scholarly journals Can an E-Mail-Delivered CBT for Insomnia Validated in the West Be Effective in the East? A Randomized Controlled Trial

2021 ◽  
Vol 19 (1) ◽  
pp. 186
Author(s):  
Isa Okajima ◽  
Noriko Tanizawa ◽  
Megumi Harata ◽  
Sooyeon Suh ◽  
Chien-Ming Yang ◽  
...  
Keyword(s):  
Young Adults ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Sleep Hygiene ◽  
Anxiety And Depression ◽  
Post Intervention ◽  
Significant Interaction Effect ◽  
Sleep Arousal ◽  
E Mail ◽  
Insomnia Severity

This study examined the effects of an e-mail-delivered cognitive behavioral therapy for insomnia (CBT-I), validated in Western countries, on insomnia severity, anxiety, and depression in young adults with insomnia in Eastern countries, particularly Japan. This prospective parallel-group randomized clinical trial included college students with Insomnia Severity Index (ISI) scores of ten or higher. Participants were recruited via advertising on a university campus and randomized to an e-mail-delivered CBT-I (REFRESH) or self-monitoring (SM) with sleep diaries group. The primary outcomes were insomnia severity, anxiety, and depression; secondary outcomes were sleep hygiene practices, dysfunctional beliefs, sleep reactivity, and pre-sleep arousal. All measurements were assessed before and after the intervention. A total of 48 participants (mean (SD) age, 19.56 (1.86) years; 67% female) were randomized and included in the analysis. The results of the intent-to-treat analysis showed a significant interaction effect for insomnia severity, anxiety, depression, sleep hygiene practice, and pre-sleep arousal. Compared with the SM group, the REFRESH group was more effective in reducing insomnia severity (Hedges’ g = 1.50), anxiety (g = 0.97), and depression (g = 0.61) post-intervention. These findings suggest that an e-mail-delivered CBT-I may be an effective treatment for young adults with elevated insomnia symptoms living in Japan.

374 Cognitive Behavioral Therapy with Exercise in Adults with Insomnia and Short Sleep: Daytime Function Outcomes from a Pilot Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A149-A149
Author(s):  
Andrew Kubala ◽  
Mara Egeler ◽  
Daniel Buysse ◽  
Martica Hall ◽  
Emma Barinas-Mitchell ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Behavioral Therapy ◽  
Exercise Program ◽  
Short Sleep Duration ◽  
Post Intervention ◽  
Short Sleep ◽  
Supervised Exercise ◽  
Daytime Function ◽  
Supervised Exercise Program ◽  
Insomnia Severity

Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) is efficacious, but there is mixed evidence as to whether improvement is blunted in adults with insomnia and short sleep duration. Exercise training can reduce physiologic hyperarousal and may increase homeostatic sleep drive, which could potentiate CBT-I treatment effects. This pilot study explored changes in self-reported outcomes from a CBT-I intervention augmented by exercise training in a sample of adults with insomnia and objective short sleep duration. Methods Eight adults (50% female, 62.5% white) with insomnia disorder and short sleep duration (mean actigraphic TST <6.5 hr) completed a 12-week single-arm trial. Participants self-administered the online “Sleep Healthy Using the Internet” (SHUT-I) CBT-I program with additional staff guidance while completing a supervised exercise program (EX; 150 min/wk of moderate-intensity aerobic exercise and 2 days/wk of strength training). Participants completed assessments of self-reported sleep and daytime function pre- and post-intervention, including the Insomnia Severity Index (ISI), Flinders Fatigue Scale (FFS), Ford Insomnia Response to Stress Test (FIRST), Perceived Stress Scale (PSS), and Epworth Sleepiness Scale (ESS). Differences between timepoints were analyzed using paired t-tests and Cohen’s d effect size calculations. Results Insomnia severity significantly decreased after the intervention (ISI: p<0.001, d=2.99), with 75% reporting post-intervention ISI ≤ 7. Likewise, fatigue significantly decreased after the intervention (FFS: p=0.032, d=0.95). Symptoms of stress-related sleep reactivity and stress were also reduced (FIRST: p=0.012, d=1.19; PSS: p=0.014, d=1.14). Though nonsignificant, large reductions in sleepiness were additionally observed (ESS: p=0.058, d=0.80). Conclusion In this pilot trial among patients with insomnia and short sleep duration, online CBT-I plus a supervised exercise program resulted in a significant reduction in insomnia severity. The intervention also produced large and meaningful reductions in fatigue and stress, which are common daytime impairments in patients with insomnia. Future research should attempt to disentangle the independent contributions of CBT-I and exercise on outcomes in this population. Support (if any) NIH: K23HL118318

scholarly journals Bot to the Rescue? Effects of a Fully Automated Conversational Agent on Anxiety and Depression: A Randomized Controlled Trial

