Temple University, United States.
Temple University, United States.
J Anxiety Disord. 2016 Jan;37:78-88. doi: 10.1016/j.janxdis.2015.11.006. Epub 2015 Dec 18.
The present study examined (a) whether sleep related problems (SRPs) improved following cognitive-behavioral therapy (CBT) for youth with anxiety disorders, (b) whether variables that may link anxiety and SRPs (e.g., pre-sleep arousal, family accommodation, sleep hygiene) changed during treatment, and (c) whether such changes predicted SRPs at posttreatment. Youth were diagnosed with anxiety at pretreatment and received weekly CBT that targeted their principal anxiety diagnosis at one of two specialty clinics (N=69 completers, Mage=10.86). Results indicated that parent-reported SRPs improved from pre- to post-treatment and that treatment responders with regard to anxiety yielded greater SRP improvements than nonresponders. Parent report of bedtime resistance and sleep anxiety showed significant improvements. Youth reported lower rates of SRPs compared to their parents and did not demonstrate pre- to post-treatment changes in SRPs. Pre-sleep arousal and family accommodation decreased over treatment but did not predict lower SRPs at posttreatment. Higher accommodation was correlated with greater SRPs. Sleep hygiene evidenced no change and did not mediate links between accommodation and posttreatment SRPs.
(a) 认知行为疗法（CBT）是否能改善青少年焦虑障碍相关的睡眠问题（SRPs）；(b) 焦虑和 SRPs 之间可能存在关联的变量（例如，睡前觉醒、家庭迁就、睡眠卫生）在治疗过程中是否发生变化；(c) 这些变化是否能预测治疗后的 SRPs。在治疗前，青少年被诊断出患有焦虑症，并在两个专业诊所之一接受每周一次的 CBT 治疗，该治疗针对他们的主要焦虑症诊断（N=69 名完成者，Mage=10.86）。结果表明，父母报告的 SRPs 从治疗前到治疗后有所改善，且在焦虑方面属于治疗反应者的 SRP 改善程度大于非反应者。父母报告的就寝时间抵抗和睡眠焦虑有显著改善。与父母相比，青少年报告的 SRPs 发生率较低，且在治疗前后 SRPs 没有变化。治疗过程中，睡前觉醒和家庭迁就减少，但在治疗后，它们与更低的 SRPs 之间没有预测关系。更高的迁就与更高的 SRPs 相关。睡眠卫生方面没有变化，也不能调解迁就与治疗后 SRPs 之间的关系。
