Cognitive Processing Therapy for Posttraumatic Stress Disorder Is Associated with Negligible Change in Subjective and Objective Sleep
Cognitive Processing Therapy for Posttraumatic Stress Disorder Is Associated with Negligible Change in Subjective and Objective Sleep
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DOI：
10.1080/15402002.2019.1692848
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发表时间：
2019-11-20
影响因子：
3.1
通讯作者：
Wilcox, James
中科院分区：
文献类型：
--
作者：
Haynes, Patricia L.;Skobic, Iva;Wilcox, James
背景：患者接受认知加工疗法（CPT），一种基于证据的创伤后应激障碍（PTSD）治疗，报告改善睡眠质量。然而，大多数研究都是通过自我报告调查或PTSD测量的单独项目来检查残余睡眠障碍。本研究使用最先进的客观和主观失眠症测量方法，检验了在VA环境中对退伍军人进行CPT是否改善了睡眠指数。参与者：参与者是目前诊断为PTSD的退伍军人，计划在两个退伍军人事务部（VA）地点开始门诊个人或团体CPT （n = 37）。方法：采用推荐的研究共识失眠评估、共识睡眠日记和活动记录仪评估睡眠症状严重程度。使用临床医生管理的PTSD量表评估治疗前和治疗后的PTSD症状。结果：在整个治疗过程中，观察到创伤后应激障碍症状的变化有小到中等的益处（ESRMC = .43）。发现CPT后每日睡眠日记和活动记录仪变量变化的效应量可以忽略不计（范围ESRMC = - 0.16至0.17）。治疗后睡眠指数维持在临床症状水平。讨论：这些发现支持了先前的研究，表明在PTSD治疗之前、期间或之后需要独立的临床关注来解决失眠问题。
Background: Patients receiving Cognitive Processing Therapy (CPT), an evidence based therapy for posttraumatic stress disorder (PTSD), report improved sleep quality. However, the majority of studies have examined residual sleep disturbance via self-report surveys or separate items on PTSD measures. This study examined whether CPT delivered to veterans in a VA setting improved sleep indices using state-of-the-art objective and subjective insomnia measures. Participants: Participants were war veterans with a current PTSD diagnosis scheduled to begin outpatient individual or group CPT at two Veteran's Affairs (VA) locations (n = 37). Methods: Sleep symptom severity was assessed using the recommended research consensus insomnia assessment, the consensus daily sleep diary and actigraphy. PTSD symptomatology pre- and post-treatment were assessed using the Clinician Administered PTSD Scale. Results: A small to moderate benefit was observed for the change in PTSD symptoms across treatment (ESRMC = .43). Effect sizes for changes on daily sleep diary and actigraphy variables after CPT were found to be negligible (Range ESRMC = - .16 to .17). Sleep indices remained at symptomatic clinical levels post-treatment. Discussion: These findings support previous research demonstrating a need for independent clinical attention to address insomnia either before, during, or after PTSD treatment.