Loading...
|
Please use this identifier to cite or link to this item:
https://nccur.lib.nccu.edu.tw/handle/140.119/52768
|
| Title: | 失眠認知行為治療的執行程度與治療效果間的關係
The association between treatment adherence and treatment outcome in Cognitive Behavior Therapy for Insomnia |
| Authors: | 陳佳琤 |
| Contributors: | 楊建銘
陳佳琤 |
| Keywords: | CBT-I
失眠
執行程度
療效
CBT-I
insomnia
adherence
treatment efficacy |
| Date: | 2011 |
| Issue Date: | 2012-04-17 09:15:47 (UTC+8) |
| Abstract: | 緒論
失眠困擾對身心健康有重大的影響，除了藥物取向的治療外，失眠認知行為治療（CBT-I）有足夠的實證研究證據肯定其療效，由於在認知行為治療（CBT）的研究中有證據支持參與者在家中，對治療技術練習與執行的程度與療效有關，因此CBT-I的療效可能也與患者對治療技術的執行程度有關，過去雖然也有少數研究探討CBT-I執行程度與療效的關係，但這些研究缺乏針對CBT-I各個治療技術的執行程度評估，因此本研究欲探討CBT-I中，各項治療技術（睡眠衛生教育、放鬆訓練、刺激控制法、睡眠限制法，及認知重建）的執行程度及執行規律程度，與特定療效指標改善程度的關係。
方法
研究參與者含原發性失眠患者22位，共病其它疾患的失眠患者16位，經篩選階段確認符合收案條件後，在接受為期七週的CBT-I團體治療期間，於第二週起需每日填寫執行程度問卷，同時帶領團體的治療師也於治療第三週起，以治療師執行程度評估量表來評估參與者的執行程度。參與者在治療前後另需分別填寫一週睡眠日誌以及睡眠困擾問卷（Insomnia Severity Inventory；ISI），以睡眠日誌中的SOL、WASO、TST、SE，及ISI得分的前後測改變分數，作為代表療效指標之依變項，預測變項則為參與者自評及治療師所評估的各項治療技術之執行程度分數，治療技術包括：睡眠衛生、放鬆訓練、刺激控制法、睡眠限制法，以及認知重建；並分別以平均數代表執行程度，而以變異數代表執行期間的規律程度。
結果
資料分析以皮爾森相關分析檢驗執行程度與療效間的關聯性，在全部樣本中的結果發現，參與者自評對認知重建的平均數與WASO的改善程度有正相關，以及治療師評估CBT-I的平均數與SOL的改善程度有正相關；而參與者自評放鬆訓練的平均數越低、刺激控制法變異數越高，則ISI的改善程度越好，為不符合預期的結果。在原發性失眠組中發現治療師評估睡眠衛生的平均數與WASO的改善有正相關，治療師評估睡眠限制法的平均數與SOL、TST，以及SE的改善有正相關，而變異數與SOL的改善有負相關，以及治療師評估CBT-I的平均數與SOL的改善有正相關；而不符合預期的結果為，參與者自評執行刺激控制法的變異數與ISI的改善有正相關。最後，在共病組中並沒有發現執行程度與療效之間有顯著相關的結果，而放鬆訓練以及刺激控制法兩項治療技術，也沒有與療效指標有符合預期的顯著相關結果。
結論
對於共病失眠患者而言，治療技術的執行評估與療效間未反映出顯著相關，可能因受限於睡眠生理疾患的干擾，使得療效未如原發性失眠組明顯；而就原發性失眠組而言，睡眠限制法的執行程度是與較多療效指標達到顯著相關的治療技術，顯示睡眠限制法的執行對於改善睡眠症狀有所幫助。本研究較為重大的限制在於，治療技術執行程度評估的評分者間一致性有限，後續研究可進一步發展評估執行程度更適當的方法。
Introduction
Insomnia is a common problem that has a significant impact on patients` physical and mental health. In addition to pharmacological therapy, there are sufficient empirical data to support treatment efficacy of cognitive behavioral therapy for insomnia (CBT-I). A major part of cognitive behavioral therapy is to teach the patients to learn specific cognitive and behavioral techniques that requires to be practiced at home by the patients. Previous studies have reported an association between the degree of adherence to treatment techniques and treatment effects in cognitive behavioral therapy for disorders other than insomnia. Some studies further explored the relationship between treatment adherence and treatment outcome in CBT-I. However, none of the study looked into the adherence to different treatment components on different aspects of treatment outcome. The aim of this study therefore is to explore the relationship between the adherence to different treatment components in CBT-I and the improvement in different sleep parameters.
