a Adult Anxiety Clinic, Department of Psychology , Temple University , Philadelphia , PA , USA.
b Department of Psychology , California State University , East Bay , CA , USA.
Anxiety Stress Coping. 2019 Jul;32(4):387-398. doi: 10.1080/10615806.2019.1617854. Epub 2019 May 13.
Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive-behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment. Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs. SAD and sleep quality were assessed pre-treatment and post-treatment; SAD was assessed again 12-months post-treatment. Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre- to post-treatment in CBGT or MBSR did not predict later social anxiety. MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed. ClinicalTrials.gov identifier: NCT02036658.
社交焦虑障碍（SAD）患者普遍存在睡眠质量差的问题，且这可能会影响治疗效果。我们考察了以下几个方面：（1）SAD 患者的睡眠质量是否与健康对照组（HC）不同；（2）基线睡眠质量是否会调节治疗效果（认知行为团体治疗[CBGT]与正念减压疗法[MBSR]、等待治疗[WL]的差异）对社交焦虑的影响；（3）治疗过程中睡眠质量是否发生变化；（4）睡眠质量的变化是否可以预测治疗 12 个月后的焦虑情况。研究参与者为 108 名来自 CBGT 与 MBSR 与 WL 随机对照试验的 SAD 成年患者和 38 名 HCs。在治疗前、治疗后评估 SAD 和睡眠质量，治疗 12 个月后再次评估 SAD。与 HCs 相比，SAD 患者报告的睡眠质量更差。治疗条件对治疗后社交焦虑的影响与基线睡眠质量无关。MBSR 组的睡眠质量改善程度显著大于 WL 组，但 CBGT 组无明显变化。CBGT 或 MBSR 组从治疗前到治疗后的睡眠质量变化与随后的社交焦虑无相关性。MBSR 可改善患者的睡眠质量，而 CBGT 无此作用。其他结果与先前的研究不一致；讨论了可能的解释、局限性和对未来研究的意义。临床试验注册号：NCT02036658。
