The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Psychiatric Comorbidity and Aspects of Cognitive Coping Negatively Predict Outcome in Cognitive Behavioral Treatment of Psychophysiological Insomnia
Abstract
Cognitive behavioral treatment is the gold standard treatment for insomnia, although a substantial group does not respond. We examined possible predictors for treatment outcome in psychophysiological insomniacs, with a focus on the presence of clearly defined psychiatric comorbidity. This was a longitudinal uncontrolled case series study comprising 60 patients with chronic psychophysiological insomnia consecutively referred to a tertiary sleep medicine center, to receive cognitive behavioral treatment for insomnia (CBT-I). Remission of insomnia was defined as a posttreatment Insomnia Severity Index score below 8. As an alternative outcome, we used a clinically relevant decrease on the Insomnia Severity Index (drop of > 7 points). Personality, coping, and social support questionnaires were assessed before the start of the treatment and were compared between treatment responders and nonresponders. To examine whether these variables were predictive for negative treatment outcome, logistic regression analyses were applied. Treatment nonresponders had a significantly higher prevalence of psychiatric comorbidity. Logistic regression analyses showed that the presence of psychiatric comorbidity was strongly predictive for negative treatment outcome (odds ratios: 20.6 and 10.3 for the 2 outcome definitions). Additionally, higher scores on the cognitive coping strategy called "refocus on planning" were associated with worse CBT-I outcome. Current psychiatric comorbidity is strongly pre…
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Many patient groups disproportionately impacted by insomnia symptoms, such as patients with comorbidities, also experience greater difficulty completing CBT-I.
“Many of the same patient groups disproportionately impacted by insomnia symptoms (e.g., patients with comorbidities) also experience greater difficulty completing CBT-I”
From Novel Treatment Based on Acceptance and Commitment Therapy Versus Cognitive Behavioral Therapy for Insomnia: A Randomized Comparative Effectiveness Trial in Women Veterans (2023) · cites this paper as van de Laar et al., 2015
Citations
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“Edinger, Stout, and Hoelscher (1988) found that nondepressed insomniacs who benefited from behavioral treatment showed a clearly defined neurotic profile.”
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Martin, J. L., Carlson, G. C., Kelly, M. R., Song, Y., Mitchell, M. N., Josephson, K. R., McGowan, S. K., Culver, N. C., Kay, M. A., Erickson, A. J., et al. (2023) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000836 · Cited by 23
Metadata
- Authors
- van de Laar, M., Pevernagie, D., van Mierlo, P., & Overeem, S.
- Affiliations
- Kempenhaeghe (NL)
- Ghent University (BE)
- Radboud University Medical Center (NL)
- Corresponding author
- van de Laar, Merijn
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2014-04-07
- Volume
- 13
- Issue
- 2
- Pages
- 140-156
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- OpenAlex
- W2025749380
- Cited by
- 35
- References
- 8
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 8 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 2 · 2017: 3 · 2016: 2 · 2015: 1
- FWCI
- 2.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioral Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion)
- TU/e Research Portal (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- psychophysiological insomnia, psychiatric comorbidity, cognitive coping, treatment outcome predictors, treatment non-responders, social support, personality, Insomnia Severity Index
- MeSH terms
- Adaptation, Psychological, Adult, Mental Disorders, Cognition, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Psychophysiologic Disorders, Sleep, Comorbidity, Cognitive Behavioral Therapy, Prevalence, Logistic Models, Treatment Outcome
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