Multicomponent Cognitive-Behavioural Intervention to Improve Sleep in Adolescents: A Multiple Baseline Design

2013 ◽  
Vol 42 (3) ◽  
pp. 368-373 ◽  
Author(s):  
Melissa C. Hendricks ◽  
Cynthia M. Ward ◽  
Lauren K. Grodin ◽  
Keith J. Slifer
Keyword(s):  
Relaxation Training ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Multiple Baseline ◽  
Behavioural Intervention ◽  
Sleep Onset Latency ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention

Background: Adolescents are prone to sleep problems that have unique developmental aspects and contribute to physical, emotional, and behavioural problems. Aims: This study evaluated an individualized, multicomponent intervention that considered developmental factors, and promoted age-appropriate autonomy in three adolescent females with disrupted sleep. Method: Adolescents recorded sleep data on daily logs. A nonconcurrent multiple baseline design was used to evaluate a cognitive-behavioural intervention including sleep hygiene training, bedtime routine development, cognitive restructuring, relaxation training, stimulus control, sleep restriction, bedtime fading, and problem-solving, along with clinically indicated individualization. Results: Outcomes demonstrated clinically meaningful improvements and decreased variability in sleep parameters following intervention. Each participant's sleep log data indicated improvement in, or maintenance of, adequate total sleep time (TST), decreased sleep onset latency (SOL), improved sleep efficiency (SE), improvement in time of sleep onset, and decreased or continued low frequency of night awakenings (NA). Anecdotally, adolescents and parents reported improvement in daytime functioning, coping, and sense of wellbeing. Conclusions: These cases highlight the potential for cognitive-behavioural interventions to facilitate healthy sleep in adolescents with challenging sleep problems.

Does Treating Insomnia With Cognitive–Behavioural Therapy Influence Comorbid Anxiety and Depression? An Exploratory Multiple Baseline Design With Four Patients

2011 ◽  
Vol 28 (4) ◽  
pp. 195-205 ◽  
Author(s):  
Daniel Maroti ◽  
Pär Folkeson ◽  
Markus Jansson-Fröjmark ◽  
Steven J. Linton
Keyword(s):  
Sleep Onset ◽  
Multiple Baseline ◽  
Anxiety And Depression ◽  
Sleep Onset Latency ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Wake Time ◽  
Cognitive Behaviour ◽  
Psychiatric Conditions ◽  
The Impact

AbstractObjectives:Although cognitive–behaviour therapy for insomnia (CBT-I) has been shown to be effective for primary insomnia, the impact of CBT-I on insomnia comorbid with psychiatric conditions is largely unknown.Design:A multiple baseline design with 2–3 weeks of baseline, 6 weeks of CBT-I, and a 3-week follow-up was employed.Methods:Four patients with insomnia comorbid with both anxiety and depressive disorders participated. Sleep onset latency (SOL), wake time after sleep onset (WASO), total sleep time (TST), the Insomnia Severity Index (ISI), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI-II) were used as outcome measures.Results:Improvements in SOL, WASO, and TST were observed for all the four patients. Based on ISI, there were reductions for all the patients (32–92%), three patients responded to treatment, and two patients remitted. Based on BAI, reductions on anxiety were observed for all the patients (40–76%), three patients were treatment responders, and two patients remitted. Based on BDI-II, all the patients experienced reductions in depression (36–53%), three patients responded to treatment, and one patient remitted.Conclusions:CBT-I was able to reduce insomnia and co-morbid anxiety and depression, thus providing preliminary evidence for using CBT-I on insomnia co-morbid with psychiatric conditions.

