@article{alessandra_preselected_2026,

title = {Preselected and preferred immersive virtual reality versus narrative alone to induce post-stress relaxation in patients with pulmonary arterial hypertension: A pilot study on perceived stress and heart rate},

author = {G. Alessandra and D. M. Beatrice and C. Sara and M. Roberta and V. Martina and K. Patrycja and B. Maurizio and B. Luca and D. V. Laura Adelaide and B. Stéphane},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105029595132&doi=10.1111%2Fbjhp.70059&partnerID=40&md5=b86f0151066a7923d8854913cbd54318},

doi = {10.1111/bjhp.70059},

issn = {1359107X (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {British Journal of Health Psychology},

volume = {31},

number = {1},

abstract = {Objectives: Several studies have shown the effectiveness of immersive virtual reality (IVR)-based relaxation techniques in alleviating stress within the general population. However, few data are available on patients, or on the effectiveness of different scenarios in inducing relaxation. This pilot study aims to compare the effectiveness of three relaxation techniques—preselected IVR (IVR-PS), preferred IVR (i.e. chosen by the participant from different alternatives—IVR-PR), and narrative alone (CTR)—in reducing physiological and psychological stress in 16 pulmonary arterial hypertension (PAH) female patients (N = 16, average age: 46 ± 10.66 years; average education: 13.31 ± 3.8 years; mean duration of illness: 8.56 ± 5.24 years) following an acute stress. Methods: Patients performed a mental stress test followed by three different relaxation sessions presented in a randomized order on three separate occasions. Self-perceived stress, level of relaxation, and heart rate (HR) were monitored during the sessions. Participants' ratings of their experiences were also collected. Results: The results indicated that the three relaxation methods were equally effective in reducing perceived stress induced by acute stress and in lowering HR. However, greater cognitive activation was reported in the two IVR conditions compared with the narrative condition. Conclusions: This is the first study to show evidence of the impact of IVR on a rare population. Despite the lack of significant differences between the two IVR and narrative-alone conditions in physiological and subjective relaxation, more than half of the participants expressed a subjective preference for the virtual experience, especially for the preferred one. © 2026 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.},

keywords = {adult, controlled study, female, Heart Rate, human, Humans, hypertension, Immersive virtual reality, mental stress, Middle Aged, Narration, pathophysiology, physiology, Pilot Projects, pilot study, procedures, Psychological, psychology, Pulmonary, pulmonary arterial hypertension, pulmonary hypertension, randomized controlled trial, rehabilitation, relaxation, Relaxation Therapy, relaxation training, Stress, Therapy, verbal communication, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{bourbeau_role_2025,

title = {The Role of Body Image Perception on a Continuum from Dysfunctional to Healthy Eating Attitudes and Behaviors Among People Seeking Treatment},

author = {F. Bourbeau and S. Bouchard and G. Corno and J. Monthuy-Blanc},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85216120423&doi=10.3390%2Fjcm14020597&partnerID=40&md5=be414bf29fdc6264d47a9c696954c80f},

doi = {10.3390/jcm14020597},

issn = {20770383 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {Journal of Clinical Medicine},

volume = {14},

number = {2},

abstract = {Background: Body image disturbance has been associated with various health conditions and has the potential to trigger the development of unhealthy behaviors, including dysfunctional attitudes and eating behaviors, which may evolve into eating disorders. This study explores the relationship between body image variables—such as global self-worth, physical self-worth, and physical attractiveness—and the continuum of eating attitudes and behaviors. Methods: A canonical correlation analysis was performed to assess the multivariate relationship between attitudinal and perceptual variables and the continuum of eating behaviors, with a total of 113 cases analyzed. Results: The findings indicate that intuitive eating and a positive body image (including global self-worth and physical attractiveness) are most strongly associated with the functional end of the continuum, while disordered eating behaviors and body dissatisfaction are linked to the dysfunctional end. Conclusions: These results suggest that interventions targeting the emotional and attitudinal dimensions of body dissatisfaction, whether delivered in vivo or via virtual reality (e.g., weight exposure), may facilitate a shift toward healthier, more functional eating behaviors along the continuum. © 2025 by the authors.},

note = {Publisher: Multidisciplinary Digital Publishing Institute (MDPI)},

keywords = {Adolescent, adult, aged, article, Attitude, behavior, body dissatisfaction, body dysmorphic disorder, body image, body image perception, body mass, correlation analysis, eating and attitudes and behaviors, eating disorder, Eating Disorder Examination Questionnaire, eating disorder inventory, eating habit, feeding behavior, female, healthy diet, healthy lifestyle, help seeking behavior, human, intuitive eating, major clinical study, male, Middle Aged, perception, physical attractiveness, psychological rating scale, retrospective study, Self Concept, self esteem, very elderly, virtual reality, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{antonio_posttraumatic_2025,

