Pchelina, Polina; Duss, Simone; Bernasconi, Corrado Angelo; Berger, Thomas; Bassetti, Claudio L. A. (October 2022). Analysis of predictors of effect in a study of guided Internet-based Cognitive-Behavioral Therapy of Insomnia (ICBT-I). Journal of sleep research, 31(S1), p. 48. Wiley
Introduction: Understanding which factors predict iCBT-I's effectiveness can help referrers to select the target group of patients that benefit most or directly refer patients that are unlikely to benefit from this intervention to a more resource-intensive treatment setting.
Methods: This is a post-hoc analysis of a three-arm randomized controlled trial (RCT) comparing the effectiveness of guided internet-based multi-component treatment (MCT), an internet-based guided sleep restriction treatment (ST), and care as usual (CAU) for 104 chronic insomnia patients (Krieger et al., 2019). Demographics (including social and work status, level of education), medical history (use of medication) and baseline scores of sleep quality, dysfunctional beliefs and attitudes about sleep, depressive symptoms, quality of life, personal significance of the sleep problems, and expectations about treatment success were obtained before the intervention. Primary outcome - the insomnia severity index (ISI) was assessed before and after the 8 weeks intervention. Since treatment groups in the RCT proved to be equally effective in reducing ISI, the MCT and ST groups were merged and compared to CAU. The ISI improvement from baseline to posttreatment was the dependent variable to assess the impact of predictors on the negative change in symptom severity over time (prognostic analysis) and response to treatment (predictive analysis). Predictors were analyzed with multiple linear regression models including ISI at baseline and condition (treatment or CAU).
Results: Higher education (Std β = 0.88 score points, p = 0.033) and female gender (Std β = 1.65 for females vs. males, p = 0.051) had prognostic value for a better outcome in both arms. Individuals who consumed medications (Std β = −3.81, p = 0.059) and those expecting high therapy success showed better effect in treatment group (Std β = 1.33, p = 0.024). The worst ISI dynamic was in the CAU group participants with the high personal significance of sleep problem (Std β = 0.21, p = 0.071) and those who were divorced (Std β = 7.36, p = 0.0036).
Conclusions: Findings indicate that insomnia patients receiving pharmacotherapy for insomnia, and those with a higher success expectancy regarding the intervention profit most of iCBT-I. Results suggest that patients requiring closer medical and/or psychological attention are those that are divorced and those who attribute a high personal relevance to sleep problems.
Item Type: |
Conference or Workshop Item (Abstract) |
|---|---|
Division/Institute: |
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology 07 Faculty of Human Sciences > Institute of Psychology |
UniBE Contributor: |
Pchelina, Polina, Duss, Simone, Bernasconi, Corrado Angelo, Berger, Thomas (B), Bassetti, Claudio L.A. |
Subjects: |
100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health |
ISSN: |
1365-2869 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Alina Kneubühler |
Date Deposited: |
29 Mar 2023 11:08 |
Last Modified: |
29 Mar 2023 23:38 |
URI: |
https://boris.unibe.ch/id/eprint/180719 |
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