Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a "One-Shot" Treatment Strategy.
Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a "One-Shot" Treatment Strategy.
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DOI：
10.3390/brainsci7010001
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发表时间：
2016-12-23
期刊：
影响因子：
3.3
通讯作者：
Ellis JG
中科院分区：
文献类型：
--
作者：
Boullin P;Ellwood C;Ellis JG
背景资料：尽管有不可否认的证据证明认知行为疗法（CBT-I）的疗效和有效性，但其广泛传播和实施的潜力尚未实现。一个建议的原因是，传统的CBT-I被认为是过于繁重的部署，在其目前的形式，在其中最重要的初级保健的背景下。旨在解决这一问题的一项战略是制定更简短的《建立信任和能力建设第一阶段》，另一项战略是以小组形式提供《建立信任和能力建设第一阶段》。另一种方法是试图在急性期解决失眠问题，以避免其发展为慢性失眠。本研究的目的是比较CBT-I（一次性）的简短版本时，单独或在组与急性失眠症。方法：28名急性失眠症患者（即，满足完整的DSM-5失眠障碍标准少于三个月），自我分配到一组或单独的治疗组。治疗包括一个单一的一小时的会议，伴随着自助小册子。受试者在治疗前和治疗后一个月完成失眠严重程度、焦虑和抑郁的测量。此外，还比较了治疗前和一个月随访时的每日睡眠日记。结果如下：在任何睡眠或情绪指标的治疗结果方面，两组之间没有显著差异，尽管组治疗组的依从性低于接受个体治疗的患者。此外，使用失眠严重程度指数，失眠症状的综合（组和个体治疗组）前后测试效应量很大（d = 2.27）。讨论内容：看来，集体治疗是有效的，作为一个“一杆”的背景下，对急性失眠症的个人干预的个人治疗。结果进行了讨论，以期整合一杆CBT-I在初级保健。
Background: Despite undeniable evidence for the efficacy and effectiveness of Cognitive Behaviour Therapy for Insomnia (CBT-I), the potential for its widespread dissemination and implementation has yet to be realised. A suggested reason for this is that traditional CBT-I is considered too burdensome for deployment, in its current form, within the context of where it would be most beneficial—Primary Care. One strategy, aimed to address this, has been to develop briefer versions of CBT-I, whilst another has been to deliver CBT-I in a group format. An alternative has been to attempt to address insomnia during its acute phase with a view to circumventing its progression to chronic insomnia. The aim of the present study was to compare a brief version of CBT-I (one-shot) when delivered individually or in groups to those with acute insomnia. Method: Twenty-eight individuals with acute insomnia (i.e., meeting full DSM-5 criteria for insomnia disorder for less than three months) self-assigned to either a group or individual treatment arm. Treatment consisted of a single one-hour session accompanied by a self-help pamphlet. Subjects completed measures of insomnia severity, anxiety and depression pre-treatment and at one-month post-treatment. Additionally, daily sleep diaries were compared between pre-treatment and at the one-month follow up. Results: There were no significant between group differences in treatment outcome on any sleep or mood measures although those in the group treatment arm were less adherent than those who received individual treatment. Furthermore, the combined (group and individual treatment arms) pre-post test effect size on insomnia symptoms, using the Insomnia Severity Index, was large (d = 2.27). Discussion: It appears that group treatment is as efficacious as individual treatment within the context of a “one shot” intervention for individuals with acute insomnia. The results are discussed with a view to integrating one-shot CBT-I in Primary Care.