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Gutu SM ◽  
◽  
Cosmoiu A ◽  
Cojocaru D ◽  
Turturescu D ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Controlled Trial ◽  
Anxiety And Depression ◽  
Conversational Agents ◽  
Web Based ◽  
Time Interaction ◽  
Transdiagnostic Factors ◽  
Secondary Outcomes ◽  
Intent To Treat ◽  
Main Effects

Web-based conversational agents powered by Artificial Intelligence (AI) and rooted in cognitive-behavioral therapy have been proven efficacious in alleviating the symptoms of anxiety and depression, when compared to passive controls. However, the benefits of a fully automated agent vs. active controls have not yet been examined. Furthermore, the potential impact of such interventions on the transdiagnostic factors underlying anxiety and depression is not known. To elucidate this, 95 adults were randomized to receive (1) a 2-week intervention with an AI-powered chatbot (Woebot) (n=39) or (2) regular psychoeducational materials (n=54). In completers’ analyses, significant main effects of time were obtained for one of the primary outcomes, anxiety, and for the secondary outcomes, transdiagnostic factors, with both groups showing decreased anxiety and intolerance of uncertainty and increased rumination, selfcompassion, guilt and shame. No group by time interaction effects were found for either of the primary outcomes, depression and anxiety, or for the secondary outcomes. Intent-to-Treat analyses also revealed no significant effects of group on the primary or secondary outcomes. Our findings point to the necessity of further research to better understand the areas where chatbots might bring benefits superior to those obtained through simple and inexpensive strategies.

Improved Mood Boosts Memory Training Gains in Older Adults With Subjective Memory Complaints: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Shufei Yin ◽  
Xinyi Zhu ◽  
Rui Li ◽  
Lijuan Huo ◽  
Weicong Ren ◽  
...  
Keyword(s):  
Older Adults ◽  
Group Counseling ◽  
Controlled Trial ◽  
Memory Performance ◽  
Anxiety And Depression ◽  
Memory Training ◽  
Depression And Anxiety ◽  
Subjective Memory ◽  
Post Intervention ◽  
Symptoms Of Depression

Abstract Objective: Older adults with subjective memory complaints (SMC) have a higher risk of dementia and commonly demonstrate symptoms of depression and anxiety. The study aimed to examine the effect of a memory training program for individuals with SMC, and whether memory training combined with group counseling aimed at alleviating depression and anxiety would boost memory training gains.Design: A three-armed, double-blind, randomized controlled trial.Setting and Participants: Community-dwelling older adults with SMC, aged ≥ 60 years.Methods: Participants (n = 124) were randomly assigned to memory training (MT), group counseling (GC), or GC+MT intervention. The GT+MT group received 4-hour group counseling followed by a 4-week memory training, while the MT group attended reading and memory training, and the GC group received group counseling and health lectures. Cognitive function and symptoms of depression and anxiety were assessed at baseline, mid-, and post-intervention. The GC+MT group and GC group had resting-state functional magnetic resonance imaging at mid- and post-intervention.Results: After group counseling, the GC+MT and GC groups showed reduced symptoms of anxiety and depression, compared to the MT group. Memory training enhanced memory performance in both MT and GC+MT groups, but the GC+MT group demonstrated larger memory improvement (Cohen’s d = 0.96) than the MT group (Cohen’s d = 0.62). Amygdala-hippocampus connectivity was associated with improved mood and memory gains.Conclusion and Implications: Group counseling reduced symptoms of anxiety and depression, and memory training enhanced memory performance. Specifically, improved mood induced larger memory training effects. The results suggest that it may need to include treatment for depression and anxiety in memory intervention for older adults with SMC.Trial Registration: ChiCTR-IOR-15006165 in the Chinese Clinical Trial Registry.

scholarly journals Cognitive behavioral therapy for insomnia among young adults who are actively drinking: a randomized pilot trial

SLEEP ◽  
2020 ◽  
Author(s):  
Mary Beth Miller ◽  
Chelsea B Deroche ◽  
Lindsey K Freeman ◽  
Chan Jeong Park ◽  
Nicole A Hall ◽  
...  
Keyword(s):  
Young Adults ◽  
Alcohol Use ◽  
Cognitive Behavioral Therapy ◽  
Binge Drinking ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Cognitive Behavioral ◽  
Wrist Actigraphy ◽  
Insomnia Severity