title = {Posttraumatic stress disorder and Physiological Response in First Responders During Virtual Reality Exposure},

author = {H. António and C. Barros and M. Vieira de Castro and J. Oliveira and P. Gamito and S. Bouchard and R. J. Pinto},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023876769&doi=10.1177%2F21522715251394917&partnerID=40&md5=c3c071b02ee24bd37789dfd06a936fbd},

doi = {10.1177/21522715251394917},

issn = {21522715 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {Cyberpsychology, Behavior, and Social Networking},

abstract = {First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 Mary Ann Liebert, (NY) LLC.},

keywords = {adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{cipolletta_validation_2024,

title = {Validation of the Italian Version of the Telepresence in Videoconference Scale (TVS) in a Sample of Psychologists and Psychotherapists During the COVID-19 Pandemic},

author = {S. Cipolletta and S. Tomaino and S. Bouchard and M. Berthiaume and G. Manzoni},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85195533802&doi=10.1002%2fcpp.3015&partnerID=40&md5=255de2597dc6747136150f331ae970ab},

doi = {10.1002/cpp.3015},

issn = {10633995 (ISSN)},

year  = {2024},

date = {2024-01-01},

journal = {Clinical Psychology and Psychotherapy},

volume = {31},

number = {3},

publisher = {John Wiley and Sons Ltd},

abstract = {Objective: Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. Method: The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). Results: Exploratory factor analysis supported the original factor structure only partially because the scale ‘Absorption’ (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. Conclusion: The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals. © 2024 John Wiley & Sons Ltd.},

note = {Publisher: John Wiley and Sons Ltd},

keywords = {adult, coronavirus disease 2019, COVID-19, female, human, Humans, Italy, male, Middle Aged, online psychological interventions, pandemic, Pandemics, procedures, psychology, Psychometrics, psychometry, psychotherapist, Psychotherapists, psychotherapy, questionnaire, reproducibility, Reproducibility of Results, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, Surveys and Questionnaires, Telemedicine, telepresence, Validation, videoconference, videoconferencing},

pubstate = {published},

tppubtype = {article}

}

@article{corno_development_2024,

title = {Development of a visual-perceptual method to assess body image: A cross-cultural validation in Canadian and Spanish women},

author = {G. Corno and A. Paquette and D. Burychka and M. Miragall and M. -C. Rivard and R. M. Baños and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85189089793&doi=10.1002%2ferv.3086&partnerID=40&md5=99c221e60e3d5caad167cec6fd25dddd},

doi = {10.1002/erv.3086},

issn = {10724133 (ISSN)},

year  = {2024},

date = {2024-01-01},

journal = {European Eating Disorders Review},

publisher = {John Wiley and Sons Ltd},

abstract = {The objectives of this study were (a) to explore the preliminary cross-cultural validity of a visual-perceptual method to assess body image; (b) to examine potential differences and similarities in body image phenomena between women from two Western countries (i.e., Canada and Spain). 201 self-identified women participated in this cross-sectional study. Ideal, normal, and self-perceived body sizes were assessed using a visual-perceptual method, whereas body dissatisfaction was measured using both a visual-perceptual method and a questionnaire. Visual-perceptual body dissatisfaction was significantly correlated with questionnaire body dissatisfaction, suggesting a preliminary convergent validity between the two assessment methods. Women in both countries were dissatisfied with their bodies. Compared to their self-perceived body, all women chose a significantly thinner visual representation of their “normal” and ideal body. These results may suggest a shift towards the “thin” body as not only ideal, but also normative. This study provides the first evidence for the cross-cultural validity of a visual-perceptual body image assessment tool. The results of the current study confirm the presence of “normative discontent”, and suggest more cross-country similarities than differences among women from these two Western societies. © 2024 Eating Disorders Association and John Wiley & Sons Ltd.},

note = {Publisher: John Wiley and Sons Ltd},

keywords = {Adolescent, adult, analytic method, article, assessment, body dissatisfaction, body image, body image dissatisfaction, Body Size, Canada, Canadian, controlled study, convergent validity, correlation analysis, cross validation, cross-country, Cross-Cultural Comparison, Cross-Sectional Studies, cross-sectional study, cultural anthropology, cultural factor, exploratory research, female, human, Humans, ideal body size, intermethod comparison, Middle Aged, normal body size, psychology, questionnaire, reproducibility, Reproducibility of Results, Self Concept, Spain, Spaniard, Surveys and Questionnaires, thin ideal, underweight, vision, Visual Perception, visual-perceptual method, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{cipolletta_validation_2024-1,

