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Objective: There is little research assessing the use of cognitive-behavioral therapy for insomnia (CBT-I) among patients with cardiovascular disease (CVD), even less on the effects of CBT-I on CVD risk factors such as anxiety and depression, and to our knowledge, only limited studies of the efficacy of CBT-I protocols with cardiac disease-specific modifications. The objective of this study is to evaluate a group-based CBT-I intervention tailored to patients with CVD on sleep quality, duration, and mental health. Participants: A sample of 47 participants (25 men) diagnosed with primary insomnia were included in this study. Methods: This study used a pre–post design comparing outcomes before and after a group intervention. Clinicians in a cardiac center referred CVD patients with self-reported sleep disturbance to the intervention group. Following screening and confirmation of insomnia disorder, participants completed a six-week CBT-I group-based intervention tailored for patients with CVD. Participants completed sleep diaries and questionnaires, including the Insomnia Severity Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, pre- and postintervention. Results: Participants' sleep outcomes (sleep duration, maintenance, efficiency, latency, and quality) were significantly improved and patients reported significantly fewer symptoms of anxiety, depression, and insomnia following the CBT-I intervention (p values <.05). Conclusions: After participating in a CBT-I group intervention tailored for cardiac patients, patients reported improved sleep and significantly lower levels of anxiety and depression. Randomized trials of this intervention are warranted. [ABSTRACT FROM AUTHOR]

The objective of the present study was to test if outcome expectancy mediated the relationship between fitness and self-efficacy, perceived stress, and depressive symptoms.Adolescents with obesity (n = 228) completed measures of perceived stress and depressive symptoms at baseline, self-efficacy and outcome expectancy at baseline and 3 months, and fitness at baseline and 6 months. Structural equation modeling was used to analyze the data. Results showed that self-efficacy was positively associated with fitness via outcome expectancies. For females, fewer depressive symptoms were linked to fitness via self-efficacy and outcome expectancies. Exercise interventions that enhance exercise self-efficacy, outcome expectancy, and reduce depressive symptoms may increase fitness. [ABSTRACT FROM AUTHOR]

Nicotine-enhanced attentional functions are purported to underlie improvements in behavioral performance in cognitive tasks but it is unclear as to whether these effects involve selective attention or attentional control under conditions of distraction. Behavioral and event-related potential measures were used to examine the effects of nicotine on distractibility in 21 non-smokers who were instructed to ignore task-irrelevant auditory stimuli while they performed a visual discrimination task. In a randomized, double-blind, placebo-controlled cross-over design, nicotine gum (6 mg) shortened overall reaction times but failed to prevent increased response slowing and errors caused by deviant sounds. Relative to placebo, nicotine did not modulate the early pre-attentive detection of deviants as reflected in the mismatch negativity but it attenuated the amplitude of the deviant-elicited P3a, an event-related potential component indexing the involuntary shifting of attention. Nicotine also enhanced attentional re-focusing back on to task-relevant stimuli following distraction as evidenced by an increased amplitude of the re-orienting negativity. These findings and the behavioral—electrophysiological dissociation seen with nicotine are discussed in relation to theories of attention and smoking motivation. [ABSTRACT FROM PUBLISHER]