Depression prevention in digital cognitive behavioral therapy for insomnia: Is rumination a mediator?

Cheng, Philip; Kalmbach, David A.; Castelan, Andrea Cuamatzi; Murugan, Nimalan; Drake, Christopher L.

doi:10.1016/j.jad.2020.03.184

Cited by 46 publications

(30 citation statements)

References 67 publications

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“…CBTi treatment has been found to improve symptoms of depression in multiple studies,20–24 as well as symptoms of anxiety,25 26 which makes this study consistent with previous research. In addition, symptoms of depression and anxiety had disappeared at the 3-month follow-up, which is in line with a previous study 9.…”

Section: Discussionsupporting

confidence: 89%

Baseline symptoms of depression and anxiety negatively impact the effectiveness of CBTi in treating acute insomnia among young adults

Zhang

Zeng

et al. 2023

Gen Psych

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BackgroundCognitive–behavioural therapy for insomnia (CBTi) is the first-line treatment for those with this sleep disorder. However, depressive and anxiety symptoms often co-occur with acute insomnia, which may affect the effectiveness of CBTi treatment.AimsThis study aimed to determine the impact of depressive and anxiety symptoms on the efficacy of CBTi in treating acute insomnia.MethodsA single-arm clinical trial was conducted among individuals who have acute insomnia. Participants underwent self-guided CBTi for 1-week. Their insomnia, depressive symptoms and anxiety symptoms were evaluated using the Insomnia Severity Index and the Hospital Anxiety and Depression Scale at baseline, post-treatment and 3-month follow-up. Repeated measures analysis of variance was used to assess the effectiveness of CBTi in treating insomnia, depressive symptoms and anxiety symptoms. A multivariate Cox regression model was used to determine the impact of depressive and anxiety symptoms on insomnia.ResultsThe study found significant reductions in insomnia, depressive symptoms and anxiety symptoms at both post-treatment and 3-month follow-up (F=17.45, p<0.001; F=36.37, p=0.001; and F=81.51, p<0.001, respectively). The duration of CBTi treatment had a positive impact on insomnia recovery (hazard ratio (HR)=0.94, p=0.018). However, baseline depressive symptoms (HR=1.83, p=0.004) and baseline anxiety symptoms (HR=1.99, p=0.001) had significant negative effects on insomnia recovery.ConclusionsThe study showed that a 1-week self-guided CBTi treatment is effective in treating acute insomnia and comorbid depressive and anxiety symptoms. However, baseline depressive and anxiety symptoms negatively impact treatment effectiveness. Therefore, clinicians should assess for depressive and anxiety symptoms before treating acute insomnia with monotherapy CBTi.

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Section: Discussionsupporting

confidence: 89%

Baseline symptoms of depression and anxiety negatively impact the effectiveness of CBTi in treating acute insomnia among young adults

Zhang

Zeng

et al. 2023

Gen Psych

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“…This growing area, lifestyle psychiatry, or lifestyle psychology aims to investigate alternative approaches to intervention. Lifestyle psychology ( Lopresti et al, 2013 ; Firth et al, 2020 ) traditionally includes three prominent areas of diet ( Jacka, 2017 ; Ventriglio et al, 2020 ), sleep ( Cheng et al, 2020 ; Reynolds et al, 2020 ) and exercise ( Kandola et al, 2019 ; Wegner et al, 2020 ), all of which are active fields in their own right. By way of a parallel example, in the field of nutritional psychology, it is thought that following a healthy diet (e.g., a Mediterranean style diet) is beneficial for mental health and wellbeing ( Marx et al, 2017 ).…”

Section: Depression: a Complex Problemmentioning

confidence: 99%

The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression

Owens

Bunce

2022

Front. Psychol.

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There is growing interest in nature-based interventions (NBI) to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature–depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or ‘active ingredients’ in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts.

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“…Individuals in a state of high tension for a long time are prone to mental symptoms such as sleep disorders, resulting in varying degrees of mental disorders such as depression in severe cases. There is evidence that sleep quality may play a key role in depression, as well as anxiety [ 25 , 26 ]. There is a high incidence of sleep disorders in adults and children with anxiety and depression disorders [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator

Yao

Lin

et al. 2023

IJERPH

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Background: In the period of the global pandemic, psychophysical problems induced by the fear of COVID-19 among college students deserve attention since the dormitory environment in college greatly increases the possibility of COVID-19 infection. Methods: A hypothesized mediated moderation model was to be verified using a cross-sectional study among 2453 college students. Fear of COVID-19, insomnia, hope, and depression were assessed by using the relevant scales. Results: (1) The fear of COVID-19 was positively correlated to depression (β = 0.365, t = 5.553, 95% CI = [0.236, 0.494]); (2) hope moderated the influence of the fear of COVID-19 on depression (β = −0.093, t = −4.066, 95% CI = [−0.137, −0.048]), as well as on insomnia (β = −0.095, t = −4.841, 95% CI = [−0.133, −0.056]); and (3) the mediated moderation model with hope as the moderator and insomnia as the full mediating variable between fear of COVID-19 and depression was verified (β = −0.060, 95% CI = [−0.093, −0.028]). Conclusions: The findings suggest that hope is a vital mechanism to explain the relationship between the fear of COVID-19 and depression in early adulthood. In practical application, mental health practitioners should focus on boosting hope and alleviating insomnia when addressing COVID-19-related depression issues among college students.

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Depression prevention in digital cognitive behavioral therapy for insomnia: Is rumination a mediator?

Cited by 46 publications

References 67 publications

Baseline symptoms of depression and anxiety negatively impact the effectiveness of CBTi in treating acute insomnia among young adults

Baseline symptoms of depression and anxiety negatively impact the effectiveness of CBTi in treating acute insomnia among young adults

The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression

Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator

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