Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia.
Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia.
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DOI：
10.1016/j.brat.2012.08.001
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发表时间：
2012-11
影响因子：
4.1
通讯作者：
Manber, Rachel
中科院分区：
文献类型：
--
作者：
Ong, Jason C.;Ulmer, Christi S.;Manber, Rachel
虽然有越来越多的证据表明，使用正念和接受为基础的治疗方法对改善失眠症状有好处，但这些治疗方法是如何起作用的还不清楚。本文的目的是提出一个基于正念和接受方法的失眠认知机制的概念框架。本文首先回顾了现有的失眠的认知和行为模型，并提出了失眠的认知（初级）和元认知（次级）唤醒两级模型。然后我们关注元认知在正念和接受治疗中的作用，然后回顾这些治疗失眠的方法。提出了一个概念性框架，详细介绍了失眠治疗背景下元认知的机制。该模型提出，在经历失眠症状时，增加对精神和身体状态的认识，然后学习如何转变心理过程，可以促进对这些症状的反应的适应性立场。这些元认知过程的特点是平衡评价、认知灵活性、平静和对价值观的重新承诺，并被认为可以减少与睡眠相关的觉醒，从而缓解失眠。我们希望这个模型将进一步理解和影响正念和接受为基础的失眠方法。
While there is accumulating evidence to suggest that therapies using mindfulness and acceptance-based approaches have benefits for improving the symptoms of insomnia, it is unclear how these treatments work. The goal of this paper is to present a conceptual framework for the cognitive mechanisms of insomnia based upon mindfulness and acceptance approaches. The existing cognitive and behavioral models of insomnia are first reviewed and a two-level model of cognitive (primary) and metacognitive (secondary) arousal is presented in the context of insomnia. We then focus on the role of metacognition in mindfulness and acceptance-based therapies, followed by a review of these therapies in the treatment of insomnia. A conceptual framework is presented detailing the mechanisms of metacognition in the context of insomnia treatments. This model proposes that increasing awareness of the mental and physical states that are present when experiencing insomnia symptoms and then learning how to shift mental processes can promote an adaptive stance to one’s response to these symptoms. These metacognitive processes are characterized by balanced appraisals, cognitive flexibility, equanimity, and re-commitment to values and are posited to reduce sleep-related arousal, leading to remission from insomnia. We hope that this model will further the understanding and impact of mindfulness and acceptance-based approaches to insomnia.
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