0339 DOES COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA ENHANCE THE EFFECTS OF COGNITIVE PROCESSING THERAPY FOR PTSD AMONG SURVIVORS OF INTERPERSONAL VIOLENCE?

Abstract Introduction: Insomnia frequently co-occurs with posttraumatic stress disorder (PTSD). Evidence-based trauma treatments like cognitive processing therapy (CPT) are efficacious, but do not directly target insomnia. We tested whether delivering cognitive behavioral therapy for insomnia (CBT-I) followed by CPT, produced greater reductions in symptom severity compared to CPT alone in a unique and underserved population of survivors of interpersonal violence (IPV). Methods: Over 2500 individuals were approached in family court and women’s shelters and 797 agreed to be screened. A total of 138 met eligibility criteria including past-year IPV exposure and diagnostic criteria for PTSD, Major Depression (MDD) and insomnia. We randomized 110 subjects to individual CBT-I (4 sessions) followed by CPT (12 sessions) or Attention Control (AC; 4 supportive phone calls) followed by CPT. Assessments occurred at baseline (T1), after CBT-I/AC (T2), and after CPT (T3) and included the Insomnia Severity Index (ISI), the Clinician-Administered PTSD Scale (CAPS), and the Hamilton Rating Scale for Depression (HRSD). General linear models with repeated measures tested time x group interactions from T1-T2 and across T1-T2-T3, for ISI, CAPS and HRSD total scores. Results: The sample was diverse (50% minorities), socioeconomically disadvantaged, mostly female, and had a mean age of 35.4. Mean baseline severity scores were: ISI=20.5, CAPS=72.1 and HRSD=24.9. CBT-I and AC groups did not differ by demographic factors or clinical severity at baseline. Time(T1,T2) x group interactions were significant for all outcomes with a greater decline in the CBT-I condition on the ISI (F(1,81)=28.4; p