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Neurological Sciences

, Volume 38, Issue 6, pp 1047–1058 | Cite as

Validation of the German version of the short form of the dysfunctional beliefs and attitudes about sleep scale (DBAS-16)

  • Christin Lang
  • Serge Brand
  • Edith Holsboer-Trachsler
  • Uwe Pühse
  • Flora Colledge
  • Markus Gerber
Original Article

Abstract

Research shows that dysfunctional sleep-related cognitions play an important role in the development, maintenance and exacerbation of insomnia. This study examines the factorial validity, psychometric properties and both concurrent and predictive validity of the German version of the 16-item DBAS (dysfunctional beliefs and attitudes about sleep) scale. Data was collected in 864 vocational students from the German-speaking part of Switzerland (43% females, M age = 17.9 years). Data collection took place twice within a 10-month interval. The students completed a German translation of the DBAS-16, the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and provided information about their psychological functioning. Descriptive statistics, factorial validity, internal consistency, gender differences, concurrent, and predictive validity were examined. Confirmatory factor analysis supported the 4-factor structure of the DBAS-16. All factors (consequences, worry/helplessness, expectations, medication) were positively correlated and had acceptable psychometric properties. Females reported higher scores across all DBAS measures. Weak-to-moderate correlations were found between dysfunctional sleep-related beliefs, insomnia and poor sleep quality. Dysfunctional sleep-related beliefs were also associated with decreased psychological functioning, and consistently predicted insomnia and poor psychological functioning at follow-up, even after controlling for socio-demographic background and baseline levels. The present study provides support for the validity and psychometric properties of the German version of the DBAS-16. Most importantly, it corroborates the relevance of cognitive-emotional factors in the onset and maintenance of insomnia and psychological symptoms among young people.

Keywords

Beliefs Confirmatory factor analysis Insomnia Psychological functioning Sleep-related cognitions Validity 

Notes

Compliance with ethical standards

Conflict of interest

The last author has received research grants from the Swiss Federal Sport Commission under Grant 10-05. The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10072_2017_2921_MOESM1_ESM.pdf (31 kb)
Supplementary material 1 (PDF 30 kb)

