Sleep and Depression Laboratory, Departmentof Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada.
J Psychosom Res. 2010 Jan;68(1):57-65. doi: 10.1016/j.jpsychores.2009.08.007.
Unhelpful beliefs about sleep have been linked to insomnia, and increasing one's cognitive flexibility about sleep has been linked to posttreatment sleep improvement. This study evaluated whether levels of such beliefs differ across insomnia groups and whether there are particular beliefs that differ for specific insomnia subtypes.
Participants (N=1384) were people with insomnia and good sleepers ranging from 18 to 89 years old (mean=42.6; S.D.=19.4). Data from previous studies at five insomnia clinical sites were pooled to examine responses on the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) across differing insomnia groups.
Group analyses revealed that those from community-based insomnia clinics and those who are hypnotic-dependent generally had the highest levels of unhelpful sleep-related beliefs. With the exception of beliefs about sleep needs (wherein only community sleep clinic patients had high scores relative to good sleepers), all insomnia groups had higher scores on the 16-item DBAS (DBAS-16) than good sleepers. A validity analysis suggested that a DBAS-16 index score of >3.8 represented the level of unhelpful beliefs associated with clinically significant insomnia, although a slightly lower cutoff may be useful for identifying an unhelpful degree of sleep-related beliefs in highly screened primary-insomnia-only and medical patient groups.
This study offers descriptive data for the use of DBAS-16 across insomnia subgroups, which will help the user understand what degree of maladaptive sleep beliefs is most strongly associated with clinically significant levels of insomnia. Results also may have implications for cognitive targeting during treatment for particular insomnia groups.
关于睡眠的无益信念与失眠有关，而增加对睡眠的认知灵活性与治疗后睡眠改善有关。本研究评估了这些信念在不同失眠组之间是否存在差异，以及是否存在特定的信念在特定的失眠亚型中存在差异。
参与者（N=1384）为年龄在 18 至 89 岁之间（平均=42.6；标准差=19.4）的失眠症患者和睡眠良好者。来自五个失眠临床站点的先前研究的数据被汇总，以检查在不同的失眠组中，对睡眠障碍信念和态度量表（DBAS）的反应。
组分析显示，来自社区失眠诊所的患者和依赖催眠药物的患者通常具有最高水平的无益睡眠相关信念。除了睡眠需求信念（仅社区睡眠诊所患者的分数高于睡眠良好者）外，所有失眠组的 16 项 DBAS（DBAS-16）得分均高于睡眠良好者。有效性分析表明，DBAS-16 指数得分>3.8 代表与临床显著失眠相关的无益信念水平，尽管对于高度筛选的原发性失眠患者和医疗患者组，稍低的临界值可能有助于识别无益程度的睡眠相关信念。
本研究提供了 DBAS-16 在不同失眠亚组中的使用的描述性数据，这将帮助用户了解与临床显著程度的失眠最相关的无益睡眠信念程度。结果还可能对针对特定失眠组的认知治疗具有影响。
