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The Chinese version of sleep behavior habits scale: A tool for identifying insomnia patients amenable to behavioral
Junwu Hu1, Zhenzhi Yang2, Xin Zhang3
1Department of Psychology, School of Public Health, Southern Medical University, 1838 Guangzhou Road, Guangzhou, Guangdong, 510515, China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, 253 Industrial Road, Guangzhou, Guangdong, 510282, China.
Objective:
To identify insomnia patients with modifiable, maladaptive sleep behaviors who are most likely to benefit from targeted behavioral interventions, we develop and validate the Chinese version of the Sleep Behavior Habits Scale (SBHS).
Methods:
The SBHS (Chinese version) was developed through a modified Delphi method with 19 experts. Its structural validity was assessed via exploratory factor analysis (EFA) in a clinical sample of 334 patients, and confirmed via confirmatory factor analysis (CFA) in an independent sample (N = 350). Predictive validity and responsiveness were evaluated in a pilot intervention where 30 patients received a single-session behavioral intervention.
Results:
The Delphi expert panel demonstrated high authority (Cr = .96), resulting in an 8-item Chinese scale. EFA and CFA supported a stable two-factor structure (nighttime and daytime sleep behaviors), accounting for 49.22% of the total variance, with excellent model fit (χ2/df = 1.90, CFI = .96, RMSEA = .051). The total scale demonstrated acceptable internal consistency (α = .70). The SBHS demonstrated discriminant validity against the Insomnia Severity Index (ISI; r = .252, p < .001). SBHS scores significantly predicted post-intervention improvement in insomnia severity (r = .38, p = .039). Moreover, changes in SBHS scores correlated with changes in Insomnia Severity Index scores (r = .67, p < .001).
Conclusion:
The SBHS (Chinese version) is a psychometrically sound tool that effectively identifies insomnia patients with modifiable sleep behaviors and predicts treatment response, thus supporting its use in clinical screening and monitoring.
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