Psychometric properties of the Insomnia Severity Index (ISI) in Mexican adults

  • Horacio Balam Álvarez García Clínica de Trastornos de Sueño, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Programa de maestría y doctorado en ciencias médicas, odontologías y de la salud. Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México. https://orcid.org/0000-0001-9533-2515
  • Isaías Vicente Lugo-González Unidad de Investigación Interdisciplinaria en Ciencias de la Salud y Educación, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Ciudad de México, México. https://orcid.org/0000-0002-2024-2598
  • Fabiola González Betanzos Facultad de Psicología, Universidad Michoacana de San Nicolás Hidalgo, Ciudad de México, México. https://orcid.org/0000-0003-4585-7211
DOI: https://doi.org/10.24016/2023.v9.311
Keywords: Insomnia, Sleep, Factorial invariance, Somnolence

Abstract

Background: Insomnia is the sleep disorder with the highest incidence worldwide. It is estimated that this condition increases the risk of developing psychiatric, neurological, and cardiovascular problems. Due to this, it is important to have brief, reliable and valid psychometric instruments that allow health personnel their timely detection in first level health centers. Objectives: Analyze the psychometric properties of the Insomnia Severity Index (ISI) in its version adapted to Spanish in a sample of Mexican adults. Methods: The sample consisted of 310 adults, 223 (71.9%) women and 87 (28.1%) men. The comparison of four ISI measurement models of one, two and three factors and a bifactor model was carried out, its internal consistency was analyzed, an analysis of invariance by sex and correlation analysis with the Athens and Epworth scales. Results: The ISI bifactor model with a general factor (G) and a specific factor for insomnia impact (I) showed the best fit indices (χ2= 29.48, gl = 11, SRMR= 0.03, CFI= 0.98, TLI= 0.96, RMSEA= 0.07), and demonstrated configural, metric, and scalar invariance by sex. Adequate reliability was demonstrated by Omega coefficients (General: ωG= 0.86, Impact: ωI= 0.86) showed adequate reliability; the scale showed very strong correlations with the Athens scale (rAGoverall= 0.84; rAImpact=0.75) and weak to moderate correlations with the Epworth scale (rEGeneral= 0.39; rEImpact=0.44). Conclusions: The ISI bifactor version in Spanish presents adequate psychometric properties for the measurement of insomnia and, as it is a brief tool, it can be used at different levels of health care.

Downloads

Download data is not yet available.

References

American Sleep Disorders Association (1990). International classification of sleep disorders (ICSD): diagnostic and coding manual. American Sleep Disorders Association.

American Academy Sleep Medicine. (2014). International Classification of Sleep Disorders (ICSD-3) 3rd ed. American Academy of Sleep Medicine.

Ato-Garcia, M., & Vallejo-Seco, G. (2015). Diseños de investigacion en psicologia. Ediciones Pirámide.

Bao, Y., Sun, Y., Meng, S., Shi, J., & Lu, L. (2020). 2019-nCoV epidemic: address mental health care to empower society. Lancet, 395(10224), e37–e38. https://doi.org/10.1016/S0140-6736(20)30309-3

Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine, 2(4), 297–307. https://doi.org/10.1016/s1389-9457(00)00065-4

Baker F. C. (2016). Personality Shapes the Experience of Insomnia in Women: Commentary on Dørheim et al., Personality and Perinatal Maternal Insomnia: A Study across Childbirth. Behavioral sleep medicine, 14(1), 2–4. https://doi.org/10.1080/15402002.2015.1119500

Castronovo, V., Galbiati, A., Marelli, S., Brombin, C., Cugnata, F., Giarolli, L., Anelli, M. M., Rinaldi, F., & Ferini-Strambi, L. (2016). Validation study of the Italian version of the Insomnia Severity Index (ISI). Neurological sciences: official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 37(9), 1517–1524. https://doi.org/10.1007/s10072-016-2620-z

Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2a ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press.

Collado Ortiz, M. A., Sanchez Escandon, O., Almanza Islas, J. A., Arch, T. E., & Arana Lechuga, Y. (2016). Epidemiología de los trastornos del sueño en poblacion mexicana: seis años de experiencia en un centro de tercer nivel. Anales Médicos, 61(2), 87 - 92.

