Piloting cognitive-behavioral therapy for insomnia integrated with prolonged exposure.
Piloting cognitive-behavioral therapy for insomnia integrated with prolonged exposure.
复制标题
DOI：
10.1037/tra0000402
复制
发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Norman SB
中科院分区：
文献类型：
--
作者：
Colvonen PJ;Drummond SPA;Angkaw AC;Norman SB
大约35-61%的创伤后应激障碍（PTSD）患者报告失眠。此外，超过70%的患者在PTSD治疗后报告了临床上明显的失眠。越来越多的证据表明，失眠不仅会独立地影响白天的功能，恶化PTSD症状，而且失眠还可能损害对PTSD治疗的反应，比如长时间暴露（PE）。综上所述，失眠和创伤后应激障碍的综合治疗可能会增加以客户为中心的护理和治疗结果。本文综述了PTSD治疗前睡眠治疗的理论和证据，描述了失眠综合认知行为治疗（CBT-I）和PE （2NITE方案）的关键要素，并介绍了12名完成2NITE方案的PTSD和失眠寻求治疗的退伍军人的试点数据。通过睡眠日记和活动记录仪收集睡眠数据。客户满意度问卷显示对2NITE方案的满意度很高（平均得分29.66分，满分32分）。平均而言，所有测量指标均有统计学和临床意义上的显著变化，包括PTSD检查表5 （PCL-5）下降20.16分，失眠严重程度指数下降11.75分，who生活质量指数增加18.58分，睡眠效率增加11%，活动记录仪数据显示总睡眠时间增加51分钟。在失眠和创伤后应激障碍患者中，将CBT-I和PE与2NITE方案相结合是一种合乎逻辑的、创新的、经验丰富的方法，可以增强现有的治疗方法，优化结果，证明进一步的研究是合理的。
Approximately 35–61% of individuals with posttraumatic stress disorder (PTSD) report insomnia. Further, upwards of 70% report clinically significant insomnia following PTSD treatment. There are converging lines of evidence suggesting that insomnia not only independently affects daytime functioning and worsens PTSD symptoms, but insomnia may also compromise response to PTSD treatment, such as prolonged exposure (PE). Taken together, integrated insomnia and PTSD treatment may increase client-centered care and treatment outcomes. This paper reviews the theory and evidence for treating sleep prior to PTSD treatment, describes the key elements of integrated cognitive behavioral treatment for insomnia (CBT-I) and PE (2NITE protocol), and presents pilot data from a sample of 12 treatment-seeking veterans with PTSD and insomnia who completed the 2NITE protocol. Sleep data were collected with sleep diaries and actigraphy watches. The Client Satisfaction Questionnaire indicated high satisfaction with the 2NITE protocol (mean score 29.66 out of 32 points). On average, there were statistical and clinically significant changes in all measures including a 20.16 point decrease in the PTSD Checklist 5 (PCL-5), a 11.75 point decrease in the insomnia severity index, a 18.58 point increase in the WHO-quality of life index, a 11% increase in sleep efficiency, and a 51 minute increase in total sleep time from the actigraphy data. Among individuals with insomnia and PTSD, integrating CBT-I and PE with the 2NITE protocol represents a logical, innovative, and empirically-informed method for augmenting existing treatments and optimizing outcomes that justifies further investigation.
登录
查看更多内容
影响因子：
4.4
作者：
Cervena, K;Dauvilliers, Y;Besset, A
通讯作者：
Besset, A
影响因子：
0.5
作者：
Kroenke, K;Spitzer, RL
通讯作者：
Spitzer, RL
影响因子：
3.3
作者：
Morin, CM;Rodrigue, S;Ivers, H
通讯作者：
Ivers, H
影响因子：
7
作者：
Morris, SB;DeShon, RP
通讯作者：
DeShon, RP
影响因子：
2.4
作者：
Martindale, Sarah L.;Morissette, Sandra B.;Dolan, Sara L.
通讯作者：
Dolan, Sara L.