published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (M. Med. Sc.)--University of Hong Kong, 2008. / Includes bibliographical references (p. 58-63)

M.Tech.

Thesis (DClinPsychol)--Salomons Centre. BLDSC no. DXN049064.

Thesis (Ph. D.)--University of Hong Kong, 2010. / Includes bibliographical references (leaves 194-218). Also available in print.

Insomnia is recognized as one of the most common sleep complaints accompanied by daytime consequences in the general population worldwide. In recent years, the use of self-help cognitive behavioral therapy (CBT) has become a popular treatment option for insomnia. Firstly, a systematic review was conducted as an update and extension of a previous review (van Straten & Cuijpers, 2009). Two researchers systematically searched 6 major electronic databases in June 2012. We independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Meta-analyses of self-help CBT vs. waiting-list (WL), routine care or no treatment, therapist-administered CBT, and placebo were performed. Twenty randomized controlled trials were included; 10 of which were recent publications. Results showed that self-help CBT improved sleep, sleep-related cognitions, and anxiety and depressive symptoms. Effect sizes for sleep diary-derived sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) at immediate posttreatment were 0.80, 0.66, and 0.55, respectively. The average attrition rate of self-help CBT at immediate posttreatment was 15.6%. Therapist-administered CBT was significantly more effective than self-help CBT. Subgroup analyses supported the inclusion of telephone consultation, but not “full” multi-component CBT and programs  6 weeks. In conclusion, self-help CBT is efficacious and acceptable as an entry level of a stepped-care model for insomnia. In places where face-to-face treatments are unavailable or too costly, self-help CBT can be considered as an adequate compromise. Secondly, a randomized controlled trial was conducted to evaluate the efficacy of an Internet-based cognitive behavioral therapy for insomnia (CBT-I) in Chinese insomnia population with or without medical and psychiatric comorbidities. Three hundred and twelve eligible participants were randomized to self-help CBT with telephone support (SHS), self-help CBT without telephone support (SH), and WL groups in a ratio of 1:1:1. Participants in the SHS and SH groups received self-help treatment once per week for 6 consecutive weeks, whereas participants in the WL group began treatment after 12 weeks of assessment. In addition to the standard self-help treatment, the participants in the SHS group received weekly brief therapist-administered telephone support. The Internet-based CBT-I showed significant improvements in insomnia symptoms and sleep-related dysfunctional cognitions. Improvement was further enhanced by weekly brief telephone support. The results suggested that Internet-based CBT-I is effective and acceptable to treat insomnia. / published_or_final_version / Psychiatry / Master / Master of Philosophy

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2010. / Title from first page of PDF file (viewed February 17, 2010). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 81-86).

published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

published_or_final_version / Psychiatry / Master / Master of Medical Sciences

This study had two purposes: (1) to examine the reliability and validity of the Verran and Snyder-Halpern (VSH) Sleep Scale in measuring the subjective sleep characteristics of nonhospitalized adult insomniacs, and (2) to explore the 16 characteristics of sleep quality examined by the scale as they relate to insomnia. In addition, a comparison of previously established norms in a healthy group of sleepers was made with the insomniac sample. The study utilized a descriptive design. The sample consisted of 33 adult insomniacs. Each participant completed the scale on three consecutive routine or workday mornings. Descriptive and inferential statistics were used to evaluate the data. The VSH Sleep Scale evidenced adequate reliability and construct validity. Significant differences existed between the insomniacs and the healthy group on all but one sleep characteristic. The factors specified in the VSH Sleep Scale taxonomy remained essentially the same in the insomniac sample.