The effectiveness, feasibility and acceptability of a school-based intervention to improve sleep and psychological wellbeing in adolescents.

Introduction: Adolescents are vulnerable to experiencing insufficient sleep which can increase the risk of developing insomnia, mental/physical health problems and mood regulation. School-based sleep improvement interventions (SBSII) have been developed utilising Cognitive Behavioural Therapy for Insomnia techniques and found improvements in sleep knowledge and behaviour. This study aimed to evaluate the effectiveness, feasibility and acceptability of a school-based sleep improvement intervention (iSLEEP) for improving sleep and psychological wellbeing in adolescents.Methods: A mixed-methods approach was adopted. The participants (115, aged 12-15) were recruited from secondary schools in Scotland. iSLEEP comprised of three lessons, combining formal sleep education and CBT-I, and were delivered over three consecutive weeks. Baseline (1 week before lesson 1) and follow-up (1 week following lesson 3) assessments comprised of self-report questionnaires to measure change in sleep, depression, anxiety and stress. Two weeks following the final lesson, a convenience sample of 19 pupils (14 females) were recruited to participate in focus groups.Results: There were significant improvements in overall sleep and marginal differences between those who were categorised with ‘probable insomnia’ at baseline and likewise for ‘good sleepers’. There were no significant improvements in symptoms of depression, anxiety or stress. Two themes and two sub-themes were generated. Participants reported that iSLEEP was acceptable and improved their sleep.Conclusions: These findings indicate that iSLEEP is an effective, feasible and acceptable SBSII. Future research should aim to utilise a controlled design to further investigate the efficacy of iSLEEP.

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Preventive intervention for anxiety in childhood: Implications for future research

The Australian Educational and Developmental Psychologist ◽

10.1017/s0816512200028509 ◽

2002 ◽

Vol 19 (1) ◽

pp. 30-48

Author(s):

Sally Johnson ◽

Paula M. Barrett

Keyword(s):

Preventive Intervention ◽

Empirical Studies ◽

Child Anxiety ◽

Prevention Programs ◽

Behavioural Therapy ◽

Future Research ◽

Clinical Settings ◽

School Based ◽

Cognitive Behavioural ◽

Research Findings

AbstractEarly intervention has become a priority for many researchers interested in reducing the prevalence of anxiety disorders within Australia (Donovan & Spence, 2000). Despite substantial advances in our knowledge of effective intervention protocols, studies investigating preventive intervention for child anxiety are sparse. Universal prevention programs targeting large cohorts of children within community settings are considered most advantageous (Greenburg, Domitrovich, & Bumbarger, 2001), although empirical studies for anxiety in youth are only beginning to emerge. This review of research in anxiety intervention explored protocols shown to have been successful in reducing symptoms of anxiety in youth and to discuss implications for future research. Findings suggested that cognitive behavioural therapy was potentially effective in reducing anxiety symptoms in youngsters when implemented in clinical settings (Kendall, 1994, 1996; Barrett, 1996, 1998) and in school-based preventive intervention (Dadds, Spence, Holland, Barrett, & Laurens, 1998). Future research evaluating the effectiveness of prevention programs at different ages in development has further practical research implications in terms of identifiing the most appropriate time conducive to enhancing long-term intervention effects.

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Nutritional psychiatry: the present state of the evidence

Proceedings of The Nutrition Society ◽

10.1017/s0029665117002026 ◽

2017 ◽

Vol 76 (4) ◽

pp. 427-436 ◽

Cited By ~ 59

Author(s):

Wolfgang Marx ◽

Genevieve Moseley ◽

Michael Berk ◽

Felice Jacka

Keyword(s):

