The efficacy of short -term group cognitive -behavioral therapy in the treatment of insomnia in the severely and persistently mentally ill.
Item
-
Title
-
The efficacy of short -term group cognitive -behavioral therapy in the treatment of insomnia in the severely and persistently mentally ill.
-
Identifier
-
AAI3037423
-
identifier
-
3037423
-
Creator
-
Mitchell, Jessica Louise.
-
Contributor
-
Adviser: Arthur Spielman
-
Date
-
2002
-
Language
-
English
-
Publisher
-
City University of New York.
-
Subject
-
Psychology, Clinical | Psychology, Behavioral | Psychology, Cognitive | Psychology, Physiological
-
Abstract
-
Study objectives. To assess the efficacy of short-term group cognitive-behavioral treatment (CBT) of insomnia in a chronic psychiatric population. The study objective was to assess the effects of CBT on sleep parameters and daytime symptoms compared to a stress treatment group (STG) and wait list control (WLC) conditions.;Design. Matched assignment to one of three conditions.;Setting. A psychiatric out-patient setting.;Patients. Forty-one out-patient subjects who met criteria of a = or >30 minute sleep latency and sleep efficiency <85%.;Interventions. Multi-component CBT, utilized stimulus control, modified sleep restriction, relaxation techniques, behavioral-cognitive strategies, sleep hygiene, and sleep education. STG utilized supportive therapy and emotional expression of current psycho-social problems.;Measurements. Data from subjective (sleep diary) measures are analyzed by means of General Linear Model 3 x 4 repeated measures analyses of variance (ANOVAs). A priori orthogonal contrasts and post hoc Tukey HSD multiple comparisons were conducted. The outcome measures were analyzed using a 3 x 2 repeated measures ANOVAs, with the 3 groups as the between-subjects factor and the 2 evaluations (pre and post-treatment) as the within-subjects factor. A priori orthogonal contrasts were done to identify differences between the treatment groups. Post hoc Tukey HSD comparisons were done to identify possible differences between the groups at each evaluation period.;Results. The CBT group produced larger improvements across the majority of outcome measures than the STG or the WLC group. Self-report measures of sleep onset latency, total wake time, number of awakenings, nap time, and time in bed, showed significant change with treatment. Post-treatment gains on most measures were maintained at Week 10.;Conclusions. Results provide evidence from a controlled trial that CBT improves insomnia in a psychiatric population with diagnoses of schizophrenia, schizoaffective, and bipolar disorder. As hypothesized, participants in the CBT condition showed significant improvements on many sleep parameters, while those participants in the STG and WLC groups showed few changes.
-
Type
-
dissertation
-
Source
-
PQT Legacy CUNY.xlsx
-
degree
-
Ph.D.
