Psychometric Properties of the Athens Insomnia Scale in Salvadoran Population
DOI:
https://doi.org/10.24265/liberabit.2022.v28n2.579Keywords:
insomnia, mental health, Salvadoran population, psychometric properties, factor analysisAbstract
Background: Insomnia can harm daily functioning and is strongly associated with depression and anxiety symptoms, especially in women. El Salvador has no scales with adequate psychometric properties for their measurement. In this context, the Athens Insomnia Scale (AIS) is a viable option to measure this symptomatology, given its short length of time, solid theoretical foundation, and relevance in other countries. Objective: To analyze the psychometric properties of AIS in the Salvadoran population, in its complete (AIS-8) and abbreviated (AIS-5) versions. Method: The study consisted of 1479 Salvadoran adults from the 14 departments of the country (mean age = 33.3 years, SD = 11.7) who were screened through a non-probability sampling design. Evidence of reliability, validity based on internal structure, and convergent validity were examined. Results: Both scales showed adequate internal consistency, validity based on internal structure through a one-factor structure, invariance between sexes, and convergent validity with depression, anxiety, and stress scales. Conclusions: Both versions have adequate psychometric properties. Shared covariances and partial mismatch indexes suggest the need to analyze its cultural adequacy. Despite this, there is sufficient evidence to support its usefulness in evaluating symptoms of non-organic insomnia in the Salvadoran population.
Authorship contribution
FM: study design, data processing and interpretation, introduction, results, discussion, general review and writing in APA format.
FC: data processing and interpretation, results, discussion, general review and writing in APA format.
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References
American Educational Research Association, American Psychological Association, & National Council on Measurement in Education. (2018). Estándares para pruebas educativas y psicológicas (M. Lieve, trad.).
American Educational Research Association. Asociación de Psiquiatría Americana. (2014). Manual Diagnóstico y Estadístico de los Trastornos Mentales (5.a ed.). Editorial Panamericana.
Baños-Chaparro, J., Fuster, F., & Marín-Contreras, J. (2021). Escala de Insomnio de Atenas: evidencias psicométricas en adultos peruanos. Liberabit, 27(1), e458. https://doi.org/10.24265/liberabit.2021.v27n1.07
Blake, M., Trinder, John A., & Allen, N. (2018). Mechanisms Underlying the Association Between Insomnia, Anxiety, and Depression in Adolescence: Implications for Behavioral Sleep Interventions. Clinical Psychology Review, 63, 25-40. https://doi.org/10.1016/j.cpr.2018.05.006
Brown, T. (2015). Confirmatory Factor Analysis for Applied Research (2.a ed.). Guilford Press.
Chen, F. (2007). Sensitivity of Goodness of Fit Indexes to Lack of Measurement Invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464-504. https://doi.org/10.1080/10705510701301834
Cheng-Fang, Y., King, B., & Yu-Ping, C. (2010). Factor Structure of the Athens Insomnia Scale and its Associations with Demographic Characteristics and Depression in Adolescents. Journal of Sleep Research, 19, 12-18. https://doi.org/10.1111/j.1365-2869.2009.00758.x
Choi, J., Kim, S., Chen, J., & Dannels, S. (2011). A Comparison of Maximum Likelihood and Bayesian Estimation for Polychoric Correlation using Monte Carlo Simulation. Journal of Educational and Behavioral Statistics, 36(4), 523-549. https://doi.org/10.3102/1076998610381398
Daza, P., Novy, D., Stanley, M. A., & Averill, P. (2002). The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample. Journal of Psychopathology and Behavioral Assessment, 24(3), 195-205. https://doi.org/10.1023/A:1016014818163
De Souza, L. F., Paineiras-Domingos, L. L., Melo-Oliveira, M. E., Pessanha-Freitas, J., Moreira-Marconi, E., Lacerda, A. C., Mendonça, V., Sá-Caputo, D., & Bernardo-Filho, M. (2021). The Impact of COVID-19 Pandemic in the Quality of Sleep by Pittsburgh Sleep Quality Index: A Systematic Review. Ciência & Saúde Coletiva, 26(4), 1457-1466. https://doi.org/10.1590/1413-81232021264.45952020