Mental Illness ◽

Mental Disorders ◽

Diet Quality ◽

Age Groups ◽

Significant Proportion ◽

Behavioural Therapy ◽

Future Research ◽

Reverse Causality ◽

Dietary Interventions ◽

Cognitive Behavioural

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and heath burden. Treatment is presently dominated by pharmacotherapy, such as antidepressants, and psychotherapy, such as cognitive behavioural therapy; however, such treatments avert less than half of the disease burden, suggesting that additional strategies are needed to prevent and treat mental disorders. There are now consistent mechanistic, observational and interventional data to suggest diet quality may be a modifiable risk factor for mental illness. This review provides an overview of the nutritional psychiatry field. It includes a discussion of the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research. Potential biological pathways related to mental disorders include inflammation, oxidative stress, the gut microbiome, epigenetic modifications and neuroplasticity. Consistent epidemiological evidence, particularly for depression, suggests an association between measures of diet quality and mental health, across multiple populations and age groups; these do not appear to be explained by other demographic, lifestyle factors or reverse causality. Our recently published intervention trial provides preliminary clinical evidence that dietary interventions in clinically diagnosed populations are feasible and can provide significant clinical benefit. Furthermore, nutraceuticals including n-3 fatty acids, folate, S-adenosylmethionine, N-acetyl cysteine and probiotics, among others, are promising avenues for future research. Continued research is now required to investigate the efficacy of intervention studies in large cohorts and within clinically relevant populations, particularly in patients with schizophrenia, bipolar and anxiety disorders.

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Evaluation of a short version of the Experiences in Close Relationships-Revised questionnaire (ECR-RD8): results from a representative German sample

BMC Psychology ◽

10.1186/s40359-021-00637-z ◽

2021 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Johannes C. Ehrenthal ◽

Johannes Zimmermann ◽

Katja Brenk-Franz ◽

Ulrike Dinger ◽

Henning Schauenburg ◽

...

Keyword(s):

Close Relationships ◽

Full Scale ◽

Self Report ◽

Future Research ◽

Short Version ◽

German Population ◽

Attachment Insecurity ◽

Convenience Sample ◽

Norm Values ◽

Experiences In Close Relationships

Abstract Background Attachment insecurity is a prominent risk factor for the development and course of psychiatric and psychosomatic disorders. The Experiences in Close Relationships - Revised (ECR-R) questionnaire is a widely used self-report to assess attachment related anxiety and avoidance. However, its length has the potential to restrict its use in large, multi-instrument studies. The aim of this study was to develop and evaluate a brief version of the ECR-R, and provide norm values for the German population. Methods A screening version of the original ECR-R was developed through principal components analysis of datasets from several previous studies. In a representative sample of 2428 randomly selected individuals from the German population, we compared fit indices of different models by means of confirmatory factor analyses (CFA). We investigated the convergent validity of the screening version in an independent convenience sample of 557 participants. Correlations between the short and the full scale were investigated in a re-analysis of the original German ECR-R evaluation sample. Results CFA indicated a satisfactory model fit for an eight-item version (ECR-RD8). The ECR-RD8 demonstrated adequate reliability. The subscales correlated as expected with another self-report measure of attachment in an independent sample. Individuals with higher levels of attachment anxiety, but especially higher levels of attachment avoidance were significantly more likely to not be in a relationship, across all age groups. Correlations between the short and the full scale were high. Conclusions The ECR-RD8 appears to be a reliable, valid, and economic questionnaire for assessing attachment insecurity. In addition, the reported population-based norm values will help to contextualize future research findings.

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“Tell Me More and Help Me to Decide, Doctor” – Information Seeking Attitudes and Use of Information Resources in Patients with Depression

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1991 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S146-S146

Author(s):

H. Almeida ◽

A.M. Pisco Almeida ◽

M. Figueiredo-Braga

Keyword(s):

