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Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies

Authors: Markus Gerber, Christin Lang, Sakari Lemola, Flora Colledge, Nadeem Kalak, Edith Holsboer-Trachsler, Uwe Pühse, Serge Brand

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

A variety of objective and subjective methods exist to assess insomnia. The Insomnia Severity Index (ISI) was developed to provide a brief self-report instrument useful to assess people’s perception of sleep complaints. The ISI was developed in English, and has been translated into several languages including German. Surprisingly, the psychometric properties of the German version have not been evaluated, although the ISI is often used with German-speaking populations.

Methods

The psychometric properties of the ISI are tested in three independent samples: 1475 adolescents, 862 university students, and 533 police and emergency response service officers. In all three studies, participants provide information about insomnia (ISI), sleep quality (Pittsburgh Sleep Quality Index), and psychological functioning (diverse instruments). Descriptive statistics, gender differences, homogeneity and internal consistency, convergent validity, and factorial validity (including measurement invariance across genders) are examined in each sample.

Results

The findings show that the German version of the ISI has generally acceptable psychometric properties and sufficient concurrent validity. Confirmatory factor analyses show that a 1-factor solution achieves good model fit. Furthermore, measurement invariance across gender is supported in all three samples.

Conclusions

While the ISI has been widely used in German-speaking countries, this study is the first to provide empirical evidence that the German version of this instrument has good psychometric properties and satisfactory convergent and factorial validity across various age groups and both men and women. Thus, the German version of the ISI can be recommended as a brief screening measure in German-speaking populations.
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Literature
1.
go back to reference Roth T. Insomnia: Defintion, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;15:S7–10. Roth T. Insomnia: Defintion, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;15:S7–10.
2.
go back to reference Ohayon MM, Paiva T. Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal. Sleep Med. 2005;6:435–41.CrossRefPubMed Ohayon MM, Paiva T. Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal. Sleep Med. 2005;6:435–41.CrossRefPubMed
3.
go back to reference Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31:473–80.CrossRefPubMedPubMedCentral Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31:473–80.CrossRefPubMedPubMedCentral
4.
6.
go back to reference Curcio G, Ferrara L, De Gennaro M. Sleep loss, learning capacity and academic performance. Sleep Med Rev. 2006;10:323–37.CrossRefPubMed Curcio G, Ferrara L, De Gennaro M. Sleep loss, learning capacity and academic performance. Sleep Med Rev. 2006;10:323–37.CrossRefPubMed
7.
go back to reference Hatzinger M, Brand S, Perren S, Stadelmann S, Von Wyl A, Von Klitzing K, Holsboer-Trachsler E. Electroencephalographic sleep profiles and hypothalamic-pituitary-adrenocortical (HPA) activity in kindergarten children: early indication of poor sleep quality associated with increased cor-tisol secretion. J Psychiatr Res. 2008;42:352–543.CrossRef Hatzinger M, Brand S, Perren S, Stadelmann S, Von Wyl A, Von Klitzing K, Holsboer-Trachsler E. Electroencephalographic sleep profiles and hypothalamic-pituitary-adrenocortical (HPA) activity in kindergarten children: early indication of poor sleep quality associated with increased cor-tisol secretion. J Psychiatr Res. 2008;42:352–543.CrossRef
8.
go back to reference Roberts RE, Roberts CR, Duong HT. Chronic insomnia and its negative consequences for health and functioning of adolescents: A 12-month prospective study. J Adolesc Health. 2008;42:294–302.CrossRefPubMed Roberts RE, Roberts CR, Duong HT. Chronic insomnia and its negative consequences for health and functioning of adolescents: A 12-month prospective study. J Adolesc Health. 2008;42:294–302.CrossRefPubMed