title = {Validation of the Italian Version of the Telepresence in Videoconference Scale (TVS) in a Sample of Psychologists and Psychotherapists During the COVID-19 Pandemic},

author = {S. Cipolletta and S. Tomaino and S. Bouchard and M. Berthiaume and G. Manzoni},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85195533802&doi=10.1002%2fcpp.3015&partnerID=40&md5=255de2597dc6747136150f331ae970ab},

doi = {10.1002/cpp.3015},

issn = {10633995 (ISSN)},

year  = {2024},

date = {2024-01-01},

journal = {Clinical Psychology and Psychotherapy},

volume = {31},

number = {3},

publisher = {John Wiley and Sons Ltd},

abstract = {Objective: Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. Method: The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). Results: Exploratory factor analysis supported the original factor structure only partially because the scale ‘Absorption’ (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. Conclusion: The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals. © 2024 John Wiley & Sons Ltd.},

keywords = {adult, coronavirus disease 2019, COVID-19, female, human, Humans, Italy, male, Middle Aged, online psychological interventions, pandemic, Pandemics, procedures, psychology, Psychometrics, psychometry, psychotherapist, Psychotherapists, psychotherapy, questionnaire, reproducibility, Reproducibility of Results, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, Surveys and Questionnaires, Telemedicine, telepresence, Validation, videoconference, videoconferencing},

pubstate = {published},

tppubtype = {article}

}

@article{baillot_factors_2023,

title = {Factors Associated with Excess Skin After Bariatric Surgery: a Mixed-Method Study},

author = {A. Baillot and J. Brunet and L. Lemelin and S. A. Gabriel and M. -F. Langlois and A. Tchernof and L. Biertho and R. Rabasa-Lhoret and P. Y. Garneau and A. Aimé and S. Bouchard and A. J. Romain and P. Bernard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85163716815&doi=10.1007%2fs11695-023-06698-w&partnerID=40&md5=c86ee43b5f7daf6c350936d38944d013},

doi = {10.1007/s11695-023-06698-w},

issn = {09608923 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Obesity Surgery},

volume = {33},

number = {8},

pages = {2324–2334},

publisher = {Springer},

abstract = {Purpose: After metabolic and bariatric surgery (MBS), many patients have excess skin (ES), which can cause inconveniences. Identifying factors related to ES quantity and inconveniences is crucial to inform interventions. The aim of this study was to identify sociodemographic, physical, psychosocial, and behavioral factors associated with ES quantity and inconveniences. Materials and Methods: A mixed-method study with a sequential explanatory design was conducted with 124 adults (92% women, M age 46.5 ± 9.9 years, M time post-MBS 34.2 ± 27.6 months). During phase I, ES quantity (arms, abdomen, thighs) and inconveniences and sociodemographic, anthropometric, clinical, and behavioral outcomes were assessed. In phase II, 7 focus groups were performed with 37 participants from phase I. A triangulation protocol was completed to identify convergences, complementarities, and dissonances from quantitative and qualitative data. Results: Quantitative data indicate only ES quantity on arms was associated with ES inconveniences on arms (r =.36, p <.01). Total ES quantity was associated with maximal body mass index (BMI) reached pre-MBS (r =.48, p <.05) and current BMI (r =.35, p <.05). Greater ES inconvenience was associated with higher social physique anxiety and age (R 2 =.50, p <.01). Qualitative data were summarized into 4 themes: psychosocial experiences living with ES, physical ailments due to ES, essential support and unmet needs, and beliefs of ES quantity causes. Conclusion: Measured ES quantity is related to higher BMI, but not reported inconveniences. Greater self-reported ES quantity and inconveniences were associated with body image concerns. Graphical Abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.},

note = {Publisher: Springer},

keywords = {adult, Alcohol Use Disorders Identification Test, anthropometry, Anxiety, article, asthma, Bariatric Surgery, body dissatisfaction, body image, body mass, Body Mass Index, controlled study, dermatomycosis, Dyadic Adjustment Scale, employment status, excess skin, female, heart disease, Hospital Anxiety and Depression Scale, household income, human, Humans, hypertension, major clinical study, male, Mental health, Middle Aged, Mixed methods, Morbid, morbid obesity, non insulin dependent diabetes mellitus, obesity, physical activity, procedures, psychology, qualitative analysis, quality of life, quantitative analysis, sedentary time, skin irritation, skin malformation, sleep apnea syndromes, social psychology, Social Support, stria, sun exposure},

