远程保健认知行为疗法对改善 6-17 岁儿童睡眠和噩梦的疗效

L. Cromer, Sarah Beth Bell, Lauren E. Prince, Nicholas Hollman, Elissar El Sabbagh, Tara R. Buck
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摘要

这项研究考察了针对儿童噩梦的五模块认知行为疗法(CBT-NC)对改善睡眠的疗效。46 名年龄在 6-17 岁、有睡眠问题且至少每周做一次长期噩梦的青少年被随机分配到治疗组(n = 23)或候补治疗组(n = 23),采用的是四区随机设计。参与者中,65%(n = 30)为白人,4%(n = 2)为黑人/非洲裔美国人,2%(n = 1)为亚裔美国人,13%(n = 6)为美洲原住民或太平洋岛民,15%(n = 7)为多种族。50%的参与者(n = 23)是顺性别女孩,35%是顺性别男孩(n = 16),7%是变性男孩(n = 3),9%是非二元性别(n = 4)。基线噩梦持续时间从 6 个月到 13.5 年不等。治疗方法采用了暴露、放松和重述疗法,用于治疗成人与创伤有关的噩梦,并增加了认知行为疗法的元素,用于治疗儿童失眠症。心理教育包括睡眠与噩梦、放松、焦虑管理和睡眠卫生等主题;青少年在噩梦暴露和重述疗法的指导下接受治疗。与等待治疗组相比,治疗组的觉醒夜数(Cohen's d = 1.08)、每周噩梦数(Cohen's d = 0.82)和噩梦困扰(Cohen's d = 1.05)均有显著改善。从治疗前到治疗后,整个治疗组的家长报告的青少年睡眠情况都有所改善(p < 0.001),但治疗组与等待组的主体间分析未达到统计学意义(p = 0.05)。本研究支持 CBT-NC 对于改善青少年的睡眠维持、噩梦频率和痛苦以及其他心理健康问题的疗效。本研究还提供了可能改善自杀想法和行为的初步证据。https://clinicaltrials.gov/study/NCT05588739,标识符:NCT05588739。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of a telehealth cognitive behavioral therapy for improving sleep and nightmares in children aged 6–17
This study examined the efficacy of a five-module cognitive behavioral therapy for nightmares in children (CBT-NC) and improving sleep.Forty-six youth aged 6–17 years with sleep problems and at least weekly chronic and distressing nightmares were randomized to treatment (n = 23) or waiting list (n = 23) using a block four randomized design. Among participants, 65% (n = 30) were White, 4% (n = 2) were Black/African American, 2% (n = 1) were Asian American, 13% (n = 6) were Native American or Pacific Islander, and 15% (n = 7) were multiracial. Fifty percent of participants (n = 23) were cisgender girls, 35% were cisgender boys (n = 16), 7% were transgender boys (n = 3), and 9% were gender non-binary (n = 4). The baseline nightmare persistence ranged from 6 months to 13.5 years. The treatment adapted exposure, relaxation, and rescription therapy for trauma-related nightmares in adults and added elements of cognitive behavioral therapy for insomnia in children. Psychoeducation included topics of sleep and nightmares, relaxation, anxiety management, and sleep hygiene; the youth were guided through nightmare exposure and rescription.There was a statistically significant improvement in the number of nights with awakening (Cohen's d = 1.08), the number of weekly nightmares (Cohen's d = 0.82), and nightmare distress (Cohen's d = 1.05) for the treatment group compared to the wait-list group. Parent-reported youth sleep improved for the entire group from pretreatment to posttreatment (p < 0.001) but did not reach statistical significance for between-subjects analyses of the treatment group compared to the wait-list group (p = 0.05). Between-subjects analyses saw improvement for the treatment group compared to the wait-list group on internalizing and externalizing problems and suicidal thoughts and behaviors.This study supports the efficacy of CBT-NC for improving sleep maintenance, nightmare frequency and distress, and other mental health difficulties in youth. Preliminary evidence of possibly improving suicidal thinking and behavior is also presented.https://clinicaltrials.gov/study/NCT05588739, identifier: NCT05588739.
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