Da Silva, M.J., Victor, J.F., Mota, F.R., Soares, E.S., Leite, B.M.B., & Oliveira, E.T. (2014). Analysis of psychometric properties of family APGAR with elderly in northeast Brazil. Escola Anna Nery, 18, 527-532. http://dx.doi.org/10.5935/1414-8145.20140075

De la Rubia, J. M., Hernández, R. L., Ramírez, M. T. G., & del Carmen Quezada Berumen, L. (2021). A bifactor model for the scale of attitudes towards statistics. Revista de Psicologia (Perú), 39(2), 805–847. https://doi.org/10.18800/PSICO.202102.011

Dieperink, K. B., Elnegaard, C. M., Winther, B., Lohman, A., Zerlang, I., Möller, S., & Zangger, G. (2020). Preliminary validation of the insomnia severity index in Danish outpatients with a medical condition. Journal of patient-reported outcomes, 4(1), 18. https://doi.org/10.1186/s41687-020-0182-6

Dimitrov, D. M. (2010). Testing for factorial invariance in the context of construct Validation. Measurement and Evaluation in Counseling and Development, 43(2), 121–149. https://doi.org/10.1177/0748175610373459

Dominguez-Lara, A., & Rodriguez, S. (2017). Índices estadísticos de modelos bifactor. Interacciones, 3(2), 59–65. https://doi.org/10.24016/2017.v3n2.51

Dragioti, E., Wiklund, T., Alföldi, P., & Gerdle, B. (2015). The Swedish version of the Insomnia Severity Index: Factor structure analysis and psychometric properties in chronic pain patients. Scandinavian journal of pain, 9(1), 22–27. https://doi.org/10.1016/j.sjpain.2015.06.001

Fernandez-Mendoza, J., Rodriguez-Muñoz, A., Vela-Bueno, A., Olavarrieta-Bernardino, S., Calhoun, S. L., Bixler, E. O., & Vgontzas, A. N. (2012). The Spanish version of the Insomnia Severity Index: a confirmatory factor analysis. Sleep medicine, 13(2), 207–210. https://doi.org/10.1016/j.sleep.2011.06.019

Gerber, M., Lang, C., Lemola, S., Colledge, F., Kalak, N., Holsboer-Trachsler, E., Pühse, U., & Brand, S. (2016). Validation of the German version of the insomnia severity index in adolescents, young adults, and adult workers: results from three cross-sectional studies. BMC psychiatry, 16, 174. https://doi.org/10.1186/s12888-016-0876-8

Jiménez-Correa, U., Haro, R., Poblano, A., Arana-Lechuga, Y., Terán-Pérez, G., González-Robles, O., & Velázquez-Moctezuma, J. (2009). Mexican Version of the Epworth Sleepiness Scale. The Open Sleep Journal, 2, 6-10. https://doi.org/10.2174/1874620900902010006

Jiménez-Genchi, A., Monteverde-Maldonado, E., Nenclares-Portocarrero, A., Esquivel-Adame, G., & Vega-Pacheco, A. (2008). Confiabilidad y análisis factorial de la versión en español del índice de calidad de sueño de Pittsburgh en pacientes psiquiátricos. Gaceta Médica de México, 144(6), 491-496.

Lin, R. M., Xie, S.S., Yan, W.J., & Yan, Y.W. (2018). Factor structure and psychometric properties of the Insomnia Severity Index in Mainland China. Social Behavior and Personality: An international journal, 46(2), 209-218. https://doi.org/10.2224/sbp.6639

Manzar, M. D., Jahrami, H. A., & Bahammam, A. S. (2021). Structural validity of the Insomnia Severity Index: A systematic review and meta-analysis. Sleep medicine reviews, 60, 101531. https://doi.org/10.1016/j.smrv.2021.101531

Mendoza-Meléndez, M. A., Jiménez-Correa, U., Gallegos-Cari, a., Ayala-Guerrero, F., & Jiménez-Anguiano, A. (2016). Prevalence of sleep disorders, daytime sleepiness and clinical symptomatology in older adults. Revista Médica del Hospital General de Mexico, 79(3), 136-143. https://doi.org/10.1016/j.hgmx.2016.05.021

Morin, C. M., & Carrier, J. (2021). The acute effects of the COVID-19 pandemic on insomnia and psychological symptoms. Sleep medicine, 77, 346–347. https://doi.org/10.1016/j.sleep.2020.06.005

Morin, C. M., Belleville, G., Bélanger, L., & Ivers, H. (2011). The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep, 34(5), 601–608. https://doi.org/10.1093/sleep/34.5.601

Moscou-Jackson, G., Allen, J., Smith, M. T., & Haywood, C., Jr (2016). Psychometric Validation of the Insomnia Severity Index in Adults with Sickle Cell Disease. Journal of health care for the poor and underserved, 27(1), 209–218. https://doi.org/10.1353/hpu.2016.0010

Nenclares Portocarrero, A., & Jimenez Genchi, A. (2005). Estudio de validación de la traducción al español de la Escala Atenas de Insomnio. Salud mental, 28(5), 34-39.

Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., Espie, C. A., Garcia-Borreguero, D., Gjerstad, M., Gonçalves, M., Hertenstein, E., Jansson-Fröjmark, M., Jennum, P. J., Leger, D., Nissen, C., Parrino, L., Paunio, T., Pevernagie, D., Verbraecken, J., Weeß, H. G., … Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of sleep research, 26(6), 675–700. https://doi.org/10.1111/jsr.12594

Putnick, D. L., & Bornstein, M. H. (2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review, 41, 71–90. https://doi.org/10.1016/j.dr.2016.06.004

Rodriguez, A., Reise, S. P., & Haviland, M. G. (2016). Evaluating bifactor models: Calculating and interpreting statistical indices. Psychological Methods, 21(2), 137–150. https://doi.org/10.1037/met0000045

Rosseel, Y. (2012). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02

Sandoval-Rincón, M., Alcalá-Lozano, R., Herrera-Jiménez, I., & Jiménez-Genchi, A. (2013). Validación de la escala de somnolencia de Epworth en población mexicana. Gaceta Médica de México, 149(4), 409-416.

Sateia M. J. (2014). International classification of sleep disorders-third edition: highlights and modifications. Chest, 146(5), 1387–1394. https://doi.org/10.1378/chest.14-0970

Savard, M. H., Savard, J., Simard, S., & Ivers, H. (2005). Empirical validation of the Insomnia Severity Index in cancer patients. Psycho-oncology, 14(6), 429–441. https://doi.org/10.1002/pon.860

Sierra, J., Guillén-Serrano, V., & Santos-Iglesias., P. (2008). Insomnia Severity Index: algunos indicadores acerca de su fiabilidad y validez en una muestra de personas mayores. Revista de neurologia, 47(11), 566–570.

Soares, C. N. (2005). Insomnia in women: An overlooked epidemic? Archives of Women's Mental Health, 8(4), 205–213. https://doi.org/10.1007/s00737-005-0100-1

Suh, Y. (2015). The Performance of Maximum Likelihood and Weighted Least Square Mean and Variance Adjusted Estimators in Testing Differential Item Functioning with Nonnormal Trait Distributions. Structural Equation Modeling, 22(4), 568–580. https://doi.org/10.1080/10705511.2014.937669

Lloret-Segura, S., Ferreres-Traver, A., Hernández-Baeza, A., & Tomás-Marco, I. (2014). El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. Anales de Psicología. https://doi.org/http://dx.doi.org/10.6018/analesps.30.3.199361

Terán-Pérez, G., Portillo-Vásquez, A., Arana-Lechuga, Y., Sánchez-Escandón, O., Mercadillo-Caballero, R., González-Robles, R. O., & Velázquez-Moctezuma, J. (2021). Sleep and Mental Health Disturbances Due to Social Isolation during the COVID-19 Pandemic in Mexico. International journal of environmental research and public health, 18(6), 2804. https://doi.org/10.3390/ijerph18062804

Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3(1), 4–69. https://doi.org/10.1177/109442810031002

World Health Organization. (2020). Coronavirus disease (COVID-2019) situation reports. World Health Organization. https://www.who.int/emergencies/diseases/nove-lcoronavirus-2019/situation-reports.

Yu D. S. (2010). Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people. Journal of advanced nursing, 66(10), 2350–2359. https://doi.org/10.1111/j.1365-2648.2010.05394.x

Published
2023-05-19
How to Cite
Álvarez García, H., Lugo-González, I., & González Betanzos, F. (2023). Psychometric properties of the Insomnia Severity Index (ISI) in Mexican adults. Interacciones, 9, e311. https://doi.org/10.24016/2023.v9.311
Issue
Vol. 9 (2023): January - December
Section
Original paper

Copyright (c) 2023 Interacciones

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the copyright and give the journal the right of the first publication and that they can edit it, reproduce it, distribute it, exhibit it and communicate it in the country and abroad through printed and digital media.

The digital version of the journal is registered under a Creative Commons license (Under Creative Commons License): Attribution 4.0 International (CC BY 4.0). Therefore, this work can be reproduced, distributed and publicly communicated in digital format, provided that the names of the authors and Interacciones.

Therefore, it is established that authors can make other independent and additional behavioural agreements for the non-exclusive distribution of the version of the article published in this journal (eg, include it in institutional repositories or publish it in a book) as long as it is clearly indicated that the work was published for the first time in this journal.