Abstract Mkid 307

SUBMIT YOUR MANUSCRIPT


Cognitive restructuring and imagery modification in insomnia disorder: a feasibility study
Carolin Schmid, Regina Steil
Sleep and Hypnosis: A Journal of Clinical Neuroscience and Psychopathology 2019;21(3):233-241

Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia disorder. Although CBT-I shows distinct and robust effects, studies report a stable percentage of non-responders, and many patients do not reach remission. Therefore, new interventions for treatment are needed. Imagery interventions are increasingly popular in cognitive behavioural therapy and might be helpful in insomnia disorder. In this feasibility study, we treated three participants suffering from insomnia disorder with a combination of cognitive and imagery techniques. Participants identified their predominant distressing thoughts and inner images. Methods of cognitive restructuring were used to address automatic thoughts and appraisals. Inner images were evoked in detail and changed into desirable images during an imagery exercise. Participants practised the learned techniques daily for three weeks. One case is described in depth to illustrate the procedure. Sleep onset latency could be reduced by nearly 23%. Subjective insomnia severity and sleep quality could not be changed significantly. Imagery seems to be a promising possibility to enrich CBT-I.
Keywords:
Insomnia disorder, cognitive therapy, imagery, adults
REFERENCES

American Academy of Sleep Medicine. (2017). Practice Guidelines, Psychological and Behavioral Treatment of Insomnia. Retrieved from https://aasm.org/clinical-resources/practice-standards/practice-guidelines/ Accessed 12 Dec 2017.



American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.



Arntz, A. (2012). Imagery Rescripting as a Therapeutic Technique: Review of Clinical Trials, Basic Studies, and Research Agenda. Journal of Experimental Psychopathology, 3(2), 189–208. https://doi.org/10.5127/jep.024211



Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53(3), 737–740. https://doi.org/10.1016/S0022-3999(02)00330-6



Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U.,. . . Riemann, D. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders, 135(1-3), 10–19. https://doi.org/10.1016/j.jad.2011.01.011



Bélanger, L., Harvey, A. G., Fortier-Brochu, É., Beaulieu-Bonneau, S., Eidelman, P., Talbot, L.,. . . Morin, C. M. (2016). Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. Journal of Consulting and Clinical Psychology, 84(8), 659–667. https://doi.org/10.1037/ccp0000084



Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Lichstein, K. L., & Morin, C. M. (2006). Recommendations for a standard research assessment of insomnia. Sleep: Journal of Sleep and Sleep Disorders Research, 29(9), 1155–1173. https://doi.org/10.1093/sleep/29.9.1155



Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4



Carney, C. E., Buysse, D. J., Ancoli-Israel, S., Edinger, J. D., Krystal, A. D., Lichstein, K. L., & Morin, C. M. (2012). The consensus sleep diary: Standardizing prospective sleep self-monitoring. Sleep: Journal of Sleep and Sleep Disorders Research, 35(2), 287–302. https://doi.org/10.5665/sleep.1642



Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM). Pittsburgh Schlafqualitätsindex (PSQI) [PDF file]. Retrieved from http://www.dgsm.de/downloads/fachinformationen/frageboegen/psqi.pdf .



Drapeau, C. W., & Nadorff, M. R. (2017). Suicidality in sleep disorders: Prevalence, impact, and management strategies. Nature and Science of Sleep, 9, 213–226. https://doi.org/10.2147/NSS.S125597



Espie, C. A., Broomfield, N. M., MacMahon, K. M. A., Macphee, L. M., & Taylor, L. M. (2006). The attention-intention-effort pathway in the development of psychophysiologic insomnia: A theoretical review. Sleep Medicine Reviews, 10(4), 215–245. https://doi.org/10.1016/j.smrv.2006.03.002



Etindele Sosso, F. A. (2017). Neurocognitive Game between Risk Factors, Sleep and Suicidal Behaviour. Sleep science (Sao Paulo, Brazil), 10(1), 41–46. https://doi.org/10.5935/1984-0063.20170007



Faul, F. (2014). G*Power. Düsseldorf: Heinrich Heine Universität. Retrieved from http://www.gpower.hhu.de/en.html



Gerber, M., Lang, C., Lemola, S., Colledge, F., Kalak, N., Holsboer-Trachsler, E.,. . . Brand, S. (2016). Insomnia Severity Index German Version [DOCX file]. Additional Material to DOI 10.1186/s12888-016-0876-8. Retrieved from https://static-content.springer.com/esm/art%3A10.1186%2Fs12888-016-0876-8/MediaObjects/12888_2016_876_MOESM1_ESM.docx



Hackmann, A., Bennett-Levy, J., & Holmes, E. A. (Eds.). (2011). Oxford guide to imagery in cognitive therapy. Oxford guides in cognitive behavioural therapy. Oxford: Oxford University Press.



Hansen, K., Höfling, V., Kröner-Borowik, T., Stangier, U., & Steil, R. (2013). Efficacy of psychological interventions aiming to reduce chronic nightmares: a meta-analysis. Clinical Psychology Review, 33(1), 146–155. https://doi.org/10.1016/j.cpr.2012.10.012



Harvey, A. G. (2005). A cognitive theory and therapy for chronic insomnia. Journal of Cognitive Psychotherapy, 19(1), 41–59.



