在ACT-I和CBT-I治疗失眠的治疗反应相关的认知和心理因素
Ila Marques Porto Linares1, Susanna Jernelöv2, Renatha El Rafihi-Ferreira3
1Department of Psychiatry, University of São Paulo, São Paulo, Brazil.
Journal of sleep research
|February 9, 2025
概括
治疗失眠的认知行为疗法 (CBT-I) 的治疗反应率高于治疗失眠的接受和承诺疗法 (ACT-I). 更高的坚持和失眠严重程度预测了心理失眠治疗的更好的结果.
科学领域:
- 心理学 心理学 心理学
- 睡眠医学 睡眠医学
- 临床试验 临床试验
背景情况:
- 失眠的认知行为疗法 (CBT-I) 是失眠的主要治疗方法.
- 并非所有患者都对CBT-I有反应,这促使人们研究替代疗法,例如对失眠的接受和承诺疗法 (ACT-I).
研究的目的:
- 评估治疗方式,坚持,失眠严重程度,焦虑,抑郁,睡眠信念,并接受睡眠问题作为心理失眠治疗反应的预测因素.
- 为了比较CBT-I和ACT-I在治疗慢性失眠方面的疗效.
主要方法:
- 一项随机临床试验,涉及152名患有慢性失眠的成年人.
- 参与者被随机分配到接受CBT-I或ACT-I.
- 治疗反应被定义为失眠严重性指数减少8个点或更多,评估在治疗前,治疗后和6个月的随访.
主要成果:
- 与接受和承诺治疗失眠 (ACT-I) 相比,对失眠的认知行为疗法 (CBT-I) 显著增加了治疗反应的几率2.70倍.
- 在治疗前更高的失眠严重程度 (OR=1.15) 和关于睡眠的功能障碍信念 (OR=1.02) 预测了治疗后的治疗反应.
- 较高的治疗坚持度在治疗后增加了3.07倍的反应概率.
- 在6个月的随访期间,治疗前失眠严重程度预测的反应 (OR=1.14).
结论:
- 与接受和承诺治疗失眠相比,对失眠的认知行为治疗显示出更高的治疗反应率.
- 治疗坚持,基线失眠严重程度和功能障碍睡眠信念是心理失眠治疗中成功结果的重要预测因素.
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