Abstract
BackgroundInsomnia symptoms are common among young adults and affect about 5% to 26% of 19 to 34-year-olds. In addition, insomnia is associated with poor mental health and may affect daily performance. In research, as well as in clinical practice, sleep questionnaires are used to screen for and diagnose insomnia. However, most questionnaires are not developed according to current DSM-5 diagnostic criteria. An exception is the recently developed Sleep Condition Indicator (SCI), an eight-item scale screening for insomnia.AimThe aim of this study was to perform a Classical Test Theory (CTT) based psychometric evaluation of the SCI in a sample of Swedish university students, by taking the ordinal nature of item level data into account.MethodsThe SCI was translated into Swedish and distributed online to undergraduate students at three Swedish universities, within programs of health, psychology, science or economy. Of 3673 invited students, 634 (mean age 26.9 years; SD = 7.4) completed the questionnaire that, in addition to the SCI, comprised other scales on sleep, stress, lifestyle and students’ study environment. Data were analyzed according to CTT investigating data completeness, item homogeneity and unidimensionality.ResultsPolychoric based explorative factor analysis suggested unidimensionality of the SCI, and internal consistency was good (Cronbach’s alpha, 0.91; ordinal alpha, 0.94). SCI scores correlated with the Insomnia Severity Index (-0.88) as well as with sleep quality (-0.85) and perceived stress (-0.50), supporting external construct validity.ConclusionsThese observations support the integrity of the of the SCI. The SCI demonstrates sound CTT-based psychometric properties, supporting its use as an insomnia screening tool.
Highlights
Insomnia symptoms are common among young adults and affect about 5% to 26% of 19 to 34-year-olds
Insomnia disorder is defined as difficulty initiating or maintaining sleep and/or waking up too early, accompanied by daytime complaints for at least 3 days a week for 3 or more months [1]
Targeting assessments found the average total Sleep Condition Indicator (SCI) score was above the scale midpoint (i.e., 16)
Summary
Insomnia disorder is defined as difficulty initiating or maintaining sleep and/or waking up too early, accompanied by daytime complaints for at least 3 days a week for 3 or more months [1]. Several screening tools have been proposed, e.g. the Athens Insomnia Scale [9], the Minimal Insomnia Symptom Scale [10] and the Insomnia Severity Index [11]. These were developed prior to publication in 2013 of the updated, 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1]. This revision incorporates updated frequency criteria, an extended duration of symptoms, and a departure from the previous distinction between primary and secondary insomnia. An exception is the recently developed Sleep Condition Indicator (SCI), an eight-item scale screening for insomnia
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