Harvey, A. G., Bélanger, L., Talbot, L., Eidelman, P., Beaulieu-Bonneau, S., Fortier-Brochu, E.,. . . Morin, C. M. (2014). Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(4), 670–683. https://doi.org/10.1037/a0036606



Holmes, E. A., Arntz, A., & Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 297–305. https://doi.org/10.1016/j.jbtep.2007.10.007



IBM Corp. (2013). IBM SPSS Statistics for Windows. Armonk, NY.



Jung, K., & Steil, R. (2013). A randomized controlled trial on cognitive restructuring and imagery modification to reduce the feeling of being contaminated in adult survivors of childhood sexual abuse suffering from posttraumatic stress disorder. Psychotherapy and Psychosomatics, 82(4), 213–220. https://doi.org/10.1159/000348450



Krakow, B., & Zadra, A. (2006). Clinical management of chronic nightmares: imagery rehearsal therapy. Behavioral Sleep Medicine, 4(1), 45–70. https://doi.org/10.1207/s15402010bsm0401_4



Monk, T. H., Reynolds, C. F., Kupfer, D. J., Buysse, D. J., Coble, P. A., Hayes, A. J.,. . . Ritenour, A. M. (1994). The Pittsburgh sleep diary. Journal of Sleep Research, 3(2), 111–120. https://doi.org/10.1111/j.1365-2869.1994.tb00114.x



Morin, C. M. (1993). Insomnia: Psychological assessment and management. New York, N.Y.: Guilford Press.



Morin, C. M., & Azrin, N. H. (1987). Stimulus control and imagery training in treating sleep-maintenance insomnia. Journal of Consulting and Clinical Psychology, 55(2), 260.



Morin, C. M., Bélanger, L., LeBlanc, M., Ivers, H., Savard, J., Espie, C. A.,. . . Grégoire, J.-P. (2009). The natural history of insomnia: a population-based 3-year longitudinal study. Archives of Internal Medicine, 169(5), 447–453. https://doi.org/10.1001/archinternmed.2008.610



Morina, N., Lancee, J., & Arntz, A. (2017). Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 55, 6–15. https://doi.org/10.1016/j.jbtep.2016.11.003



Müller-Engelmann, M., & Steil, R. (2017). Cognitive restructuring and imagery modification for posttraumatic stress disorder (CRIM-PTSD): A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 54, 44–50. https://doi.org/10.1016/j.jbtep.2016.06.004



Nelson, J., & Harvey, A. G. (2003). An exploration of pre‐sleep cognitive activity in insomnia: Imagery and verbal thought. British Journal of Clinical Psychology, 42(3), 271–288. https://doi.org/10.1348/01446650360703384



Pearson, D. G., Deeprose, C., Wallace-Hadrill, S. M.A., Burnett Heyes, S., & Holmes, E. A. (2013). Assessing mental imagery in clinical psychology: a review of imagery measures and a guiding framework. Clinical Psychology Review, 33(1), 1–23. https://doi.org/10.1016/j.cpr.2012.09.001



Perlis, M. L. (2005). Cognitive behavioral treatment of insomnia: A session-by-session guide. New York, N.Y.: Springer.



Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 165(2), 125–133. https://doi.org/10.7326/M15-2175



Riemann, D., Nissen, C., Palagini, L., Otte, A., Perlis, M. L., & Spiegelhalder, K. (2015). The neurobiology, investigation, and treatment of chronic insomnia. The Lancet Neurology, 14(5), 547–558. https://doi.org/10.1016/S1474-4422(15)00021-6



Schlack, R., Hapke, U., Maske, U., Busch, M., & Cohrs, S. (2013). Frequency and distribution of sleep problems and insomnia in the adult population in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1) [Häufigkeit und Verteilung von Schlafproblemen und Insomnie in der deutschen Erwachsenenbevölkerung: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 56(5-6), 740–748. https://doi.org/10.1007/s00103-013-1689-2



Smith, M. T., & Wegener, S. T. (2003). Measures of sleep: The Insomnia Severity Index, Medical Outcomes Study (MOS) Sleep Scale, Pittsburgh Sleep Diary (PSD), and Pittsburgh Sleep Quality Index (PSQI). Arthritis & Rheumatism, 49(5), 184-196. https://doi.org/10.1002/art.11409



Steil, R., Jung, K., & Stangier, U. (2011). Efficacy of a two-session program of cognitive restructuring and imagery modification to reduce the feeling of being contaminated in adult survivors of childhood sexual abuse: a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 42(3), 325–329. https://doi.org/10.1016/j.jbtep.2011.01.008



Wittchen, H.-U., Zaudig, M., & Fydrich, T. (1997). Skid. Strukturiertes klinisches Interview für DSM-IV. Achse I und II. Handanweisung.

GUIDE FOR AUTHORS
EDITORIAL BOARD
ABOUT JOURNAL
INDEXED IN
AHEAD OF PRINT
ARCHIVES
CURRENT ISSUE
CONTACT US


{"email":"Email address invalid","url":"Website address invalid","required":"Required field missing"}