References

  1. 1.
    American Academy of Sleep Medicine (2005) The international classification of sleep disorders: diagnostic and coding manual, ICSD-2, 2nd edn. American Academy of Sleep Medicine, Westchester, ILGoogle Scholar
  2. 2.
    Harvey AG (2002) A cognitive model of insomnia. Behav Res Ther 40:869–894. doi: 10.1016/s0005-7967(01)00061-4 CrossRefPubMedGoogle Scholar
  3. 3.
    Morin CM (1993) Insomnia: Psychological assessment and management. Guildford Press, New YorkGoogle Scholar
  4. 4.
    Carney CE, Edinger JD (2006) Identifying critical beliefs about sleep in primary insomnia. Sleep 29:444–453CrossRefPubMedGoogle Scholar
  5. 5.
    Edinger JD, Wohlgemuth WK, Radtke RA, Marsh GR, Quillian RE (2001) Does cognitive-behavioral insomnia therapy alter dysfunctional beliefs about sleep? Sleep 24:591–599CrossRefPubMedGoogle Scholar
  6. 6.
    Espie CA, Inglis SJ, Harvey L, Tessier S (2000) Insomniacs’ attribution: psychometric properties of the dysfunctional beliefs and attitudes about sleep scale and the sleep disturbance questionnaire. J Psychosom Res 48:141–148CrossRefPubMedGoogle Scholar
  7. 7.
    Soehner AM, Harvey AG (2012) Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample. Sleep 35:1367–1375. doi: 10.5665/sleep.2116 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Norell-Clarke A, Jansson-Fröjmark M, Tillfors M, Harvey AG, Linton SJ (2014) Cognitive processes and their association with persistence and remission of insomnia: findings from a longitudinal study in the general population. Behav Res Ther 54:38–48. doi: 10.1016/j.brat.2014.01.002 CrossRefPubMedGoogle Scholar
  9. 9.
    Fernandez-Mendoza J, Vgontzas AN (2013) Insomnia and its impact on physical and mental health. Curr Psychiatry Rep 15:418. doi: 10.1007/s11920-013-0418-8 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Vgontzas AN, Fernandez-Mendoza J, Miksievicz T, Kritikou I, Shaffer ML, Liao D et al (2014) Unveiling the longitudinal association between short sleep duration and the incidence of obesity: the Penn State Cohort. Int J Obes 38:825–832. doi: 10.1038/ijo.2013.172 CrossRefGoogle Scholar
  11. 11.
    Calhoun SL, Vgontzas AN, Fernandez-Mendoza J, Mayes SD, Tsaoussoglou M, Basta M et al (2011) Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep. Sleep 34:503–507CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Fernandez-Mendoza J, Vgontzas AN, Liao D, Schaffer ML, Vela-Bueno A, Basta M et al (2012) Insomnia with objective short sleep duration and incident hypertension: the Penn State Cohort. Hyptertension 60:929–935. doi: 10.1161/HYPERTENSIONAHA.112.193268 CrossRefGoogle Scholar
  13. 13.
    Smagula SF, Stone KL, Fabio A, Caulev JA (2016) Risk factors for sleep disturbances in older adults: evidence from prospective studies. Sleep Med Rev 25:21–30. doi: 10.1016/j.smrv.2015.01.003 CrossRefPubMedGoogle Scholar
  14. 14.
    Sadler P, McLaren S, Jenkins M (2013) A psychological pathway from insomnia to depression among older adults. Int Psychogeriatrics 25:1375–1383. doi: 10.1017/s1041610213000616 CrossRefGoogle Scholar
  15. 15.
    Harvey AG, Tang NKY, Browning L (2005) Cognitive approaches to insomnia. Clin Psychol Rev 25:593–611. doi: 10.1016/j.cpr.2005.04.005 CrossRefPubMedGoogle Scholar
  16. 16.
    Harvey AG, Schmidt DA, Scarnà A, Neitzert Semler C, Goodwin GM (2005) Sleep-related functioning in euthymic patients with bipolar disorder, patients with insomnia, and subjects without sleep problems. Am J Psychiatry 162:50–57. doi: 10.1176/appi.ajp.162.1.50 CrossRefPubMedGoogle Scholar
  17. 17.
    Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U et al (2011) Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord 135:10–19. doi: 10.1016/j.jad.2011.01.011 CrossRefPubMedGoogle Scholar
  18. 18.
    Spiegelhalder K, Scholtes C, Riemann D (2010) The association between insomnia and cardiovascular diseases. Nat Sci Sleep 2:71–78CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Behav Sleep Med 9:216–223Google Scholar
  20. 20.
    Morin CM, Vallières A, Ivers H (2007) Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep 30:1547–1554CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Blais FC, Gendron L, Mimeault V, Morin CM (1997) Assessment of insomnia: validation of three questionnaires. Encephale 23:447–453PubMedGoogle Scholar
  22. 22.
    Morin CM, Stone J, Trinkle D, Mercer J, Remsberg S (1993) Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychol Aging 8:463–467. doi: 10.1037/0882-7974.8.3.463 CrossRefPubMedGoogle Scholar
  23. 23.
    Cordaschi DCN, Morin CM (2000) Dysfunctional beliefs and attitudes about sleep questionnaire: versione italiana ed alalisi della fedeltà. Psicoter Cogn E Comport 6:33–44Google Scholar
  24. 24.