9.
go back to reference Yu DS. Insomnia Severity Index: Psychometric properties with Chines community-dwelling older people. J Adv Nurs. 2010;66:2350–9.CrossRefPubMed Yu DS. Insomnia Severity Index: Psychometric properties with Chines community-dwelling older people. J Adv Nurs. 2010;66:2350–9.CrossRefPubMed
11.
go back to reference El-Anzi FO. Insomnia in relation to depression and somatic symptoms. Psychol Rep. 2006;99:171–5.PubMed El-Anzi FO. Insomnia in relation to depression and somatic symptoms. Psychol Rep. 2006;99:171–5.PubMed
12.
go back to reference Lang C, Kalak N, Brand S, Holsboer-Trachsler E, Pühse U, Gerber M. The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and meta-analysis. Sleep Med Rev. 2015;58:28–41. Lang C, Kalak N, Brand S, Holsboer-Trachsler E, Pühse U, Gerber M. The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and meta-analysis. Sleep Med Rev. 2015;58:28–41.
13.
go back to reference Monk TH, Buysse DJ, Rose DJ, Hall JA, Kupfer DJ. The sleep of healthy people – A diary study. Chronobio Int. 2000;17:49–60.CrossRef Monk TH, Buysse DJ, Rose DJ, Hall JA, Kupfer DJ. The sleep of healthy people – A diary study. Chronobio Int. 2000;17:49–60.CrossRef
14.
go back to reference Morin CM, Leblanc M, Bélanger L, Ivers H, Mérette C, Savard J. Prevalence of insomnia and its treatment in Canada. Can J Psychiatry. 2011;56:540–8.CrossRefPubMed Morin CM, Leblanc M, Bélanger L, Ivers H, Mérette C, Savard J. Prevalence of insomnia and its treatment in Canada. Can J Psychiatry. 2011;56:540–8.CrossRefPubMed
15.
go back to reference Morin CM. Insomnia: Psychological assessment and management. New York: Guilford; 1993. Morin CM. Insomnia: Psychological assessment and management. New York: Guilford; 1993.
16.
go back to reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Washington: American Psychiatric Publishing; 2000. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Washington: American Psychiatric Publishing; 2000.
17.
go back to reference Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index (ISI) as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.CrossRefPubMed Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index (ISI) as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.CrossRefPubMed
18.
go back to reference Savard MH, Savard J, Simard S, Ivers H. Empirical validation of the Insomnia Severity Index in cancer patients. Psychooncology. 2005;14:429–41.CrossRefPubMed Savard MH, Savard J, Simard S, Ivers H. Empirical validation of the Insomnia Severity Index in cancer patients. Psychooncology. 2005;14:429–41.CrossRefPubMed
19.
go back to reference Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–8.PubMedPubMedCentral Morin CM, Belleville G, Belanger L, Ivers H. The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–8.PubMedPubMedCentral
20.
go back to reference Smith S, Trinder J. Detecting insomnia: Comparison of four self-report measures of sleep in a young adult population. J Sleep Res. 2001;10:229–35.CrossRefPubMed Smith S, Trinder J. Detecting insomnia: Comparison of four self-report measures of sleep in a young adult population. J Sleep Res. 2001;10:229–35.CrossRefPubMed
21.
go back to reference Gagnon C, Bélanger L, Ivers H, Morin CM. Validation of the Insomnia Severity Index in primary care. J Am Board Fam Med. 2013;26:701–10.CrossRefPubMed Gagnon C, Bélanger L, Ivers H, Morin CM. Validation of the Insomnia Severity Index in primary care. J Am Board Fam Med. 2013;26:701–10.CrossRefPubMed
22.
go back to reference Fernandez-Mendoza J, Rodriguez-Munoz A, Vela-Bueno A, Olevarrieta-Bernardino S, Calhoun SL, Bixler EO, Vgontzas AN. The Spanish version of the Insomnia Severity Index: A confirmatory factor analysis. Sleep Med. 2012;13:207–10.CrossRefPubMed Fernandez-Mendoza J, Rodriguez-Munoz A, Vela-Bueno A, Olevarrieta-Bernardino S, Calhoun SL, Bixler EO, Vgontzas AN. The Spanish version of the Insomnia Severity Index: A confirmatory factor analysis. Sleep Med. 2012;13:207–10.CrossRefPubMed
