Adaptation and preliminary evaluation of the Transdiagnostic Intervention for Sleep-Circadian Dysfunction (TranS-C) in individuals with common mental disorders in India

Abstract

Despite sleep disturbances being a common symptom and a maintaining factor, sleep has often been overlooked as a transdiagnostic variable in interventions for common mental disorders (CMDs). The present study describes the adaptation of the Transdiagnostic Intervention for Sleep-Circadian Dysfunction (TSC) and examines preliminary evidence for the adapted intervention on sleep quality, mood, and other cognitive outcomes for individuals with CMDs in the Indian context. Phase One of the study focused on iterative steps to adapt the TSC, using stakeholder surveys ( n = 20) and expert interviews ( n = 6). In Phase Two, the adapted intervention was piloted on five individuals diagnosed with CMDs and who were experiencing significant sleep quality disturbances using an open label trial design. Assessments were conducted at baseline and post-intervention. The outcome measures were: Self-reported sleep quality (primary outcome), mood, dysfunctional beliefs about sleep (DBAS), repetitive negative thinking (RNT), and self-efficacy. The data was analyzed using descriptive statistics and graphs to evaluate trends. Phase One findings revealed a felt need for the adapted intervention with self-regulatory and cognitive mediating components, such as targeting dysfunctional beliefs and RNT that play a role in sleep-mood bidirectionality. The Phase 2 pilot study showed an improving trend in sleep, mood, dysfunctional beliefs, RNT, and general self-efficacy. The adaptation of the TSC to CMDs in India was acceptable and the initial results are promising. A larger scale clinical trial is warranted to test the efficacy of the adapted TSC.