Abstract
Sleep quality, circadian phase, and mood are highly interdependent processes. Remarkably, there is currently no self-report questionnaire that measures all three of these clinically significant functions: The aim of this project was to address this deficit. In Study 1, 720 participants completed a set of potential items was generated from existing questionnaires in each of the three domains and refined to follow a single presentation format. Study 2 used an independent sample (N = 498) to interrogate the latent structure. Exploratory factor analysis was used to identify a parsimonious, three-factor latent structure. Following item reduction, the optimal representation of sleep quality, circadian phase, and mood was captured by a questionnaire with three 5-item scales: Depressed Mood, Morningness, and Good Sleep. Confirmatory factor analysis found the three-scale structure provided adequate fit. In both samples, Morningness and Good Sleep were positively associated, and each was negatively associated with the Depressed Mood scale. Further research is now required to quantify the convergent and discriminant validity of its three face-valid and structurally replicated scales. The new sleep, circadian rhythms, and mood (SCRAM) questionnaire is the first instrument to conjointly measure sleep quality, circadian phase, and mood processes, and has significant potential as a clinical tool.
Highlights
A range of evidence in normative and clinical populations demonstrates that sleep quality, circadian phase, and mood are highly interdependent (Mason and Harvey, 2014; Soehner et al, 2014, 2016)
In clinical settings this generates a common problem: When a patient presents with some combination of sleep quality, circadian phase, and mood problems, where should treatment be targeted (Harvey, 2015)? At least in part, this clinical problem arises from the fact that, while well-validated measures of sleep quality, circadian phase, and mood exist, there is no self-report instrument that quantifies function in all three domains
Data-driven factor structures supported the theoretically-based three-factor solution, and systematic item reduction led to the 15item SCRAM questionnaire—a face-valid instrument maximally separating the measurement of sleep quality, circadian phase and mood
Summary
A range of evidence in normative and clinical populations demonstrates that sleep quality, circadian phase, and mood are highly interdependent (Mason and Harvey, 2014; Soehner et al, 2014, 2016). This clinical problem arises from the fact that, while well-validated measures of sleep quality, circadian phase, and mood exist, there is no self-report instrument that quantifies function in all three domains Such an instrument would provide a quantum advance over existing single-construct measures that, while validly capturing the individual construct of interest, pay no attention to independent and overlapping variance arising from the mechanistic interplay between the three processes. The aim of this project was to take the first step toward addressing this problem by developing a novel self-report questionnaire to measure sleep quality, circadian phase, and mood processes. That comprehensive consideration of all three processes has the potential to improve case formulation and treatment planning
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