• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • No language data
  • Tagged with
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Effectiveness of a CBT Intervention for Persistent Insomnia and Hypnotic Dependency in an Outpatient Psychiatry Clinic

Taylor, Hannah 06 September 2013 (has links)
Previous research supports the efficacy of cognitive-behavioral therapy for insomnia (CBT-I) in patients with comorbid psychiatric diagnoses; however, questions remain about the effectiveness of CBT-I due to the fact that previous studies excluded patients with significant psychiatric symptoms and comorbid diagnoses. This study begins to address this gap in the insomnia literature by testing a five-session CBT-I intervention in a diverse sample of patients receiving mental health treatment in an outpatient psychiatry clinic (N=23) who continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. Participants were randomized to CBT-I (n=13) or a treatment as usual control group (n=10). Following one week of baseline sleep diary assessment, those in the CBT-I group completed five sessions of individual treatment; three in-person and two by phone. Those in the treatment as usual group continued with medication treatment as prescribed by their psychiatrist for a five-week period and were then given the opportunity to cross over to receive CBT-I. Study results show that adding a brief CBT-I intervention to usual care led to significant improvements in sleep compared to treatment as usual. Effect sizes were generally large, illustrating the potency of CBT-I in a psychiatric sample. Sleep gains were largely maintained at two-month follow-up. No significant changes in depression or anxiety severity were seen in the CBT-I group, suggesting that sleep interventions alone may not have the same impact in a psychiatric population with more severe and chronic mental health symptoms. Quality of life in the area of social functioning was improved following CBT-I compared to treatment as usual; however, this gain was not maintained at two-month follow-up. Finally, CBT-I was not associated with a reduction in use of sleep medication. This may reflect this sample's high level of chronicity of insomnia or a propensity towards medication dependency. In sum, the findings of this study suggest that selected patients with complex and chronic psychiatric conditions can obtain sleep improvements with CBT-I beyond those obtained with pharmacotherapy alone. Future research should focus on identifying factors that predict which “real-world” psychiatric patients are most likely to undergo and benefit from CBT-I.

Page generated in 0.0224 seconds