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    政大機構典藏 > 理學院 > 心理學系 > 期刊論文 >  Item 140.119/21209
    Please use this identifier to cite or link to this item: http://nccur.lib.nccu.edu.tw/handle/140.119/21209


    Title: 失眠病因理論與認知行為治療療效因子:理論與實務的對應
    Other Titles: Etiological Model of Insomnia and Therapeutic Factors of cognitive-behavioral Therapy for Insomnia: The Correspondence of Theories and Practices
    Authors: 陳昌偉;楊建銘
    Chen,Chang-Wei;Yang,Chien-Ming
    Keywords: Insomnia;Psychopathological model;Neurobehavioral model;CBT;Treatment outcome
    失眠;病因;神經行為模式;認知行為治療;療效
    Date: 2006-06
    Issue Date: 2008-12-31 11:18:13 (UTC+8)
    Abstract: Objective: Much progress has been made lately about the understanding of the pathology of insomnia and the efficacy of cognitive-behavioral therapy for insomnia (CBTI). However, there is still much to be learned about the therapeutic mechanisms of CBTI. This article reviewed etiological models of insomnia and the research on treatment effects of CBTI in order to clarify the therapeutic factors of CBTI in corresponding etiological models. Method: Etiological factors of insomnia were reviewed under the framework of the neurobehavioral model of insomnia. Research on the therapeutic effects of CBTI were then reviewed based on the etiological factors proposed by the framework. Result: Most of the treatment outcome studies of CBTI focused on the improvements of insomnia symptoms. Only few studies explored the degree of changes in the psychological or behavioral aspects of the etiological factors in the neurobehavioral model, including sleep cognition, behavioral practices and emotional arousal. Relatively more supporting evidence were reported in the changes of maladaptive beliefs and arousal following CBTI. No study was found reporting improvements in sleep hygiene practices. Also, very limited number of studies showed changes in the neurophysiological aspects of the etiological factors within the etiological models. Conclusion: To date, the correspondence between the therapeutic mechanisms of CBTI and the etiological models of insomnia is still not clear. Future studies are needed to clarify these issues by measuring changes on the different etiological factors following CBTI. Better understanding of the therapeutic mechanisms will validate the etiological models of insomnia, as well as, facilitate more efficient treatment programs for insomnia.
    目的:近年來對於失眠病因的瞭解以及失眠認知行為治療的療效研究都有相當的進展,然而,失眠認知行為治療的改變機制仍然所知有限。本篇綜說回顧失眠的病因模式以及失眠認知行為療效研究,嘗試整合病因理論與療效因子的研究結果,並探討失眠認知行為治療的療效與病因理論所提出的相關因子的關係。 方法:本文以失眠神經行為模式之病因理論為架構,探討認知行為治療療效研究當中,療效因子與病因理論間的關係。 結果:失眠認知行為治療的療效研究多將研究焦點放在失眠症狀的改善程度,僅有少數研究針對病因理論中的心理及行為因子,探討患者在治療前後其認知信念、睡眠保健行為以及情緒激發程度的改變,其中在認知信念的部分有相對較多的研究支持,也有少數研究呈現了睡前激發狀態的改善,然而在睡眠保健行為的探討仍相當缺乏。而關於調節失眠症狀的重要中介-神經生理系統是否因認知行為治療而有所改善,過去對此部分的研究則非常有限。 結論:目前有關失眠認知行為治療的療效因子與改變機制的研究仍相當有限,難以由治療的結果與病因理論整合印證,以提供理論或治療的修正方向。建議後續療效研究能針對失眠病因理論當中各項病理機轉及相關因子加以測量,以期對失眠的本質以及改變的機制有更清楚的瞭解,並可藉此調整認知行為治療的施行方式或比重,使其能更有效率地達到治療效果。
    Relation: 臨床心理學刊, 3(1), 1-12
    Data Type: article
    Appears in Collections:[心理學系] 期刊論文

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