Acceptance and commitment therapy versus cognitive behavioral therapy for insomnia: A randomized controlled trial.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Journal of consulting and clinical psychology Pub Date : 2024-06-01 DOI:10.1037/ccp0000881

Renatha El Rafihi-Ferreira, Rosa Hasan, Andrea C Toscanini, Ila M P Linares, Daniel Suzuki Borges, Israel P Brasil, Marwin Carmo, Francisco Lotufo Neto, Charles Morin

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引用次数: 0

Abstract

Objective: To compare the effectiveness of an acceptance and commitment therapy (ACT)-based protocol and cognitive behavior therapy (CBT) for insomnia in adults.

Method: The participants comprised 227 adults with insomnia. They were randomized to six weekly group sessions consisting of acceptance and commitment therapy for insomnia (n = 76), cognitive behavioral therapy for insomnia (n = 76), or waitlist (WL; n = 75).

Results: Both treatment modalities significantly reduced insomnia severity with large effect sizes in the posttreatment phase. These results were maintained during the follow-up period with large effect sizes. CBT was superior to ACT in reducing the Insomnia Severity Index at posttreatment and follow-up, with a small effect size. ACT was superior to WL at posttreatment and at follow-up, with a moderate effect size. The treatment response and remission ratios were higher with CBT at posttreatment and similar at 6-month follow-up for both therapies, as ACT made further gains in response and remission. ACT had a significantly higher proportion of response and remission than WL in both periods (posttreatment and follow-up). Both therapies improved daytime functioning at both posttreatment and follow-up, with few differential changes across the groups.

Conclusions: Both cognitive behavior therapy and acceptance and commitment therapy are effective, with CBT showing superiority and ACT showing delayed improvement. ACT has proven to be an effective therapy, especially in the long term, even in the absence of behavioral techniques such as stimulus control and sleep restriction, and it is a viable option for those who have difficulties adhering to behavioral techniques. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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接受和承诺疗法与认知行为疗法治疗失眠：随机对照试验。

目的比较基于接纳与承诺疗法（ACT）的方案和认知行为疗法（CBT）对成人失眠症的治疗效果：参与者包括 227 名失眠症成人。他们被随机分配到每周六次的小组治疗中，其中包括接受和承诺疗法治疗失眠（76 人）、认知行为疗法治疗失眠（76 人）或候补名单（WL；75 人）：结果：两种治疗方式都能明显减轻失眠症的严重程度，且在治疗后阶段具有较大的效应大小。这些结果在随访期间得以保持，且效果显著。在治疗后和随访期间，CBT 在降低失眠严重程度指数方面优于 ACT，但影响大小较小。在治疗后和随访期间，ACT优于WL，效果中等。在治疗后，CBT 的治疗应答率和缓解率更高，而在 6 个月的随访中，两种疗法的应答率和缓解率相近，因为 ACT 在应答率和缓解率方面取得了进一步提高。在两个阶段（治疗后和随访），ACT 的应答和缓解比例都明显高于 WL。在治疗后和随访期间，两种疗法都改善了患者的日间功能，但各组之间的差异不大：结论：认知行为疗法和接纳与承诺疗法都很有效，其中认知行为疗法显示出优越性，接纳与承诺疗法显示出延迟改善。事实证明，接纳与承诺疗法是一种有效的疗法，尤其是在长期治疗中，即使没有采用刺激控制和睡眠限制等行为技术，对于那些难以坚持采用行为技术的人来说，接纳与承诺疗法也是一种可行的选择。(PsycInfo Database Record (c) 2024 APA，保留所有权利）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.