| Summary: | 碩士 === 國立政治大學 === 心理學系 === 104 === Insomnia has high prevalence and is prone to develop into a chronic problem. Hypnotics are the most common choice of treatment for insomnia. Although short-term usage is effective in relieving insomnia, the safety and efficacy of long-term usage are still in controversy. Long-term usage has also been reported to increase risks of tolerance and dependence. Even though the efficacy of hypnotics is not always satisfying, the duration of hypnotics use in insomnia patients is often longer than clinical recommendation. This may be influenced by some psychological factors.
The theory of planned behavior has been demonstrated to be able to predict cognitive factors of substance use behaviors. It can therefore possibly be used to model hypnotic use behavior. In addition to cognitive factors, craving that is associated with losing control over drug use may also play a role in the use of hypnotics. The purpose of current study is to 1) explore the cognitive factors of long-term hypnotics use based on the theory of planned behavior, and 2) understand whether the cognitive factors would be influenced by the craving state.
Method and result:
We first conducted a semi-structured interview with 21 insomnia patients to develop the questionnaire of the theory of planned behavior of hypnotics use and a hypnotic craving scale. The insomnia patients who had used or are currently using hypnotics were recruited to complete the questionnaires. They were contacted by telephone at 1-month and 3-month follow-ups. Total number of valid questionnaires of 1-month and 3-month follow-ups were 143 and 139, respectively. We found that behavior intention could be predicted by perceived behavior control, but not attitude and subjective norms. Frequency of hypnotics use at 1-month and 3-month follow-ups could be predicted by behavior intention and perceived behavior control, and behavior intention was the best predictor. Craving has a negative moderating effect on the relationship between behavior intention and the hypnotics use behavior at both 1-month and 3-month follow-ups.
Conclusion:
The findings of current study show that behavior intention is the most crucial cognitive factor to predict hypnotics use behavior. It indicates that insomnia patients may have higher behavior intention and are more likely to use hypnotics when they perceive more situational factors that lead to drug use. In addition, our study indicates the association between behavior intention and actual hypnotic use behavior can be moderated by craving. The higher the craving state the lower the predictability of hypnotic use by behavior intention, and vice versa. Our study helps understand the psychological factors of long-term hypnotics use, and assists in developing the tapering interventions.
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