Readiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder

dc.contributor.author Micic, Gorica en_US
dc.contributor.author Richardson, Cele en_US
dc.contributor.author Cain, Neralie Louisa en_US
dc.contributor.author Reynolds, Chelsea M en_US
dc.contributor.author Bartel, Kate en_US
dc.contributor.author Maddock, Ben en_US
dc.contributor.author Gradisar, Michael Shane en_US
dc.date.accessioned 2019-02-25T04:58:16Z
dc.date.available 2019-02-25T04:58:16Z
dc.date.issued 2019-03
dc.description © 2018 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ 12 month embargo from date of publication (Dec 2018) per publisher’s policy en_US
dc.description.abstract Objectives Recent evidence indicates that adolescents' motivation to change sleep-wake patterns is low, despite significant impact of adolescent sleep problems on many areas of daytime functioning. The aim of the present study is to evaluate components of adolescents' motivation, and subsequent changes in behaviour. Methods Fifty-six adolescents, aged 13–23 (M = 15.8 ± 2.3 y; 38% m) diagnosed with Delayed Sleep-Wake Phase Disorder (DSWPD) underwent three therapy sessions involving bright light therapy to phase advance sleep patterns. Adolescents were instructed to advance wake-up times by 30-min daily. Motivation ratings of desire, ability, reason, need and commitment to change sleep patterns were taken at baseline. Sleep diaries were taken at the end of treatment session 1, with sequentially earlier wake-up times in 30-min intervals indicating compliance. Results At the outset of therapy, adolescents indicated strong desire, reasons and need, yet moderate ability and commitment to advance their sleep-wake patterns. Following therapy, sleep-onset times were significantly advanced, total sleep time increased and sleep latency decreased (all p < 0.05). Therapy lasted 6–27 days (M = 13.9 ± 4.5) and clients complied for approximately half the time (between 3 and 15 days; M = 8.8 ± 2.7). Commitment was associated with ability (r = 0.66, p < 0.001) but not desire, reason or need (all p > 0.05). Adolescents' desire to change (r = 0.30, p = 0.03) and commitment (r = 0.30, p = 0.03) were positively correlated with behaviour change, but their need, ability and reasons were not. A mediation analysis showed that ability and desire were important in predicting behaviour change, by total effects through commitment (ie, indirectly and directly). Conclusion Our findings suggest that the total effects of ability (ie, confidence) and desire to change are the best predictors of behavioural changes, thus clinicians should focus on these components of the readiness to change model when undertaking treatments with sleep-disordered adolescents. en_US
dc.identifier.citation Micic, G., Richardson, C., Cain, N., Reynolds, C., Bartel, K., Maddock, B., & Gradisar, M. (2019). Readiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder. Sleep Medicine, 55, 48–55. https://doi.org/10.1016/j.sleep.2018.12.002 en_US
dc.identifier.doi https://doi.org/10.1016/j.sleep.2018.12.002 en_US
dc.identifier.issn 1389-9457
dc.identifier.uri http://hdl.handle.net/2328/39020
dc.language.iso en en_US
dc.oaire.license.condition.license CC-BY-NC-ND
dc.publisher Elsevier en_US
dc.rights © 2018 Elsevier B.V. en_US
dc.rights.holder Elsevier en_US
dc.subject Motivational interviewing en_US
dc.subject Adolescents en_US
dc.subject Sleep en_US
dc.subject Commitment en_US
dc.subject Readiness to change en_US
dc.subject Sleep disorders en_US
dc.title Readiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder en_US
dc.type Article en_US
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