Dimitrov, D. (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
Dirección General de Estadísticas y Censos. (2022). 2021 Encuesta de Hogares y Propósitos Múltiples (EHPM). Ministerio de Economía. https://www.bcr.gob.sv/documental/Inicio/descarga/PUBLICACION_EHPM_2021.pdf
DiStefano, C., Liu, J., Jiang, N., & Shi, D. (2017). Examination of th Weighted Root Mean Square Residual: Evidence for Trustworthiness? Structural Equation Modeling: A Multidisciplinary Journal, 25(3), 1-14. https://doi.org/10.1080/10705511.2017.1390394
Emamian, F., Khazaie, H., Okun, M. L., Tahmasian, M., & Sepehry, A. A. (2019). Link Between Insomnia and Perinatal Depressive Symptoms: A Meta Analysis. Journal of Sleep Research, 28(6), e12858. https://doi.org/10.1111/jsr.12858
Erazo, M. (2020). Medición y análisis del empleo inormal en El Salvador: retos en el contexto del COVID-19. Revista Estudios de Políticas Públicas, 6(2), 16-33. http://dx.doi.org/10.5354/0719-6296.2020.58399
Feldt, L. (1980). A Test of the Hypothesis that Cronbach’s Alpha Reliability Coefficient is the Same for Two Tests Administered to the Same Sample. Psychometrika, 45(1), 99-105. https://psycnet.apa.org/doi/10.1007/BF02293600
Flora, D., & Curran, P. (2004). An Empirical Evaluation of Alternative Methods of Estimation for Confirmatory Factor Analysis with Ordinal Data. Psychological Methods, 9(4), 466-491. https://doi.org/10.1037/1082-989X.9.4.466
Ford, D., & Kamerow, D. (1989). Epidemiologic Study of Sleep Disturbances and Psychiatric Disorders. JAMA, 262(11), 1479-1484. https://doi.org/10.1001/jama.1989.03430110069030
Gómez-Benito, J., Ruiz, R., & Guilera, G. (2011). A Spanish Version of the Athens Insomnia Scale. Quality of Life Research, 20, 931-937. https://doi.org/10.1007/s11136-010-9827-x
Greenfield, P. M. (1997). You can’t Take it with You: Why Ability Assessments Don’t Cross Cultures. American Psychologist, 52(10), 1115-1124. https://doi.org/10.1037/0003-066X.52.10.1115
Gutiérrez-Quintanilla, J., Lobos-Rivera, M., & TejadaRodríguez, J. (2020). Adaptación psicométrica de las escalas de depresión, ansiedad y estrés en una muestra de adolescentes salvadoreños. Entorno, 69, 12-22. https://doi.org/10.5377/entorno.v0i69.9556
Hatcher, L. (2013). Advanced Statistics in Research. Shadow Finch Media LLC.
Hu, L., & Bentler, P. M. (1999). Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria versus New Alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118
International Business Machines Corporation. (2016). International Business Machines SPSS Statistics para Windows (versión 24.0) [software]. IBM Corporation.
Jackson, D., Gillaspy, J., & Purc-Stephenson, R. (2009). Reporting Practices in Confirmatory Factor Analysis: An Overview and Some Recommendations. Psychological Methods, 14(1), 6-23. https://doi.org/10.1037/a0014694
Junta de Vigilancia de la Profesión en Psicología. (2021). Código de ética de la profesión en psicología. https://bit.ly/3lh27Ak
Kolakowsky-Hayner, S. A., Goldin, Y., Kingsley, K., Alzueta, E., Arango-Lasprilla, J. C., Perrin, P. B., Baker, F. C., Ramos-Usuga, D., & Constantinidou, F. (2021). Psychosocial Impacts of the COVID-19 Quarantine: A Study of Gender Differences in 59 Countries, Medicina, 57(8), 789. https://doi.org/10.3390/medicina57080789
Krishnan, V., & Collop, N. (2006). Gender differences in sleep disorders. Current Opinion in Pulmonary Medicine, 12(6), 383-389. https://doi.org/10.1097/01.mcp.0000245705.69440.6a
Lallukka, T., Sares-Jäske, L., Kronholm, E., Sääksjärvi, K., Lundqvist, A., Partonen, T., Rahkonen, O., & Knekt, P. (2012). Sociodemographic and Socioeconomic Differences in Sleep Duration and Insomnia-Related Symptoms in Finnish Adults. BMC Public Health, 12, 565. https://doi.org/10.1186/1471-2458-12-565
Leal-Grimaldo, J., Álvarez-Contreras, J., Tamez-Rodríguez, A., Vega-Pérez, M., & Castañeda-Sánchez, O. (2017). Nivel de insomnio no orgánico posterior a una estrategia de higiene del sueño. Atención Familiar, 24(1), 23-26. https://doi.org/10.1016/j.af.2016.08.005
Little, T. (2013). Longitudinal Structural Equation Modeling. Guildford Publications.
