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1、ClinicalPsychologyReview32(2012)664–675ContentslistsavailableatSciVerseScienceDirectClinicalPsychologyReviewMediatorsofcognitive-behavioraltherapyforinsomnia:AreviewofrandomizedcontrolledtrialsandsecondaryanalysisstudiesDanielleR.Schwartz,ColleenE.Carney?Departmentof
2、Psychology,RyersonUniversity,Toronto,Ontario,CanadaHIGHLIGHTS?Thisstudyreviewedmediatorsofcognitive-behavioraltherapyforinsomnia.?Randomizedcontrolledtrialsandsecondaryanalysisstudieswereinvestigated.?21RCTs(39%oftotal)and11secondaryanalysisstudiesincludedmediatorvar
3、iables.?Cognitive-behavioraltherapyofinsomniaappearstotargetproposedsleepprocesses.?Futuremediationalanalyseswouldallowforfurtherre?nementoftreatment.articleinfoabstractArticlehistory:Theexaminationoftreatmentmechanismsinrandomizedcontrolledtrials(RCTs)hasconsiderabl
4、eimplica-Received12January2012tionsforresearchandclinicalpractice.Insomniaisahighlyprevalentanddistressingdisorder,associatedReceivedinrevisedform2May2012withmanyadverseoutcomes.Althoughextensiveworkhasfocusedonthecognitive-behavioraltreatmentAccepted25June2012ofinso
5、mnia(CBT-I),fewstudieshavedirectlyexaminedthemechanismsofthisintervention.CBT-IisaAvailableonline3July2012short-term,multi-componenttreatmentthathasdemonstratedstrongef?cacyintreatinginsomnia.Thepur-poseofthepresentstudyis:(a)toinvestigateifCBT-Iworksinaccordancewith
6、itsproposedmechanisms,Keywords:Cognitive-behavioraltherapyand(b)toevaluatehowthe?eldisprogressinginitsunderstandingoftheseprocesses.Thisstudycompre-InsomniahensivelyreviewedCBT-IRCTsfortheirinclusionofmediatorvariables.SecondaryanalysisstudieswerealsoMediatorssurveye
7、dforrelevantmediatorvariables.Resultsdemonstratedthat21RCTs(39%ofthetotalRCTs)and11Randomizedcontrolledtrialssecondaryanalysisstudiesexaminedatleastoneoftheproposedmediators.ResultsofthisreviewhighlightSecondaryanalysisstudiesthat,althoughCBT-Iappearstobetargetingthe
8、hypothesizedsleepprocesses,moreresearchisneededtobetterunderstandwhetherCBT-Iworksinaccordancewithitstheorizedmechanisms.Inclusiono
