Novel treatment based on acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized comparative effectiveness trial in women veterans.

Autor: Martin JL; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Carlson GC; VA Health Services Research & Development, Center for the Study of Healthcare Innovation, Implementation & Policy, Veteran Affairs Greater Los Angeles Healthcare System., Kelly MR; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Song Y; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Mitchell MN; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Josephson KR; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., McGowan SK; Department of Mental Health, Veteran Affairs Greater Los Angeles Healthcare System., Culver NC; Department of Mental Health, Veteran Affairs Greater Los Angeles Healthcare System., Kay MA; Department of Mental Health, Veteran Affairs Greater Los Angeles Healthcare System., Erickson AJ; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Saldana KS; Department of Mental Health, Veteran Affairs Greater Los Angeles Healthcare System., May KJ; Department of Mental Health, Veteran Affairs Greater Los Angeles Healthcare System., Fiorentino L, Alessi CA; Geriatric Research, Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System., Washington DL; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles., Yano EM; VA Health Services Research & Development, Center for the Study of Healthcare Innovation, Implementation & Policy, Veteran Affairs Greater Los Angeles Healthcare System.
Jazyk: angličtina
Zdroj: Journal of consulting and clinical psychology [J Consult Clin Psychol] 2023 Nov; Vol. 91 (11), pp. 626-639. Date of Electronic Publication: 2023 Aug 03.
DOI: 10.1037/ccp0000836
Abstrakt: Objective: This randomized comparative effectiveness trial evaluated a novel insomnia treatment using acceptance and commitment therapy (ACT) among women veterans. Participants received either the acceptance and the behavioral changes to treat insomnia (ABC-I) or cognitive behavioral therapy for insomnia (CBT-I). The primary objectives were to determine whether ABC-I was noninferior to CBT-I in improving sleep and to test whether ABC-I resulted in higher treatment completion and adherence versus CBT-I.
Method: One hundred forty-nine women veterans with insomnia disorder ( M age = 48.0 years) received ABC-I or CBT-I. The main sleep outcomes were Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and sleep efficiency (SE) by actigraphy (objective) and sleep diary (subjective). Measures were collected at baseline, immediate posttreatment, and 3-month posttreatment follow-up. Treatment completion and adherence were assessed during the interventions.
Results: Both interventions improved all sleep outcomes from baseline to immediate posttreatment and 3-month posttreatment follow-up. At immediate posttreatment, ABC-I was statically noninferior for sleep diary SE and objective SE, but noninferiority was not statistically confirmed for ISI or PSQI total scores. At 3-month posttreatment follow-up, ABC-I was noninferior for all four of the key outcome variables. There was not a statistically significant difference between the number of participants who discontinued CBT-I (11%) versus ABC-I (18%; p = .248) before completing treatment. ABC-I was superior to CBT-I for some adherence metrics.
Conclusions: Overall, ABC-I was similar in effectiveness compared to CBT-I for the treatment of insomnia and may improve adherence to some behavioral elements of treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Databáze: MEDLINE
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