Exploring predictors of treatment outcome in cognitive behavior therapy for sleep disturbance following acquired brain injury

AbstractPurpose: To identify predictors of treatment response to cognitive behavior therapy (CBT) for sleep disturbance following acquired brain injury (ABI).Methods: Classification and regression tree (CART) analysis was conducted on individual patient data from two pilot randomized controlled trials (RCTs): one in traumatic brain injury (TBI), the other in stroke. The combined sample comprised 32 participants; 15 receiving CBT and 17 allocated to treatment as usual (TAU). The outcome was reliable improvement on the Pittsburgh Sleep Quality Index (PSQI).Results: Study group was a statistically significant predictor of outcome, with CBT participants more likely to achieve reliable improvements than TAU (OR = 4.88, p = 0.042). Study group (CBT vs. TAU) exhibited an area under the ROC curve (AUROC) of 69%. In separate CART analyzes, verbal memory (CVLT-II >45.5), age (  6) predicted positive outcomes in CBT recipients. Each of these variables added a small (∼5%) but no...