University of Twente Student Theses


Moderation of Efficacy of Cognitive Behavioral Therapy for Adolescents with Insomnia

Friesen, Jennifer (2019) Moderation of Efficacy of Cognitive Behavioral Therapy for Adolescents with Insomnia.

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Abstract:Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective for insomnia in adolescents. However, little is known about for whom this treatment is most effective. The present study aims to investigate the moderating effects of the following variables. It was tested whether 1) insomnia (baseline insomnia symptoms), and 2) mental health (baseline psychopathology symptoms) moderate effectiveness. In total, 116 adolescents with primary insomnia participated in the study (M = 15.6, SD = 1.6 years, 25 % males), receiving either internet-based treatment, group therapy or no treatment at all. The therapy consisted of six weekly sessions and a booster session after s months. Pre- and post-intervention as well as two months follow-up measurements assessed psychopathological and sleep parameters. Sleep was assessed by sleep efficiency (sleep logs) and insomnia symptoms (Holland Sleep Disorder Questionnaire). Moderating (baseline sleep efficiency and insomnia symptoms) and outcome variables were derived from these measurements. Baseline psychopathology symptoms were measured by the Youth Self-Report. From hierarchical regression analyses it appeared that CBT-I's effectiveness on reducing HSDQ levels was significantly moderated by baseline insomnia symptoms (β = -.27) and baseline psychopathology symptoms (β = .31). CBT-I's effectiveness on enhancing sleep efficiency was significantly moderated by baseline insomnia symptoms (β = .16), baseline sleep efficiency (β = -.38), and baseline psychopathology symptoms (β = -.18). Different effects for different sleep parameters can be explained by the different aspects of insomnia they are measuring. The HSDQ score represents insomnia-related distress while sleep efficiency represents the quantitative aspect of insomnia. The present study is one of the first to explore for whom CBT-I is most effective. Overall, it can be said, that the patients with high baseline levels of insomnia, less psychopathological symptoms and low sleep efficiency predict greater effectiveness of CBT-I.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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