Method
Twenty-two patients with primary insomnia and sixteen patients with comorbid insomnia were recruited for this study. During the 6-week period of treatment with CBT-I, they completed a treatment adherence questionnaire daily. The therapists also evaluated the patients’ adherence weekly after treatment sessions. They were required to keep sleep diaries from one week before to one week after the end of the 6-week CBT-I program. They also completed the ISI and sleep diary for one week before and after the treatment. The treatment outcome variables included the ISI score, and sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST) and the sleep efficiency (SE) from sleep diaries. The treatment components evaluated included sleep hygiene, relaxation, stimulus control, sleep restriction and cognitive reconstruction. The predictive variables included the mean for the adherence degrees and the variance for the adherence regularity of the adherence score evaluated by the participants and therapists.
Results
Pearson correlation was used to examine the associations between the adherence to respective treatment components in CBT-I and the variables of treatment outcome. In the whole sample, the decrease of the WASO correlated significantly with adherence to cognitive reconstruction evaluated by the patients, and the decrease of the SOL correlated significantly with adherence to CBT-I evaluated by the therapists. Nonetheless, the lower adherence to relaxation and the higher variance of adherence to stimulus control, the more improvement of the ISI. In patients with primary insomnia, the decrease of WASO correlated significantly with adherence to sleep hygiene evaluated by the therapists; the decrease of SOL and the increase of TST and SE showed significant correlation with adherence to sleep restriction evaluated by the therapists; the decrease of SOL showed significant negative correlation with the variance of adherence to sleep restriction evaluated by the therapists; the decrease of SOL showed significant positive correlation with the adherence to CBT-I evaluated by the therapists. Opposite to expectation, the decrease of the ISI score correlated significantly with variability of adherence to stimulus control evaluated by the patients. Finally, in patients with comorbid insomnia, the treatment component adherence did not correlate significantly with any outcome variables. The adherence of relaxation and stimulus control did not show significant correlation with outcome variables.
Conclusion
In patients with comorbid insomnia, treatment effects were not associated with adherence. This may due to the multifactorial nature of comorbid insomnia. Among the treatment components, adherence to sleep restriction seems to be the most predictive factor for good treatment outcome in primary insomnia. One limitation of the present study is its low inter-rater reliability of treatment components adherence evaluation. Therefore, more appropriate methods need to be developed to evaluate the adherence of treatment techniques. |
| Reference: | 孔繁鐘.（2005）.精神疾病的診斷與統計手冊（4 ed.）.台北市: 合記圖書出版社.
李宇宙, 曾美智, 陳映燁, 謝明憲, 許森彥, 李信謙, et al.（1999. M.I.N.I.台灣版: 台灣精神醫學會.
林詩淳、楊建銘、許世杰（2006年3月）失眠嚴重度量表、睡前激發程度量表及睡眠師功能信念及態度量表中譯版之信效度研究。台灣睡眠醫學會壁報論文發表。台灣睡眠醫學學會第四屆研討會，台灣大學醫學院。
AASM. (2005). The International Classificatino of Sleep Disoders（ICSD-2）( 2 ed.）. Westchester,IL: AASM.
APA. (1994). (Diagnostic and statistical Manual of Mental Disorders4th ed.). Washington, DC: Author.