Liu, X., Buysse, D. J., Gentzler, A. L., Kiss, E., Mayer, L., Kapornai, K., Vetró, Á., & Kovacs, M. (2007). Insomnia and Hypersomnia Associated with Depressive Phenomenology and Comorbidity in Childhood Depression. Sleep, 30(1), 83-90. https://doi.org/10.1093/sleep/30.1.83
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, 30(3), 1151-1169. http://dx.doi.org/10.6018/analesps.30.3.199361
Lobos, M., Alfaro, S., Cortéz, M., Escobar, R., López, M., Márquez, M., Peñate, B., & Ramírez, Y. (2021). Prevalencia de síntomas de insomnio en estudiantes de la carrera de Licenciatura en Psicología. Psykhé a la Vanguardia, 8, 10-14. https://bit.ly/3csSmKN
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. (2.a ed.). Psychology Foundation.
MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power Analysis and Determination of Sample Size for Covariance Structure Modeling. Psychological Methods, 1(2), 130-149. https://doi.org/10.1037/1082-989X.1.2.130
Maede, A., Johnson, E., & Braddy, P. (2008). Power Sensitivity of Alternative Fit Indices in Tests of Measurement Invariance. Journal of Applied Psychology, 93(3), 568-592. https://doi.org/10.1037/ 0021-9010.93.3.568
McDonald, R. (1999). Test Theory: A Unified Treatment. Psychology Press. https://doi.org/10.4324/9781410601087
Mena, F., De Paz, V., Avilés, M., & Orantes, L. (2021). Educabilidad y salud mental de universitarios salvadoreños durante la pandemia por Covid19. Ciencia Y Educación, 5(3), 19-38. https://doi.org/10.22206/cyed.2021.v5i3.pp19-38
Mena, F., Molina, C., & Castillo, Y. (2020). La salud mental de los salvadoreños durante el confinamiento voluntario por el COVID-19. Fundación Pro Educación de El Salvador. https://bit.ly/2OkPAhP
Mena, F., Molina, C., & Castillo, Y. (2022). Salud mental de los salvadoreños y factores asociados. Fundación Pro Educación de El Salvador. https://bit.ly/3xhu6Gy
Montero, I., & León, O. (2007). A Guide for Naming Research Studies in Psychology. International Journal of Clinical and Health Psychology, 7(3), 847- 862. https://bit.ly/2LbQVSV
Monterrosa-Castro, A., Marrugo-Flórez, M., Romero-Pérez,I., Chedraui, P., Fernández-Alonso, A. M., & PérezLópez, F. R. (2013). Prevalence of Insomnia and Related Factors in a Large Mid-Aged Female Colombian Sample. Maturitas, 74(4), 346-351. https://doi.org/10.1016/j.maturitas.2013.01.009
Nenclares, P., & Jiménez-Genchi, A. (2005). Estudio de validación de la traducción al español de la Escala Atenas de Insomnio. Salud Mental, 28(5), 34-39. https://bit.ly/2GzWP17
Orellana, C., & Orellana, L. (2020). Predictores de síntomas emocionales durante la cuarentena domiciliar por la pandemia de COVID-19 en El Salvador. Actualidades en Psicología, 34(128), 103-120. http://dx.doi.org/10.15517/ap.v34i128.41431
Orellana, C., & Orellana, L. (2021). Propiedades psicométricas de la Escala abreviada de Depresión, Ansiedad y Estrés (DASS-21) en adultos salvadoreños. Teoría y Praxis, 19(38), 45-54. http://hdl.handle.net/11715/2411
Park, M., & Wu, A. (2019). Item Response Tree Models to Investigate Acquiescence and Extreme Response Styles in Likert-Type Rating Scales. Educational Psychology Measurement, 79(5), 911-930. https://doi.org/10.1177%2F0013164419829855
Philips. (2021). Philips Global Sleep Survey. Seeking Solutions: How COVID-19 Changed Sleep Around the World. Philips. https://bit.ly/3whfHYj