Decision Making ◽

Information Seeking ◽

Psychiatric Treatment ◽

A Priori ◽

Information Resources ◽

Self Report ◽

Mental Condition ◽

Future Research ◽

Limited Information ◽

Convenience Sample

IntroductionShared decision-making (SDM) has shown to improve adherence, decrease hospitalization, and enhance knowledge of the illness and satisfaction with mental health services. Eliciting each patient's preferences for information allows tailoring the physician behavior according perspectives and expectations. Patients with depression (PWD) have frequently limited information regarding the availability and efficacy of psychiatric treatments.Aims/objectivesUnveil information seeking attitudes of patients with depression and their a priori use of digital sources of information.MethodsA convenience sample of PWD was submitted to a battery of self-report questionnaires. Standardized instruments were used to measure information seeking attitudes and the accessibility and usage of digital information resources.ResultsThirty-six patients were inquired, with a mean age of 39.8 (13.4) years. Information-seeking preferences were high, with an API-I score of 90.1 (13.8). Preferences for information-seeking behaviors were higher in severely depressed (P = 0.010) and less educated (P = 0.026) patients. Preferences were negatively correlated with length of psychiatric treatment (r = −0.514; P = 0.002). Sixty-one percent had a priori information regarding their psychiatric problem, and 68.8% considered it was influential in the decision-making behavior. Access and use of digital resources were correlated with education level (0.644; P = 0.000 and 0.554; P = 0.003), age (−0.357; P = 0.001 and −0.559; P = 0.007) and illness severity (−0.431; P = 0.04).ConclusionPatients with depression want to be informed about their mental condition and treatment options. Few resources are used and decision mostly relies on health professional's opinion and guidance. Accessible resources seem scarce and future research shall address the acceptance and impact of decisional-aid instruments on this population.

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Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x19000278 ◽

2019 ◽

Vol 12 ◽

Author(s):

Farooq Naeem

Keyword(s):

Cultural Adaptation ◽

Behavioural Therapy ◽

Vital Role ◽

Sufficient Evidence ◽

Future Research ◽

Full Potential ◽

Special Issue ◽

Current Form ◽

Cognitive Behavioural ◽

Cognitive Behaviour

AbstractCognitive behavioural therapy (CBT) in its current form might not be acceptable to service users from a variety of backgrounds. Therefore, it makes sense to adapt CBT when working with diverse populations. Contributors to this special issue of theCognitive Behaviour Therapisthave tackled the issues around the cultural adaptation of CBT from various perspectives, using a variety of methods, and have addressed topics ranging from cultural adaptation to improving access to CBT. Here, I briefly summarize and discuss the papers in this special issue. I start with a systematic review of CBT for social anxiety across cultures. Seven articles cover aspects of adaptation of therapies for people from different backgrounds. Three papers discuss the issues of gender and sexuality when using CBT, while another three papers focus on refugees, asylum seekers and the homeless, and two papers describe the application of CBT with religious populations. Finally, there are seven papers on issues related to service delivery, practice and training and supervision when working with a diverse population. Collectively, papers in this special issue provide us with sufficient evidence that cultural considerations play a vital role when using CBT, offer practical suggestions for improving cultural competence and most importantly, can catalyse future research. However, the full potential of culturally adapted interventions will not be realized until and unless access to CBT is improved. Therefore, there is a need to build robust evidence to convince funders, policy makers and service managers.

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Can pain catastrophizing be changed in surgical patients? A scoping review

Canadian Journal of Surgery ◽

10.1503/cjs.015417 ◽

2018 ◽

pp. 311-318

Author(s):

Eric Gibson ◽

Marlis T. Sabo

Keyword(s):

Surgical Outcomes ◽

Pain Catastrophizing ◽

Behavioural Therapy ◽

Surgical Patients ◽

Future Research ◽

Surgical Patient ◽

Original Research ◽

Surgery Patient ◽

Cognitive Behavioural ◽

Before And After

Background: Catastrophizing, a coping style characterized by an exaggerated negative affect when experiencing or anticipating pain, is an important factor that adversely affects surgical outcomes. Various interventions have been attempted with the goal of reducing catastrophizing and, by extension, improving treatment outcomes. We performed a systematic review to determine whether catastrophizing can be altered in surgical patients and to present evidence for interventions aimed at reducing catastrophizing in this population. Methods: Using a scoping design, we performed a systematic search of MEDLINE and Embase. Studies reporting original research measuring catastrophizing, before and after an intervention, on the Pain Catastrophizing Scale (PCS) or Coping Strategies Questionnaire (CSQ) were selected. Studies were assessed for quality, the nature of the intervention and the magnitude of the effect observed. Results: We identified 47 studies that measured the change in catastrophizing score following a broad range of interventions in surgical patients, including surgery, patient education, physiotherapy, cognitive behavioural therapy, psychologist-directed therapy, nursing-directed therapy and pharmacological treatments. The mean change in catastrophizing score as assessed with the PCS ranged from 0 to –19, and that with the CSQ, from +0.07 to –13. Clinically important changes in catastrophizing were observed in 7 studies (15%). Conclusion: Catastrophizing was observed to be modifiable with an intervention in a variety of surgical patient populations. Some interventions produced greater reductions than others, which will help direct future research in the improvement of surgical outcomes.

