The original Inventory of Depression and Anxiety Symptoms (IDAS) contains 11 nonoverlapping scales assessing specific depression and anxiety symptoms. In creating the expanded version of the IDAS (the IDAS-II), our goal was to create new scales assessing other important aspects of the anxiety disorders as well as key symptoms of bipolar disorder. Factor analyses of the IDAS-II item pool led to the creation of seven new scales (Traumatic Avoidance, Checking, Ordering, Cleaning, Claustrophobia, Mania, Euphoria) plus an expanded version of Social Anxiety. These scales are internally consistent and show strong convergent and significant discriminant validity in relation to other self-report and interview-based measures of anxiety, depression, and mania. Furthermore, the scales demonstrate substantial criterion and incremental validity in relation to interview-based measures of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) symptoms and disorders. Thus, the expanded IDAS-II now assesses a broad range of depression, anxiety, and bipolar symptoms.

SummaryInsomnia is the most common sleep disorder among the general population. Although cognitive behavioral therapy for insomnia (CBT-I) is the psychological treatment of choice, the availability of individual therapy is often not sufficient to meet the demand for treatment. Group treatment can increase the efficiency of delivery, but its efficacy has not been well-established. Randomized controlled trials (RCTs) comparing group CBT-I to a control group in patients with insomnia were identified. A review of 670 unique citations resulted in eight studies that met criteria for analysis. Outcome variables included both qualitative (e.g., sleep quality) and quantitative (e.g., sleep diary) outcomes, as well as depression and pain severity, at both pre-to post-treatment and follow-up (3-12 months post-treatment). Overall, we found medium to large effect sizes for sleep onset latency, sleep efficiency, and wake after sleep onset and small effect sizes for pain outcomes. Effect sizes remained significant at follow-up, suggesting that treatment gains persist over time. Other variables, including total sleep time, sleep quality, and depression, showed significant improvements, but these findings were limited to the within treatment group analyses. It is clear that group CBT-I is an efficacious treatment. Implications for stepped care models for insomnia are discussed.

We explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; Watson et al., 2007) in two samples (306 college students, and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS (IDAS-CR); the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of Well-Being, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to DSM-IV mood and anxiety disorder diagnoses in the patient sample. We identified particularly clear and strong associations between (for a recent review, see Joiner, Walker, Pettit, Perez, & Cukrowicz, 2005). At the same time, however, the accumulating research also has exposed some limitations of these instruments, thereby establishing the need for alternative measures (Joiner et al., 2005). Watson et al. (2007) created the Inventory of Depression and Anxiety Symptoms (IDAS) to complement these traditional measures and to address their limitations.The IDAS differs from these older instruments in two basic ways. First, these traditional measures originally were created to yield a single overall index of symptom severity. These total scores are valuable in many contexts; nevertheless, this focus on global dysfunction ignores the heterogeneous and multidimensional nature of depressive symptoms, and it hampers the identification of meaningful subtypes (Ingram & Siegle, 2002;Joiner et al., 2005). In contrast, the IDAS was specifically designed to contain multiple scales assessing specific symptoms of depression (e.g., insomnia, suicidality, appetite loss).Second, extensive evidence has established that these depression measures are very strongly associated with symptoms of anxiety (e.g., Clark & Watson, 1991;Mineka, Watson, & Clark, 1998;Watson, 2005). Consequently, the original IDAS item pool contained a broad range of anxiety-related symptoms. The inclusion of these items facilitated the development of depression scales with good discriminant validity, and also eventually led to the creation of complementary anxiety scales (e.g., social anxiety, panic). Development and Preliminary Validation of the IDAS Further Validation of the IDAS 4 Development of the IDASAn initial pool of 180 items was subjected to a series of analyses in a large undergraduate sample (see Watson et al., 2007, Study 1); this yielded a revised pool of 169 items. Next, this revised set of items was administered to large samples of college students, psychiatric patients, and community adults (Watson et al., 2007, Study 2). Data from these three samples were subjected to separate series of principal factor analyses. Ten specific content factors emerged in all three samples and were used to create corresponding scales. Five of these scales represent specific symptoms of major depression: Insomnia, Lassitude (which includes items refle...

This paper reviews studies that have examined associations between unusual sleep experiences (including nightmares, vivid dreaming, narcolepsy symptoms, and complex nighttime behaviors) and dissociation and schizotypy. Using correlational studies and structural analyses, evidence is provided that unusual sleep experiences, dissociation, and schizotypy belong to a common domain. It is demonstrated that unusual sleep experiences show specificity to dissociation and schizotypy compared to other daytime symptoms (e.g., anxiety, depression, substance use) and other sleep disturbances (e.g., insomnia, lassitude/fatigue). The paper also outlines the methodological limitations of the existing evidence and makes suggestions for future research. Finally, three models for the overlap of daytime and nighttime symptoms are reviewed, including biological abnormalities, trauma, and personality traits. Although further research is needed, it is suggested that daytime and nighttime symptoms result from problems with sleep-wake state boundaries, which may be precipitated by stress or trauma. In addition, association between daytime and nighttime symptoms can be attributed to the higher order personality trait of Oddity. Keywords dissociation; schizotypy; sleepPeople have long noted the phenotypic similarities between select nighttime experiences and daytime psychological symptoms, such nightmares and hallucinations. It is possible that phenotypically similar daytime and nighttime experiences are related, although this remains an empirical question. Specifically, it has been suggested that dissociation, schizotypy, and certain sleep experiences (i.e., nightmares, narcolepsy symptoms) belong to a domain that involves unusual cognitions and perceptions (Watson, 2001). Moreover, these daytime and nighttime experiences may share common processes under different contexts (e.g., walking around during the day versus lying in bed) (Butler, 2006;Watson, 2001), although the exact nature of these processes and whether they are due to biological or environmental factors is still uncertain.The purpose of this paper is to review evidence that certain sleep experiences, dissociation, and schizotypy represent a common domain with shared etiology. We begin by defining dissociation and schizotypy and outline the disorders and symptom dimensions that will be Correspondence should be sent to Erin Koffel,

The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review. Implementation research testing specific interventions to increase routine and sustained use of CBT-I was lacking. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. These findings are organized using a conceptual model to represent the many challenges inherent in providing guideline-concordant insomnia care. We conclude with an agenda for future implementation research to systematically address these challenges.