A Randomized Clinical Trial of Cognitive-Behavioral Therapy for Insomnia to Augment Posttraumatic Stress Disorder Treatment in Survivors of Interpersonal Violence.
Cognitive-behavioral therapy
Depression
Insomnia
Interpersonal violence
Posttraumatic stress disorder
Journal
Psychotherapy and psychosomatics
ISSN: 1423-0348
Titre abrégé: Psychother Psychosom
Pays: Switzerland
ID NLM: 0024046
Informations de publication
Date de publication:
Historique:
received:
11
09
2020
accepted:
11
06
2021
pubmed:
16
7
2021
medline:
28
1
2022
entrez:
15
7
2021
Statut:
ppublish
Résumé
Individuals exposed to interpersonal violence (IPV) commonly develop posttraumatic stress disorder (PTSD) with co-occurring depression and insomnia. Standard PTSD interventions such as cognitive processing therapy (CPT) do not typically lead to remission or improved insomnia. Cognitive behavioral therapy for insomnia (CBTi) improves insomnia in individuals with PTSD, but PTSD severity remains elevated. To determine whether sequential treatment of insomnia and PTSD is superior to treatment of only PTSD. In a 20-week trial, 110 participants exposed to IPV who had PTSD, depression and insomnia were randomized to CBTi followed by CPT or to attention control followed by CPT. Primary outcomes following CBTi (or control) were the 6-week change in score on the Insomnia Severity Index (ISI), the Clinician-Administered PTSD Scale (CAPS), and the Hamilton Rating Scale for Depression (HAM-D). Primary outcomes following CPT were the 20-week change in scores. At 6 weeks, the CBTi condition had greater reductions in ISI, HAM-D, and CAPS scores than the attention control condition. At 20 weeks, participants in the CBTi+CPT condition had greater reductions in ISI, HAM-D, and CAPS scores compared to control+CPT. Effects were larger for insomnia and for depression than for PTSD. Similar patterns were observed with respect to clinical response and remission. A tipping point sensitivity analyses supported the plausibility of the findings. The sequential delivery of CBTi and CPT had plausible, significant effects on insomnia, depression, and PTSD compared to CPT alone. The effects for PTSD symptoms were moderate and clinically meaningful.
Identifiants
pubmed: 34265777
pii: 000517862
doi: 10.1159/000517862
pmc: PMC8760360
mid: NIHMS1721780
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-62Subventions
Organisme : NINR NIH HHS
ID : R01 NR013909
Pays : United States
Informations de copyright
© 2021 S. Karger AG, Basel.
Références
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Psychol Methods. 2001 Dec;6(4):330-51
pubmed: 11778676
Control Clin Trials. 1988 Dec;9(4):345-64
pubmed: 3203525
Prev Sci. 2007 Sep;8(3):206-13
pubmed: 17549635
Sleep. 2008 Apr;31(4):489-95
pubmed: 18457236
J Trauma Stress. 2018 Aug;31(4):591-601
pubmed: 30070398
Psychother Psychosom. 1999 Sep-Oct;68(5):227-9
pubmed: 10516527
J Biopharm Stat. 2009 Nov;19(6):1085-98
pubmed: 20183466
Sleep. 2004 Dec 15;27(8):1567-96
pubmed: 15683149
Am J Psychother. 2013;67(2):203-14
pubmed: 23909060
Am J Psychiatry. 2016 Feb 1;173(2):128-37
pubmed: 26481173