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‘Message to Dentist’: Facilitating Communication with Dentally Anxious Children

Dentistry Journal ◽

10.3390/dj7030069 ◽

2019 ◽

Vol 7 (3) ◽

pp. 69

Author(s):

Helen Rodd ◽

Laura Timms ◽

Fiona Noble ◽

Sarah Bux ◽

Jenny Porritt ◽

...

Keyword(s):

Dental Anxiety ◽

Effective Means ◽

Young Patients ◽

Behavioural Therapy ◽

Self Report ◽

Dental Practice ◽

Negative Consequences ◽

Communication Aid ◽

Cognitive Behavioural ◽

Hospital Clinic

Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9–16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1–10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans.

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Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients

BMJ Open ◽

10.1136/bmjopen-2017-020842 ◽

2018 ◽

Vol 8 (3) ◽

pp. e020842 ◽

Cited By ~ 2

Author(s):

Federica Picariello ◽

Rona Moss-Morris ◽

Iain C Macdougall ◽

Sam Norton ◽

Maria Da Silva-Gane ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Behavioural Therapy ◽

Self Report ◽

Behavioural Responses ◽

Feasibility Randomised Controlled Trial ◽

Cognitive Behavioural ◽

Potential Benefits ◽

Randomised Controlled

IntroductionFatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients.MethodsWe aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue. Patients will be randomised individually (using a 1:1 ratio) to either a 4–6 weeks’ CBT-based intervention (intervention arm) or to a waiting-list control (control arm). The primary feasibility outcomes include descriptive data on numbers within each recruiting centre meeting eligibility criteria, rates of recruitment, numbers retained postrandomisation and treatment adherence. To assess the potential benefits of the cognitive-behavioural therapy for renal fatigue intervention, secondary self-report outcomes include measures of fatigue severity (Chalder Fatigue Questionnaire), fatigue-related functional impairment (Work and Social Adjustment Scale), sleep quality (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Changes in fatigue perceptions (Brief Illness Perception Questionnaire), cognitive and behavioural responses to fatigue (Cognitive and Behavioural Responses to Symptoms Questionnaire), sleep hygiene behaviours (Sleep Hygiene Index) and physical activity (International Physical Activity Questionnaire–short form) will also be explored. These self-report measures will be collected at baseline and 3 months postrandomisation. Nested qualitative interviews will be conducted postintervention to explore the acceptability of the intervention and identify any areas in need of improvement. The statistician and assessor will be blinded to treatment allocation.Ethics and disseminationA National Health Service (NHS) Research Ethics Committee approved the study. Any amendments to the protocol will be submitted to the NHS Committee and study sponsor.Trial registration numberISRCTN91238019;Pre-results.

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A Pragmatic Pilot Study Of Cognitive Behavioural Therapy For Insomnia Among People Living With HIV

10.32920/ryerson.14644653 ◽

2021 ◽

Author(s):

Tyler Gordon Tulloch

Keyword(s):