Adachi, Y., Tanaka, H., Kunkitsuka, K., Takanashi, M., Doi, Y., Kawakami, N., et al. (2003). Brief behavior therapy for sleep-habit improvement in a work place by correspondence. Sleep and Biological Rhythms, 1, 133-135.
Baglioni, C., Spiegelhalder, K., Lombardo, C., & Riemann, D. (2010) .Sleep and emotions: a focus on insomnia. Sleep Medicine Reviews, 14, 227-238.
Baillargeon, L., Demers, M., & Ladouceur, R. (1998). Stimulus-control: nonpharmacologic treatment for insomnia. Canadian Family Physician, 44, 73-79.
Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 4, 297-307.
Bonnet, M. H., & Arand, D. L. (1995). 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep, 18(7), 581-588.
Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine Reviews 1, 97-108.
Bonnet, M. H., & Arand, D. L. (1998). Heart rate variability in insomniacs and matched normal sleepers. Psychosomatic Medicine 60(5), 610-615.
Bonnet, M. H., & Arand, D. L. (2005). Sleep latency testing as a time course measure of state arousal. Journal of Sleep Research, 144, 387-392.
Bootzin, R. R. (1972). A stimulus control treatment for insomnia. Proceddings of the 80th Annual Convention of the American Psychological Association, 7, 395-396.
Bootzin, R. R., Epstein, D., & Wood, J. M. (1991). Stimulus control instructions. (In P. Hauri Ed.), Case Studies in Insomnia pp. 19-28. New York: Pleunm.
Borkovec, T. D., & Weerts, T. C. (1976). Effects of progressive relaxation on sleep disturbance: an electroencephalographic evaluation. Psychosomatic Medicine, 38(3), 173-180.
Bouchard, S., Bastien, C., & Morin, C. M. (2003). Self-efficacy and adherence to cognitive-behavioral treatment of insomnia. Behavioral Sleep Medicine, 1, 187-199.
Bouscoulet, L. T., Vazquez-Garcia, J. C., Muino, A., Marquez, M., Lopez, M. V., de Oca, M. M., et al. (2008). Prevalence of sleep related symptoms in four Latin American cities. Journal of Clinical Sleep Medicine
4(6), 579-585.
Brown, F. C., Buboltz, W. C., Jr., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Journal
of Behavioral Medicine, 28, 33-38.
Bruce, R., Edward, S., Louis, F., Martita, L., Paulette, B., & Andrew, D. (2005). A Placebo-Controlled Test of Cognitive-Behavioral Therapy for Comorbid Insomnia in Older Adults. Journal of Consulting and Clinical Psychology, 73(6), 1164-1174.
Burns, D. D., & Spangler, D. L. (2000). Does psychotherapy homework lead to improvements in depression in cognitivebehavioral therapy or does improvement lead to increased homework compliance? Journal of Consulting and Clinical Psychology, 68(1), 46-56.
Carney, C. E., & Waters, W. F. (2006). Effects of a structured problem-solving procedure on pre-sleep cognitive arousal in college students with insomnia. Behavioral Sleep Medicine, 4(1), 13-28.
Carroll, K. M., Nich, C., & Ball, S. A. (2005). Practice makes progress? Homework assignments and outcome in treatment of cocaine dependence. Journal of Consulting and Clinical Psychology, 73(4), 749-755.
Coates, T. J., Killen, J. D., George, J., Marchini, E., Silverman, S., & Thoresen, C. (1982). Estimating sleep parameters: a multitrait--multimethod analysis. Journal of Consulting and Clinical Psychology, 50, 345-352.
Coon, D. W., & Thompson, L. W. (2003). The relationship between homework compliance and treatment outcomes among older adult outpatients with mild-to-moderate depression. American Journal of Geriatric Psychiatry, 11(1), 53-61.
