Cognitive behaviour therapy for older adults experiencing insomnia and depression in a community mental health setting: Study protocol for a randomised controlled trial
- Sadler, Paul, McLaren, Suzanne, Klein, Britt, Jenkins, Megan, Harvey, Jack
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Trials Vol. 16, no. 1 (2015), p.1-12
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- Description: Background: Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. Methods/Design: We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Discussion: This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG. It will also establish whether an advanced form of CBT-I-D generates greater reductions in insomnia and depression severity compared to standard CBT-I. The results from the proposed trial are anticipated to have important clinical implications for older adults, researchers, therapists, and community mental health services. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN: 12615000067572 , Date Registered 12 December 2014. © 2015 Sadler et al.
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Trials Vol. 16, no. 1 (2015), p.1-12
- Full Text:
- Reviewed:
- Description: Background: Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. Methods/Design: We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Discussion: This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG. It will also establish whether an advanced form of CBT-I-D generates greater reductions in insomnia and depression severity compared to standard CBT-I. The results from the proposed trial are anticipated to have important clinical implications for older adults, researchers, therapists, and community mental health services. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN: 12615000067572 , Date Registered 12 December 2014. © 2015 Sadler et al.
Choking under pressure : The role of fear of negative evaluation
- Mesagno, Christopher, Harvey, Jack, Janelle, Christopher
- Authors: Mesagno, Christopher , Harvey, Jack , Janelle, Christopher
- Date: 2011
- Type: Text , Journal article
- Relation: Psychology of Sport and Exercise Vol.13 , no.1 (2012), p.60-68
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- Description: Objective: Conceptual models and predictors of choking under pressure (i.e., choking) have been proposed, but the role of fear of negative evaluation remains largely unknown. The purpose of the current study was to determine the degree to which fear of negative evaluation (FNE) may predispose athletes to choking. Design and method: 138 Experienced basketball players participated in a pre-selection stage, which involved completing a set of questionnaires that included the Brief Fear of Negative Evaluation-II (BFNE-II) questionnaire. Based on the scores from the BFNE-II, 34 athletes, categorized as either low- or high-FNE, were selected to perform basketball shots from five different areas of the court under low- and high-pressure phases. Shooting performance was evaluated based on the total number of successful shots out of 50 attempts. Results: Results indicated that the high-FNE athletes displayed a significant increase in anxiety and a significant decrease in performance from low- to high-pressure phases. The low-FNE group exhibited only minimal changes in anxiety throughout the study and was able to maintain performance under pressure. Further mediation analysis investigating significant difference in performance between FNE groups within the high-pressure phase indicated that that cognitive anxiety was a partial mediator between FNE group and performance, but somatic anxiety was not. Conclusions: Findings extend the existing choking literature by providing empirical support for the role of FNE in the context of the self-presentation model of choking. © 2011 Elsevier Ltd.
- Authors: Mesagno, Christopher , Harvey, Jack , Janelle, Christopher
- Date: 2011
- Type: Text , Journal article
- Relation: Psychology of Sport and Exercise Vol.13 , no.1 (2012), p.60-68
- Full Text:
- Reviewed:
- Description: Objective: Conceptual models and predictors of choking under pressure (i.e., choking) have been proposed, but the role of fear of negative evaluation remains largely unknown. The purpose of the current study was to determine the degree to which fear of negative evaluation (FNE) may predispose athletes to choking. Design and method: 138 Experienced basketball players participated in a pre-selection stage, which involved completing a set of questionnaires that included the Brief Fear of Negative Evaluation-II (BFNE-II) questionnaire. Based on the scores from the BFNE-II, 34 athletes, categorized as either low- or high-FNE, were selected to perform basketball shots from five different areas of the court under low- and high-pressure phases. Shooting performance was evaluated based on the total number of successful shots out of 50 attempts. Results: Results indicated that the high-FNE athletes displayed a significant increase in anxiety and a significant decrease in performance from low- to high-pressure phases. The low-FNE group exhibited only minimal changes in anxiety throughout the study and was able to maintain performance under pressure. Further mediation analysis investigating significant difference in performance between FNE groups within the high-pressure phase indicated that that cognitive anxiety was a partial mediator between FNE group and performance, but somatic anxiety was not. Conclusions: Findings extend the existing choking literature by providing empirical support for the role of FNE in the context of the self-presentation model of choking. © 2011 Elsevier Ltd.
Self-presentation origins of choking: Evidence from separate pressure manipulations
- Mesagno, Christopher, Harvey, Jack, Janelle, Christopher
- Authors: Mesagno, Christopher , Harvey, Jack , Janelle, Christopher
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Sport and Exercise Psychology Vol. 33, no. 3 (2011), p. 441-459
- Full Text: false
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- Description: Whether self-presentation is involved in the choking process remains unknown. The purpose of the current study was to determine the role of self-presentation concerns on the frequency of choking within the context of a recently proposed self-presentation model. Experienced field hockey players (N = 45) were randomly assigned to one of five groups (i.e., performance-contingent monetary incentive, video camera placebo, video camera self-presentation, audience, or combined pressure), before taking penalty strokes in low- and high-pressure phases. Results indicated that groups exposed to self-presentation manipulations experienced choking, whereas those receiving motivational pressure treatments decreased anxiety and increased performance under pressure. Furthermore, cognitive state anxiety mediated the relationship between the self-presentation group and performance. These findings provide quantitative support for the proposed self-presentation model of choking, while also holding implications for anxiety manipulations in future sport psychology research. © 2011 Human Kinetics, Inc.
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