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A German version of the Insomnia Severity Index

Validation and identification of a cut-off to detect insomnia

Deutsche Version des Insomnia Severity Index

Validierung und Bestimmung eines Cut-off-Punkts für Insomnie

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Abstract

Background

Insomnia is a prevalent disorder. There is a need for brief, easily manageable, and valid questionnaires to support practitioners in the clinical evaluation of insomnia.

Objective

This paper assesses the psychometric properties, the discriminatory power and the optimal clinical cut-off point of a German version of the Insomnia Severity Index (ISI) with both a sample of patients with primary insomnia as well as a non-clinical sample.

Methods

Two datasets were used (N = 700). The first dataset is from an initial screening for a sleep training program for patients with insomnia (n = 416). The second dataset consists of a general sample (n = 284). The internal consistency, the factor structure, the construct validity, the discriminatory power and the optimal clinical cut-off point were calculated.

Results

The internal consistency of the German ISI was good (α = 0.83) and test–retest reliability (n = 143) was satisfactory (r = 0.78). Significant correlations between the ISI and measures of sleep quality, depression and stress reactivity confirmed the expectations regarding construct validity. The discriminatory power was excellent and the optimal cut-off point was >10 (sensitivity: 91%, specificity: 83%).

Conclusion

The findings demonstrate that the German version of the ISI has good psychometric properties and can be recommended as a measurement tool to quantify symptom severity for both research and clinical practice.

Zusammenfassung

Hintergrund

Insomnie ist eine weitverbreitete Störung. Es besteht ein Bedarf an kurzen, leicht handhabbaren und validen Fragebögen, um Praktiker bei der klinischen Bewertung von Schlafschwierigkeiten zu unterstützen.

Zielsetzung

Im vorliegenden Artikel werden die psychometrischen Eigenschaften und die diskriminatorische Fähigkeit evaluiert und der optimale klinische Cut-off einer deutschen Version des Insomnia Severity Index (ISI) an einer Stichprobe von Patienten mit primärer Insomnie sowie an einer nichtklinischen Stichprobe bestimmt.

Methoden

Es wurden 2 Datensätze verwendet (N = 700). Der erste Datensatz stammt aus einem Screening für ein Schlaf-Trainingsprogramm für Patienten mit Insomnie (n = 416). Der zweite Datensatz besteht aus einer allgemeinen Stichprobe (n = 284). Die interne Konsistenz, die Faktorenstruktur, die Konstruktvalidität, die diskriminatorische Fähigkeit und der optimale klinische Cut-off wurden berechnet.

Ergebnisse

Die interne Konsistenz der deutschen Version des ISI war gut (α = 0,83) und die Test-Retest-Reliabilität (n = 143) war zufriedenstellend (r = 0,78). Signifikante Korrelationen zwischen dem ISI, Schlafqualität, Depressivität und Stressreaktivität entsprachen den Erwartungen hinsichtlich der Konstruktvalidität. Die diskriminatorische Fähigkeit war ausgezeichnet und der optimale Cut-off lag bei >10 (Sensitivität: 91 %, Spezifität: 83 %).

Schlussfolgerungen

Die Ergebnisse zeigen, dass die deutsche Version des ISI gute psychometrische Eigenschaften hat und als Messinstrument zur Bestimmung der Symptomschwere sowohl für die Forschung als auch für die klinische Praxis empfohlen werden kann.

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Authors and Affiliations

  1. Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111, Bonn, Germany

    Arne Dieck M.Sc.-Psych. & Jutta Backhaus

  2. School of Psychology, Laval University Québec, Pavillon Félix-Antoine-Savard 2325, rue des Bibliothèques Université Laval Québec, G1V 0A6, Québec, Canada

    Charles M. Morin

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  1. Arne Dieck M.Sc.-Psych.
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  2. Charles M. Morin
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  3. Jutta Backhaus
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Correspondence to Arne Dieck M.Sc.-Psych..

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Conflict of interest

A. Dieck, C.M. Morin and J. Backhaus declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Dieck, A., Morin, C.M. & Backhaus, J. A German version of the Insomnia Severity Index. Somnologie 22, 27–35 (2018). https://doi.org/10.1007/s11818-017-0147-z

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