Objective: Cognitive therapy (CT) and behavior therapy (BT) are both effective for insomnia but are expected to work via different pathways. Empirically, little is known about their symptom-specific effects. Method: This was a secondary analysis of a randomized controlled trial of online treatment for insomnia disorder (N = 219, 72.9% female, mean age = 52.5 years, SD = 13.9). Participants were randomized to CT (n = 72), BT (n = 73), or wait-list (n = 74). Network Intervention Analysis was used to investigate the symptom-specific treatment effects of CT and BT throughout treatment (wait-list was excluded from the current study). The networks included the Insomnia Severity Index items and the sleep diary-based sleep efficiency and were estimated biweekly from Week 0 until Week 10. Results: Participants in the BT condition showed symptom-specific effects compared to CT on "sleep efficiency" (Week 4-8, post-test), "difficulty maintaining sleep" (Week 4), and "dissatisfaction with sleep" (post-test). Participants in the CT showed symptom-specific effects compared to BT on "interference with daily functioning" (Week 8, post-test), "difficulty initiating sleep", "early morning awakenings," and "worry about sleep" (all post-test). Conclusions: This is the first study that observed specific differential treatment effects for BT and CT throughout the course of their treatment. These effects were more pronounced for BT than for CT and were in line with the theoretical background of these treatments. We think the embedment of the theoretical background of CT and BT in empirical data is of major importance to guide further treatment development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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认知疗法和行为疗法对失眠的症状特异性影响：网络干预分析。

目的：认知疗法（CT）和行为疗法（BT）对失眠都有效，但有望通过不同途径起作用。从经验上讲，人们对它们的症状特异性作用知之甚少。方法：这是对失眠症在线治疗的随机对照试验的次要分析（N = 219，女性72.9％，平均年龄= 52.5岁，SD = 13.9）。参与者被随机分为CT（n = 72），BT（n = 73）或候补名单（n = 74）。网络干预分析用于研究整个治疗过程中CT和BT的症状特异性治疗效果（当前研究中不包括候补名单）。该网络包括失眠严重性指数项目和基于睡眠日记的睡眠效率，并且从第0周到第10周每两周进行一次估算。结果：与CT相比，BT症状的参与者在“睡眠效率”（第4-8周，测试后），“难以维持睡眠”（第4周）和“睡眠不满意”（测试后）方面表现出特定于症状的效果。 。与BT相比，CT参与者在“干扰日常功能”（第8周，测试后），“难以入睡”，“清晨醒来”和“担心睡眠”方面表现出特定于症状的效果（均在测试）。结论：这是第一项研究，在整个治疗过程中观察到BT和CT的特异性差异治疗效果。与BT相比，BT的这些作用更为明显，并且与这些治疗的理论背景相符。我们认为将CT和BT的理论背景嵌入经验数据对于指导进一步治疗的发展具有重要意义。（PsycInfo数据库记录（c）2021 APA，保留所有权利）。