Clemente Vanda, Marques Daniel Ruivo, Miller-Mendes Mariana, Morin Charles M, Serra Joana, Allen Gomes Ana
Sleep Medicine Centre, Hospital and University Centre of Coimbra (CHUC), Coimbra, Portugal; University of Coimbra, Faculty of Psychology and Educational Sciences, Coimbra, Portugal; Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal; University of Aveiro, Department of Education and Psychology, Aveiro, Portugal.
Sleep Med. 2023 Jun;106:59-68. doi: 10.1016/j.sleep.2023.03.021. Epub 2023 Mar 24.
The Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) is the most widely validated instrument for assessing sleep-related cognitions. This study aimed to examine the reliability of the DBAS-30 European Portuguese version, explore its dimensionality, and develop a new short version suitable for differentiating the presence/absence of insomnia.
From 824 participants aged 18-85 years, the Insomnia Group (IG, n = 355, 261 females and 94 males) and Normal Sleepers Group (NSG, n = 292, 237 females, 54 males and 1 with no response) were constituted. Thirty-one patients with Obstructive Sleep Apnea Syndrome were also recruited. For the DBAS 16-items version, the ability to differentiate dysfunctional beliefs between people with and without insomnia was used as the main criterion for item retention.
DBAS-30 PT demonstrated good internal consistency and significantly discriminated IG from NSG. Based on a robust EFA (RDWLS), a three-dimensional structure was determined for IG (Ageing and Hopelessness, Sleep Expectations, and Consequences and Helplessness). DBAS-SF-16 presented as an internally-consistent measure with a reliable two-factor structure (Consequences and Helplessness, Medication and Hopelessness) and showed construct and known groups validity. ROC analysis demonstrated DBAS-SF-16's relevant clinical accuracy, and 4.3 provides the best cut-off score in detecting the level of dysfunctional beliefs associated with clinical insomnia.
A new and meaningful dimensionality of the DBAS-30 was found. DBAS-SF-16 showed to be a reliable, valid, and robust tool for evaluating dysfunctional beliefs about insomnia in clinical and non-clinical populations.
睡眠功能障碍信念与态度量表（DBAS）是评估与睡眠相关认知最广泛验证的工具。本研究旨在检验DBAS - 30欧洲葡萄牙语版本的信度，探索其维度，并开发一个适用于区分失眠存在与否的新简短版本。
从824名年龄在18 - 85岁的参与者中，组成了失眠组（IG，n = 355，女性261名，男性94名）和正常睡眠者组（NSG，n = 292，女性237名，男性54名，1名无回应者）。还招募了31名阻塞性睡眠呼吸暂停综合征患者。对于DBAS 16项版本，区分有无失眠者功能障碍信念的能力被用作项目保留的主要标准。
DBAS - 30 PT表现出良好的内部一致性，并显著区分了IG组和NSG组。基于稳健的探索性因素分析（RDWLS），确定了IG组的三维结构（衰老与绝望、睡眠期望以及后果与无助）。DBAS - SF - 16呈现为一种内部一致的测量方法，具有可靠的双因素结构（后果与无助、药物治疗与绝望），并显示出结构效度和已知群体效度。ROC分析证明了DBAS - SF - 16的相关临床准确性，4.3是检测与临床失眠相关功能障碍信念水平的最佳临界值。
发现了DBAS - 30新的且有意义的维度。DBAS - SF - 16被证明是一种可靠、有效且稳健的工具，用于评估临床和非临床人群中关于失眠的功能障碍信念。
