Validating Insomnia Severity Index (ISI) in a Bangladeshi Population: Using Classical Test Theory and Rasch Analysis

• Published in: International journal of environmental research and public health Vol. 19; no. 1; p. 225
• Main Authors: Mamun, Mohammed A, Alimoradi, Zainab, Gozal, David, Manzar, Md Dilshad, Broström, Anders, Lin, Chung-Ying, Huang, Ru-Yi, Pakpour, Amir H
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.01.2022; MDPI
• Subjects: Adult; Bangla language; Bangladesh; Bangladeshi; Classical test theory; cohort analysis; concurrent validity; controlled study; coronavirus disease 2019; Coronaviruses; COVID-19; cross-sectional study; depression; distress syndrome; Fear of COVID 19 Scale; female; gender; Health problems; human; Humans; Insomnia; Insomnia Severity Index; Likert scale; lingua franca; major clinical study; Male; Mental depression; Mental disorders; Mental health; Outbreaks; pandemic; Pandemics; Patient Health Questionnaire 9; population research; Psychological distress; Psychometric testing; Psychometrics; psychometry; Public health; Quantitative psychology; questionnaire; Questionnaires; Rasch analysis; Rasch model; Reproducibility of Results; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sleep; sleep disorder assessment; Sleep disorders; Sleep Initiation and Maintenance Disorders - epidemiology; statistical analysis; Subgroups; suicidal ideation; Suicides & suicide attempts; validation study; Bangladesh; COVID-19; Bangladesh; psychological distress; insomnia; psychometric testing
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19010225

The COVID-19 outbreak is associated with sleep problems and mental health issues among individuals. Therefore, there is a need to assess sleep efficiency during this tough period. Unfortunately, the commonly used instrument on insomnia severity-the Insomnia Severity Index (ISI)-has never been translated and validated among Bangladeshis. Additionally, the ISI has never been validated during a major protracted disaster (such as the COVID-19 outbreak) when individuals encounter mental health problems. The present study aimed to translate the ISI into Bangla language (ISI-Bangla) and validate its psychometric properties. First, the linguistic validity of the ISI-Bangla was established. Then, 9790 Bangladeshis (mean age = 26.7 years; SD = 8.5; 5489 [56.1%] males) completed the Bangla versions of the following questionnaires: ISI, Fear of COVID-19 Scale (FCV-19S), and Patient Health Questionnaire-9 (PHQ-9). All the participants also answered an item on suicidal ideation. Classical test theory and Rasch analyses were conducted to evaluate the psychometric properties of the ISI-Bangla. Both classical test theory and Rasch analyses support a one-factor structure for the ISI-Bangla. Moreover, no substantial differential item functioning was observed across different subgroups (gender, depression status (determined using PHQ-9), and suicidal ideation). Additionally, concurrent validity of the ISI-Bangla was supported by significant and moderate correlations with FCV-19S and PHQ-9; known-group validity was established by the significant difference of the ISI-Bangla scores between participants who experienced suicidal ideation and those without. The present psychometric validation conducted during the COVID-19 outbreak suggests that the ISI-Bangla is a promising and operationally adequate instrument to assess insomnia in Bangladeshis.