Development and Evaluation of a Cognitive Behavioural Intervention for Chronic Post-Stroke Insomnia

2018 ◽  
Vol 46 (6) ◽  
pp. 641-660 ◽  
Author(s):  
Katie Herron ◽  
Lorna Farquharson ◽  
Abigail Wroe ◽  
Annette Sterr
Keyword(s):  
Sleep Onset ◽  
Community Dwelling ◽  
Post Treatment ◽  
Dysfunctional Attitudes ◽  
Future Research ◽  
Behavioural Intervention ◽  
Sleep Onset Latency ◽  
Post Stroke ◽  
Cognitive Behavioural

Background:Cognitive behavioural therapy for insomnia (CBTI) has been successfully applied to those with chronic illness. However, despite the high prevalence of post-stroke insomnia, the applicability of CBTI for this population has not been substantially researched or routinely used in clinical practice.Aims:The present study developed a ‘CBTI+’ protocol for those with post-stroke insomnia and tested its efficacy. The protocol also incorporated additional management strategies that considered the consequences of stroke.Method:A single-case experimental design was used with five community-dwelling individuals with post-stroke insomnia. Daily sleep diaries were collected over 11 weeks, including a 2-week baseline, 7-week intervention and 2-week follow-up. The Insomnia Severity Index, Dysfunctional Attitudes and Beliefs About Sleep Scale, Epworth Sleepiness Scale, Fatigue Severity Scale and Stroke Impact Scale were administered pre- and post-treatment, as well as at 2-week follow-up.Results:At post-treatment, three participants no longer met diagnostic criteria for insomnia and all participants showed improvements on two or more sleep parameters, including sleep duration and sleep onset latency. Three participants showed a reduction in daytime sleepiness, increased quality of life and reduction in unhelpful beliefs about sleep.Conclusions:This study provides initial evidence that CBTI+ is a feasible and acceptable intervention for post-stroke insomnia. Furthermore, it indicates that sleep difficulties in community-dwelling stroke populations are at least partly maintained by unhelpful beliefs and behaviours. The development and delivery of the CBTI+ protocol has important clinical implications for managing post-stroke insomnia and highlights directions for future research.

Parent Management of Sleep Difficulties in Young Children

1987 ◽  
Vol 4 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Frederick W. Seymour
Keyword(s):  
Young Children ◽  
Multiple Baseline ◽  
Behavioural Intervention ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Common Problems ◽  
Parent Management ◽  
Sleep Difficulties ◽  
Night Waking

Difficulties in settling children to sleep and night waking are common problems faced by parents with young children. The effectiveness of parent-managed behavioural intervention is examined in this study of four children which employs a multiple-baseline-design across subjects. Components of the intervention included: establishing regular bedtime routines; paying attention to the children before bed in the living areas and staying with the children only briefly when settling them in bed; adopting procedures for ignoring disruptive bedtime behaviour and night waking; and giving praise for appropriate behaviour. Complete success in settling the three children who were difficult at bedtime was achieved in five to fourteen days. Persistent night waking in all four children was eliminated in five to thirteen nights.

Effects of Phonological Decoding Training on Children's Word Recognition of CVC, CV, and VC Structures

1996 ◽  
Vol 5 (1) ◽  
pp. 67-78 ◽  
Author(s):  
Kenyatta O. Rivers ◽  
Linda J. Lombardino ◽  
Cynthia K. Thompson
Keyword(s):  
Word Recognition ◽  
Multiple Baseline ◽  
Single Subject ◽  
Group Training ◽  
Complex Structures ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Phonological Decoding ◽  
The Third ◽  
Letter Sound

The effects of training in letter-sound correspondences and phonemic decoding (segmenting and blending skills) on three kindergartners' word recognition abilities were examined using a single-subject multiple-baseline design across behaviors and subjects. Whereas CVC pseudowords were trained, generalization to untrained CVC pseudowords, untrained CVC real words, untrained CV and VC pseudowords, and untrained CV and VC real words were assessed. Generalization occurred to all of the untrained constructions for two of the three subjects. The third subject did not show the same degree of generalization to VC pseudowords and real words; however, after three training sessions, this subject read all VC constructions with 100% accuracy. Findings are consistent with group training studies that have shown the benefits of decoding training on word recognition and spelling skills and with studies that have demonstrated the effects of generalization to less complex structures when more complex structures are trained.