Abstract Study Objectives More than half of young adults at risk for alcohol-related harm report symptoms of insomnia. Insomnia symptoms, in turn, have been associated with alcohol-related problems. Yet one of the first-line treatments for insomnia (Cognitive Behavioral Therapy for Insomnia or CBT-I) has not been tested among individuals who are actively drinking. This study tested (1) the feasibility and short-term efficacy of CBT-I among binge-drinking young adults with insomnia and (2) improvement in insomnia as a predictor of improvement in alcohol use outcomes. Methods Young adults (ages 18–30 years, 75% female, 73% college students) who met criteria for Insomnia Disorder and reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomly assigned to 5 weekly sessions of CBT-I (n = 28) or single-session sleep hygiene (SH, n = 28). All participants wore wrist actigraphy and completed daily sleep surveys for 7+ days at baseline, posttreatment, and 1-month follow-up. Results Of those randomized, 43 (77%) completed posttreatment (19 CBT-I, 24 SH) and 48 (86%) completed 1-month follow-up (23 CBT-I, 25 SH). CBT-I participants reported greater posttreatment decreases in insomnia severity than those in SH (56% vs. 32% reduction in symptoms). CBT-I did not have a direct effect on alcohol use outcomes; however, mediation models indicated that CBT-I influenced change in alcohol-related consequences indirectly through its influence on posttreatment insomnia severity. Conclusions CBT-I is a viable intervention among individuals who are actively drinking. Research examining improvement in insomnia as a mechanism for improvement in alcohol-related consequences is warranted. Trial Registration U.S. National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT03627832, registration #NCT03627832

scholarly journals Cognitive behavioral therapy positively affects fatigue in patients with multiple sclerosis: Results of a randomized controlled trial

2017 ◽  
Vol 23 (11) ◽  
pp. 1542-1553 ◽  
Author(s):  
Lizanne E van den Akker ◽  
Heleen Beckerman ◽  
Emma H Collette ◽  
Jos WR Twisk ◽  
Gijs Bleijenberg ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Control Treatment ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Societal Participation

Background: Fatigue is a common symptom in multiple sclerosis (MS) and often restricts societal participation. Cognitive behavioral therapy (CBT) may alleviate MS-related fatigue, but evidence in literature is inconclusive. Objective: To evaluate the effectiveness of CBT to improve MS-related fatigue and participation. Methods: In a multi-center, assessor-masked, randomized controlled trial, participants with severe MS-related fatigue were assigned to CBT or control treatment. CBT consisted of 12 individual sessions with a psychologist trained in CBT, the control treatment consisted of three consultations with a MS nurse, both delivered over 16 weeks. Assessments were at baseline, 8, 16 (i.e. post-intervention), 26, and 52 weeks post-baseline. Primary outcomes were the Checklist Individual Strength-fatigue subscale (CIS20r fatigue) and the Impact on Participation and Autonomy questionnaire (IPA). Data were analyzed according to the intention-to-treat principle, using mixed-model analysis. Results: Between 2011 and 2014, 91 patients were randomized (CBT: n = 44; control: n = 47). Between-group analysis showed a positive post-intervention effect for CBT on CIS20r fatigue (T16: −6.7 (95% confidence interval (CI) = −10.7; −2.7) points) that diminished during follow-up (T52: 0.5 (95% CI = −3.6; 4.4)). No clinically relevant effects were found on societal participation. Conclusion: Severe MS-related fatigue can be reduced effectively with CBT in the short term. More research is needed on how to maintain this effect over the long term.

Treating anxiety and depression in young adults: A randomised controlled trial comparing clinician-guided versus self-guided Internet-delivered cognitive behavioural therapy

2017 ◽  
Vol 52 (7) ◽  
pp. 668-679 ◽  
Author(s):  
Blake F Dear ◽  
Vincent J Fogliati ◽  
Rhiannon Fogliati ◽  
Bareena Johnson ◽  
Olivia Boyle ◽  
...  
Keyword(s):  
Young Adults ◽  
Cognitive Behaviour Therapy ◽  
Large Scale ◽  
Satisfaction With Life ◽  
Controlled Trial ◽  
Post Treatment ◽  
Anxiety And Depression ◽  
Behaviour Therapy ◽  
Advantages And Disadvantages ◽  
Cognitive Behaviour

Background: Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-based treatments for anxiety and depression. Objective: The aim of this study was to compare the efficacy of an Internet-delivered cognitive behaviour therapy intervention designed for adults aged 18–24 years, when delivered in clinician-guided versus self-guided formats. Design: The intervention, the Mood Mechanic Course, is a transdiagnostic treatment that simultaneously targets symptoms of anxiety and depression using cognitive and behavioural skills. The brief intervention comprised four lessons, delivered over 5 weeks. Following a brief telephone interview, young adults ( n = 191) with symptoms of anxiety and depression were randomly allocated to either (1) clinician-guided treatment ( n = 96) or (2) self-guided treatment ( n = 95). Results: At post treatment, large reductions (average improvement; clinician guided vs self-guided) were observed in symptoms of anxiety (44% vs 35%) and depression (40% vs 31%) in both groups. Significant improvements were also observed in general psychological distress (33% vs 29%), satisfaction with life (18% vs 15%) and disability (36% vs 29%). No marked or consistent differences in clinical outcomes emerged between conditions at post-treatment, at 3-month or 12-month follow-up. Satisfaction was high with both treatment formats, but slightly higher for clinician-guided treatment. Conclusion: These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine the short- and long-term advantages and disadvantages of different models of support.