Dennis M., Kivlighan, Jr. & Debra C. Goldfine. (1991). Endorsement of Therapeutic Factors as a Function of Stage of Group Development and Participant Interpersonal Attitudes. Journal of Counseling Psychology, 38(2), 150-158
Dolan-Sewell, R. T., Riley, W. T., & Hunt, C. E. (2005). NIH State-of-the-Science Conference on Chronic Insomnia. Journal of Clinical Sleep Medicine 1(4), 335-336.
Edinger, J. D., Carney, C. E., & Wohlgemuth, W. K. (2008). Pretherapy cognitive dispositions and treatment outcome in cognitive behavior therapy for insomnia. Behavior Therapy, 39(4), 406-416.
Edinger, J. D., & Means, M. K. (2005). Cognitive-behavioral therapy for primary insomnia. Clinical Psychology Review 25(5), 539-558.
Edinger, J. D., Olsen, M. K., Stechuchak, K. M., Means, M. K., Lineberger, M. D., Kirby, A., Carney, C. E., (2009). Cognitive behavioral therapy for patients with primary insomnia or insomnia associated predominantly with mixed psychiatric disorders: a randomized clinical trial, Sleep, 32(4), 499-510
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E. (2001a). Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. Journal of the American Medical Association, 285, 1856-1864.
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R., & Quillian, R. E. (2001b). Does cognitive-behavioral insomnia therapy alter dysfunctional beliefs about sleep? Sleep, 24, 591-599.
Espie, C. A., Inglis, S. J. & Harvey, L. (2001). Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analyses of outcome data at 12 months posttreatment. Journal of Consulting and Clinical Psychology. 69(1). 58-66
Espie, C. A., Inglis, S. J., Harvey, L., & Tessier, S. (2000). Insomniacs` attributions. psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep Scale and the Sleep Disturbance Questionnaire. Journal of Psychosomatic Research, 48(2), 141-148.
Espie, C. A., Inglis, S. J., Tessier, S., & Harvey, L. (2001). The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behaviour research and therapy, 39, 45-60.
Freedman, & Papsdorf, J. D. (1976). Biofeedback and progressive relaxation treatment of sleep-onset insomnia: a controlled, all-night investigation. Biofeedback and Self-Regulation, 1, 253-271.
Glovinsky, P. B., & Spielman, A. J. (1991). Sleep restriction therapy. (In P. Hauri Ed.), Case Studies in Insomnia pp. 49-64. New York: Pleunm.
Gooneratne, N. S., Gehrman, P. R., Nkwuo, J. E., Bellamy, S. L., Schutte-Rodin, S., Dinges, D. F., et al. (2006). Consequences of comorbid insomnia symptoms and sleep-related breathing disorder in elderly subjects. Archives of Internal Medicine, 166, 1732-1738.
Guilleminault, C., Davis, K., Huynh, N. T. (2008). Prospective randomized study
of patients with insomnia and mild sleep disordered breathing. Sleep, 31(10), 1527-1533
Hajak, G. (2001). Epidemiology of severe insomnia and its consequences in Germany. European Archives of Psychiatry and Clinical Neuroscience, 2512）, 49-56.
Hajak, G., Bandelow, B., Zulley, J., & Pittrow, D. (2002). "As needed" pharmacotherapy combined with stimulus control treatment in chronic insomnia--assessment of a novel intervention strategy in a primary care setting. Annals of Clinical Psychiatry, 14(1), 1-7.
Harvey. (2002a). A cognitive model of insomnia. Behaviour Research and Therapy 40, 869-893.
Harvey. (2002b). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869-893.
Harvey, Inglis, S. J., & Espie, C. A. (2002). Insomniacs` reported use of CBT components and relationship to long-term clinical outcome. Behaviour Research and Therapy, 40, 75-83.
Harvey, & Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction. Behaviour Research and Therapy, 40(3), 267-277.
Hiroko Morishima, Emiko SUGIYAMA, Masateru MATSUSHITA, Shigehiko URUHA, Satoko ITO, Yukari ABE, et al. (2009). How is autonomic nervous system activity in subjects who are sleepy but are unable to sleep in the daytime? Sleep and Biological Rhythms, 7(1), 23-30.