scholarly journals Effect of early intervention for anxiety on sleep outcomes in adolescents: a randomized trial

2021 ◽  
Author(s):  
Bente Storm Mowatt Haugland ◽  
Mari Hysing ◽  
Asle Hoffart ◽  
Åshild Tellefsen Haaland ◽  
Jon Fauskanger Bjaastad ◽  
...  
Keyword(s):  
Early Intervention ◽  
Standard Length ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Clinical Trial Registration

AbstractThe potential effect of early intervention for anxiety on sleep outcomes was examined in a sample of adolescents with anxiety (N = 313, mean 14.0 years, SD = 0.84, 84% girls, 95.7% Norwegians). Participants were randomized to one of three conditions: a brief or a standard-length cognitive-behavioral group-intervention (GCBT), or a waitlist control-group (WL). Interventions were delivered at schools, during school hours. Adolescents with elevated anxiety were recruited by school health services. Questionnaires on self-reported anxiety symptoms, depressive symptoms, and sleep characteristics were administered at pre- and post-intervention, post-waitlist, and at 1-year follow-up. Adolescents reported reduced insomnia (odds ratio (OR) = 0.42, p < 0.001) and shorter sleep onset latency (d = 0.27, p <  0.001) from pre- to post-intervention. For insomnia, this effect was maintained at 1-year follow-up (OR = 0.54, p = 0.020). However, no effect of GCBT on sleep outcomes was found when comparing GCBT and WL. Also, no difference was found in sleep outcomes between brief and standard-length interventions. Adolescents defined as responders (i.e., having improved much or very much on anxiety after GCBT), did not differ from non-responders regarding sleep outcomes. Thus, anxiety-focused CBT, delivered in groups, showed no effect on sleep outcomes. Strategies specifically targeting sleep problems in adolescents should be included in GCBT when delivered as early intervention for adolescents with elevated anxiety.Trial registry Clinical trial registration: School Based Low-intensity Cognitive Behavioral Intervention for Anxious Youth (LIST); http://clinicalrials.gov/; NCT02279251, Date: 11.31. 2014

Multiple baseline design

TVZ ◽  
2021 ◽  
Vol 131 (1) ◽  
pp. 52-53
Author(s):  
Katrien Cuyvers
Keyword(s):  
Multiple Baseline ◽  
Multiple Baseline Design ◽  
Baseline Design

Pain Management in Rheumatoid Arthritis: A Cognitive-Behavioural Intervention

1993 ◽  
Vol 23 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Sean Germond ◽  
Hein Helgo Schomer ◽  
Orlando Llewellyn Meyers ◽  
Lindsay Weight
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Studies ◽  
Psychological Adjustment ◽  
Psychological Health ◽  
Treatment Effects ◽  
Disease Status ◽  
Complex Nature ◽  
Behavioural Intervention ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention

Psychological adjustment is thought to play an important role in determining pain experience, disease status, and immune function in rheumatoid arthritis (RA). Fourteen female RA out-patients were tested longitudinally in a matched-random assigned two-groups design with cognitive-behavioural intervention designed to improve pain and stress management skills. Pre-intervention correlational analyses tested the extent to which mood disturbance, self-perceptions of coping efficacy, health locus of control, and stressful life experience were related to pain, disease activity, functional status and lymphocyte proliferation rate variables. Intra- and inter-group analyses were conducted to determine treatment effects, and case studies were conducted. RA was characterized more by poor psychological health status than physical disability, with pain more a function of psychological adjustment than actual disease status. No significant treatment effects were observed. Case studies indicated the complex nature of the individual disease experience. The value of cognitive-behavioural intervention in RA, and implications for future-related research are discussed in terms of such findings.

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