Psychometric Properties of the Insomnia Severity Index Among Arabic Chronic Diseases Patients

Abstract

Introduction The Insomnia Severity Index (ISI) is a self-administrated questionnaire most frequently used to assess insomnia in clinical and non-clinical populations. Objective To evaluate the psychometric properties of the Arabic ISI among patients diagnosed with chronic diseases. Methods A cross-sectional and descriptive correlational design was used. A total of 1,005 patients with chronic diseases completed the seven items of the Arabic ISI version. The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored with the use of principal factor analysis and confirmatory factor analysis, to examine the dimensional structure of the ISI. Results The Cronbach's alpha coefficient for the Arabic ISI was 0.82, which shows good reliability. The total ISI score did not have floor or ceiling effects. There was evidence of discriminate validity. The Principal Component Analysis (PCA) indicated two factors (four items loading on Factor I and three items loading on Factor II). The construct validity of PCA in terms of two factors was explored by confirmatory factor analysis to examine the dimensional structure of the ISI. The confirmatory factor analysis showed an absolute fit for the two-factor model. Conclusion The results support the two-factor structure of ISI. The Arabic version of the ISI demonstrated good reliability and validity for assessing insomnia in patients diagnosed with chronic diseases.

Validation of the Insomnia Severity Index among University Students in Korea

“…Specifically, based on the EFA and CFA fit indices in this study, the two-factor model, consisting of the severity of sleep disturbance and the impact of sleep, provided the best fit for the data among Korean university students. These results are consistent with those from more recent studies that support the twofactor structure of the ISI [33,[37][38][39][40]. However, some scholars have suggested several other factor structures, compromising the consensus regarding the tool's dimensionality [32,[34][35][36][37]41].…”

“…One promising insomnia screening instrument is the Insomnia Severity Index (ISI) [29], a seven-item self-report measure designed to map onto the Diagnostic and Statistical Manual of Mental Disorders [30] and the International Classification of Sleep Disorders [31] symptom criteria for insomnia. Since its introduction in 1993, the ISI has been widely used for clinical purposes and research and translated into several languages, with these language versions exhibiting adequate psychometric properties as evidenced by good reliability and construct validity [32][33][34][35][36][37][38][39]. However, while the ISI showed sound psychometric properties, studies examining its factor structure have yielded mixed results.…”

“…Nevertheless, this study involved patients with chronic and severe sleep disorders selected from those who visited a regional sleep center. Thus, in nonclinical samples, the psychometric properties of the ISI are not well understood; most studies that examined the ISI have focused on clinical models [26,29,35,[38][39][40][41]. Although a few studies have used the ISI to screen for insomnia in the general population [32-34, 36, 37], its utility in campus settings has not been well established.…”

The impact of smartphone addiction on attention control and sleep in Egypt—an online survey

“…The ISI is used in screening and diagnosis, according to the criteria for insomnia in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Sleep Disorders (ICSD). It also showed good reliability and validity among the Arab population [14].…”

Uncovering Cognitive Distortions in Adolescents: Cultural Adaptation and Calibration of an Arabic Version of the “How I Think Questionnaire”

“…A five-point Likert scale (e.g., 0 = none; 4 = very severe) is used to assess each item, with a total score ranging from 0 to 28, with a higher total score indicating more severe sleep difficulties: no insomnia (0-7), subthreshold insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21), and severe insomnia (22)(23)(24)(25)(26)(27)(28) [46]. An Arabic version of the ISI [47] was administered to the participants by the interviewer. This version has acceptable psychometric properties, showing good reliability Cronbach's alpha coefficient of 0.82 [48].…”