Lichstein, K. L., Riedel, B. W., Lester, K. W., & Aguillard, R. N. (1999). Occult sleep apnea in a recruited sample of older adults with insomnia. Journal of Consulting and Clinical Psychology, 67(3), 405-410.
Iber, C., Ancoli-Israel, S., Chesson, A., & Quan, S. (2007). The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications (1 ed.). Illinois: American Academy of Sleep Medicine.
Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.
Jefferson, C. D., Drake, C. L., Scofield, H. M., Myers, E., McClure, T., Roehrs, T., et al (2005). Sleep hygiene practices in a population-based sample of insomniacs. Sleep, 285）, 611-615.
Johnson, J. E., Burlingame, G. M., Olsen, J. A., Davies, D. R., & Gleave, R. L. (2005). Group Climate, Cohesion, Alliance, and Empathy in Group Psychotherapy:Multilevel Structural Equation Models. Journal of Counseling Psychology, 52(3),
310-32
Kanas, N., & Ziegler, J. L. (1984). Group climate in a stress discussion group for medical interns. Group, 8, 35–38.
Kao, C. C., Huang, C. J., Wang, M. Y., & Tsai, P. S. (2008). Insomnia: prevalence and its impact on excessive daytime sleepiness and psychological well-being in the adult Taiwanese population. Quality of lLife Research, 17(8), 1073-1080.
Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7(2), 189-202.
Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy:A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144-156.
Kivlighan, D. M., & Goldfine, D. C. (1991). Endorsement of therapeutic factors as a function of stage of group development and participant interpersonal attitudes. Journal of Counseling Psychology, 38, 150 –158.
Krakow, B., Melendrez, D., Lee, S. A., Warner, T. D., Clark, J. O., Sklar, D. (2004). Refractory insomnia and sleep-disordered breathing: a pilot study. Sleep and Breath, 8(1), 15-29
Kravitz, R. L., Hays, R. D., Sherbourne, C. D., DiMatteo, M. R., Rogers, W. H., Ordway, L., et al. (1993). Recall of recommendations and adherence to advice among patients with chronic medical conditions. Archives of Internal Medicine, 153(16), 1869-1878.
Lack, L. C., Gradisar, M., Eus J.W., Someren, V., Wright, H. R., & Lushington, K. (2008). The relationship between insomnia and body temperatures. Sleep Medicine Reviews, 12, 307-317.
Leger, D., Guilleminault, C., Dreyfus, J. P., Delahaye, C., & Paillard, M. (2000). Prevalence of insomnia in a survey of 12,778 adults in France. Journal of Sleep Research, 9(1), 35-42.
Leung, A. W., & Heimberg, R. G. (1996). Homework compliance, perceptions of control, and outcome of cognitive-behavioral treatment of social phobia. Behaviour Research and Therapy, 345(6), 423-432.
Lick, J. R., & Heffler, D. (1977). Relaxation training and attention placebo in the treatment of severe insomnia. Journal of Consulting and Clinical Psychology, 45(2), 153-161.
MacKenzie, K. R. (1983). The clinical application of a Group Climate measure. (In R. R. Dies & K. R. MacKenzie Eds.), Advances in group psychotherapy: Integrating research and practice (pp. 159-170). New York: International Universities Press.
Manber, R., Edinger, J. D., Gress, J. L., San Pedro-Salcedo, M. G., Kuo, T. F., Kalista, T. (2008). Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep, 31(4), 489-495
Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated eta-analysis. Cognitive Therapy and Research, 34(5), 429-438.
McCrae, C. S., Rowe, M. A., Dautovich, N. D., Lichstein, K. L., Durrence, H. H., Riedel, W., et al. (2006). Sleep hygiene practices in two community dwelling samples of older adults. Sleep, 29(12), 1551-1560.
Mitchell, K. R. (1979). Behavioral treatment of presleep tension and intrusive cognitions in patients with severe predormital insomnia. Journal of Behavioral Medicine, 2(1), 57-69.
