No abstract

In this study, we examined the association between naturalistically observed in-person contact with an ex-partner and separation-related psychological distress (SRPD). One hundred twenty-two recently separated adults were assessed using the Electronically Activated Recorder on three occasions across 5 months. The association between in-person contact with an ex-partner, as a between-person variable, and concurrent SRPD was not reliably different from zero, nor was the time-varying effect of in-person contact. However, more frequent in-person contact with an ex-partner predicted higher SRPD 2 months later, above and beyond the variance accounted for by concurrent in-person contact, demographic, relationship, and attachment factors. Follow-up analyses showed that this effect was present only for people without children; a 1 SD increase in in-person contact offset and slowed the predicted decline in SRPD over 2 months by 112%. In our discussion, we emphasize new ways to think about the role of in-person contact in shaping adults’ psychological adjustment to separation over time.

Background Cognitive behavioral therapy for insomnia (CBTI) targets changing dysfunctional sleep-related beliefs. The impact of these changes on daytime functioning in older adults is unknown. Purpose We examined whether changes in sleep-related beliefs from pre- to post-CBTI predicted changes in sleep and other outcomes in older adults. Method Data included 144 older veterans with insomnia from a randomized controlled trial testing CBTI. Sleep-related beliefs were assessed with the Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16, subscales: Consequences, Worry/Helplessness, Sleep Expectations, Medication). Outcomes included sleep diary variables, actigraphy-measured sleep efficiency, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), Patient Health Questionnaire-9, and health-related quality of life. Analyses compared slope of change in DBAS subscales from baseline to posttreatment between CBTI and control, and assessed the relationship between DBAS change and the slope of change in outcomes from baseline to 6 months. Results Compared to controls, the CBTI group demonstrated stronger associations between improvement in DBAS-Consequences and subsequent improvement in PSQI, ISI, ESS, and FFS. The CBTI group also demonstrated stronger associations between improvement in DBAS-Worry/Helplessness and subsequent improvements in PSQI, ISI, and FFS; improvements in DBAS-Medication and PSQI; and improvements in DBAS-Sleep Expectations and wake after sleep onset (sleep diary) and FFS (all p < .05). Conclusions Significant reduction in dysfunctional sleep-related beliefs following CBTI in older adults predicted improvement in several outcomes of sleep and daytime functioning. This suggests the importance of addressing sleep-related beliefs for sustained improvement with CBTI in older veterans. Trial Registration ClinicalTrials.gov Identifier: NCT00781963.