Dysfunctional Beliefs and Attitudes about Sleep (DBAS) : validation of a brief version (DBAS-16)

Abstract

Study Objective : Sleep related cognitions (e.g., faulty beliefs and ap-praisals, unrealistic expectations, perceptual and attention bias) play an important role in perpetuating insomnia. This paper presents new psycho-metric data on an abbreviated version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), a 16-item self-report measure designed to evaluate a subset of those sleep related cognitions. Design : Psychometric study of a patient-reported measure of sleep re-lated beliefs based on existing clinical and research databases. Participants : A total of 283 individuals (60% women; mean age of 46.6 years old) with insomnia, including 124 clinical patients and 159 research participants. Measurements and Results : Participants completed the DBAS, Insom-nia Severity Index, Beck Depression and Anxiety Inventories, daily sleep diaries for 2 weeks, and 3 nights of polysomnography (research sample only) as part of a baseline assessment. The DBAS-16 was found to be reliable, as evidenced by adequate internal consistency (Cronbach alpha = 0.77 for clinical and 0.79 for research samples) and temporal stability (r = 0.83). The factor structure was similar to the original 30-item version, with 4 factors emerging and re¿ecting: (a) perceived consequences of insomnia, (b) worry/helplessness about insomnia, (c) sleep expectations, and (d) medication. DBAS total scores were signi¿cantly correlated with other self-report measures of insomnia severity, anxiety, and depression, but not with speci¿c sleep parameters. Conclusion : The psychometric qualities of this abbreviated DBAS-16 version seem adequate. This patient-reported measure should prove a useful instrument to evaluate the role of sleep related beliefs and attitudes in insomnia and to monitor change on this cognitive variable as a potential moderator of treatment outcome.