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:: Volume 24, Issue 4 (Bimonthly 2020) ::
Feyz 2020, 24(4): 433-445 Back to browse issues page
Efficacy of cognitive behavioral therapy with or without metacognitive techniques on sleep efficiency and perceived social support in people with chronic insomnia disorder
Behzad Salmani * , Jaafar Hasani , Afshin Ahmadvand , Shahram Mohammad-Khani , Hamid-Reza Hassan-Abadi
Ph.D. in Health Psychology, Department of Clinical Psychology, Faculty of Psychology & Educational Sciences, Kharazmi University, Tehran, I.R. Iran. , b.salmani1365@gmail.com
Abstract:   (1572 Views)
Background: Cognitive behavioral therapy is the first-line and golden standard in treating chronic insomnia disorder but some studies showed that by addressing metacognitive components, its efficacy increases. The present study aimed to evaluate efficacy of cognitive behavioral therapy with or without metacognitive techniques in people with chronic insomnia disorder.
Materials and Methods: Once evaluator took diagnostic assessments, four patients including one male and three females who met eligibility criteria were assigned to cognitive behavioral therapy and cognitive behavioral therapy with metacognitive techniques consisting of detached mindfulness and worry/ rumination postponement. All of the patients were assessed six times by sleep efficacy index and perceived social support scale. Then, dada were analyzed by visual interpretation of ups and downs in graphs, effect size and diagnostic recovery.
Results: Although duration of the disorder in patients who received cognitive behavioral therapy with metacognitive techniques was longer compared to patients in the other group, they had higher sleep efficiency and perceived social support than the other group. Both of the groups especially which received metacognitive techniques were achieved high effect size and diagnostic recovery. Treatment gains were maintained till three months after treatment ended. 
Conclusion: Adding metacognitive techniques to golden standard in treating of chronic insomnia disorder could increase the efficacy of cognitive behavioral therapy in terms of sleep efficiency and perceived social support.
Keywords: Chronic insomnia disorder, Cognitive behavioral therapy, Metacognitive techniques, Sleep efficiency, Perceived social support
Full-Text [PDF 631 kb]   (507 Downloads)    
Type of Study: Research | Subject: General
Received: 2019/07/27 | Accepted: 2020/02/10 | Published: 2020/10/10
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013. p. 362-68.
2. World Health Organization. The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 2007. p. 136-55.
3. American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual. 3rd ed. Darien IL: American Academy of Sleep Medicine; 2014. p. 150-59.
4. Finan PH, Smith, MT. The comorbidity of insomnia, chronic pain, and depression: dopamine as putative mechanism. Sleep Med Rev 2013; 17: 173-83.
5. Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, et al. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord 2011; 135(1-3): 9-10.
6. Gourineni R. Prognosis and complications. In: Attarian HP. Clinical handbook of insomnia. 3rd ed. Chicago, IL: Spinger International Publishing; 2017. p. 59-74.
7. Taylor D, Gehrman P, Dautovich N, Lichstein K McCrae C. Handbook of Insomnia. London. UK: Springer Healthcare; 2014. p. 102-220.
8. Baron KG, Perlis ML, Nowakowski S, Smitt MT, Jungquist CR, Orff HJ. Cognitive behavioral therapy for insomnia. In: In: Attarian HP. Clinical handbook of insomnia. 3rd ed. Chicago, IL: Spinger International Publishing; 2017. p. 75-96.
9. Haynes J, Talbert M, Fox S, Close E. Cognitive behavioral therapy in treatment of insomnia. South Med J 2018; 111(2): 75-80.
10. Ma ZR, Shi LJ, Deng MH. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Braz J Med Biol Res 2018; 51(6): e7070-78.
11. Davidson JR, Dawson S, Krsmanovic A. Effectiveness of group cognitive behavioral therapy for insomnia (CBT-I) in a primary care setting. Behav Sleep Med 2017; 00: 1-13.
12. Morin CM, Belanger L, LeBlanc M, Ivers H, Savard J, Espie CA, et al. The natural history of insomnia: a population-based 3-year longitudinal study. Arch Intern Med 2009; 169(5): 447-53.
13. Palagini L, Ong JC, Riemann D. The mediating role of sleep related metacognitive processes in trait and pre-sleep state hyperarousal in insomnia disorder. J Psychosom Res 2017; 99: 59-65.
14. Palagini L, Mauri M, Dell'Osso L, Riemann D, Drake CL. Trait and pre-sleep-state-dependent arousal in insomnia disorder: what role may stress reactivity and sleep-related metacognitions play? A pilot study. Sleep Med 2016a; 25: 42-8.
15. Palagini L, Bruno RM, Paolo T, Caccavale L, Gronchi A, Mauri M, et al. Association between stress-related sleep reactivity and metacognitive beliefs about sleep in insomnia: preliminary results. Behav Sleep Med 2016b; 14(6): 636-49.
16. Doos Ali Vand H, Gharraee B, Asgharnejad Farid AA, Ghaleh Bandi MF. Prediction of insomnia severity based on cognitive, metacognitive and emotional variables in college students. Explore 2014; 10(4): 233-40.
17. Ong JC, Ulmer CS, Manber R. Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia. Behav Res Ther 2012; 50: 651-60.
18. Wells A. Metacognitive Therapy for Anxiety Depression. New York: Guilford Press; 2009. p. 55-250.
19. Wells A, Matthews G. Modeling cognition in emotional disorder: the S-REF model. Behav Res Ther 1996; 34(11/12): 881-88.