Morgenthaler, T., Kramer, M., Alessi, C., Friedman, L., Boehlecke, B., Brown, T., et al. (2006). Practice parameters for the psychological and behavioral treatment of insomnia: an update. An american academy of sleep medicine report. Sleep, 29, 1415-1419.
Morin, C. M., Blais, F., & Savard, J. (2002). Are changes in beliefs and attitudes about sleep related to sleep improvements in the treatment of insomnia? Behaviour Research and Therapy 40, 741-752.
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia:update of the recent evidence (1998-2004). Sleep, 29, 1398-1414.
Morin, C. M., Colecchi, C., Stone, J., Sood, R., & Brink, D. (1999). Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. Journal of the American Medical Association, 281, 991-999.
Morin, C. M., Culbert, J. P., & Schwartz, S. M. (1994). Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. The American Journal of Psychiatry 15(18), 1172-1180.
Morin, C. M., & Espie, C. A. (1993). Insomnia: psychological assessment and management. New Youk: Kluwer Academic/ Plunem.
Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Medicine, 7, 123-130.
Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging, 8, 463-467.
Morin, C. M., & Wooten, V. (1996). Psychological and pharmacological approaches to treating insomnia: Critical issues in assessing their separate and combined effects Clinical Psychology Review, 16, 521-542.
Murtagh, D. R., & Greenwood, K. M. (1995). Identifying effective psychological treatments for insomnia: a meta-analysis. Journal of Consulting and Clinical Psychology, 63(1), 79-89.
Nelson, J., & Harvey, A. G. (2003). An exploration of pre-sleep cognitive activity in insomnia: imagery and verbal thought. British Journal of Clinical Psychology 42Pt 3）, 271-288.
Nicassio, P., & Bootzin, R. (1974). A comparison of progressive relaxation and autogenic training as treatments for insomnia. Journal of Abnormal Psychology, 83, 253-260.
Nomura, K., Yamaoka, K., Nakao, M., & Yano, E. (2005). Impact of insomnia on individual health dissatisfaction in Japan, South Korea, and Taiwan. Sleep, 28, 1328-1332.
Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6, 97-111.
Primakoff, L., Epsteinb, N., & Covia, L. (1986). Homework compliance: An uncontrolled variable in cognitive therapy outcome research. Behavior Therapy, 17(4).
Puder, R., Lacks, P., Bertelson, A. D., & Storandt, M. (1983). Short-term stimulus control treatment of insomnia in older adults. Behavior Therapy, 14(3), 424-429.
Rees, C. S., McEvoy, P., & Nathan, P. R. (2005). Relationship between homework completion and outcome in cognitive behaviour therapy. Cognitive Behaviour Therapy, 34(4), 242-247.
Reynolds, C. F., Kupfer, D., Buysse, D., & Yeager, C. P. (1991). A subtyping DSM-III-R primary insomnia: a literature review by the DSM-IV work group on sleep disorders. The American Journal of Psychiatry, 148, 432-438.
Riedel, B. W., & Lichstein, K. L. (2001). Strategies for evaluating adherence to sleep restriction treatment for insomnia. Behaviour Research and Therapy, 39, 201-212.
Rodenbeck, A., Huether, G., Rüther, E., & Hajak, G. (2002). Interactions between evening and nocturnal cortisol secretion and sleep parameters in patients with severe chronic primary insomnia. Neuroscience Letters, 32(42), 159-163.
Rybarczyk, B., Stepanski, E., Fogg, L., Lopez, M., Barry, P. & Davis, A. (2005). A placebo-controlled test of cognitive-behavioral therapy for comorbid insomnia in older adults. Journal of Consulting and Clinical Psychology, 73(6), 1164-74
Schmidt, N. B., & Woolaway-Bickel, K. (2000). The effects of treatment compliance on outcome in cognitive—behavioral therapy for panic disorder quality versus quantity. Journal of Consulting and Clinical Psychology, 68(1), 13-18.
