Details

Autor(en) / Beteiligte

• Pigeon, WR
• Crean, H
• Cerulli, C
• Walsh, P
• Gallegos, A
• Bishop, TM
• Casey, C
• Gorman, C
• Bui, A
• Oleynk, C
• Heffner, KL

Titel

0339 DOES COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA ENHANCE THE EFFECTS OF COGNITIVE PROCESSING THERAPY FOR PTSD AMONG SURVIVORS OF INTERPERSONAL VIOLENCE?

Ist Teil von

• Sleep (New York, N.Y.), 2017-04, Vol.40 (suppl_1), p.A126-A126

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Introduction: Insomnia frequently co-occurs with posttraumatic stress disorder (PTSD). Evidence-based trauma treatments like cognitive processing therapy (CPT) are efficacious, but do not directly target insomnia. We tested whether delivering cognitive behavioral therapy for insomnia (CBT-I) followed by CPT, produced greater reductions in symptom severity compared to CPT alone in a unique and underserved population of survivors of interpersonal violence (IPV). Methods: Over 2500 individuals were approached in family court and women’s shelters and 797 agreed to be screened. A total of 138 met eligibility criteria including past-year IPV exposure and diagnostic criteria for PTSD, Major Depression (MDD) and insomnia. We randomized 110 subjects to individual CBT-I (4 sessions) followed by CPT (12 sessions) or Attention Control (AC; 4 supportive phone calls) followed by CPT. Assessments occurred at baseline (T1), after CBT-I/AC (T2), and after CPT (T3) and included the Insomnia Severity Index (ISI), the Clinician-Administered PTSD Scale (CAPS), and the Hamilton Rating Scale for Depression (HRSD). General linear models with repeated measures tested time x group interactions from T1-T2 and across T1-T2-T3, for ISI, CAPS and HRSD total scores. Results: The sample was diverse (50% minorities), socioeconomically disadvantaged, mostly female, and had a mean age of 35.4. Mean baseline severity scores were: ISI=20.5, CAPS=72.1 and HRSD=24.9. CBT-I and AC groups did not differ by demographic factors or clinical severity at baseline. Time(T1,T2) x group interactions were significant for all outcomes with a greater decline in the CBT-I condition on the ISI (F(1,81)=28.4; p<.001), HRSD (F(1,81)=23.8; p<.001), and CAPS (F(1,81)=10.1; p<.01). Using all three time points, time x group interactions indicated significantly greater declines in the CBT-I+CPT condition, compared to AC+CPT, on the ISI (F(2,56)=8.2; p<.01), HRSD (F(2,56)=9.8; p<.01), and CAPS (F(2,56)=7.7; p<.01). Notably, the mean reduction in CAPS score from T1 to T3 was 33.3(SD=22.6) in the CBT-I+CPT condition compared to 17.0(15.5) in the AC+CPT condition. Conclusion: The findings suggest that CBT-I effectively reduces insomnia severity in patients with IPV who have concurrent PTSD and MDD and, in addition, augments the effects of subsequent CPT on PTSD and depression symptoms. Support (If Any): R01NR013909.