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How does cognitive behavioral therapy for insomnia work?: An investigation of cognitive processes and time in bed as outcomes and mediators in a sample with insomnia and depressive symptomatology
Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden.
Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.ORCID iD: 0000-0001-9500-7763
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2017 (English)In: International Journal of Cognitive Therapy, ISSN 1937-1209, E-ISSN 1937-1217, Vol. 10, no 4, p. 304-329Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to gain a greater understanding of the five cognitive processes from the cognitive model of insomnia, negative automatic thoughts, and time in bed as outcomes and potential mediators of cognitive behavioral therapy for insomnia (CBT-I), in a sample with insomnia and depressive symptomatology. Sixty-four participants were randomized to receive either CBT-I or an active control (relaxation training: RT) in groups during four biweekly sessions. Insomnia, depressive severity, and the potential processes of change were measured pre-, mid-, and post-treatment. CBT-I was associated with greater reductions of dysfunctional beliefs about sleep, sleep-related safety behaviors, and time in bed compared to RT. Mid-treatment dysfunctional beliefs about sleep was the only process that mediated between CBT-I and outcomes on insomnia and depressive severity, respectively. The relationships were reciprocal. Dysfunctional beliefs about sleep may be a transdiagnostic process of both insomnia and depression.

Place, publisher, year, edition, pages
Guilford Publications, 2017. Vol. 10, no 4, p. 304-329
Keywords [en]
Cognitive behavioral therapy, depression, dysfunctional beliefs, insomnia, mediation
National Category
Psychiatry Psychology (excluding Applied Psychology)
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-64742DOI: 10.1521/ijct.2017.10.4.304ISI: 000423606400003Scopus ID: 2-s2.0-85039558365OAI: oai:DiVA.org:oru-64742DiVA, id: diva2:1179354
Note

Funding Agencies:

Psykiatrifonden  

Research Committee of Region Örebro County, Sweden

Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-02-23Bibliographically approved

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Holländare, FredrikEngström, Ingemar

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