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Biomedical subjects

C M Morin

Publications and source records attributed to C M Morin.

30 records · Page 2Linked to original sources
PubMed1993

Cognitive-behavior therapy for late-life insomnia.

Twenty-four older adults with persistent psychophysiological insomnia were randomly assigned to an immediate or a delayed cognitive-behavioral intervention in a waiting-list control group design. Cognitive-behavior therapy consisted of an 8-week group intervention aimed at changing maladaptive sleep habits and altering dysfunctional beliefs and attitudes about sleeplessness. Treatment was effective in reducing sleep latency, wake after sleep onset, and early morning awakening, and in increasing sleep efficiency. The magnitude of changes obtained on polysomnographic measures was smaller but in the same direction as that obtained on daily sleep diaries. Sleep improvements obtained by the immediate-treatment group were replicated with the delayed treatment condition. Therapeutic gains were well maintained at 3- and 12-month follow-ups. Clinical validation of outcome was obtained through collateral ratings from the patients and their significant others. The findings indicate that late-life insomnia can be effectively treated with nonpharmacological interventions.

Aged↗
PubMed1993

Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints.

This study examined the beliefs and attitudes about sleep among 145 older adults. Ss were either chronic insomniacs (n = 74) or self-defined good sleepers (n = 71). They rated their level of agreement or disagreement (visual analog scale) with 28 statements tapping various beliefs, expectations, and attributions about several sleep-related themes. The results showed that insomniacs endorsed stronger beliefs about the negative consequences of insomnia, expressed more hopelessness about the fear of losing control of their sleep, and more helplessness about its unpredictability. These findings suggest that some beliefs and attitudes about sleep may be instrumental in perpetuating insomnia. The main clinical implication is that these cognitions should be identified and targeted for alteration in the management of late-life insomnia.

Aged↗
PubMed1992

Recent advances in the assessment and treatment of insomnia.

Persistent insomnia has multiple potential causes such as medical, pharmacological, life-style, personality, and behavioral factors. Although many poor sleepers use hypnotic medications, a wide array of cognitive-behavioral interventions are available that target somatic and cognitive arousal, dysfunctional thoughts, and learned maladaptive sleep habits. Outcome research conducted over the past decade reveals that the single treatments of stimulus control and sleep restriction produced the best results, reducing self-reported target complaints by 50-60%. Approximately half of insomniacs show reliable change although only about one third become good sleepers. Multicomponent methods offer considerable promise but on the whole have not surpassed results achieved with the simpler stimulus control. Recommended new directions of pursuit include (a) examination of a broader range of insomnia sufferers, (b) use of multimodal assessment and more objective verification of self-reported benefits (c) research on treatments tailored to individual causal and maintaining factors, and (d) further scrutiny of newer interventions like sleep restriction and more comprehensive multifaceted strategies.

Behavior Therapy↗
PubMed1992

Patients' acceptance of psychological and pharmacological therapies for insomnia.

This study evaluated the acceptance of psychological and pharmacological therapies among chronic insomniacs and noncomplaining good sleepers. After reading a brief written description of two treatment methods commonly used for persistent insomnia (i.e. cognitive-behavior therapy and pharmacotherapy), the subjects rated in a counter-balanced order several dimensions of these two treatment modalities. The results showed that the psychological intervention was rated as more acceptable and more suitable than the pharmacological one among both insomniacs and their noncomplaining significant others. Behavior therapy was also expected to be more effective on a long-term basis and to produce fewer side effects as well as more benefits on daytime functioning. The clinical implications and relevance of treatment acceptance in the management of insomnia are discussed.

Aged↗
PubMed1990

Sleep restriction for the inpatient treatment of insomnia.

This study evaluates the efficacy of sleep restriction therapy for treating insomnia on an inpatient psychiatric unit. A depressed patient with concomitant chronic pain and severe insomnia was treated with a sleep restriction procedure. This procedure consisted of curtailing the amount of time spent in bed and then gradually increasing it contingent upon improved sleep efficiency. The treatment was found to be effective for increasing total sleep time from an initial baseline of 2.5 h of sleep per night to 6 h of sleep per night at discharge time. Clinical gains were well maintained immediately after discharge and at a 4-month follow-up.

Affect↗
PubMed1989

Behavioral management of sleep disturbances secondary to chronic pain.

The clinical efficacy of a behavioral management program for treating insomnia secondary to chronic pain was evaluated within a multiple-baseline design across subjects. Treatment consisted of a combination of stimulus control and sleep restriction procedures. Daily sleep diaries and all-night polysomnographic (PSG) measures were used to document changes in sleep/wake patterns. The results showed that treatment was effective in improving sleep patterns in all three patients. A substantial decrease of time awake at night was obtained and this was reflected by reductions of sleep onset latency, wake time after sleep onset, and early morning awakenings. Sleep improvements were well maintained at follow-ups and were also paralleled by improved mood states. The findings indicate that behavioral procedures are effective for treating sleep disturbances associated with chronic pain conditions.

Back Pain↗
PubMed1989

Sleep patterns and aging: comparison of older adults with and without insomnia complaints.

The nature of geriatric insomnia was studied by comparing older adults with (n = 42) and without (n = 30) insomnia complaints on measures of sleep, mood, life-style, health, and sleep-requirement expectations. Elderly persons with insomnia complaints reported longer sleep latency and more frequent and longer awakenings and used sleeping aids more often than those without insomnia complaints. Nocturnal sleep time was not a reliable discriminator. Poor sleepers showed greater discrepancies between their current sleep patterns and sleep-requirement expectations than did good sleepers. Elderly insomniacs acknowledged greater symptomatology of depression and anxiety than did good sleepers. Daytime napping and physical exercise were equivalent in both groups. Medical disorders, pain conditions, and drug usage (other than sleep aids) did not distinguish the two groups. Clinical implications for the treatment of geriatric insomnia are discussed.

Aged↗
PubMed1987

Bulimia: a case illustration of the superiority of behavioral over cognitive treatment.

The present study compared the relative efficacy of two major clinical procedures previously used in multicomponent cognitive-behavioral programs for treating bulimia. A single-subject experimental design was used and the results showed that the behavioral procedure of exposure plus response prevention was more effective than the cognitive procedure in reducing binge and vomit episodes as well as the urges to binge-vomit. These results suggest that the exposure plus response prevention component is more relevant for cognitive as well as behavioral changes in treating bulimia.

Adult↗
PubMedDate not supplied

[Evaluation of insomnia: validity of 3 questionnaires].

Insomnia is a widespread problem impairing daytime functioning and carrying important social and economic costs. No valid instrument exists in French to assess sleep difficulties. Two studies assess the French translation of three insomnia measures. The Pittsburgh Sleep Quality Index (PSQI), the Sleep Impairment Rating Scales (SIRS) and the Beliefs and Attitudes about Sleep (BAS) questionnaires were selected according to their clinical utility. Study one established the inferential translation of the preliminary versions with six expert judges. The empirical equivalence of the original and translated versions were confirmed with bilingual nonclinical sample. Study two assessed the fidelity and convergent validity of these instruments with a nonclinical French sample. The results showed adequate internal consistency; test-retest fidelity for a two-week interval was acceptable. The findings on convergent validity are also appropriate. While future research is necessary to confirm their psychometric properties, these questionnaires are good measures to assess insomnia in a research or clinical context.

Adolescent↗