Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Competence Center for Psychotherapy Research and Education, Liljeholmstorget 7, Stockholm 117 63, Sweden.
Department of Neurobiology, Care Sciences and Society, Academic Primary Health Care Centre, Karolinska Institutet, Solnavägen 1 E, Stockholm 113 65, Sweden.
Sleep Med Clin. 2023 Mar;18(1):9-19. doi: 10.1016/j.jsmc.2022.10.001.
Paradoxic intention (PI) was one of the first psychological interventions for insomnia. Historically, PI has been incorporated in cognitive behavioral therapy for insomnia (CBT-I) or delivered as a sole intervention for insomnia. PI instructions have varied over the years, but a common denominator is the instruction to try to stay awake in bed for as long as possible. This article reviews and discuss treatment rationales and theoretic frameworks for PI, the current evidence base for PI, its clinical relevance, and considerations needed when PI is used as an adjunct treatment to CBT-I, or as a second-line intervention for insomnia.
矛盾意向法(PI)是最早的失眠心理干预方法之一。从历史上看,PI 被纳入失眠的认知行为疗法(CBT-I)中,或作为失眠的单一干预措施。PI 的指导原则多年来一直在变化,但一个共同点是指导患者尽可能长时间地躺在床上保持清醒。本文综述和讨论了 PI 的治疗原理和理论框架、PI 的现有证据基础、其临床相关性,以及当 PI 作为 CBT-I 的辅助治疗或失眠的二线干预措施时需要考虑的问题。