Encephale
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Insomnia is considered to be a serious public health issue affecting approximately 10% of adults. Chronic insomnia may increase the risk of health problem, psychological vulnerability and proneness to accidents. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment. Even though CBT-I is widely considered as an effective therapy, 20 to 30% of patients do not respond to this treatment. Mindfulness therapy, known to reduce rumination and stress, could be an interesting complement to enhance CBT-I. The aim of this study is to evaluate the efficacy of therapy combining mindfulness meditation and CBT-I for the treatment of chronic insomnia. ⋯ This study confirms the beneficial effects of CBT for patients suffering from insomnia on sleep parameters, anxiety symptoms and quality of life. Furthermore, this study suggests, for the first time, that combining CBT and mindfulness is a superior approach compared to that of only conventional CBT-I in improving sleep.
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The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used measure of alexithymia in non-clinical or clinical populations. The TAS-20 evaluates three dimensions of the alexithymia construct: the difficulty identifying feelings (DIF), the difficulty describing feelings (DDF) and externally oriented thinking (EOT). The TAS-20 is also used in adolescents or children, and the psychometric properties of the scale have not been systematically evaluated in these populations. Recently several studies have shown systematic age differences in the factor structure and a decrease of the quality of the measurement with age. Notably, low reliability measured by the Cronbach α coefficient has been found for the EOT factor. Taking into account the limitations of the TAS-20 in pre-adult populations the Alexithymia Questionnaire for Children (AQC), an adaptation of the TAS-20, has been proposed by a reformulation of the TAS-20 items (Rieffe et al., 2006). Two studies in healthy children found satisfactory psychometric properties with the three-factor structure demonstrating adequate parameters in the confirmatory factorial analyses (CFA). In the two studies low reliabilities of the EOT factor were reported, and recent studies in adolescents using the TAS-20 found that a two-factor model (DDF, DIF) had a better fit than the original three-factor model. Thus, the aim of the present study was firstly to verify the psychometric properties of the AQC in a sample of adolescents presenting various psychiatric disorders and secondly to test the adequacy of the bi- or tridimensional model of the scale. ⋯ The Alexithymia Questionnaire for Children had satisfactory psychometric properties found in a sample of adolescent psychiatric inpatients. Taking into account firstly the superiority of the two-factor model over the classical three-factor model and secondly the low value of the Cronbach α for the EOT factor, it is proposed to use only the twelve-item scale by excluding the EOT items.