SUMMARY
Actigraphy is increasingly used in the assessment and treatment of various clinical conditions, being a convenient and cost-effective method of capturing bodily movements over long periods of time. This study examined the use of actigraphy in the measurement of sleep of patients with depression and insomnia. Fifty four patients diagnosed with a current major depressive episode and chronic insomnia underwent a baseline overnight study with concurrent actigraphic and polysomnography (PSG) monitoring, as well as subjective sleep diaries. Agreement between PSG, actigraphy and sleep diary measurements was evaluated using two-tailed t-tests, Pearson’s correlations, and the Bland-Altman concordance technique. The only significant difference found between actigraphy and PSG was in latency to persistent sleep, in which actigraphy underestimated sleep latency relative to PSG (p<0.05). There were moderate positive correlations between actigraphy and PSG for all variables. In contrast, significant differences were observed between sleep diaries and PSG for all sleep variables. Bland-Altman concordance diagrams also demonstrated that, while bias was limited between PSG and the other two measurement types, there were somewhat broad 95% limits of agreement for all sleep variables with both sleep diaries and actigraphy. In summary, actigraphic measurements of sleep more closely approximated those of PSG than did sleep diaries in this sample of depressed insomniacs.
The objective of this study was to evaluate and compare the efficacy of two short-term individual therapy interventions for sexually abused girls and their nonoffending female caretakers. Thirty-two girls, ages 8 to 13, and their caretakers from primarily low-income, African-American families were randomly assigned to a theoretically based, structured experimental treatment program or to a relatively unstructured comparison intervention. Measures of child outcome were completed before and after the treatment program by each parent and child, and by a clinician blind to treatment condition. Pre- and postmeasures of maternal outcome were completed by the caretaker and a clinician not involved in the treatment. Both treatment programs yielded decreases in children's posttraumatic stress disorder symptoms and traumagenic beliefs reflecting self-blame and powerlessness, and increases in children's overall psychosocial functioning. The experimental intervention was more effective than the comparison program in increasing abuse-related caretaker support of the child and in decreasing caretaker self-blame and expectations of undue negative impact of the abuse on the child. Clinical implications of these findings include the development of interventions targeting sexually abused children's traumagenic beliefs and nonoffending parents' support of their victimized children.
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