23.
go back to reference Chung JW, Chung LM, Chen B. The impact of lifestyle on the physical fitness of primary school children. J Clin Nurs. 2009;18:1002–9.CrossRefPubMed Chung JW, Chung LM, Chen B. The impact of lifestyle on the physical fitness of primary school children. J Clin Nurs. 2009;18:1002–9.CrossRefPubMed
24.
go back to reference Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity. J Sci Med Sport. 2010;13:496–502.CrossRefPubMed Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity. J Sci Med Sport. 2010;13:496–502.CrossRefPubMed
25.
go back to reference Sierra JC, Guillén-Serrano V, Santos-Iglesias P. Insomnia Severity Index: Some indicators about its reliability and validity on an older adult sample. Rev Neurology. 2008;47:566–70. Sierra JC, Guillén-Serrano V, Santos-Iglesias P. Insomnia Severity Index: Some indicators about its reliability and validity on an older adult sample. Rev Neurology. 2008;47:566–70.
26.
go back to reference Chung KF, Kan KK, Yeung WF. Assessing insomnia in adolescents: Comparison of Insomnia SEverity Index, Athens Insomnia Scale and Sleep Quality Index. Sleep Med. 2011;12:463–70.CrossRefPubMed Chung KF, Kan KK, Yeung WF. Assessing insomnia in adolescents: Comparison of Insomnia SEverity Index, Athens Insomnia Scale and Sleep Quality Index. Sleep Med. 2011;12:463–70.CrossRefPubMed
27.
go back to reference Cho YW, Song ML, Morin CM. Validation of a Korean version of the Insomnia Severity Index. J Clin Neurology. 2014;10:210–5.CrossRef Cho YW, Song ML, Morin CM. Validation of a Korean version of the Insomnia Severity Index. J Clin Neurology. 2014;10:210–5.CrossRef
28.
go back to reference Yazdi Z, Haghighi KS, Zohal MA, Elmizadeh K. Validity and reliability of the Iranian version of the Insomnia Severity Index. Malaysian J Med Sci. 2012;19:31–6. Yazdi Z, Haghighi KS, Zohal MA, Elmizadeh K. Validity and reliability of the Iranian version of the Insomnia Severity Index. Malaysian J Med Sci. 2012;19:31–6.
29.
go back to reference Lahan V, Gupta R. Translation and validation of the Insomnia Severity Index in Hindi language. Ind J Psychol Med. 2011;33:172–6.CrossRef Lahan V, Gupta R. Translation and validation of the Insomnia Severity Index in Hindi language. Ind J Psychol Med. 2011;33:172–6.CrossRef
30.
go back to reference Brand S, Beck J, Gerber M, Hatzinger M. Football is good for your sleep. Favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls. J Health Psychol. 2009;14:1144–55.CrossRefPubMed Brand S, Beck J, Gerber M, Hatzinger M. Football is good for your sleep. Favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls. J Health Psychol. 2009;14:1144–55.CrossRefPubMed
31.
go back to reference Brand S, Gerber M, Pühse U, Holsboer-Trachsler E. Depression, hypomania and dysfunctional cognitions as mediators between stress and insomnia: The best advice is not always found on the pillow! Int J Stress Management. 2010;17:114–34. doi:10.1037/a0019090.CrossRef Brand S, Gerber M, Pühse U, Holsboer-Trachsler E. Depression, hypomania and dysfunctional cognitions as mediators between stress and insomnia: The best advice is not always found on the pillow! Int J Stress Management. 2010;17:114–34. doi:10.​1037/​a0019090.CrossRef
32.
go back to reference Brand S, Beck J, Gerber M, Hatzinger M, Holsboer-Trachsler E. Evidence of favorable sleep-EEG patterns in adolescent male vigorous football players compared to controls. W J Biol Psychiatry. 2009;11:465–75.CrossRef Brand S, Beck J, Gerber M, Hatzinger M, Holsboer-Trachsler E. Evidence of favorable sleep-EEG patterns in adolescent male vigorous football players compared to controls. W J Biol Psychiatry. 2009;11:465–75.CrossRef
33.
go back to reference Kalak N, Gerber M, Kirov R, Mikoteit T, Puehse U, Holsboer-Trachsler E, Brand S. The relation of objective sleep patterns, depressive symptoms, and sleep disturbances in adolescent children and their parents: A sleep-EEG study with 47 families. J Psychiatr Res. 2012;46:1374–82.CrossRefPubMed Kalak N, Gerber M, Kirov R, Mikoteit T, Puehse U, Holsboer-Trachsler E, Brand S. The relation of objective sleep patterns, depressive symptoms, and sleep disturbances in adolescent children and their parents: A sleep-EEG study with 47 families. J Psychiatr Res. 2012;46:1374–82.CrossRefPubMed
