Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: a parallel-group randomized controlled trial.

BACKGROUND: Despite its efficacy in treating comorbid insomnia and depression, cognitive behavioral therapy for insomnia (CBT-I) is limited in its accessibility and, in many countries, cultural compatibility. Smartphone-based treatment is a low-cost, convenient alternative modality. This study evaluated a self-help smartphone-based CBT-I in alleviating major depression and insomnia. METHODS: A parallel-group randomized, waitlist-controlled trial was conducted with 320 adults with major depression and insomnia. Participants were randomized to receive either a 6-week CBT-I via a smartphone application, proACT-S, or waitlist condition. The primary outcomes included depression severity, insomnia severity, and sleep quality. The secondary outcomes included anxiety severity, subjective health, and acceptability of treatment. Assessments were administered at baseline, post-intervention (week 6) follow-up, and week 12 follow-up. The waitlist group received treatment after the week 6 follow-up. RESULTS: Intention to treat analysis was conducted with multilevel modeling. In all but one model, the interaction between treatment condition and time at week 6 follow-up was significant. Compared with the waitlist group, the treatment group had lower levels of depression [Center for Epidemiologic Studies Depression Scale (CES-D): Cohen's d = 0.86, 95% CI (-10.11 to -5.37)], insomnia [Insomnia Severity Index (ISI): Cohen's d = 1.00, 95% CI (-5.93 to -3.53)], and anxiety [Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A): Cohen's d = 0.83, 95% CI (-3.75 to -1.96)]. They also had better sleep quality [Pittsburgh Sleep Quality Index (PSQI): Cohen's d = 0.91, 95% CI (-3.34 to -1.83)]. No differences across any measures were found at week 12, after the waitlist control group received the treatment. CONCLUSION: proACT-S is an efficacious sleep-focused self-help treatment for major depression and insomnia. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04228146. Retrospectively registered on 14 January 2020. http://www.w3.org/1999/xlink">https://clinicaltrials.gov/ct2/show/NCT04228146.

Boredom begets boredom: An experience sampling study on the impact of teacher boredom on student boredom and motivation.

BACKGROUND: Boredom is a common complaint among students. Boredom was previously found to be negatively associated with academic outcomes, such as academic motivation, strategies, and achievement. It is of interest to understand students' in-class boredom, especially factors that might exacerbate it. AIMS: The current study examines the influence of teacher's boredom on students' in-class boredom and learning experience. It aims to understand the relationship between teacher boredom, students' perceived teacher boredom, student boredom, and student learning motivation. SAMPLE: A total of 437 students (54.8% female, MAge  = 14.5 years, SD = 1.6) and 17 of their teachers (29.4% female, 76.5% 40 years old or below) participated in the study. METHODS: We conducted an experience sampling study, in which participants completed a 2-week diary. Data were analysed using multilevel modelling. RESULTS AND CONCLUSIONS: Results from multilevel modelling of 2,675 post-class evaluations indicated that teacher boredom was negatively associated with students' motivation. However, the relationship between teacher boredom and students' perceived teacher boredom was not significant, suggesting that students did not accurately perceive whether their teacher was bored. Results from indirect effect analysis further revealed that students' perception of teacher boredom predicted student learning motivation through student boredom. In other words, perceiving teachers being bored promoted students' own feeling of boredom, which in turn reduced their learning motivation. Together, these results indicate that when a teacher is bored in class, or when students perceive that their teacher is bored, students would have lower learning motivation.