中国科学院心理研究所机构知识库

目的:探讨失眠的认知行为疗法在矫正失眠患者认知过程中的影响因素。方法:2016年3-9月在广安门医院心理科门诊就诊的70例慢性失眠患者，记录患者的一般资料情况(年龄、性别、病程、有无抽烟喝酒、家族史、受教育程度、就业情况、婚姻状况及有无躯体疾病)。于治疗前、治疗第4周、治疗结束(治疗第8周)时，记录各组的失眠严重程度指数(ISI)、睡眠个人信念和态度量表(DBAS)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)各因子，并分析比较患者的一般资料与DBAS量表是否相关、患者不同时间的量表得分情况。结果:(1)治疗结束时，ISI、DBAS较治疗前总分显著下降(F=157.796,86.951;P<0.001);(2)经过8周治疗之后，患者部分一般资料(年龄、受教育程度、是否抽烟以及患病时长)与DBAS总分差异有统计学意义(P<0.05);(3)患者在治疗结束时，失眠严重程度指数(ISI)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)各因子(ISI、BAI及BDI)与DBAS总分呈负相关，相关性有统计学意义(P<0.05)。结论:CBT-I治疗对于失眠患者的认知偏差改善疗效显著；另外，患者的情绪变化、部分社会特征在CBT-I治疗中，对认知偏差改善具有潜在影响。

Objective: To investigate the influencing factors of cognitive behavior therapy for insomnia in correcting the cognitive process of insomniac patients. Methods: From March 2016 to September 2016，70 patients with chronic msomma treated in the Outpatient Department of Psychology of Guang' anmen Hospital were selected. The general of data(age，gender，coures of disease，smoking and drinking，family history，educational level, employment, marital sta tus and physical diseases)of the patients were recorded. Before treatment，at the 4th week of treatment and at the end of treatment(the 8th week of treatment)，Insomnia Severity Index(ISI>，Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS)，Beck Depression Inventory( BDI) and Beck Anxiety Inventory( BAI) were recorded. The correladons of the general data with DBAS and the scale score at different times were analyzed and compared. Results: ①At the end of treatment，the total scpres of ISI and DBAS decreased significantly compared with those before treatment (F= 157.796，86.951;P<0.001).②After treatment for 8 weeks，statistically significant differences were found in age，educational level，smoking，course of disease and total DBAS score(P<0.05).③At the end of treatment，ISI， BDI and BAI were negatively correlated with total DBAS score，with statistical significance(P<0.05).Conclusion: CBT-I has significant efficacy in the improvement of cognitive bias in patients with insomnia. In addition，patients e- motional changes and some social characteristics have potential effects on the improvement of cognitive bias in CBT-I.

北京市科委重点临床特色课题(编号：Z121107001012034)