Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial.
Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial.
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DOI：
10.1037/a0036606
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发表时间：
2014-08
影响因子：
5.9
通讯作者：
Morin CM
中科院分区：
文献类型：
--
作者：
Harvey AG;Bélanger L;Talbot L;Eidelman P;Beaulieu-Bonneau S;Fortier-Brochu É;Ivers H;Lamy M;Hein K;Soehner AM;Mérette C;Morin CM
探讨行为疗法（BT）和认知疗法（CT）相对于全面认知行为疗法（CBT）治疗持续性失眠症的独特贡献。参与者是188名患有持续性失眠（平均14.5年）的成年人（117名女性，年龄47.4岁，SD=12.6）。他们被随机分配到8个每周的单独疗程，包括BT （n = 63）、CT （n = 65）或CBT （n = 60）。完全CBT与最大的改善相关，与BT相关的改善更快但不持久，与CT相关的改善更慢且持续。治疗后，CBT组（67.3%）和BT组（67.4%）的治疗应答者比例明显高于CT组（42.4%），而6个月后，CT组的治疗应答率进一步显著提高（62.3%），BT组显著下降（44.4%），CBT组保持其初始应答率（67.6%）。缓解率遵循类似的轨迹，CBT治疗后的缓解率（57.3%）相对于CT（30.8%）更高，BT介于两者之间（39.4%）；CT从治疗后到随访有进一步的提高（30.9% ~ 51.6%）。在治疗后和随访中，所有三种疗法都能改善日间功能，各组之间几乎没有差异变化。完全的认知行为治疗是一种选择。BT和CT均有效，但BT起效较快，CT起效较慢。这些不同的变化轨迹通过行为与认知途径为行为改变过程提供了独特的见解。
To examine the unique contribution of behavior therapy (BT) and cognitive therapy (CT) relative to the full cognitive behavior therapy (CBT) for persistent insomnia. Participants were 188 adults (117 women; M age = 47.4 years old, SD=12.6) with persistent insomnia (average of 14.5 years duration). They were randomized to eight, weekly, individual sessions consisting of BT (n = 63), CT (n = 65), or CBT (n = 60). Full CBT was associated with greatest improvements, the improvements associated with BT were faster but not as sustained and the improvements associated with CT were slower and sustained. The proportion of treatment responders was significantly higher in the CBT (67.3%) and BT (67.4%) relative to CT (42.4%) groups at post treatment, while 6-months later CT made significant further gains (62.3%), BT had significant loss (44.4%) and CBT retained its initial response (67.6%). Remission rates followed a similar trajectory, with higher remission rates at post treatment in CBT (57.3%) relative to CT (30.8%), with BT falling in between (39.4%); CT made further gains from post treatment to follow up (30.9% to 51.6%). All three therapies produced improvements of daytime functioning at both post treatment and follow up, with few differential changes across groups. Full CBT is the treatment of choice. Both BT and CT are effective, with a more rapid effect for BT and a delayed action for CT. These different trajectories of changes provide unique insights into the process of behavior change via behavioral versus cognitive routes.
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影响因子：
5.9
作者：
Clark, DM;Salkovskis, PM;Gelder, M
通讯作者：
Gelder, M
影响因子：
4.8
作者：
Bastien, Celyne H.;Vallieres, Annie;Morin, Charles M.
通讯作者：
Morin, Charles M.
影响因子：
5.9
作者：
Espie, CA;Inglis, SJ;Harvey, L
通讯作者：
Harvey, L
影响因子：
--
作者：
DeRubeis, RJ;Hollon, SD;Gallop, R
通讯作者：
Gallop, R
影响因子：
5.9
作者：
Clark, David M.;Ehlers, Anke;Wild, Jennifer
通讯作者：
Wild, Jennifer