34.
go back to reference Lang C, Brand S, Feldmeth AK, Holsboer-Trachsler E, Pühse U, Gerber M. Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents. Physiol Behav. 2013;120:46–53.CrossRefPubMed Lang C, Brand S, Feldmeth AK, Holsboer-Trachsler E, Pühse U, Gerber M. Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents. Physiol Behav. 2013;120:46–53.CrossRefPubMed
35.
go back to reference Gerber M, Brand S, Herrmann C, Colledge F, Holsboer-Trachsler E, Pühse U. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults. Physiol Behav. 2014;135:17–24.CrossRefPubMed Gerber M, Brand S, Herrmann C, Colledge F, Holsboer-Trachsler E, Pühse U. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults. Physiol Behav. 2014;135:17–24.CrossRefPubMed
36.
go back to reference Ammon U. Die Stellung der deutschen Sprache in der Welt. Berlin: de Gruyter; 2014.CrossRef Ammon U. Die Stellung der deutschen Sprache in der Welt. Berlin: de Gruyter; 2014.CrossRef
37.
go back to reference Alexander JL, Dennerstein L, Kotz K, Richardson GS. Women, anxiety and mood: a review of nomenclature, comorbidity and epidemiology. Expert Rev Neurother. 2007;7:S45–58.CrossRefPubMed Alexander JL, Dennerstein L, Kotz K, Richardson GS. Women, anxiety and mood: a review of nomenclature, comorbidity and epidemiology. Expert Rev Neurother. 2007;7:S45–58.CrossRefPubMed
38.
go back to reference Nunnally J, Bernstein B. Psychometric theory. New York: McGraw-Hill; 1994. Nunnally J, Bernstein B. Psychometric theory. New York: McGraw-Hill; 1994.
39.
go back to reference Comrey AL, Lee HB. A first course in factor analysis. Hillsdale: Erlbaum; 1992. Comrey AL, Lee HB. A first course in factor analysis. Hillsdale: Erlbaum; 1992.
40.
go back to reference Brand S, Kalak N, Gerber M, Clough PJ, Lemola S, Pühse U, et al. During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life. J Health Psychol. 2014. Brand S, Kalak N, Gerber M, Clough PJ, Lemola S, Pühse U, et al. During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life. J Health Psychol. 2014.
41.
go back to reference Brislin RW. The wording and translation of research instrument. In: Lonner WJ, Berry JW, editors. Field methods in cross-cultural research. Beverly Hills: Sage; 1986. p. 137–64. Brislin RW. The wording and translation of research instrument. In: Lonner WJ, Berry JW, editors. Field methods in cross-cultural research. Beverly Hills: Sage; 1986. p. 137–64.
42.
go back to reference Backhaus J, Riemann D. Schlafstörungen bewältigen [Coping with sleep disorders]. Weinheim: Beltz Psychologie Verlags Union; 1996. Backhaus J, Riemann D. Schlafstörungen bewältigen [Coping with sleep disorders]. Weinheim: Beltz Psychologie Verlags Union; 1996.
43.
go back to reference Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: New instrument for psychiatric practice and research. Psychiatr Rev. 1989;28:193–213. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: New instrument for psychiatric practice and research. Psychiatr Rev. 1989;28:193–213.
44.
go back to reference Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Power M, et al. The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value Health. 2008;11. Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Power M, et al. The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value Health. 2008;11.
45.
go back to reference McDonald RP, Ho RM. Principles and practice in reporting structural equation analyses. Psychol Methods. 2002;7:65–9.CrossRef McDonald RP, Ho RM. Principles and practice in reporting structural equation analyses. Psychol Methods. 2002;7:65–9.CrossRef
46.
go back to reference Widaman KF, Ferrer E, Conger RD. Factorial invariance within longitudinal structural equation models: Measuring the same construct across time. Child Dev. 2010;4:10–8.CrossRef Widaman KF, Ferrer E, Conger RD. Factorial invariance within longitudinal structural equation models: Measuring the same construct across time. Child Dev. 2010;4:10–8.CrossRef