Pilot Study ◽

Sleep Disturbance ◽

Cognitive Behavioural Therapy ◽

Thematic Analysis ◽

Behavioural Therapy ◽

Future Research ◽

People Living With Hiv ◽

Cognitive Behavioural ◽

Living With Hiv ◽

Insomnia Severity

The prevalence of insomnia among people living with HIV (PWH) is considerably higher than in the general population. Cognitive, behavioural, and biopsychosocial explanations for this elevated prevalence have been proposed, but there is a lack of consensus in the literature. Sleep disturbance is associated with disrupted immune functioning at the cellular level and increased risk of contracting infectious diseases; therefore, insomnia may be particularly problematic for PWH. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment for insomnia, and is effective at treating insomnia among individuals with comorbid medical disorders. Surprisingly, no study has examined its efficacy among PWH. This pragmatic pilot study examined features of insomnia among 48 PWH and was the first study to examine sleep disturbance among PWH using American Academy of Sleep Medicine guidelines for evaluating chronic insomnia. On average, insomnia chronicity was 8.2 years and was of moderate severity. Psychiatric comorbidity was common, as were comorbid sleep disorders. Insomnia severity was associated with psychosocial variables including sleep effort, self-efficacy for sleep, depression, anxiety, stress, and social functioning-related quality of life. This study was also the first to examine safety, feasibility, acceptability, and intervention effects of CBT-I. These were examined among a subsample of 10 PWH using single-case interrupted time-series design. Thematic analysis was used to explore participant perceptions of CBT-I. Large effect sizes were observed for improvement in insomnia severity, sleep efficiency, and total wake time. Reliable and clinically significant reduction in insomnia severity was observed for all but one participant, and half met criteria for insomnia remission. Overall, CBT-I was an efficacious treatment for insomnia, and participant feedback was consistent with quantitative results. Participants viewed CBT-I as a safe and acceptable treatment for insomnia. Participant feedback identified preexisting needs, positive impacts and challenges of CBT-I, perceived mechanisms of change, and suggested modifications to tailor CBT-I for PWH. Given this preliminary support for the efficacy of CBT-I among PWH, future research should seek to demonstrate generalizability of these effects. Partnering with HIV community organizations may be important next step in conducting future research and increasing accessibility of CBT-I to PWH. Keywords: HIV, insomnia, cognitive behavioural therapy, pilot study, pragmatic trial, thematic analysis

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O005 Cognitive behavioural therapy and light dark therapy for postpartum insomnia symptoms: a randomised controlled trial

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.004 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A2-A3

Author(s):

S Verma ◽

N Quin ◽

L Astbury ◽

C Wellecke ◽

J Wiley ◽

...

Keyword(s):

Sleep Disturbance ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Future Research ◽

Depression And Anxiety ◽

Post Intervention ◽

Cognitive Behavioural ◽

Randomised Controlled ◽

Insomnia Symptoms

Abstract Introduction Symptoms of postpartum insomnia are common however interventions remain scarce. Cognitive Behavioural Therapy (CBT) and Light Dark Therapy (LDT) target distinct mechanisms to improve sleep. This randomised controlled superiority trial compared CBT and LDT against treatment-as-usual (TAU) in reducing maternal postpartum insomnia symptoms. Methods Nulliparous females 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores >7) were included; excluded were those at risk or with high medical/psychiatric needs. Eligible participants were randomised 1:1:1 to 6 weeks of CBT, LDT (gaining light upon awakening, night-time light avoidance) or TAU. Interventions were therapist-assisted through two telephone calls and included automated self-help emails over six weeks. Symptoms of insomnia (ISI; primary outcome), sleep disturbance, fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Latent growth models were used. Results 114 participants (mean age=32.2±4.6 years) were randomised. There were significantly greater reductions in insomnia and sleep disturbance in both intervention groups with very large effect sizes (d>1·4, p<0·0001) from baseline to post-intervention compared to TAU; improvements were maintained at one-month follow-up. There were greater reductions in fatigue symptoms in the CBT group (d=0.85, p<.0001) but not LDT (p=0.11) compared to TAU; gains were maintained for CBT at follow-up. Changes in sleepiness, depression and anxiety over time were non-significant compared to TAU (p-values>0.08). Conclusion Therapist-assisted CBT and LDT are both efficacious for reducing postpartum insomnia symptoms. Findings were mixed for fatigue, sleepiness and mood. Future research is needed on predictors of treatment response.

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