Improvements of adolescent psychopathology after insomnia treatment: results from a randomized controlled trial over 1 year / E. J. DE BRUIN in Journal of Child Psychology and Psychiatry, 59-5 (May 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.509-522 Titre : Improvements of adolescent psychopathology after insomnia treatment: results from a randomized controlled trial over 1 year Type de document : Texte imprimé et/ou numérique Auteurs : E. J. DE BRUIN, Auteur ; Susan M. BOGELS, Auteur ; F. J. OORT, Auteur ; A. M. MEIJER, Auteur Article en page(s) : p.509-522 Langues : Anglais (eng) Mots-clés : Adhd  Cognitive behavioural therapy  adolescents  anxiety  depression  insomnia  psychopathology  sleep Index. décimale : PER Périodiques Résumé : BACKGROUND: Adolescent insomnia can be treated effectively with cognitive behavioural therapy for insomnia (CBTI). However, little is known about effects of CBTI on psychopathology in adolescents. This study aimed to investigate whether (a) CBTI improves psychopathology in Internet- (IT) and face-to-face group treatment (GT) compared to waitlist (WL), (b) improvement in psychopathology can be attributed to reduced insomnia, (c) improvement in psychopathology remains stable for up to 1 year. METHODS: One hundred and sixteen participants (age = 15.6 years, 25% males) with DSM-5 insomnia, were randomly assigned to IT, GT or WL. CLINICAL TRIAL REGISTRATION: http://www.controlledtrials.com (ISRCTN33922163). Assessments of psychopathology, insomnia and objectively and subjectively measured sleep occurred at baseline, post-treatment, and at 2-, 6- and 12-month follow-up. Multilevel and mediation analyses were run to test hypotheses. The CBTI protocol, 'Sleeping Smart' for both IT and GT consisted of six weekly sessions and a booster session after 2 months. RESULTS: Psychopathology symptoms, insomnia and sleep problems as measured by actigraphy and sleep logs decreased substantially in IT and GT compared with WL at 2-month follow-up with medium to large effect sizes (ESs). Psychopathology symptoms remained stable or further improved for up to 12-month follow-up. ESs at 12-month follow-up for IT and GT were respectively: affective (d = -0.87 and -0.97), anxiety (d = -0.81 for IT), somatic (d = -0.38 and d = -0.52), oppositional (d = -0.42 for GT) and attention deficit hyperactivity disorder (ADHD) problems (d = -0.47 and -0.46). Mediation analyses indicated that reduction of insomnia symptoms after CBTI fully mediated the effects of CBTI on affective and anxiety problems, and partially mediated the effect on ADHD problems. CONCLUSIONS: This is the first study demonstrating that Internet and face-to-face CBT for insomnia achieves long-term reduction in adolescent psychopathology and does so by improving insomnia. This finding can have profound implications for youth mental health care. En ligne : http://dx.doi.org/10.1111/jcpp.12834 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359 [article] Improvements of adolescent psychopathology after insomnia treatment: results from a randomized controlled trial over 1 year [Texte imprimé et/ou numérique] / E. J. DE BRUIN, Auteur ; Susan M. BOGELS, Auteur ; F. J. OORT, Auteur ; A. M. MEIJER, Auteur . - p.509-522. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.509-522 Mots-clés : Adhd  Cognitive behavioural therapy  adolescents  anxiety  depression  insomnia  psychopathology  sleep Index. décimale : PER Périodiques Résumé : BACKGROUND: Adolescent insomnia can be treated effectively with cognitive behavioural therapy for insomnia (CBTI). However, little is known about effects of CBTI on psychopathology in adolescents. This study aimed to investigate whether (a) CBTI improves psychopathology in Internet- (IT) and face-to-face group treatment (GT) compared to waitlist (WL), (b) improvement in psychopathology can be attributed to reduced insomnia, (c) improvement in psychopathology remains stable for up to 1 year. METHODS: One hundred and sixteen participants (age = 15.6 years, 25% males) with DSM-5 insomnia, were randomly assigned to IT, GT or WL. CLINICAL TRIAL REGISTRATION: http://www.controlledtrials.com (ISRCTN33922163). Assessments of psychopathology, insomnia and objectively and subjectively measured sleep occurred at baseline, post-treatment, and at 2-, 6- and 12-month follow-up. Multilevel and mediation analyses were run to test hypotheses. The CBTI protocol, 'Sleeping Smart' for both IT and GT consisted of six weekly sessions and a booster session after 2 months. RESULTS: Psychopathology symptoms, insomnia and sleep problems as measured by actigraphy and sleep logs decreased substantially in IT and GT compared with WL at 2-month follow-up with medium to large effect sizes (ESs). Psychopathology symptoms remained stable or further improved for up to 12-month follow-up. ESs at 12-month follow-up for IT and GT were respectively: affective (d = -0.87 and -0.97), anxiety (d = -0.81 for IT), somatic (d = -0.38 and d = -0.52), oppositional (d = -0.42 for GT) and attention deficit hyperactivity disorder (ADHD) problems (d = -0.47 and -0.46). Mediation analyses indicated that reduction of insomnia symptoms after CBTI fully mediated the effects of CBTI on affective and anxiety problems, and partially mediated the effect on ADHD problems. CONCLUSIONS: This is the first study demonstrating that Internet and face-to-face CBT for insomnia achieves long-term reduction in adolescent psychopathology and does so by improving insomnia. This finding can have profound implications for youth mental health care. En ligne : http://dx.doi.org/10.1111/jcpp.12834 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359

