Reliability And Validity Of The Brief Version Of Dysfunctional Beliefs And Attitudes About Sleep And Preliminary Application

ObjectiveTo evaluate the reliability and validity of the brief version of dysfunctional beliefs and attitudes about sleep (DBAS-16) and explore the different patterns of dysfunctional sleep beliefs endorsed by insomniacs.MethodsUsing convenience sampling, participants were out-patients (who with insomnia or insomnia comorbided depression disorder or anxiety disorder) and good sleepers. All of them were assessed by DBAS-16, Pittsburgh sleep quality index (PSQI), self-rating depression scale (SDS), self-rating anxiety scale (SAS).30of them were evaluated by DBAS-16two weeks later.300subjects were assessed,277pieces of questionnaire with integral answers were collected.Results1. The demographics among good sleepers group, insomniacs group, anxiety patients groups and depression patients groups were not different significantly beside occupation(χ2=19.520, P<0.05).2. Except few subscales, the Cronbach a coefficient and split-half reliability coefficient of total and subscales in patients group and good sleepers groups were greater than0.70. Items2,6,15in good sleepers group did not remarkablely relate with total scale, the correlation coefficient of other items and total score were0.350-0.652(all P<0.01), the coefficient in patients group were0.283-0.602(all P<0.01). The test-retest reliability coefficient was0.928, and coefficient of each subscales ranged from0.709to0.907(all P<0.05). Confirmatory factor analysis was used to estimate the construct validity. The fit indices:χ2/df was1.623, fit indexes were greater than or close to0.90. Total DBAS-16score of patients group correlated with PSQI (r=-0.311,P<0.01),SDS (r=-0.192,P<0.01), SAS (r=-0.162,P<0.01) significantly, total score of good sleepers group only correlated with PSQI (r=-0.293,P<0.05)3. The scores of total and subscales in patients group were lower than in good sleepers group remarkablely (all P<0.01). The score of each item in patients group were significantly lower than in good sleepers group, but items7,8,13,15,16.4. Patients’scores on four subscales were conducted to a cluster analysis, which resulted in four demographics, primary disease-matched subgroups. Subgroups were worried, high endorsement, low endorsement, worried and symptom focused. The scores of PSQI, SDS, SAS were significant different among four subgroups (all P<0.05).5. Comparing the total scores and subscale scores of DBAS-16, PSQI, SDS, SAS among good sleepers group, insomniacs group, anxiety patients groups and depression patients groups, the difference were significant (all P<0.05). ConclusionThe reliability and validity of the brief version of DBAS-16in insomnia patients are adequate, the reliability in good sleepers is adequate, but the validity is insufficient. Insomniac can be divided to different subgroups by different sleep beliefs patterns, and targeted therapies should be taken in each subgroup.