pubstate = {published},

tppubtype = {article}

}

@article{belleville_efficacy_2023,

title = {Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD, Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial},

author = {G. Belleville and M. -C. Ouellet and V. Békés and J. Lebel and C. M. Morin and S. Bouchard and S. Guay and N. Bergeron and S. Ghosh and T. Campbell and F. P. Macmaster},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140981202&doi=10.1016%2fj.beth.2022.08.004&partnerID=40&md5=261383919bbdaa149ac0eeb6d3317fc0},

doi = {10.1016/j.beth.2022.08.004},

issn = {00057894 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Behavior Therapy},

volume = {54},

number = {2},

pages = {230–246},

publisher = {Elsevier Inc.},

abstract = {This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128},

note = {Publisher: Elsevier Inc.},

keywords = {adult, Anxiety, article, clinical effectiveness, clinical feature, cognitive behavioral therapy, controlled study, Depression, disaster, Disasters, disease severity, e-mental health, female, human, Humans, insomnia, Internet-Based Intervention, major clinical study, male, Middle Aged, natural disaster, physical disability, Post-Traumatic, posttraumatic stress disorder, psychotherapist, PTSD, randomized controlled trial, risk factor, Sleep Initiation and Maintenance Disorders, Stress Disorders, telepsychotherapy, treatment outcome, wildfire},

pubstate = {published},

tppubtype = {article}

}

@article{le_du_new_2023,

title = {A New Option for Pain Prevention Using a Therapeutic Virtual Reality Solution for Bone Marrow Biopsy (REVEH Trial): Open-Label, Randomized, Multicenter, Phase 3 Study},

author = {K. Le Du and A. -L. Septans and F. Maloisel and H. Vanquaethem and A. Schmitt and M. Le Goff and A. Clavert and M. Zinger and H. Bourgeois and O. Dupuis and F. Denis and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85148250546&doi=10.2196%2f38619&partnerID=40&md5=e27bfbd3d4c42f8850daf70bdf60b384},

doi = {10.2196/38619},

issn = {14388871 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Medical Internet Research},

volume = {25},

publisher = {JMIR Publications Inc.},

abstract = {Background: Evidence regarding the analgesic effect of distraction through immersion in virtual reality (VR) for care-induced pain has been documented in several phase 2 trials, but comparison with standard treatments in large, randomized studies is needed. Objective: In this open-label, multicenter, randomized, phase 3 trial, we evaluated the safety and efficacy of a novel VR therapy solution for distraction in the context of bone marrow biopsy. Methods: Bliss is a VR software with 4 imaginary interactive environments in 3 dimensions with binaural sound (head-mounted display). Efficacy regarding pain intensity was evaluated using a visual analog scale (VAS; score from 0 to 10) immediately after the biopsy. Secondary end points were anxiety and tolerance. Modified intention-to-treat analysis was performed. Results: Overall, 126 patients with previously documented untreated or suspected malignant hemopathy between September 6, 2018, and May 18, 2020, were randomly assigned in a 1:1 ratio to receive pain prevention with a mixture of nitrous oxide/oxygen (MEOPA; n=63) or VR (n=63) before and during the bone marrow biopsy. We excluded 8 patients from the final analysis (3 in the MEOPA group and 5 in the VR group). All patients received local anesthesia (lidocaine) before biopsy. Follow-up was limited to 1 month after the biopsy. Participants' median age was 65.5 (range 18-87) years, and 54.2% (64/118) of patients were male. The average pain intensity was 3.5 (SD 2.6, 95% CI -1.6 to 8.6) for the MEOPA group and 3.0 (SD 2.4, 95% CI -1.7 to 7.7) for the VR group, without any significant differences in age, sex, center, and hemopathy (P=.26). Concerning anxiety, 67.5% (79/117; fear of pain questionnaire) of the patients were afraid before the biopsy, and anxiety scores were moderate to very high in 26.3% (30/114; revised Spielberger State-Trait Anxiety Inventory questionnaire) of the patients before the biopsy and 9.0% (10/114) after the biopsy for all patients, without a significant difference between the 2 groups (P=.83). Immersion in VR was well tolerated by the majority (54/57, 95%) of patients in the VR group. Conclusions: The intensity of pain did not significantly differ between both arms. VR was well tolerated, and the satisfaction of patients, nurses, and physicians was very high. VR could be an alternative treatment in case of contraindication or intolerance to MEOPA. © 2023 Journal of Medical Internet Research. All rights reserved.},

