Impact of Cognitive Behavioral Therapy for Insomnia on Veterans' Willingness to Seek Treatment for Comorbid Health Conditions

认知行为疗法治疗失眠对退伍军人寻求合并症治疗意愿的影响

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Abstract

OBJECTIVES: This study aimed to determine the extent to which Cognitive Behavioral Therapy for Insomnia (CBT-I) influences participant willingness to seek treatment for behavioral health conditions. We hypothesized that, relative to sleep hygiene control, CBT-I would be associated with increased willingness to seek treatment for alcohol use, depression, anxiety, PTSD, and chronic pain. Since all participants had insomnia, we also tested CBT-I effects on willingness to seek treatment for residual or future episodes of insomnia. METHOD: Data were derived from a randomized controlled trial comparing the efficacy of CBT-I to sleep hygiene control among heavy-drinking Veterans with insomnia (N = 70; 57 men, 13 women; age M = 37.6, SD = 9.4). Willingness to seek treatment was measured on a scale from 0 (strongly disagree) to 4 (strongly agree). RESULTS: At the end of treatment, across both groups, participants reported most willingness to seek treatment for insomnia (M = 3.08, SD = 1.04), followed by chronic pain (M = 2.82, SD = 1.21), anxiety (M = 2.76, SD = 1.24), depression (M = 2.75, SD = 1.29), PTSD (M = 2.61, SD = 1.27), and alcohol use (M = 2.51, SD = 1.19). Relative to those in sleep hygiene, CBT-I participants reported increased willingness to seek treatment for insomnia [F(1,48) = 10.25, p = .002, d = 0.86] and chronic pain [F(1,48) = 5.76, p = .02, d = 0.60]. No other group-by-time interactions were significant. CONCLUSIONS: CBT-I does increase willingness for future treatment, but only targeting insomnia and chronic pain. Continued research on how to engage Veterans in evidence-based treatment for common mental health concerns (e.g. alcohol use, depression, anxiety, and PTSD) is needed.

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