Sequential Treatment of Comorbid Insomnia and Generalized Anxiety Disorder.

TitleSequential Treatment of Comorbid Insomnia and Generalized Anxiety Disorder.
Publication TypeJournal Article
Year of Publication2016
AuteursBelleville, G, Ivers, H, Bélanger, L, Blais, FC, Morin, CM
JournalJ Clin Psychol
Volume72
Issue9
Pagination880-96
Date Published2016 Sep
ISSN1097-4679
KeywordsAdult, Anxiety Disorders, Cognitive Therapy, Comorbidity, Female, Humans, Middle Aged, Outcome Assessment (Health Care), Sleep Initiation and Maintenance Disorders
Abstract

OBJECTIVE: To explore the efficacy of cognitive-behavior therapy (CBT) for patients with comorbid generalized anxiety disorder (GAD) and insomnia using 2 sequential treatments.METHOD: Using a single-case methodology, 10 women (mean age = 45) with chronic insomnia and GAD were randomly assigned to CBT for GAD followed by CBT for insomnia, or to CBT for insomnia followed by CBT for GAD. Sleep and anxiety were measured via diagnostic interviews, daily diaries, and self-report questionnaires.RESULTS: Time series analyses, group effect sizes, and indications of clinically significant change revealed improvements on anxiety, worry, and sleep after CBT for GAD. Following CBT for insomnia, positive changes were observed on sleep and, to a lesser extent, anxiety and worry.CONCLUSIONS: In the presence of comorbid GAD and insomnia, initiating treatment for GAD first produced superior clinical benefits in anxiety and sleep. The addition of insomnia-specific treatment led to additional improvements in worry and sleep quality.

DOI10.1002/jclp.22300
Alternate JournalJ Clin Psychol
PubMed ID27111542