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While long-term hypnotic use is very common in clinical practice, the associated factors have been understudied. This study aims to explore the cognitive factors that might influence the long-term use of hypnotics based on the theory of planned behavior (TPB), and examines the moderating effect of craving between cognitive intention and actual hypnotic-use behavior at follow-up. A total of 139 insomnia patients completed a self-constructed TPB questionnaire to measure their attitude, subjective norm, perceived behavioral control, and behavioral intention of hypnotic use, as well as the Hypnotic-Use Urge Scale (HUS) to measure their craving for hypnotics. They were then contacted through phone approximately three months later to assess their hypnotic use. Hierarchical regression showed that perceived behavioral control was the most significant determinant for behavioral intention of hypnotic use. Behavioral intention, in turn, can predict the frequency of hypnotic use after three months. However, this association was moderated by hypnotic craving. The association was lower among the participants with higher cravings for hypnotic use. The findings suggest that the patients' beliefs about their control over sleep and daily life situations, and their craving for hypnotics should be taken into consideration in the management of hypnotic use. [ABSTRACT FROM AUTHOR]

Hypnotic dependence is a major concern for long-term hypnotic use, but is not consistently reported in empirical studies. The inconsistent findings may be in part due to individual differences in the psychological processes of hypnotic use. To further the understanding of this issue, the current study developed the Hypnotic-Use Urge Scale (HUS) to measure the urge to take hypnotics at bedtime. Insomnia patients with a history of hypnotic use (n = 202; mean age = 46.4 years) were included in the study. Participant's agreement with 37 statements regarding anticipation, desire, and feelings about hypnotic use at bedtime was rated using Likert-type scales. An exploratory factor analysis identified 20 statements to be included as items of the HUS, which were categorized into three subscales: Factor 1—anticipated effects of hypnotic use; Factor 2—compelling desire to use hypnotics; and Factor 3—preoccupation and pleasurable feelings from hypnotic use. The total scale and subscales demonstrated good internal consistency and test-retest reliability. The scale scores correlated significantly with the frequency of hypnotic use. Intriguingly, although Factor 1 accounted for the highest portion of the total variance, Factor 2 was identified to be the best predictor for the frequency of hypnotic use. The results support the use of the HUS as a valid and reliable measure to assess the urge to use hypnotic at bedtime. It could be used to measure the psychological processes associated with hypnotic dependence in both research and clinical settings. [ABSTRACT FROM AUTHOR]