note = {Publisher: JMIR Publications Inc.},

keywords = {80 and over, Adolescent, adult, aged, alprazolam, Anxiety, article, Biopsy, blood pressure measurement, Bone Marrow, bone marrow biopsy, clinical trial, controlled study, demographics, digital health, digital therapeutics, Distraction, Effectiveness, efficacy, eHealth, female, follow up, head-mounted display, hematologic disease, human, human tissue, Humans, hypertension, imagery, imaginary, imagination, Immersive environment, Intention to Treat Analysis, interactive environment, leukemia, lidocaine, local anesthesia, lymphoma, major clinical study, male, medical procedure, Meopa, Middle Aged, monoclonal immunoglobulinemia, multicenter study, myelodysplastic syndrome, myeloma, myeloproliferative disorder, myeloproliferative neoplasm, nitrous oxide plus oxygen, open study, Pain, pain intensity, pain measurement, paracetamol, phase 3 clinical trial, prospective study, questionnaire, randomized controlled trial, RCT, relaxation training, safety, satisfaction, solid malignant neoplasm, State Trait Anxiety Inventory, very elderly, virtual reality, visual analog scale, VR, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{savard_efficacy_2021,

title = {Efficacy of a stepped care approach to deliver cognitive-behavioral therapy for insomnia in cancer patients: A noninferiority randomized controlled trial},

author = {J. Savard and H. Ivers and M. -H. Savard and C. M. Morin and A. Caplette-Gingras and S. Bouchard and G. Lacroix},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85121217599&doi=10.1093%2fsleep%2fzsab166&partnerID=40&md5=8c3390082d345b725c47465f96bb8e44},

doi = {10.1093/sleep/zsab166},

issn = {01618105 (ISSN)},

year  = {2021},

date = {2021-01-01},

journal = {Sleep},

volume = {44},

number = {11},

publisher = {Oxford University Press},

abstract = {Study Objectives: Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia, but its accessibility is very limited in routine care. A stepped care approach has been recommended as a cost-effective way to make CBT-I more widely accessible. However, no controlled study has yet been published about the efficacy of this approach. The goal of this noninferiority randomized controlled trial (RCT) was to compare the short and long-term efficacy of a stepped care CBT-I (StepCBT-I) to a standard face-to-face CBT-I (StanCBT-I). Methods: A total of 177 cancer patients were randomized to: (1) StanCBT-I (6 face-to-face CBT-I sessions; n = 59) or (2) StepCBT-I (n = 118). In the StepCBT-I group, patients with less severe insomnia first received a web-based CBT-I (n = 65), while those with more severe insomnia received 6 face-to-face CBT-I sessions (n = 53). In both cases, patients could receive up to three booster sessions of CBT-I if they still had insomnia symptoms following this first step. Results: Results indicated that the Step-CBT-I group showed an Insomnia Severity Index score reduction and a sleep efficiency (on a sleep diary) increase that was not significantly inferior to that of StanCBT-I at all post-treatment time points. Analyses of secondary outcomes indicated significant time effects (ps <. 001) and no significant group-by-time interactions (ps from. 07 to. 91) on other sleep diary parameters, sleep medication use, depression, anxiety, fatigue, and quality of life scores. Conclusion(s): The efficacy of stepped care CBT-I is not inferior to that of a standard face-to-face intervention and is a valuable approach to making this treatment more widely accessible to cancer patients. Trial registration: ClinicalTrials.gov Identifier: NCT01864720 (https://clinicaltrials.gov/ct2/show/NCT01864720?term=Savard&draw=2&rank=6; Stepped Care Model for the Wider Dissemination of Cognitive-Behavioural Therapy for Insomnia Among Cancer Patients). © 2021 Sleep Research Society 2021. Published by Oxford University Press on behalf of the Sleep Research Society.},

note = {Publisher: Oxford University Press},

keywords = {adult, Anxiety, Anxiety disorder, cancer, cancer diagnosis, cancer patient, cognitive behavioral therapy, Cognitive-behavioral therapy, comparative study, complication, controlled study, cost effectiveness analysis, Depression, disease severity, drug use, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, fatigue, female, Hospital Anxiety and Depression Scale, human, Humans, insomnia, Insomnia Severity Index, long term care, major clinical study, male, malignant neoplasm, Middle Aged, Montreal cognitive assessment, neoplasm, Neoplasms, outcome assessment, procedures, psychotropic agent, quality of life, randomized controlled trial, remission, review, Self Care, short course therapy, sleep, sleep efficiency, Sleep Initiation and Maintenance Disorders, sleep pattern, stepped care, stepped care approach, Structured Clinical Interview for DSM Disorders, therapy effect, treatment outcome, web-based intervention},

pubstate = {published},

tppubtype = {article}

}