مدیریت ناخواسته پیش از خواب در بی خوابی: حواس پرتی با تصاویر در مقابل حواس پرتی عمومی
کد مقاله | سال انتشار | تعداد صفحات مقاله انگلیسی |
---|---|---|
38715 | 2002 | 11 صفحه PDF |
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Behaviour Research and Therapy, Volume 40, Issue 3, March 2002, Pages 267–277
چکیده انگلیسی
Abstract Insomniacs commonly complain that they are unable to get to sleep at night due to unwanted thoughts, worries and concerns. The present study investigated whether brief training in identifying and elaborating an interesting and engaging imagery task for use during the pre-sleep period can reduce unwanted pre-sleep cognitive activity and sleep onset latency. Forty one people with insomnia were given one of three instructional sets to follow on the experimental night; instructions to distract using imagery, general instructions to distract, or no instructions. Based on previous findings reported by Salkovskis & Campbell (1994) ‘Behaviour Research and Therapy 32 (1994) 1’ and ironic control theory (Wegner, 1994) ‘Psychological Review 101 (1994) 34’, it was predicted that (1) “imagery distraction” would be associated with shorter sleep onset latency and less frequent and distressing pre-sleep cognitive activity compared to the “no instruction” group and that (2) “general distraction” would be associated with longer sleep onset latency and more frequent and distressing pre-sleep cognitive activity compared to the “no instruction” group. Support was found for the first but not the second prediction. The success of the “imagery distraction” task is attributed to it occupying sufficient “cognitive space” to keep the individual from re-engaging with thoughts, worries, and concerns during the pre-sleep period. In addition, “imagery distraction” involved a very specific alternative cognitive task hence the operating process was given a feature positive search, conditions where mental control is likely to be achieved.
نتیجه گیری انگلیسی
2. Results Unless otherwise stated, the following analyses were based on a one way analysis of variance (ANOVA) with Sheffe post-hoc tests to explore significant effects. 2.1. Participant characteristics Table 1 presents the mean scores for participant characteristics. The three groups did not differ according to sex (analysed with chi-square), age, PSQI global score, length of insomnia, or sleep onset latency on a typical night. Table 1. Mean scores for participant characteristicsa Imagery distraction General distraction No instruction Sex Male: 6 6 8 Female: 8 8 5 Age 21.7 (3.2) 22.5 (4.4) 22.9 (4.6) PSQI global score 9.6 (2.6) 8.4 (2.1) 8.5 (2.6) Length of insomnia 9.9 (4.2) 7.6 (5.9) 5.9 (5.9) Sleep onset latency on a typical night 50.4 (28.1) 37.9 (26.1) 60.0 (30.5) a Standard deviations appear in parentheses. Age is reported in years. PSQI global score=total score on the Pittsburg Sleep Quality Index (maximum score=21). Length of insomnia is reported in years. Sleep onset latency is reported in minutes. Table options 2.2. Manipulation checks On the experimental night participants in the “imagery distraction” group imagined a past or future holiday (n=8), a summer afternoon in the sun (n=3), Christmas day with family (n=1), walking through a meadow (n=1), or a countryside scene with a waterfall (n=1). Participants in the “general distraction” group thought through events that happened today (n=6), counted (n=2), meditated (n=2), subvocally hummed a favourite tune (n=1), blanked their mind whenever an unpleasant thought occurred (n=2), or focused on body relaxation (n=1). Participants in the “no instruction” group used no particular technique (n=4), listened to music (n=3), tried to relax (n=1), engaged in breathing exercises (n=1), suppressed thoughts (n=2), got a friend to talk until sleepy (n=1), and blanked the mind (n=1). There was a group main effect for ratings of the engagingness of the strategy, F(2, 38)=7.69, p<0.01. Follow up tests indicated that the “imagery distraction” group (M=5.6, SD=1.5) rated their strategy to be more engaging than the ratings made by the “general distraction” (M=3.8, SD=1.7, p<0.05) and the “no instruction” (M=3.2, SD=1.9, p<0.01) groups. Participants in the “imagery distraction” group rated the vividness of their imagery during the pre-sleep period as follows; 43% (n=6) reported the image to be “clear and reasonably vivid”, 43% (n=6) reported the image to be “moderately vivid”, and 14% (n=2) reported the image to be “vague and dim”. The average vividness rating was 2.73 (SD=0.70) (between “moderately vivid” and “clear and reasonably vivid”). 2.3. Frequency of pre-sleep cognitive activity No significant effects were observed between groups for the thought frequency rating, F(2, 38)=0.78, ns, [“imagery distraction” M=5.7, SD=2.2, “general distraction” M=4.9, SD=2.4, “no instruction” M=4.6, SD=2.7]. A significant group effect was observed for the thought discomfort rating, F(2, 38)=4.17, p<0.05, such that the “imagery distraction” group rated their thoughts to be less uncomfortable/distressing than the “general distraction” (p=0.075 — note marginal significance) and “no instruction” (p<0.05) groups. [“Imagery distraction” M=3.2, SD=1.9, “general distraction” M=5.0, SD=2.1, “no instruction” M=5.2, SD=2.1]. 2.4. Sleep onset latency Fig. 1 presents the mean sleep onset latency for the experimental night across groups. The group main effect was significant, F(2, 38)=7.66, p<0.01. Follow up tests indicated that the “imagery distraction” group estimated their sleep onset latency to be shorter than the “no instruction” group (p<0.01). Further, the “general distraction” group estimated their sleep onset latency to be shorter than the “no instruction” group (p<0.05). Estimated sleep onset latency on the experimental night and the deviation score ... Fig. 1. Estimated sleep onset latency on the experimental night and the deviation score across groups. Note: Deviation score=sleep onset latency on a typical night minus sleep onset latency on an experimental night. Figure options A deviation score was calculated by subtracting the estimated sleep onset latency for the experimental night from the estimated sleep onset latency on a typical night. These scores are graphically displayed in Fig. 1. The group main effect was significant, F(2, 38)=3.27, p<0.05. Follow up tests indicated that the deviation score for the “imagery distraction” group was higher than for the “no instruction” group, although the difference was marginally significant (p=0.59). That is, the “imagery distraction” group estimated their sleep onset latency to be shorter on the experimental night compared to a typical night. Whereas the “no instruction” group estimated their sleep onset latency to be longer on the experimental night compared to a typical night.