Sarfan Laurel D, Milner Anne E, Tiab Sondra, Tuli Diya, Harvey Allison G
University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
J Behav Ther Exp Psychiatry. 2025 Dec;89:102049. doi: 10.1016/j.jbtep.2025.102049. Epub 2025 Aug 23.
Habits are underexplored in research on evidence-based psychological treatments (EBPTs). We recruited participants (N = 286) with sleep problems via Mechanical Turk for an experiment to shift wake-up habits, a key target of EBPTs for sleep problems. Participants were randomly assigned to a control (i.e., psychoeducation about healthy wake-up habits) or one of five active habit-change strategies: substitution with RISE UP, awareness training, vigilant monitoring, implementation intentions, and values. New and old wake-up habit strength, sleep disruption, and sleep-related impairment were assessed at baseline, six-week follow-up, and three-month follow-up. Aim 1 tested within- and between-condition change in the outcomes. Aim 2 tested whether change in wake-up habit strength predicted improvements in sleep disruption and sleep-related impairment. Except the values condition, all habit-change strategies and the control were significantly associated with within-condition improvements at 6-week follow-up and 3-month follow-up in: new habit strength (d = 0.81 to 1.68), old habit strength (d = -0.63 to -1.04), sleep disruption (d = -0.97 to -1.98), and sleep-related impairment (d = -0.60 to -1.65). Few differences between conditions emerged. Across conditions, more than 50% of participants met thresholds for clinically meaningful improvement, except the values condition at 3-month follow-up. Change in new and old habit strength significantly predicted change in sleep problems. Key limitations included: an exclusively online study design, dropout rate, and sample collected via Mechanical Turk using self-report measures without formal assessment of sleep diagnoses. Future research should investigate the clinical presentations and EBPT skills for which these habit-change strategies are most effective.
在基于证据的心理治疗(EBPTs)研究中,习惯尚未得到充分探索。我们通过亚马逊土耳其机器人平台招募了有睡眠问题的参与者(N = 286),进行一项改变起床习惯的实验,起床习惯是EBPTs治疗睡眠问题的一个关键目标。参与者被随机分配到对照组(即关于健康起床习惯的心理教育)或五种积极的习惯改变策略之一:用“RISE UP”替代、意识训练、警惕监测、实施意图和价值观。在基线、六周随访和三个月随访时评估新旧起床习惯强度、睡眠中断情况以及与睡眠相关的损害。目标1测试了组内和组间结果的变化。目标2测试了起床习惯强度的变化是否能预测睡眠中断和与睡眠相关损害的改善情况。除了价值观条件组外,所有习惯改变策略组和对照组在六周随访和三个月随访时,在以下方面均与组内改善显著相关:新习惯强度(d = 0.81至1.68)、旧习惯强度(d = -0.63至-1.04)、睡眠中断(d = -0.97至-1.98)以及与睡眠相关的损害(d = -0.60至-1.65)。组间差异很少出现。在所有条件下,超过50%的参与者达到了具有临床意义的改善阈值,但三个月随访时的价值观条件组除外。新旧习惯强度的变化显著预测了睡眠问题的变化。主要局限性包括:完全在线的研究设计、脱落率以及通过亚马逊土耳其机器人平台收集样本,使用自我报告测量方法且未对睡眠诊断进行正式评估。未来的研究应调查这些习惯改变策略最有效的临床表现和EBPT技能。