Kazarian S S, Howe M G, Merskey H, Deinum E J
J Clin Psychol. 1978 Oct;34(4):865-9. doi: 10.1002/1097-4679(197810)34:4<865::aid-jclp2270340408>3.0.co;2-6.
Evaluated the relevance of the physiological-arousal model, the stimulus-control paradigm, and depression to insomnia both as a unitary construct and to its components. The Manifest Anxiety Scale, the Sleep Behavior Self Rating Scale and the Zung Depression Scale were administered to 81 clinical Ss. Three separate discriminant function analyses were performed with self-reported "sleeping difficulty," "latency of falling asleep," and "total hours of sleep" as criterion variables. The above three scales and the following four sleep patterns were used as indices: number of nocturnal wakings, latency to fall asleep once awake, number of early wakings, and frequency of feelings of fatigue upon wakings. The findings indicated that the physiological-arousal model was relevant both to insomnia overall and to its component of sleep-onset insomnia. The stimulus-control paradigm was found to be relevant only to sleep-onset insomnia. Depression was not a sensitive discriminator, possibly due to the heterogeneity of the patient population studied. It is emphasized that different mechanisms might be operating with the heterogeneous symptom "insomnia," and the replication of findings with criteria that include significant others and electroencephalographic measures is suggested.
评估了生理唤醒模型、刺激控制范式以及抑郁与失眠作为一个整体结构及其组成部分之间的相关性。对81名临床受试者施测了显性焦虑量表、睡眠行为自评量表和zung抑郁量表。以自我报告的“睡眠困难”、“入睡潜伏期”和“总睡眠时间”作为判别变量，进行了三项独立的判别函数分析。以上三个量表以及以下四种睡眠模式作为指标：夜间醒来次数、醒来后入睡潜伏期、早醒次数以及醒来时疲劳感的频率。研究结果表明，生理唤醒模型与整体失眠及其入睡性失眠成分均相关。发现刺激控制范式仅与入睡性失眠相关。抑郁不是一个敏感的判别因素，可能是由于所研究患者群体的异质性。强调不同机制可能在异质性症状“失眠”中起作用，并建议用包括重要他人和脑电图测量的标准重复研究结果。