R project. (2021). The R project for statistical computing.https://www.r-project.org/
Ramírez-Ortíz, J., Castro-Quintero, D., Lerma-Córdoba, C., Yela-Ceballos, F., & Escobar-Córdoba, F. (2020). Mental Health Consequences of the COVID-19 Pandemic Associated with Social Isolation. Colombian Journal of Anesthesiology, 48(4), 1-8. https://doi.org/10.5554/22562087.e930
Romero, O., Sagalés, T., & Jurado, M. J. (2005). Insomnio: diagnóstico, manejo y tratamiento. Revista de Médicina de la Universidad de Navarra, 49(1), 25-30. https://doi.org/10.15581/021.7498
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
Rstudio. (2021). Rstudio. https://www.rstudio.com/products/rstudio/download/
Ruiz, C. (2007). Revisión de los diversos métodos de evaluación del trastorno de insomnio. Anales de Psicología, 23(1), 109-117. https://bit.ly/2Wj5b4Z
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H.(2003). Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Methods of Psychological Research, 8(2), 23-74.
Soldatos, C., Dikeos, D., & Paparrigopoulos, T. (2000). Athens Insomnia Scale: Validation of an Instrument Based on ICD-10 Criteria. Journal of Psychosomatic Research, 48(6), 555-560. https://doi.org/10.1016/s0022-3999(00)00095-7
Taber, K. (2017). The Use of Cronbach’s Alpha when Developing and Reporting Research Instruments in Science Education. Research in Science Education, 48, 1273-1296. https://doi.org/10.1007/s11165-016-9602-2
Taple, B. J., Chapman, R., Schalet, B. D., Brower, R., & Griffith, J. W. (2022). The Impact of Education on Depression Assessment: Differential Item Functioning Analysis. Assessment, 29(2), 272-284. https://doi.org/10.1177/1073191120971357
Trafimow, D. (2015). The Attenuation of Correlation Coefficients: A Statistical Literacy Issue. Teaching Statistics, 38(1), 25-28. https://psycnet.apa.org/doi/10.1111/test.12087
Twenge, J., & Joiner, T. (2020). U. S. Census Bureau Assessed Prevalence of Anxiety and Depressive Symptoms in 2019 and During the 2020 COVID 19 Pandemic. Depression & Anxiety, 37(10), 954-956. https://doi.org/10.1002/da.23077
Van de Laar, M., Verbeek, I., Pevernagie, D., Aldenkamp, D., & Overeem, S. (2010). The Role of Personality Traits in Insomnia. Sleep Medicine Reviews, 14(1), 61-68. https://doi.org/10.1016/j.smrv.2009.07.007
Van Dijk, T., Datema, F., F., Welten, S. C. M., & Van de Vijver, F. J. R. (2009). Acquiescence and Extremity in CrossNational Surveys: Domain Dependence and CountryLevel Correlates. En G. Aikaterini & K. Mylonas (Eds.), Quod Erat Demonstrandum: From Herodotus’Ethnographic Journeys to Cross-Cultural Research: Proceedings from the 18th International Congress of the International Association for CrossCultural Psychology. https://scholarworks.gvsu.edu/iaccp_papers/51/
Zeng, L-N., Zong, Q-Q., Yang, Y., Zhang, L., Xiang, Y-F., Ng, C., Chen, L-G., & Xiang, Y-T. (2020). Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies. Frontiers in Psychiatry, 11, 1-9. https://doi.org/10.3389/fpsyt.2020.577429
Zhai, L., Zhang, H., & Zhang, D. (2015). Sleep Duration and Depression among Adults: A Meta-Analyisis of Prospective Studies. Depression & Anxiety, 32(9), 664-670. https://doi.org/10.1002/da.22386
Zhang, B., & Wing, Y. K. (2006). Sex Differences in Insomnia: A Meta-Analysis. Sleep, 29(1), 85-93. https://doi.org/10.1093/sleep/29.1.85
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