The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: a randomized controlled trial / J. F. DEWALD-KAUFMANN in Journal of Child Psychology and Psychiatry, 55-3 (March 2014)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 55-3 (March 2014) . - p.273-283 Titre : The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: a randomized controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : J. F. DEWALD-KAUFMANN, Auteur ; F. J. OORT, Auteur ; A. M. MEIJER, Auteur Article en page(s) : p.273-283 Langues : Anglais (eng) Mots-clés : Adolescents  sleep  chronic sleep reduction  sleep extension  depression Index. décimale : PER Périodiques Résumé : Objective Sleep problems are common and persistent during adolescence and can have negative effects on adolescents' mood. To date, studies that investigate the effects of sleep extension on adolescents' sleep and depressive symptoms are still lacking. This study aims to investigate the effects of gradual sleep extension combined with sleep hygiene advice in adolescents with chronic sleep reduction on objectively measured sleep, self-reported sleep problems and depressive symptoms. Methods Fifty-five adolescents with chronic sleep reduction (mean age: 15.44 years; 85.5% females) were included in the study. Participants were randomly assigned to either a sleep extension group (gradual sleep extension by advancing bedtimes in the evening and receiving sleep hygiene advice) or to a control group (no instruction). Sleep was measured with actigraphy during three weeks, the first week was the baseline week, and the last two weeks were the experimental weeks during which sleep was extended. Other outcome variables were self-reported sleep problems (daytime sleepiness, symptoms of insomnia and circadian rhythm sleep disorder) and depressive symptoms, which were assessed before and after the experimental manipulation. Results During the third week of the experiment, adolescents in the sleep extension group had earlier bedtimes, earlier sleep onsets, spent more time in bed and slept longer than adolescents in the control group. Their chronic sleep reduction, insomnia symptoms and depressive symptoms diminished significantly. In addition, there was a trend of improved circadian rhythm sleep disorder symptoms and sleep quality. Conclusion Gradual sleep extension combined with sleep hygiene advice seems to have beneficial effects on sleep, self-reported sleep problems and depressive symptoms of adolescents with chronic sleep reduction. Although we cannot distinguish between the effects of sleep extension and sleep hygiene advice, the results suggest that advancing bedtimes can extend sleep and improve depressive symptoms. En ligne : http://dx.doi.org/10.1111/jcpp.12157 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=226 [article] The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: a randomized controlled trial [Texte imprimé et/ou numérique] / J. F. DEWALD-KAUFMANN, Auteur ; F. J. OORT, Auteur ; A. M. MEIJER, Auteur . - p.273-283. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 55-3 (March 2014) . - p.273-283 Mots-clés : Adolescents  sleep  chronic sleep reduction  sleep extension  depression Index. décimale : PER Périodiques Résumé : Objective Sleep problems are common and persistent during adolescence and can have negative effects on adolescents' mood. To date, studies that investigate the effects of sleep extension on adolescents' sleep and depressive symptoms are still lacking. This study aims to investigate the effects of gradual sleep extension combined with sleep hygiene advice in adolescents with chronic sleep reduction on objectively measured sleep, self-reported sleep problems and depressive symptoms. Methods Fifty-five adolescents with chronic sleep reduction (mean age: 15.44 years; 85.5% females) were included in the study. Participants were randomly assigned to either a sleep extension group (gradual sleep extension by advancing bedtimes in the evening and receiving sleep hygiene advice) or to a control group (no instruction). Sleep was measured with actigraphy during three weeks, the first week was the baseline week, and the last two weeks were the experimental weeks during which sleep was extended. Other outcome variables were self-reported sleep problems (daytime sleepiness, symptoms of insomnia and circadian rhythm sleep disorder) and depressive symptoms, which were assessed before and after the experimental manipulation. Results During the third week of the experiment, adolescents in the sleep extension group had earlier bedtimes, earlier sleep onsets, spent more time in bed and slept longer than adolescents in the control group. Their chronic sleep reduction, insomnia symptoms and depressive symptoms diminished significantly. In addition, there was a trend of improved circadian rhythm sleep disorder symptoms and sleep quality. Conclusion Gradual sleep extension combined with sleep hygiene advice seems to have beneficial effects on sleep, self-reported sleep problems and depressive symptoms of adolescents with chronic sleep reduction. Although we cannot distinguish between the effects of sleep extension and sleep hygiene advice, the results suggest that advancing bedtimes can extend sleep and improve depressive symptoms. En ligne : http://dx.doi.org/10.1111/jcpp.12157 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=226

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