Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California, USA.
J Trauma Stress. 2012 Dec;25(6):665-74. doi: 10.1002/jts.21757.
Poor sleep quality among individuals with posttraumatic stress disorder (PTSD) is associated with poorer prognosis and outcomes. The factor structure of the most commonly employed measure of self-reported sleep quality, the Pittsburgh Sleep Quality Index (PSQI), has yet to be evaluated among individuals with PTSD. The current study sought to fill this gap among a sample of 226 U.S. military veterans with PTSD (90% with co-occurring mood disorders, 73.5% with substance use disorders). We evaluated the factor structure of the PSQI by conducting an exploratory factor analysis (EFA) in approximately half of the sample (n = 111). We then conducted a second EFA in the other split half (n = 115). Lastly, we conducted a path analysis to investigate the relations between sleep factors and PTSD symptom severity, after accounting for the relation with depression. Results suggested sleep quality can best be conceptualized, among those with PTSD, as a multidimensional construct consisting of 2 factors, Perceived Sleep Quality and Efficiency/Duration. After accounting for the association between both factors and depression, only the Perceived Sleep Quality factor was associated with PTSD (β = .51). The results provide a recommended structure that improves precision in measuring sleep quality among veterans with PTSD.
创伤后应激障碍（PTSD）患者的睡眠质量差与预后和结果较差有关。最常用于评估自我报告睡眠质量的匹兹堡睡眠质量指数（PSQI）的因素结构尚未在 PTSD 患者中进行评估。本研究旨在填补 PTSD 美国退伍军人样本（90%合并心境障碍，73.5%合并物质使用障碍）中这一空白。我们通过对大约一半的样本（n=111）进行探索性因素分析（EFA）来评估 PSQI 的因素结构。然后，我们在另一半样本（n=115）中进行了第二次 EFA。最后，我们进行了路径分析，以调查睡眠因素与 PTSD 症状严重程度之间的关系，同时考虑到与抑郁的关系。结果表明，在 PTSD 患者中，睡眠质量最好被概念化为由 2 个因素组成的多维结构，即感知睡眠质量和效率/持续时间。在考虑到两个因素与抑郁之间的关联后，只有感知睡眠质量因素与 PTSD 相关（β=0.51）。结果提供了一种推荐的结构，可提高 PTSD 退伍军人睡眠质量测量的准确性。