    Yang C-M, Chou CP-W, Hsiao F-C (2011) The association of dysfunctional beliefs about sleep with vulnerability to stress-related sleep disturbance in young adults. Behav Sleep Med 9:86–91. doi: 10.1080/15402002.2011.557990 CrossRefPubMedGoogle Scholar
  25. 25.
    Adan A, Fabbri M, Natale V, Prat G (2006) Sleep Beliefs Scale (SBS) and circadian typology. J Sleep Res 15:125–132. doi: 10.1111/j.1365-2869.2006.00509.x CrossRefPubMedGoogle Scholar
  26. 26.
    Dhyani M, Rajput R, Gupta R (2013) Hindi translation and validation of dysfunctional beliefs and attitudes about sleep (DBAS-16). Indian Psychiatry J 22:80–85. doi: 10.4103/0972-6748.123639 CrossRefGoogle Scholar
  27. 27.
    Boysan M, Merey Z, Kalafat T, Kagan M (2010) Validation of a brief version of the dysfunctional beliefs and attitudes about sleep scale in Turkish sample. Proc Soc Behav Sci 5:314–317. doi: 10.1016/j.sbspro.2010.07.095 CrossRefGoogle Scholar
  28. 28.
    OECD (2012) Education at a glance. OECD indicators. OECD Publishing, Paris, p 2012Google Scholar
  29. 29.
    Brislin RW (1986) The wording and translation of research instrument. In: Lonner WJ, Berry JW (eds) Field methods in cross-cultural research. Sage, Beverly Hills, pp 137–164Google Scholar
  30. 30.
    Bastien C, Vallières A, Morin C (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 9:216–223. doi: 10.1016/s1389-9457(00)00065-4 Google Scholar
  31. 31.
    Morin CM, Belleville G, Belanger L, Ivers H (2011) The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 34:601–608CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    American Psychiatric Association (2000) DSM-IV. Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  33. 33.
    Cho YW, Song ML, Morin CM (2014) Validation of a Korean version of the Insomnia Severity Index. J Clin Neurol 10:210–215. doi: 10.3988/jcn.2014.10.3.210 CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Savard M, Savard J, Simard S, Ivers H (2005) Empirical validation of the Insomnia Severity Index in cancer patients. Psychooncology 14:429–441. doi: 10.1002/pon.860 CrossRefPubMedGoogle Scholar
  35. 35.
    Backhaus J, Riemann D (1996) Schlafstörungen bewältigen [Coping with sleep disorders]. Beltz Psychology Verlags Union, WeinheimGoogle Scholar
  36. 36.
    Buysse DJ, Reynolds CF, Monk TH (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213. doi: 10.1016/0165-1781(89)90047-4 CrossRefPubMedGoogle Scholar
  37. 37.
    Byrne DG, Davenport SC, Mazanov J (2007) Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ). J Adolesc 30:393–416. doi: 10.1016/j.adolescence.2006.04.004 CrossRefPubMedGoogle Scholar
  38. 38.
    De Vriendt T, Moreno LA, De Henauw S (2009) Chronic stress and obesity in adolescents: scientific evidence and methodological issues for epidemiological research. Nutr Metab Cardiovasc Dis 19:511–519. doi: 10.1016/j.numecd.2009.02.009 CrossRefPubMedGoogle Scholar
  39. 39.
    Gerber M, Brand S, Feldmeth AK, Lang C, Elliot C, Holsboer-Trachsler E et al (2013) Adolescents with high mental toughness adapt better to perceived stress: a longitudinal study with Swiss vocational students. Pers Individ Differ 54:808–814. doi: 10.1016/j.paid.2012.12.003 CrossRefGoogle Scholar
  40. 40.
    Hampel P, Petermann F (2005) Age and gender effects on coping in children and adolescents. J Youth Adolesc 34:73–83. doi: 10.1007/s10964-005-3207-9 CrossRefGoogle Scholar
  41. 41.
    Hampel P, Petermann F, Dickow B (2003) SVF-KJ S. SVF-KJ. Stressverarbeitungsfragebogen von Janke und Erdmann angepasst für Kinder und Jugendliche 49. doi: 10.1026//0012-1924.49.3.136
  42. 42.
    Clough PJ, Earle K, Sewell D (2002) Mental toughness. The concept and its measurement. In: Cockerill I (ed) Solut. Sport Psychol. Thomson Learning, London, pp 32–46Google Scholar
  43. 43.
    Perry JL, Clough PJ, Crust L, Earle K, Nicholls AR (2013) Factorial validity of the Mental Toughness Questionnaire-48. Pers Individ Dif 54:587–592. doi: 10.1016/j.paid.2012.11.020 CrossRefGoogle Scholar
  44. 44.
    Gerber M, Kalak N, Lemola S, Clough PJ, Perry JL, Pühse U et al (2013) Are adolescents with high mental toughness levels more resilient against stress? Stress Heal 29:164–171. doi: 10.1002/smi.2447 CrossRefGoogle Scholar
  45. 45.
    Pavot W, Diener E (1993) Review of the satisfaction with life scale. Psychol Assess 5:164–172. doi: 10.1037/1040-3590.5.2.164 CrossRefGoogle Scholar
  46. 46.
    Pavot W, Diener E (2008) The Satisfaction With Life Scale and the emerging construct of life satisfaction. J Posit Psychol 3:137–152. doi: 10.1080/17439760701756946 CrossRefGoogle Scholar
  47. 47.
    Radloff LS (1977) The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401. doi: 10.1177/014662167700100306 CrossRefGoogle Scholar
  48. 48.
    Hautzinger M, Bailer M (1993) Allgemeine depressions Skala. Manual. Beltz Test GmbH, GöttingenGoogle Scholar
  49. 49.
    McDonald RP, Ho RM (2002) Principles and practice in reporting structural equation analyses. Psychol Methods 7:64–82. doi: 10.1037/1082-989x.7.1.64 CrossRefPubMedGoogle Scholar