47.
go back to reference Brand S, Gerber M, Pühse U, Holsboer-Trachsler E. The relationship between sleep and pain among a non-clinical sample of young adults. Eur Arch Psychiatry and Clin Neurosci. 2010;260:543–51.CrossRef Brand S, Gerber M, Pühse U, Holsboer-Trachsler E. The relationship between sleep and pain among a non-clinical sample of young adults. Eur Arch Psychiatry and Clin Neurosci. 2010;260:543–51.CrossRef
48.
go back to reference Gerber M, Brand S, Holsboer-Trachsler E, Pühse U. Fitness and exercise as correlates of sleep complaints. Is it all in our minds? Med Sci Sports Exerc. 2010;43:893–901.CrossRef Gerber M, Brand S, Holsboer-Trachsler E, Pühse U. Fitness and exercise as correlates of sleep complaints. Is it all in our minds? Med Sci Sports Exerc. 2010;43:893–901.CrossRef
49.
go back to reference Von Zerssen D. Depressivitäts-Skala [Depression scale]. Göttingen: Hogrefe; 1976. Von Zerssen D. Depressivitäts-Skala [Depression scale]. Göttingen: Hogrefe; 1976.
50.
go back to reference Gerber M, Hartmann T, Brand S, Holsboer-Trachsler E, Pühse U. The relationship between shift work, perceived stress, sleep and health in Swiss police officers. J Crim Just. 2010;38:1167–75.CrossRef Gerber M, Hartmann T, Brand S, Holsboer-Trachsler E, Pühse U. The relationship between shift work, perceived stress, sleep and health in Swiss police officers. J Crim Just. 2010;38:1167–75.CrossRef
51.
go back to reference Gerber M, Kellmann M, Elliot C, Hartmann T, Brand S, Holsboer-Trachsler E, Pühse U. Perceived fitness protects against stress-based mental health impairments among police of-ficers who report good sleep. J Occ Health. 2013;55:376–84.CrossRef Gerber M, Kellmann M, Elliot C, Hartmann T, Brand S, Holsboer-Trachsler E, Pühse U. Perceived fitness protects against stress-based mental health impairments among police of-ficers who report good sleep. J Occ Health. 2013;55:376–84.CrossRef
52.
go back to reference Bullinger M, Kirchberger I. SF-36 Fragebogen zum Gesundheitszustand. Göttingen: Hogrefe; 2011. Bullinger M, Kirchberger I. SF-36 Fragebogen zum Gesundheitszustand. Göttingen: Hogrefe; 2011.
53.
go back to reference Zhang B, Wing Y-K. Sex differences in insomnia: A meta-analysis. Sleep. 2006;29:85–93.PubMed Zhang B, Wing Y-K. Sex differences in insomnia: A meta-analysis. Sleep. 2006;29:85–93.PubMed
54.
go back to reference Akerstedt T. Shift work and disturbed sleep/wakefulness. Occ Med. 2003;53:89–94.CrossRef Akerstedt T. Shift work and disturbed sleep/wakefulness. Occ Med. 2003;53:89–94.CrossRef
55.
go back to reference Byrne BM. Structural equation modeling with AMOS. Basic concepts, applications, and programming. New York: Taylor & Francis; 2010. Byrne BM. Structural equation modeling with AMOS. Basic concepts, applications, and programming. New York: Taylor & Francis; 2010.
56.
go back to reference Kalak N, Gerber M, Kirov R, Mikoteit T, Yordanova J, Puhse U, Holsboer-Trachsler E, Brand S. Daily morning running for 3 weeks improved sleep and psychological functioning in healthy adolescents compared with controls. J Adolesc Health. 2012;51:615–22.CrossRefPubMed Kalak N, Gerber M, Kirov R, Mikoteit T, Yordanova J, Puhse U, Holsboer-Trachsler E, Brand S. Daily morning running for 3 weeks improved sleep and psychological functioning in healthy adolescents compared with controls. J Adolesc Health. 2012;51:615–22.CrossRefPubMed
57.
go back to reference Soldatos CR, Dieos DG, Paparrigopoulos TJ. Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48:555–60.CrossRefPubMed Soldatos CR, Dieos DG, Paparrigopoulos TJ. Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48:555–60.CrossRefPubMed
Metadata
Title
Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies
Authors
Markus Gerber
Christin Lang
Sakari Lemola
Flora Colledge
Nadeem Kalak
Edith Holsboer-Trachsler
Uwe Pühse
Serge Brand
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0876-8

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