Development of the scale on the effects of sleep disorder on stress: validity and reliability study.

Abstract

Background: The relationship between sleep disorders and cognitive stress in clinical psychology, especially from the perspective of Beck's Cognitive Theory, holds critical importance. The current measurement tools do not adequately assess the cognitive components of sleep-related stress (e.g., automatic thoughts, cognitive distortions), highlighting the need for a new instrument in this field. Specifically, quantitatively evaluating the effects of insomnia on an individual's perception of the future, self-esteem, and worldview is fundamental for clinical interventions.

Purpose: This study aims to develop a valid and reliable scale capable of measuring stress caused by sleep disorders with a multidisciplinary approach, based on Beck's Cognitive Theory's "cognitive triad" (perception of future/self/world) and the concept of cognitive distortion.

Method: The study was conducted with 637 participants who had a Pittsburgh Sleep Quality Index (PSQI) score of ≥ 5. Data were collected using the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and a draft scale. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to assess construct validity, while Cronbach's Alpha (α) and McDonald Omega (ω) were used for reliability analysis.

Results: The results of the exploratory and confirmatory factor analyses revealed that the scale consists of two main dimensions: (1) Cognitive Distortions dimension (10 items, α = 0.952), which measures automatic negative thoughts such as "When I feel inadequate in any aspect due to sleep disorder" experienced by participants during sleep deprivation. (2) Cognitive Triad dimension (8 items, α = 0.925), which reflects disruptions in perceptions of the future, self, and the world (environment), with statements like "On days when I experience sleep disorders, I feel like my appearance looks bad." The overall reliability coefficients of the scale were found to be α = 0.964 and ω = 0.961. The developed scale was found to have a positive correlation with the Pittsburgh Sleep Quality Index, Perceived Stress Scale, and VAS. CONCLUSıONS: The developed scale is the first tool to clinically and meaningfully reveal the cognitive stress mechanisms caused by sleep disorders. Its structure, directly aligning with the core components of Beck's Cognitive Theory, increases the potential for its use in cognitive-behavioral therapy protocols. Furthermore, the methodological framework it provides for cross-cultural validity studies lays the groundwork for comparative research on a global scale.