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini International Neuropsychiatric Interview. (M.I.N.I.) :the development and validation of a structured diagnostic psychiatric interview forDSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(20), 22-57.
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., et al. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. The American Journal of Psychiatry 159(1), 5-11.
Spielman, A. J. (1986). Assessment of Insomnia. Clinical Psychology Review, 6, 11-25.
Spielman, A. J., Saskin, P., & Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed. Sleep, 10, 45-56.
Stepanski, & Wyatt, J. K. (2003). Use of sleep hygiene in the treatment of insomnia. Sleep Medicine Reviews, 7(3), 215-225.
Stepanski, E., Zorick, F., Roehrs, T., Young, D., & Roth, T. (1988). Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects. Sleep, 11, 54-60.
Tolin, D. F., Frost, R. O., & Steketee, G. (2007). An open trial of cognitive-behavioral therapy for compulsive hoarding. Behaviour Research and Therapy, 45(7), 1461-1470.
Tremblay, V., Savard, J & Ivers, H. (2009). Predictors of the effect of cognitive behavioral therapy for chronic insomnia comorbid with breast cancer. Journal of Consulting and Clinical Psychology, 77(4), 742-50
Tschuschke, V., & Greene, L. R. (2002). Group therapists’ training: What predicts learning? International Journal of Group Psychotherapy, 52, 463–482.
Turner, R. M., & Ascher, L. M. (1979_. A within-subject analysis of stimulus control therapy with severe sleep-onset insomnia. Behaviour Research Therapy, 17(2), 107-112.
Van Egeren, L., Haynes, S. N., Franzen, M., & Hamilton, J. (1983). Presleep
cognitions and attributions in sleep-onset insomnia. Journal of Behavioral Medicine 6,
217-232.
Vgontzas, A. N., Bixler, E. O., Lin, H. M., Prolo, P., Mastorakos, G., Vela-Bueno, A., et al. (2001). Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis: clinical implications. Journal of Clinical Endocrinology and Metabolism, 86(8), 3787-3794.
Vincent, & Hameed, H. (2003). Relation between adherence and outcome in the group treatment of insomnia. Behavioral Sleep Medicine 1, 125-139.
Vincent, Lewycky, S., & Finnegan, H. (2008). Barriers to engagement in sleep restriction and stimulus control in chronic insomnia. Journal of Consulting and Clinical Psychology, 76, 820-828.
Vincent, & Lionberg, C. (2001). Treatment preference and patient satisfaction in chronic insomnia. Sleep, 24, 411-417.
Woodley, J., & Smith, S. (2006). Safety behaviors and dysfunctional beliefs about sleep: testing a cognitive model of the maintenance of insomnia. Journal of Psychosomatic Research, 60(6), 551-557.
Woods, C. M., Chambless, D. L., & Steketee, G. (2002). Homework compliance and behavior therapy outcome for panic with agoraphobia and obsessive compulsive disorder. Cognitive Behaviour Therapy, 31(2), 88-95.
Yang, C. M., Lin, S. C., Hsu, S. C., & Cheng, C. P. (2010). Maladaptive sleep
hygiene practices in good sleepers and patients with insomnia. Journal of Health Psychology, 15(1), 147-155.
Yang, C. M., Spielman, A. J., & Glovinsky, P. (2006). Nonpharmacologic strategies in the management of insomnia. Psychiatric Clinics of North America 29, 895-919.
Zambotti M, D. E., Covassin, N., Min Tona G, D. E., Sarlo, M., & Stegagno, L. (2010). Sleep onset and cardiovascular activity in primary insomnia. Journal of Sleep Research. |
| Description: | 碩士
國立政治大學
心理學研究所
96752017
100 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0096752017 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
|
Files in This Item:
| File |
Size | Format | |
|---|
| 201701.pdf | 1315Kb | Adobe PDF2 | 1263 | View/Open |
|
All items in 政大典藏 are protected by copyright, with all rights reserved.
|
