Paradoxical intention for insomnia: A systematic review and meta-analysis

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Paradoxical intention for insomnia : A systematic review and meta-analysis

Jansson-Frojmark, Markus (author): Karolinska Institutet,Stockholm County Council,Region Stockholm

Alfonsson, Sven (author): Karolinska Institutet,Stockholm County Council,Region Stockholm

Bohman, Benjamin (author): Karolinska Institutet,Stockholm County Council,Region Stockholm

Rozental, Alexander (author): Karolinska Institutet,Stockholm County Council,University College London,Region Stockholm

Norell-Clarke, Annika, 1979- (author): Karlstads universitet,Institutionen för sociala och psykologiska studier (from 2013),Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden; Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden,Department of Nursing and Integrated Health Sciences,Forskningsplattformen Hälsa i samverkan,Childrens and Young Peoples Health in Social Context (CYPHiSCO),Karlstad University,Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap

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(creator_code:org_t)

2021-08-17
2022
English.
In: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 31:2

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Journal article (peer-reviewed)

Abstract Subject headings

Paradoxical intention (PI) has been considered an evidence-based treatment for insomnia since the 1990s, but it has not been evaluated with modern review techniques such as meta-analysis. The present study aimed to conduct the first systematic review and meta-analysis of studies that explore the effectiveness of PI for insomnia on insomnia symptomatology and theory-derived processes. A systematic review and meta-analysis was conducted by searching for eligible articles or dissertations in six online bibliographic databases. Randomised controlled trials and experimental studies comparing PI for insomnia to active and passive comparators and assessing insomnia symptoms as outcomes were included. A random effects model was estimated to determine the standardised mean difference Hedge's g at post-treatment. Test for heterogeneity was performed, fail-safe N was calculated, and study quality was assessed. The study was pre-registered at International Prospective Register of Systematic Reviews (PROSPERO, CRD42019137357). A total of 10 trials were identified. Compared to passive comparators, PI led to large improvements in key insomnia symptoms. Relative to active comparators, the improvements were smaller, but still moderate for several central outcomes. Compared to passive comparators, PI resulted in great reductions in sleep-related performance anxiety, one of several proposed mechanisms of change for PI. PI for insomnia resulted in marked clinical improvements, large relative to passive comparators and moderate compared to active comparators. However, methodologically stronger studies are needed before more firm conclusions can be drawn.

Subject headings

SAMHÄLLSVETENSKAP -- Psykologi -- Tillämpad psykologi (hsv//swe)
SOCIAL SCIENCES -- Psychology -- Applied Psychology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
SOCIAL SCIENCES -- Psychology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)

Keyword

adults
cognitive behavioural therapy
cognitive therapy
effectiveness
paradoxical intention
sleep disturbance
Psykologi
Psychology

Publication and Content Type

ref (subject category)
art (subject category)

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SOCIAL SCIENCES: SOCIAL SCIENCES; and Psychology; and Applied Psycholo ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Public Health Gl ...

SOCIAL SCIENCES: SOCIAL SCIENCES; and Psychology

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nursing

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By the university: Karlstad University; Örebro University; Karolinska Institutet; Kristianstad University College

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