  50. 50.
    Byrne BM (2010) Structural equation modeling with AMOS. Basic concepts, applications, and programming. Taylor & Francis, New YorkGoogle Scholar
  51. 51.
    Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model A Multidiscip J 6:1–55. doi: 10.1080/10705519909540118 CrossRefGoogle Scholar
  52. 52.
    Comrey AL, Lee HB (1992) A first course in factor analysis. Erlbaum, HillsdaleGoogle Scholar
  53. 53.
    Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, MahwahGoogle Scholar
  54. 54.
    West SG, Finch JF, Curran PJ (1995) Structural equation models with nonnormal variables: problems and remedies. In: Hoyle RH (ed) Struct. Equ. Model. Concepts, issues, Appl. Sage, Thousand Oaks, pp 56–75Google Scholar
  55. 55.
    Cohen J (1977) Statistical power analysis for the behavioral sciences. Academic Press, New York. doi: 10.1016/b978-0-12-179060-8.50016-5 Google Scholar
  56. 56.
    Woods HC, Scott H (2016) Sleepyteens: social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. J Adolesc 51:41–49. doi: 10.1016/j.adolescence.2016.05.008 CrossRefPubMedGoogle Scholar
  57. 57.
    Shaw JM, Mitchell CA, Welch AJ, Williamson MJ (2015) Social media used as a health intervention in adolescent health: a systematic review of the literature. Digit Heal 1:1–10. doi: 10.1177/2055207615588395 Google Scholar
  58. 58.
    Kim H (2014) Enacted Social Support on Social Media and Subjective Well-being. Int J Commun 8:2340–2342Google Scholar
  59. 59.
    Morin CM (1994) Dysfunctional beliefs and attitudes about sleep: preliminary scale development and description. Behav Ther 3:163–164Google Scholar
  60. 60.
    Nunnally J, Bernstein B (1994) Psychometric theory. McGraw-Hill, New YorkGoogle Scholar
  61. 61.
    Ohayon MM, Paiva T (2005) Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal. Sleep Med 6:435–441. doi: 10.1016/j.sleep.2005.03.006 CrossRefPubMedGoogle Scholar
  62. 62.
    Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rössler W (2008) Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep 31:473–480CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Alexander JL, Dennerstein L, Kotz K, Richardson GS (2007) Women, anxiety and mood: a review of nomenclature, comorbidity and epidemiology. Expert Rev Neurother 7:45–58. doi: 10.1586/14737175.7.11s.s45 CrossRefGoogle Scholar
  64. 64.
    Espie CA (2007) Understanding insomnia through cognitive modelling. Sleep Med 8:3–8. doi: 10.1016/s1389-9457(08)70002-9 CrossRefGoogle Scholar
  65. 65.
    Brand S, Gerber M, Pühse U, Holsboer-Trachsler E (2010) Depression, hypomania and dysfunctional cognitions as mediators between stress and insomnia: the best advice is not always found on the pillow! Int J Stress 17:114–134. doi: 10.1037/a0019090 CrossRefGoogle Scholar
  66. 66.
    Carney CE, Edinger JD, Manber R, Garson C, Segal Z (2007) Beliefs about sleep in disorders characterized by sleep and mood disturbance. J Psychosom Res 62:179–188. doi: 10.1016/j.jpsychores.2006.08.006 CrossRefPubMedGoogle Scholar
  67. 67.
    Lang C, Feldmeth AK, Brand S, Holsboer-Trachsler E, Pühse U, Gerber M (2016) Stress management in physical education class: an experiential approach to improve coping skills and reduce stress perceptions in adolescents. J Teach Phys Educ 35:149–158. doi: 10.1123/jtpe.2015-0079 CrossRefGoogle Scholar
  68. 68.
    Brand S, Gerber M, Kalak N, Kirov R, Lemola S, Clough PJ et al (2014) “Sleep well, our tough heroes!”—in adolescence, greater mental toughness is related to better sleep schedules. Behav Sleep Med 12:444–454. doi: 10.1080/15402002.2013.825839 CrossRefPubMedGoogle Scholar
  69. 69.
    Brand S, Gerber M, Kalak N, Kirov R, Lemola S, Clough PJ et al (2014) Adolescents with greater mental toughness show higher sleep efficiency, more deep sleep and fewer awakenings after sleep onset. J Adolesc Heal 54:109–113. doi: 10.1016/j.jadohealth.2013.07.017 CrossRefGoogle Scholar
  70. 70.
    Brand S, Kalak N, Gerber M, Clough PJ, Lemola S, Pühse U et al (2014) During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life. J Health Psychol. doi: 10.1177/1359105314542816 Google Scholar
  71. 71.
    Beck AT, Alford BA (2009) Depression. Causes and treatment. University of Pennsylvania Press, PhiladelphiaGoogle Scholar
  72. 72.
    Seligman M (1975) Helplessness: On depression, development, and death. Reeman, New YorkGoogle Scholar

Copyright information

© Springer-Verlag Italia 2017

Authors and Affiliations

  1. 1.School of PsychologyFlinders UniversityAdelaideAustralia
  2. 2.Sport Science Section, Department of Sport, Exercise and Health (DSBG)University of BaselBaselSwitzerland
  3. 3.Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK)University of BaselBaselSwitzerland

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