Chronotype and Improved Sleep Efficiency Independently Predict Depressive Symptom Reduction after Group Cognitive Behavioral Therapy for XXXX .

@entity1 @entity308 @entity25 @entity22
STUDY OBJECTIVES: Cognitive behavioral therapy for @entity22 (CBT-I) has been shown to improve both @entity308 , but predictors of @entity308 outcome following CBT-I have not been well examined. This study investigated how chronotype (i.e., morningness- eveningness trait) and changes in @entity25 ( @entity25 ) were related to changes in @entity308 among recipients of CBT-I. METHODS: Included were 419 adult @entity22 outpatients from a @entity25 clinic (43.20% males, age M  SD = 48.14  14.02). All @entity1 completed the Composite Scale of Morningness and attended a 6-session group CBT-I up to the second last session. @entity25 was extracted from sleep diary; @entity308 were assessed using the Beck Depression Inventory (BDI) prior to (Baseline), and at the end (End) of intervention. RESULTS: Multilevel structural equation modeling revealed that from Baseline to End, @entity25 increased and BDI decreased significantly. Controlling for age, sex, BDI, and @entity25 at Baseline, stronger evening chronotype and less improvement in @entity25 significantly and uniquely predicted less reduction in BDI from Baseline to End. Chronotype did not predict improvement in @entity25 . CONCLUSIONS: In an @entity22 outpatient sample, @entity25 and @entity308 improved significantly after a CBT-I group intervention. All chronotypes benefited from sleep improvement, but those with greater eveningness and/or less sleep improvement experienced less reduction in @entity308 symptom severity. This suggests that evening preference and @entity22 may have distinct relationships with mood, raising the possibility that the effect of CBT-I on @entity308 could be enhanced by assessing and addressing circadian factors.
