Insomnia treatment effects on negative emotionality among veterans in treatment for alcohol use disorder.

IF 3 Q2 SUBSTANCE ABUSE
Alcohol (Hanover, York County, Pa.) Pub Date : 2024-11-01 Epub Date: 2024-10-28 DOI:10.1111/acer.15436
Mary Beth Miller, Ryan W Carpenter, Melissa Nance, Lindsey K Freeman, Jane Metrik, Brian Borsari, Christina S McCrae, Jennifer E Merrill, Kate B Carey, John E McGeary
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Abstract

Background: Insomnia symptoms are pervasive and persistent in alcohol use disorder (AUD), though little is known about the mechanisms that underlie this association. We previously found that cognitive behavioral therapy for insomnia (CBT-I) reduced alcohol-related problems among veterans by improving insomnia severity (NCT03806491). In this planned secondary analysis of the same clinical trial data, we tested negative emotionality as one potential mechanism to explain this effect. Specifically, we tested the change in negative emotionality as a mediator of the association between change in insomnia symptoms and alcohol-related outcomes (craving, heavy drinking frequency, and alcohol-related problems).

Methods: Participants were 67 veterans in treatment for AUD who also met the criteria for insomnia disorder (91% male, 84% White, average age = 46.3 years). Participants were randomized to five sessions of CBT-I or a single-session sleep hygiene control. Assessments occurred at baseline, immediately posttreatment (~6 weeks after baseline), and at 6-week follow-up. Measures included the Insomnia Severity Index, Penn Alcohol Craving Scale, Timeline Followback, and Short Inventory of Problems. We created a latent negative emotionality indicator based on five validated and reliable measures of negative emotionality.

Results: Contrary to hypotheses, CBT-I did not improve negative emotionality relative to sleep hygiene control. However, across both treatment conditions, decreases in insomnia symptoms from baseline to posttreatment were associated with concurrent decreases in negative emotionality, which in turn predicted reductions in alcohol craving and heavy drinking.

Conclusion: Negative emotionality may help explain links between insomnia symptoms and alcohol-related outcomes.

失眠治疗对接受酒精使用障碍治疗的退伍军人负面情绪的影响。
背景:失眠症状在酒精使用障碍(AUD)患者中普遍存在且持续存在,但人们对这种关联的机制知之甚少。我们之前发现,失眠认知行为疗法(CBT-I)通过改善失眠严重程度,减少了退伍军人中与酒精相关的问题(NCT03806491)。在计划对同一临床试验数据进行的二次分析中,我们测试了负性情绪作为解释这种效应的一种潜在机制。具体来说,我们测试了负性情绪变化作为失眠症状变化与酒精相关结果(渴求、大量饮酒频率和酒精相关问题)之间关联的中介因素的作用:参与者为 67 名正在接受 AUD 治疗的退伍军人,他们也符合失眠症的标准(91% 为男性,84% 为白人,平均年龄为 46.3 岁)。参与者被随机分配到五个疗程的 CBT-I 或一个疗程的睡眠卫生对照组。分别在基线、治疗后(基线后约 6 周)和 6 周随访时进行评估。评估项目包括失眠严重程度指数、宾州酒精渴求量表、时间轴回溯和问题简表。我们根据五种经过验证的可靠负性情绪测量方法创建了一个潜在负性情绪指标:与假设相反,与睡眠卫生控制相比,CBT-I 并未改善负性情绪。然而,在两种治疗条件下,失眠症状从基线到治疗后的减少与负性情绪性的同时减少有关,而负性情绪性的减少又预示着酒精渴求和大量饮酒的减少:结论:负性情绪可能有助于解释失眠症状与酒精相关结果之间的联系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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