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Cognitive-behavioral group therapy as an early intervention for insomnia: a randomized controlled trial
Örebro University, Department of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0003-2059-1621
Örebro University, Department of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0001-5359-0452
2005 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 15, no 2, p. 177-190Article in journal (Refereed) Published
Abstract [en]

A randomized controlled design was used with a 1-yr follow-up. The purpose was to compare the effects of two early interventions, a cognitive-behavioral group intervention and a self-help information package, in patients with insomnia. In sum, 165 individuals seeking care for insomnia of 3–12 months duration were randomized to either a group receiving a CBT intervention or a group receiving a self-help information package. At the 1-yr follow-up, 136 participants had completed the entire study. At the 1-yr follow-up, the CBT group intervention was, compared with the control group, effective in producing reductions in dysfunctional beliefs and attitudes about sleep, negative daytime symptoms, as well as vital improvements in sleep (i.e. sleep onset latency, time awake after sleep onset, total sleep time, sleep quality, and sleep efficiency). In comparison with the control group, significantly more participants in the CBT group met criteria at the 1-yr follow-up for clinically meaningful improvements in sleep onset latency, time awake after sleep onset, and sleep efficiency. A CBT group intervention may well be a viable early intervention for patients with insomnia in a wide range of health services.

Place, publisher, year, edition, pages
2005. Vol. 15, no 2, p. 177-190
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-2890DOI: 10.1007/s10926-005-1217-9OAI: oai:DiVA.org:oru-2890DiVA, id: diva2:135420
Available from: 2005-09-16 Created: 2005-09-16 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Insomnia: psychological mechanisms and early intervention: a cognitive-behavioral perspective
Open this publication in new window or tab >>Insomnia: psychological mechanisms and early intervention: a cognitive-behavioral perspective
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

This dissertation focused on the role of psychological mechanisms in the development of insomnia and the effectiveness of an early cognitive-behavioral intervention for insomnia. The first aim was to examine whether distress, worry, and dysfunctional beliefs and attitudes about sleep were related to the development of insomnia. The findings from study I indicated that distress (anxiety and, to some extent, depression) was related to the development of insomnia. In study II, the relationship between sleep-related worry and subjective sleep perception was demonstrated to intensify over time, indicating that sleep-related worry was also linked to the development of insomnia. This indicates that both distress and sleep-related worry may be mechanisms that can be regarded as two of several pathways to insomnia. While distress was related to developing an onset of insomnia, worry was linked to the early development of insomnia. In study IV, dysfunctional beliefs and attitudes about sleep were not related to clinical improvement following cognitive behavior therapy for early insomnia. However, reductions in dysfunctional beliefs and attitudes about sleep were consistently linked to improvements in daytime symptoms, but not to sleep improvements. Instead of implying that such beliefs and attitudes are less important than distress and worry in the development of insomnia, it may rather suggest that dysfunctional beliefs and attitudes about sleep play a slightly different role in insomnia than previously envisioned.

The second aim of this dissertation was to compare the effects of cognitive-behavioral therapy for insomnia with self-help information in patients with a short history of insomnia. In study III, the results showed that an early cognitive-behavioral intervention was effective for individuals with insomnia. To the benefit of the patients with insomnia and to society, cognitive behavior therapy may have a deserving and vital role as an early intervention for patients with insomnia.

Taken together, the results in this dissertation indicate that psychological mechanisms play an important role in the development of insomnia. The findings might thus add to the elaboration of cognitive-behavioral models of insomnia. While most previous research has examined insomnia only in its persistent form, the focus of this dissertation was to study insomnia in its early phase. An approach where insomnia is studied in its early phase of development has not only heuristic value to the development of cognitive-behavioral models of the condition, but might also have implications for how cognitive-behavioral therapy for insomnia can be elaborated in future research and integrated in clinical settings.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2005. p. 85
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 6
Keywords
Psychology, insomnia, development, distress, worry, early intervention, cognitive-behavioral therapy, dysfunctional beliefs and attitudes about sleep, Psykologi
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-175 (URN)91-7668-449-0 (ISBN)
Public defence
2005-10-07, B-husets aula, Universitetssjukhuset, Örebro, 13:00
Opponent
Supervisors
Available from: 2005-09-16 Created: 2005-09-16 Last updated: 2017-10-18Bibliographically approved

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Jansson, MarkusLinton, Steven J.

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