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How can CBT and Medication help Insomnia comorbid with anxiety and Depression long

term ?

Jylene Elizondo

Research Methods in Psychology, Los Angeles Pacific University

PSYC 300, Executive Summary

Dr. J. Morgan

October 23, 2022

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Audience

How can CBT and Medication help Insomnia comorbid with anxiety and Depression long

term ? The intended audience for this executive summary includes practitioners and therapists.

The purpose of this research is to find how cognitive behavioral therapy and medication can help

people diagnosed with insomnia coexisting with anxiety and depression in a long term study over

six months. Many studies have been researched but only applied to the participants up to six

months, which leaves the question of, if these people elongated their research would the result

then change to have better outcomes?

Research Topic and Research Question

The hypothesis for the study is to find how cognitive behavioral therapy and medication

have different effects on people who are diagnosed with insomnia comorbid with anxiety and

depression in a long time frame. Cognitive behavioral therapy is a timely process and requires

time to result as these sessions require a lot of in depth and personal conversations with a

licensed provider. Prescribed medication might have an immediate effect on an individual but

uncertainty regarding if this will help over a long period of time. Insomnia increases the

likelihood of developing a mood or anxiety disorder. Moreover, symptoms of anxiety and

depression, such as worry and rumination, contribute to insomnia” (Mason & Harvey, 2014).

Insomnia is a public health problem that does not only affect sleep but in addition affects many

other aspects in a person's life such as work, relationships, and behavior.

Diversity is appropriately captured by my research question because of the inability to

see the background information of each individual patient. This study is focused on a health

condition and how CBT and medication can help in finding what works best for each patient.

Although this research is directly approaching a certain topic there are many different types and
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methods of Cognitive Behavioral Therapy as well as different types of medications that can be

used to help the diagnosis. According to research, “The more cognitive approaches emphasize

the role of meaning in their etiological models (cognitive theory of disorder) and conceptualize

therapy as a process of testing the accuracy of existing beliefs (cognitive theory of change)”

(Holton & Beck, 2013).

Proposed Methodology

The method being used to answer the research question will be quantitative using

quasi-experimental research. This type of method would be the most effective because, “They

are often conducted to evaluate the effectiveness of a treatment-perhaps a type of psychotherapy

or an educational intervention”(Jhangiani et al., 2019). This type of research will allow for the

development of a design that will be able to distinguish a relationship between the variables and

the participants which will not be randomly assigned. The participants will be patients that are

diagnosed with insomnia comorbid with anxiety and depression that are using methods such as

cognitive behavioral therapy and prescription medication.

Using the quasi-experimental approach will be most accurate when using the dependent

variables being cognitive behavioral therapy and medications and the independent variable being

insomnia with anxiety and depression. The quasi-experimental approach will allow for the

independent variables the ability to be modified before the dependent variables.

The method that will be used to collect the data needed will be a self-made questionnaire.

“Questionnaire forms are often standardized, thereby increasing the reliability, comparability,

and precision of data from region or time frame to another” (Lakshman et al., 2000). The ability

to use a questionnaire for the research will allow for patient privacy for sensitive or specific

health related questions in accordance with HIPAA. “The Health Insurance Portability and
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Accountability act of 1966 (HIPAA) is a federal law that required the creation of national

standards to protect sensitive patient health information form being disclosed without the

patient’s consent or knowledge”(Health Insurance Portability and Accountability Act of 1996

(HIPAA) | CDC, n.d.). This questionnaire will allow for the data collection of the effectiveness of

cognitive behavioral therapy and prescription medications.

This methodology and analysis approach takes into account multi-cultural diversity

because being diagnosed with insomnia alongside anxiety and depression is not determined by

cultures; it can affect a multitude of people. The population in my study will be using a

questionnaire to answer questions about their condition, and does not ask about demographic

information other than age and gender. These questionnaires contain open ended questions that

allow the participants to be able to answer freely and willingly.