Dialogues Clin Neurosci. 2015 Jun;17(2):141-50
pubmed: 26246789
JAMA Psychiatry. 2021 Mar 1;78(3):261-269
pubmed: 33237285
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
J Affect Disord. 2013 Sep 5;150(2):384-8
pubmed: 23759278
J Clin Psychiatry. 2011 Jul;72(7):914-28
pubmed: 21208597
Stat Med. 2002 Oct 15;21(19):2917-30
pubmed: 12325108
J Consult Clin Psychol. 2008 Apr;76(2):243-258
pubmed: 18377121
J Consult Clin Psychol. 1991 Feb;59(1):12-9
pubmed: 2002127
Stat Med. 2011 Feb 20;30(4):377-99
pubmed: 21225900
Behav Ther. 2011 Jun;42(2):236-48
pubmed: 21496509
World Psychiatry. 2019 Feb;18(1):77-87
pubmed: 30600620
Behav Res Ther. 2017 Nov;98:4-18
pubmed: 27890222
J Clin Psychiatry. 2013 Jun;74(6):e541-50
pubmed: 23842024
JAMA. 2012 Aug 15;308(7):700-9
pubmed: 22893167
Transl Behav Med. 2019 Nov 25;9(6):1169-1177
pubmed: 31271210
Psychol Med. 2017 Oct;47(13):2260-2274
pubmed: 28385165
JAMA. 2007 Feb 28;297(8):820-30
pubmed: 17327524
Sleep. 2007 Feb;30(2):203-12
pubmed: 17326546
Psychol Trauma. 2020 Feb;12(2):175-185
pubmed: 31246050
J Interpers Violence. 2021 Mar;36(5-6):NP2443-NP2463
pubmed: 29589520
J Consult Clin Psychol. 2002 Aug;70(4):867-79
pubmed: 12182270
Clin Psychol Rev. 2016 Feb;43:128-41
pubmed: 26574151
Qual Life Res. 2004 Mar;13(2):299-310
pubmed: 15085902
Sleep Med Clin. 2015 Mar;10(1):41-8
pubmed: 26055672
Biol Psychiatry. 2006 Jun 1;59(11):1052-60
pubmed: 16581036
Sleep. 2011 May 01;34(5):601-8
pubmed: 21532953
J Womens Health (Larchmt). 2011 Dec;20(12):1923-9
pubmed: 21988551
N Engl J Med. 2017 Jun 22;376(25):2459-2469
pubmed: 28636846
Am J Psychiatry. 1989 Jun;146(6):697-707
pubmed: 2658624
Arch Gen Psychiatry. 2003 May;60(5):481-9
pubmed: 12742869
J Trauma Stress. 2013 Jun;26(3):299-309
pubmed: 23696449
Sleep Med Rev. 2015 Oct;23:54-67
pubmed: 25645130
Depress Anxiety. 2001;13(3):132-56
pubmed: 11387733
Hum Psychopharmacol. 2016 May;31(3):185-92
pubmed: 26999588
J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
pubmed: 14399272
Trials. 2014 Apr 23;15:139
pubmed: 24755011
Stat Methods Med Res. 2018 Sep;27(9):2610-2626
pubmed: 28034175
N Engl J Med. 2015 Oct 8;373(15):1437-44
pubmed: 26444730
Psychother Psychosom. 2018;87(5):276-284
pubmed: 30007961
Behav Res Ther. 2013 Dec;51(12):817-22
pubmed: 24184428
Depress Anxiety. 2019 Feb;36(2):162-169
pubmed: 30576030
J Consult Clin Psychol. 2016 Feb;84(2):167-77
pubmed: 26689303
Stat Med. 2020 Sep 20;39(21):2815-2842
pubmed: 32419182
Front Behav Neurosci. 2018 Nov 02;12:258
pubmed: 30450043
J Clin Psychiatry. 2016 Oct;77(10):e1316-e1323
pubmed: 27788313
J Affect Disord. 2001 Oct;66(2-3):133-8
pubmed: 11578665
J Interpers Violence. 2009 Apr;24(4):653-74
pubmed: 18667689
Sleep. 2017 Apr 1;40(4):
pubmed: 28199710
J Consult Clin Psychol. 1993 Aug;61(4):620-30
pubmed: 8370857
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Contemp Clin Trials. 2015 Nov;45(Pt B):252-260
pubmed: 26343743
J Nerv Ment Dis. 2005 Oct;193(10):658-64
pubmed: 16208161
J Trauma Stress. 1995 Jan;8(1):75-90
pubmed: 7712061
J Consult Clin Psychol. 2006 Oct;74(5):898-907
pubmed: 17032094
Soc Psychiatry Psychiatr Epidemiol. 2016 Aug;51(8):1137-48
pubmed: 27106853