Evidence map›Paper›PMID 34265777›Full record

Trial reportPsychotherapy and psychosomatics

A Randomized Clinical Trial of Cognitive-Behavioral Therapy for Insomnia to Augment Posttraumatic Stress Disorder Treatment in Survivors of Interpersonal Violence.

Wilfred R Pigeon, Hugh F Crean, Catherine Cerulli, Autumn M Gallegos, Todd M Bishop, Kathi L Heffner

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychotherapy and psychosomatics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Cognitive behavioral therapy for insomnia treatment attrition in patients with weekly nightmares.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023
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  17. Autonomic regulation during sleep in PTSD.Neurobiology of stress · 2022
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  18. Acute sleep interventions as an avenue for treatment of trauma-associated disorders.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Wilfred R PigeonSleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
Hugh F CreanUS Department of Veterans Affairs Center of Excellence for Suicide Prevention, Finger Lakes Health Care System, Canandaigua, New York, USA.
Catherine CerulliSusan B. Anthony Center and Laboratory of Interpersonal Violence and Victimization, University of Rochester Medical Center, Rochester, New York, USA.
Autumn M GallegosSleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
Todd M BishopSleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
Kathi L HeffnerSleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA.
University of Rochester Medical Center · US

Funding

Managing Sleep Symptoms and Modifying Mechanisms of Traumatic StressR01NR013909 · NINR · UNIVERSITY OF ROCHESTER · PI HEFFNER, KATHI L, PIGEON, WILFRED R · 2012 to 2015
$1.5M
NINR NIH HHS R01 NR013909
6 · The paper itself

Abstract

introductionIndividuals exposed to interpersonal violence (IPV) commonly develop posttraumatic stress disorder (PTSD) with co-occurring depression and insomnia. Standard PTSD interventions such as cognitive processing therapy (CPT) do not typically lead to remission or improved insomnia. Cognitive behavioral therapy for insomnia (CBTi) improves insomnia in individuals with PTSD, but PTSD severity remains elevated.

objectiveTo determine whether sequential treatment of insomnia and PTSD is superior to treatment of only PTSD.

methodsIn a 20-week trial, 110 participants exposed to IPV who had PTSD, depression and insomnia were randomized to CBTi followed by CPT or to attention control followed by CPT. Primary outcomes following CBTi (or control) were the 6-week change in score on the Insomnia Severity Index (ISI), the Clinician-Administered PTSD Scale (CAPS), and the Hamilton Rating Scale for Depression (HAM-D). Primary outcomes following CPT were the 20-week change in scores.

resultsAt 6 weeks, the CBTi condition had greater reductions in ISI, HAM-D, and CAPS scores than the attention control condition. At 20 weeks, participants in the CBTi+CPT condition had greater reductions in ISI, HAM-D, and CAPS scores compared to control+CPT. Effects were larger for insomnia and for depression than for PTSD. Similar patterns were observed with respect to clinical response and remission. A tipping point sensitivity analyses supported the plausibility of the findings.

conclusionsThe sequential delivery of CBTi and CPT had plausible, significant effects on insomnia, depression, and PTSD compared to CPT alone. The effects for PTSD symptoms were moderate and clinically meaningful.

Indexed as

Cognitive Behavioral TherapySleep Initiation and Maintenance DisordersStress Disorders, Post-TraumaticHumansSurvivorsTreatment OutcomeViolenceCognitive-behavioral therapyDepressionInsomniaInterpersonal violencePosttraumatic stress disorder

Identifiers

PMID34265777
PMCPMC8760360
OpenAlexW3180273958

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.