Potential Impact

This research study can have both potentially positive and negative impacts on the

outcomes. While conducting this research the positive outcomes that can come from the data

being collected can include new information regarding the efficiency of cognitive behavioral

therapy on these patients over a six month period. Cognitive behavioral therapy is a time

sensitive method and can not be determined on its effects in less than six months. Using different

types of medication to help with insomnia can help and determine which ingredients in the

medication can be helpful with the patients with insomnia and can possibly create a new drug to

better cope with insomnia, anxiety, and depression. Like cognitive behavioral therapy medication

takes a time to digest in the body system and might have different effects on the brain and body

over time. Negative impacts can include incomplete data, because this research needs to have the

participants continuously answering the questionnaires over a longer period of time, there might
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be participants who lose interest or no longer wish to be a part of the research. Additionally, the

participants must be consistent with their cognitive behavioral therapies as well as their

medication intake to fairly determine the effects of both methods.

Ethical and Faith Implications

Anxiety, depression and insomnia are known to have a relationship between each other

and can require the use of prescription medication. Some potential ways that ethics may not be

followed in my project can include my participants receiving medication or treatments that may

not be in their best interest for the sole purpose of the research and to collect the data. According

to the article, Ethics in Clinical Research, "Another example is in diabetes. Exenatide has been

found to be more active than placebo in patients treated with a glitazone and metformin in

lowering fasting plasma glucose and glycosylated hemoglobin (Hb A1c). This design has

exposed diabetic patients treated with placebo to useless risk. A fair comparison would have

been to use one of the many antidiabetic agents available on the market instead of placebo"

(Garattini & Bertele, 2009, p. 793). Finding the solution to new health data is always resourceful

for scientists to know and learn from, but not at the risk of the patient's health. A way to mitigate

this potential ethical problem can include the use of participants who are able to volunteer on

their own and be able to withdraw at any given time. This will allow the participants in the study

to be able to be free and stop the research at their convenience without being forced to take risks

due to health problems.

In the Bible it is mentioned in 2 Timothy 3:16-17, ‘All scripture is breathed out by God

and profitable for teaching, for reproof, for correction, and for training in righteousness, that the

man of God may be competent, equipped for every good work”. This scripture is in accordance
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with this research study and ethics because what is learned is alway important and can be shared

and retaught, used for training purposes and always have room for correction and adjustment.

The proposed methodology and analysis approach takes into account impacts to

multicultural diversity relevant to the target audience because of the ability to alter the research

that is most beneficial to the audience. This research shows diversity because of the ability to be

able to alter the variables in the research.

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References:

Draper, N. R., & Smith, H. (1998). Applied regression analysis (Vol. 326). John Wiley & Sons.

Garattini, S., & Bertele’, V. (2009). Ethics in clinical research. Journal of Hepatology, 51(4),

792–797. https://doi.org/10.1016/j.jhep.2009.07.005

Health Insurance Portability and Accountability Act of 1996 (HIPAA) | CDC. (n.d.). Retrieved

October 7, 2022, from https://www.cdc.gov/phlp/publications/topic/hipaa.html

Hollon, S. D., & Beck, A. T. (2013). Cognitive and cognitive-behavioral therapies. Bergin and

Garfield’s handbook of psychotherapy and behavior change, 6, 393-442.

Jhangiani, R. S., Chiang, I. A., Cuttler, C., & Leighton, D. C. (2019, July 29). Research Methods

in Psychology: 4th edition. Independently published.

Lakshman, M., Sinha, L., Biswas, M., Charles, M., & Arora, N. K. (2000). Quantitative Vs

Qualitative Research Methods. Link.Springer.com.

https://link.springer.com/content/pdf/10.1007/BF02820690.pdf

Mason, E. C., & Harvey, A. G. (2014, October 15). Insomnia before and after treatment for

anxiety and depression. reader.elsevier.com. Retrieved October 7, 2022, from

https://reader.elsevier.com/reader/sd/pii/S0165032714004510?token=04534A314A77592

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