A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study

The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment.     

Relationality in Kohut's psychology of the self

In this essay, I will posit that Kohut's psychology of the self portrays relationality and that its relationality can be categorized into the explicit aspects. I will also put forth the six aspects of relationality contained in Kohut's psychology of the self as relational, dynamic, wholistic, unilateral, mutual, and doxological and they can be summarized as following: (1) Relational: Narcissism is not self-love but is a particular kind of object relationship; (2) Dynamic: The most central self is dynamic or agentic and not defined in substantival attributes; (3) Wholistic: The whole of the self is important; (4) Unilateral: In order for one's self to develop, one is in need of and at the receptive end of another's empathy; (5) Mutual: Others’ empathy is needed in maintaining the health of the developed selves; and (6) Doxological: Joy and thanksgiving are natural expression of developed selves.     

Mother–infant mutual eye gaze supports emotion regulation in infancy during the Still-Face paradigm

This study was designed to examine the sequential relationship between mother–infant synchrony and infant affect using multilevel modeling during the Still Face paradigm. We also examined self-regulatory behaviors that infants use during the Still-Face paradigm to modulate their affect, particularly during stressors where their mothers are not available to help them co-regulate. There were 84 mother–infant dyads, of healthy full term 4 month old infants. Second-by-second coding of infant self-regulation and infant affect was done, in addition to mother–infant mutual eye gaze. Using multilevel modeling, we found that infant affect became more positive when mutual gaze had occurred the previous second, suggesting that the experience of synchronicity was associated with observable shifts in affect. We also found a positive association between self-regulatory behaviors and increases in positive affect only during the Still-Face episode (episode 2). Our study provides support for the role of mother–infant synchronicity in emotion regulation as well as support for the role of self-regulatory behaviors in emotion regulation that can have important implication for intervention.