Videoconference-Based Cognitive Behavioral Therapy in Symptomatic Panic Disorder Following Primary Pharmacotherapy: Randomized, Assessor-Blinded, Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Yoichi Seki ◽  
Ryo Takemura ◽  
Chihiro Sutoh ◽  
Remi Noguchi ◽  
Yoko Okamoto ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Medical Information ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Cognitive Behavioral ◽  
University Hospital ◽  
Open Label ◽  
Post Intervention

BACKGROUND Background: Given the difficulty in accessing cognitive behavioral therapy, pharmacotherapy remains the standard of care for panic disorder (PD). OBJECTIVE Objectives: This study aimed to determine the effectiveness of videoconference-based cognitive behavioral therapy (VCBT) for patients who remain symptomatic after primary pharmacotherapy as an adjunct to usual care (UC) when compared with UC alone. METHODS Methods: This prospective, randomized, open-label endpoint trial enrolled 30 patients with PD who did not respond to primary pharmacotherapy, including antidepressants and anxiolytics, after ≥8 weeks of therapy, who underwent VCBT (n=15) or UC (n=15) between November 2017 and March 2020 at Chiba University Hospital in Chiba, Japan. They were evaluated at screening, week 0 (baseline), week 8 (mid-intervention), and week 16 (post-intervention). The primary outcome was the change in the PD Severity Scale (PDSS) score at week 16 from baseline. RESULTS Results: After 16 weeks, the adjusted mean changes in the PDSS score from baseline were −7.92 and 0.75 in the VCBT and UC groups, respectively, with a between-group difference of −8.67 (95% CI: −11.80 to −5.54, P<.0001). A higher proportion of patients in the VCBT group responded to treatment (≥40% reduction in the PDSS score at week 16) and experienced remission (PDSS score <8 points at week 8) than those in the UC group (P<.0001). CONCLUSIONS Conclusions: Our results suggest that VCBT is an effective treatment adjunct to UC in patients with PD who remain symptomatic following primary pharmacotherapy and improves PD symptoms in these patients. CLINICALTRIAL Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000029987; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000034247.

A randomized controlled trial of cognitive behavior therapy for reducing anxiety and depressive symptoms in patients with locoregional advanced nasopharyngeal carcinoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12121-12121
Author(s):  
Feng Liu ◽  
Shengnan Fu ◽  
Yanzhu Chen ◽  
Ouying Yan ◽  
Xiangwei Wu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Randomized Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Depression Scale ◽  
Response Rates ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Treatment As Usual

12121 Background: The purpose of this randomized trial was to compare the efficacy of cognitive behavioral therapy (CBT) versus treatment as usual (TAU) on anxiety and depression, response rates and acute adverse events in patients with locoregional advanced nasopharyngeal carcinoma (NPC) receiving chemoradiotherapy. To the best of our knowledge, this is the first randomized trial evaluating the effect of CBT for depression and anxiety in patients with locoregional advanced NPC treated with chemoradiotherapy. Methods: A total of 202 patients with diagnosis of stage III-IVa (8th AJCC) NPC were randomly assigned to receive CBT plus chemoradiotherapy (CBT group, n = 101) or treatment as usual (TAU) plus chemoradiotherapy (TAU group, n = 101). Patients in the CBT group received a series of six CBT sessions for 6 weeks during concurrent chemoradiotherapy. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS) score at baseline, the completion of chemoradiotherapy, 1 and 3 months after chemoradiotherapy. Response rates and adverse events were also evaluated. This trial is registered with chictr.org.cn, number ChiCTR2000034701. Results: Patients in the CBT group showed significantly less depression and anxiety than patients in the TAU group after the completion of CBT (P < 0.01). Complete response (CR) rate was significantly higher in CBT group than in TAU group (100% vs. 93.1%，P = 0.014). Compared with the TAU group, the CBT group showed a significantly lower incidence of acute adverse events including anemia, fatigue, mucositis, insomnia and weight losing (P < 0.05). Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and anxiety symptoms. CBT combined with chemoradiotherapy is associated with improved response rates, with reduced incidence of acute toxic effects in patients with locoregional advanced nasopharyngeal carcinoma. Clinical trial information: ChiCTR2000034701.

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