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Brief CBT-I for Insomnia Comorbid with Social Phobia: A Case Study

Published online by Cambridge University Press:  26 October 2009

Nicole K. Y. Tang
Nicole K. Y. Tang*
Affiliation:
Institute of Psychiatry, King's College London, UK
*
Reprint requests to Nicole K. Y. Tang, Department of Psychology (PO 77), Institute of Psychiatry, King's College London, de Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: [email protected] An extended version is also available online in the table of contents for this issue: http://journals.cambridge.org/jid_BCP
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Abstract

Background: Despite an obvious link between social anxiety and acute state of insomnia, chronic types of sleep disturbances in people with social phobia have so far received limited research/clinical attention. This case report aims to illustrate the possibility of rectifying sleep disturbances comorbid with social phobia, using a brief cognitive behaviour therapy for insomnia (CBT-I). Method: Treatment involved five sessions of CBT-I provided individually on a weekly basis. Major treatment components included psychoeducation, sleep restriction therapy, stimulus control and cognitive restructuring. Results: Treatment effects were assessed using sleep diary and questionnaires over the course of the treatment and at ~9 month follow-up. The results were encouraging with all targeted sleep parameters demonstrating improvements that met dual criteria for clinical significance. The gains were well maintained even at ~9 months after treatment. These improvements in sleep were accompanied by a reduction in sleep-related anxiety and dysfunctional beliefs and attitudes about sleep. Whilst the patient also reported a corresponding improvement in daytime functioning and general anxiety, no gains were observed in depression and social anxiety. Conclusions: These findings highlight the potential benefits of incorporating brief CBT-I into existing treatments for social phobia and encourage further research on the intricate relationship between sleep, mood and social anxiety.

Keywords

Insomniasocial phobiasocial anxietycognitive behaviour therapytreatment outcomecase report
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 38 , Issue 1 , January 2010 , pp. 113 - 122
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Bastien, C., Vallières, A. and Morin, C. M. (2001). Validation of the Insomnia Severity Index as a clinical outcome measure for insomnia research. Sleep Medicine, 2, 297–307.CrossRefGoogle ScholarPubMed
Buckner, J. D., Bernert, R. A., Cromer, K. R., Joiner, T. E. and Schmidt, N. B. (2008). Social anxiety and insomnia: the mediating role of depressive symptoms. Depression and Anxiety, 25, 124–130.CrossRefGoogle ScholarPubMed
Clark, D. M. (2001). A cognitive perspective on social phobia. In Crozier, W.R., and Alden, L. E. (Eds.), International Handbook of Social Anxiety: concepts, research and interventions relating to the self and shyness (pp. 405–430). Chichester, UK: John Wiley and Sons.Google Scholar
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R., Liebowitz, M., Hope, D. A. and Schneier, F. R. (Eds.), New Oxford Textbook of Psychiatry. Oxford, UK: Oxford University Press.Google Scholar
Degonda, M. and Angst, J. (1993). The Zurich study. XX: social phobia and agoraphobia. European Archives of Psychiatry and Clinical Neuroscience, 243, 95–102.CrossRefGoogle ScholarPubMed
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R. and Quillian, R.E. (2001) Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. Journal of the American Medical Association, 285, 1856–1864.CrossRefGoogle ScholarPubMed
Kazdin, A. E. (2003). Drawing valid inferences from case studies. In Kazdin, A. E. (Ed.), Methodological Issues and Strategies in Clinical Research (3rd ed.). Washington, DC: American Psychological Association.Google Scholar
Lichstein, K., Wilson, N. and Johnson, C. T. (2000). Psychological treatment of secondary insomnia. Psychology and Aging, 15, 232–240.CrossRefGoogle ScholarPubMed
Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173.CrossRefGoogle ScholarPubMed
Manber, R., Edinger, J., Gress, J., San Pedro-Salcedo, M., Kuo, T. and Kalista, T. (2008). Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep, 31, 489–495.CrossRefGoogle ScholarPubMed
Morin, C. M., Vallières, A. and Ivers, H. (2007). Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30, 1547–1554.CrossRefGoogle ScholarPubMed
Neckelmann, D., Mykletun, A. and Dahl, A. A. (2007). Chronic insomnia as a risk factor for developing anxiety and depression. Sleep, 30, 873–880.CrossRefGoogle ScholarPubMed
Ohayon, M. M. and Roth, T. (2003). Place of chronic insomnia in the course of depressive and anxiety disorders. Journal of Psychiatric Research, 37, 9–15.CrossRefGoogle ScholarPubMed
Smith, M., Huang, M. and Manber, R. (2005). Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders. Clinical Psychology Review, 25, 559–592.CrossRefGoogle ScholarPubMed
Stein, M. B., Kroft, C. D. L. and Walker, J. R. (1993). Sleep impairment in patients with social phobia. Psychiatry Research, 49, 251–256.CrossRefGoogle ScholarPubMed
Tang, N. K. Y. and Harvey, A. G. (2004a). Correcting distorted perception of sleep in insomnia: a novel behavioural experiment? Behaviour Research and Therapy, 42, 27–39.CrossRefGoogle ScholarPubMed
Tang, N. K. Y. and Harvey, A. G. (2004b). Effects of cognitive arousal and physiological arousal on sleep perception. Sleep, 27, 69–78.CrossRefGoogle ScholarPubMed
Vallieres, A. V., Ivers, H., Bastien, C. H., Beaulieu-Bonneau, S. and Morin, C. M. (2005). Variability and predictability in sleep patterns of chronic insomniacs. Journal of Sleep Research, 14, 447–453.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed
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