20. Nezu AM, Nezu CM. Evidence-based outcome research: A practical guide to conducting randomized controlled trials for psychosocial interventions. Oxford: Oxford University Press; 2008. p. 179-200.
21. Liu X, Liu C, Tian X, Zou G, Li G, Kong L, et al. Association between perceived stress, resilience and social support with sleep disturbance among community-dwelling adults. Stress Health 2015; 32(5): 578-86.
22. Kim S, Suh S. Social support as a mediator between insomnia and depression in female undergraduate students. Behav Sleep Med 2017; 7: 1-9.
23. Steine IM, Krystal JH, Nordhus IH, Bjorvatn B, Harvey AG, Eid J, et al. Insomnia, nightmare, frequency, and nightmare distress in victims of sexual abuse: the role of perceived social support and abuse characteristics. J Interpers Violence 2012; 27(9): 1827-43.
24. Morin CM, Leblanc M, Ivers H, Belanger L, Merette C, Savard J, et al. Monthly fluctuations of insomnia symptoms in a population-based sample. Sleep 2014; 37(2): 319-26.
25. Goodwin CJ. Research in Psychology: Method & Design. 6th ed. New York: Wiley; 2009. p. 408-50.
26. Perlis ML, Jungquist CR, Smith MT, Posner D. Cognitive behavioral treatment of insomnia: a session by session guide. New York: Springer; 2005. p. 34-105.
27. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med 1991; 32(6): 705-14.
28. Shyu YI, Tang WR, Liang J, Weng LJ. Psychometric testing of social support survey on a Taiwanese sample. Nurs Res 2006; 55(6): 411-17.
29. Mohammadzadeh J, Sayehmiri K, Mahmoudi B. Standardization of Social Support Scale (MOS) of adults who have chronic disease in Ilam. J Ilam Uni Med Sci 2015; 23 (7): 69-77. [in Persian]
30. Busk PL, Serlin RC. Meta-analysis for single case research. In: Kratochwill TR, Levin JR. Single Case Research Design and Analysis: New Direction for Psychology and Education. 1st ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1992. p. 208-25.
31. Olive ML, Smith BW. Effect size calculations and single subject designs. Educ Psychol 2005; 25(2-3): 313-24.
32. Bootzin RR, Smith LJ, Franzen PL, Shapiro SL. Stimulus control therapy. In: Sateia MJ, Buysse DJ. Insomnia: Diagnosis and Treatment. London: Informa Healthcare; 2010. p. 126-38.
33. Speilman AJ, Yang CM, Glovinsky PB. Insomnia: sleep restriction therapy. In: Sateia MJ, Buysse DJ. Insomnia: Diagnosis and Treatment. London: Informa Healthcare; 2010. p. 277-89.
34. Harvey AG. A cognitive model of insomnia. Behav Res Ther 2002; 40(8): 869-93.
35. Kamen C, Garland SN, Hecker CE, Peoples AR, Kleckner IR, Cole CL, et al. Social support, insomnia, and adherence to cognitive behavioral therapy for insomnia after cancer treatment. Behav Sleep Med 2017; 17(1): 70-80.
36. Ellis JG, Deary V, Troxel WM. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the partner alliance in insomnia research study (PAIRS). Behav Sleep Med 2014; 13(1): 64-72.
37. Troxel WM, Robles TF, Hall M, Buysse DJ. Marital quality and the marital bed: examining the covariation between relationship quality and sleep. Sleep Med Rev 2007; 11(5): 389-404.
38. Frith CD. The role of metacognition in human social interactions. Philos Trans R Soc Lond B Biol Sci 2012; 367(1599): 2213-23.
39. Bahrami B, Olsen K, Bang D, Roepstroff A, Rees G, Frith CD. Together, slowly nut surely: the role of social interaction and feedback on the build-up of benefit in collective decision-making. J Exp Psychol Hum Percept Perform 2012; 38(1): 3-8.
40. Kazdin AE. Evidence-based treatment and practice: new opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. Am Psychol 2008; 63(3): 146-59.
41. Shrivastava D, Jung S, Saadat M, Sirohi R, Crewson K. How to interpret the results of a sleep study. J Community Hosp Intern Med Perspect 2014; 4(5): 1-4.
42. Grewal RG, Doghramji EB. Epidemiology of insomnia. In: Attarian HP. Clinical handbook of insomnia. 3rd ed. Chicago, IL: Spinger International Publishing; 2017. p. 13-27.
43. Wells A, King P. Metacognitive therapy for generalized anxiety disorder: an open trial. J Behav Ther Exp Psychiatry 2006; 37(3): 206-12.
44. Salmani B, Hasani J, Mohammad-Khani S, Karami GR. Efficacy of metacognitive therapy on metacognitive beliefs, meta-worry, and the signs and symptoms of patients with generalized anxiety disorder. Feyz 2014; 18(5): 429-40. [in Persian]
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Salmani B, Hasani J, Ahmadvand A, Mohammad-Khani S, Hassan-Abadi H. Efficacy of cognitive behavioral therapy with or without metacognitive techniques on sleep efficiency and perceived social support in people with chronic insomnia disorder. Feyz 2020; 24 (4) :433-445
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