia.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2023-10-01 Epub Date: 2023-02-23 DOI:10.1037/ccp0000802

Laurel D Sarfan, Charles M Morin, Allison G Harvey

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Abstract

Objective: Treatments that alleviate insomnia over the long term are critical. We evaluated the relative long-term efficacy of cognitive therapy (CT), behavior therapy (BT), and cognitive behavior therapy (CBT) for insomnia.

Method: Patients (N = 188, 62.2% female, 81.1% White, 6.5% Hispanic or Latinx, M_age = 47.4 years) with insomnia were randomized to eight sessions of CT, BT, or CBT for insomnia. Assessments at pretreatment and 12-month follow-up measured insomnia severity, insomnia response/remission, sleep diary parameters, and daytime functioning.

Results: Patients in all three treatment groups improved on insomnia severity, sleep onset latency, wake after sleep onset, total sleep time, sleep efficiency, work and social adjustment, and mental health (ps < .05). Moreover, in each treatment group, a substantial proportion of patients achieved remission and response. CBT was associated with larger improvements in insomnia severity relative to CT as well as greater remission and improvements in physical health, relative to CT and BT (ps < .05). For patients with a psychiatric comorbidity, CBT was associated with greater improvements in work and social adjustment and mental health, relative to CT (ps < 0.05). CT was not associated with change in time in bed, and none of the treatment conditions were associated with change in daytime fatigue (ps > .05).

Conclusions: These encouraging results suggest that therapists may be able to offer CBT, BT, or CT to improve nighttime and daytime symptoms of insomnia over the long-term, with CBT offering a relative advantage for select outcomes and subgroups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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12个月随访：认知疗法、行为疗法和认知行为疗法对失眠患者的疗效比较。

目的：长期治疗失眠至关重要。我们评估了认知疗法（CT）、行为疗法（BT）和认知行为疗法（CBT）治疗失眠的相对长期疗效。方法：将患有失眠的患者（N=188，女性62.2%，白人81.1%，西班牙裔或拉丁裔6.5%，Mage=47.4岁）随机分为八组，分别接受CT、BT或CBT治疗。预处理和12个月随访的评估测量了失眠的严重程度、失眠反应/缓解、睡眠日记参数和日间功能。结果：三个治疗组的患者在失眠严重程度、睡眠开始潜伏期、睡眠开始后醒来、总睡眠时间、睡眠效率、工作和社会适应以及心理健康方面都有所改善（ps<.05）。此外，在每个治疗组中，相当大比例的患者都获得了缓解和缓解。与CT相比，CBT与失眠严重程度的更大改善以及与CT和BT相比，身体健康的更大缓解和改善相关（ps<.05）。对于患有精神病合并症的患者，与CT相比（ps<0.05），CBT在工作、社会适应和心理健康方面有更大改善。CT与卧床时间的变化无关，结论：这些令人鼓舞的结果表明，治疗师可能能够长期提供CBT、BT或CT来改善夜间和日间失眠症状，CBT在选择结果和亚组方面具有相对优势。（PsycInfo数据库记录（c）2023 APA，保留所有权利）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.