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Sleiman J, Ahmed O, Chung S. Validation of Shortened Forms of Metacognition Questionnaire-Insomnia and Its Feasibility in the Discrepancy-Cognitive Arousal Model of Insomnia Among Patients With Cancer. Psychiatry Investig 2024; 21:573-582. [PMID: 38960434 PMCID: PMC11222085 DOI: 10.30773/pi.2023.0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE We aimed to explore the reliability and validity of the two shortened versions of the Metacognition Questionnaire-Insomnia (Metacognition Questionnaire-Insomnia-6 items [MCQI-6], Metacognition Questionnaire-Insomnia-14 items [MCQI-14]) among patients with cancer and examine the feasibility of the Discrepancy-Cognitive Arousal (DCA) model of insomnia among the cancer patients. METHODS A total of 154 patients with cancer were enrolled in this survey, which included rating scales such as the discrepancy between desired time in bed and desired total sleep time (DBST) index, Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs and Attitude about Sleep-14 items (C-DBAS-14), MCQI-6, and MCQI-14. RESULTS Both the MCQI-6 and MCQI-14 showed a good reliability of internal consistency. Confirmatory factor analysis showed a good model fit for two single-factor shortened versions. The total score of the MCQI-6 was significantly correlated with the MCQI-14 (r=0.97, p<0.01), ISI (r=0.68, p<0.01), C-DBAS-14 (r=0.78, p<0.01), and DBST index (r=0.21, p<0.05). Mediation analysis showed that the DBST index did not directly influence insomnia severity; however, the relationship was mediated by cancer-related dysfunctional beliefs about sleep and sleep-related metacognitive process among patients with cancer. CONCLUSION The Korean versions of MCQI-6 and MCQI-14 are useful, reliable, and valid tools to evaluate sleep-related metacognitive processes among patients with cancer. The DCA model of insomnia was feasible even among cancer patients.
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Affiliation(s)
- Jana Sleiman
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Life Care Center for Cancer Patient, Asan Medical Center Cancer Institute, Seoul, Republic of Korea
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Ghodratitoostani I, Vaziri Z, Miranda Neto M, de Giacomo Carneiro Barros C, Delbem ACB, Hyppolito MA, Jalilvand H, Louzada F, Leite JP. Conceptual framework for tinnitus: a cognitive model in practice. Sci Rep 2024; 14:7186. [PMID: 38531913 DOI: 10.1038/s41598-023-48006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/21/2023] [Indexed: 03/28/2024] Open
Abstract
Tinnitus is a conscious attended awareness perception of sourceless sound. Widespread theoretical and evidence-based neurofunctional and psychological models have tried to explain tinnitus-related distress considering the influence of psychological and cognitive factors. However, tinnitus models seem to be less focused on causality, thereby easily misleading interpretations. Also, they may be incapable of individualization. This study proposes a Conceptual Cognitive Framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of tinnitus and consequent cognitive-emotional disturbances. The current CCF for tinnitus relies on evaluative conditional learning and appraisal, generating negative valence (emotional value) and arousal (cognitive value) to annoyance, distress, and distorted perception. The suggested methodology is well-defined, reproducible, and accessible, which can help foster future high-quality clinical databases. Perceived tinnitus through the perpetual-learning process can always lead to annoyance, but only in the clinical stage directly cause annoyance. In the clinical stage, tinnitus perception can lead indirectly to distress only with experiencing annoyance either with ("I n d - 1 C " = 1.87; 95% CI 1.18-2.72)["1st indirect path in the Clinical stage model": Tinnitus Loudness → Attention Bias → Cognitive-Emotional Value → Annoyance → Clinical Distress]or without ("I n d - 2 C "= 2.03; 95% CI 1.02-3.32)[ "2nd indirect path in the Clinical stage model": Tinnitus Loudness → Annoyance → Clinical Distress] the perpetual-learning process. Further real-life testing of the CCF is expected to express a meticulous, decision-supporting platform for cognitive rehabilitation and clinical interventions. Furthermore, the suggested methodology offers a reliable platform for CCF development in other cognitive impairments and supports the causal clinical data models. It may also enhance our knowledge of psychological disorders and complicated comorbidities by supporting the design of different rehabilitation interventions and comprehensive frameworks in line with the "preventive medicine" policy.
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Affiliation(s)
- Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of Sao Paulo, Sao Carlos, Brazil.
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil.
- Adjunct Scholar, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Vaziri
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of Sao Paulo, Sao Carlos, Brazil
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Milton Miranda Neto
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of Sao Paulo, Sao Carlos, Brazil
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Camila de Giacomo Carneiro Barros
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of Sao Paulo, Sao Carlos, Brazil
- Department of Otorhinolaryngology, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Alexandre Cláudio Botazzo Delbem
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of Sao Paulo, Sao Carlos, Brazil
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Miguel Angelo Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Hamid Jalilvand
- Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Francisco Louzada
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Joao Pereira Leite
- Department of Neurosciences and Behavioral Sciences, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Alghamdi AA, Abanumai AA, Althobaiti MF, Alzahrani MS, Abu-Saleh SY, Ammar A, Ghazzawi H, Trabelsi K, Bragazzi N, BaHammam AS, Jahrami H, AlRasheed MM. The Psychometric Properties of the Arabic Version of the Anxiety and Preoccupation About Sleep Questionnaire (APSQ). Nat Sci Sleep 2024; 16:75-83. [PMID: 38322015 PMCID: PMC10846094 DOI: 10.2147/nss.s449354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/29/2024] [Indexed: 02/08/2024] Open
Abstract
Background Insomnia disorder is a common health condition; it has a role in increasing the possibility of developing other psychological disorders, including anxiety and depression. Anxiety and preoccupation with sleep are two examples of common cognitive factors that contribute to the development of chronic insomnia; thus, it is important to have a tool that assesses worry in insomnia. There is no comprehensive psychiatric measure to assess anxiety and preoccupation with sleep in Arabic. We conducted this study to translate, adapt, and validate the Arabic version of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), providing a reliable psychometric tool to assess concerns regarding sleep within Arabic-speaking communities. Methods The translation process of the scale involved several steps, including forward and backward translation. A cross-sectional study was conducted using an online survey completed by 523 participants from various Arabic-speaking countries. Psychometric analysis was performed utilizing the R software, including internal consistency, test-retest reliability, and confirmatory factor analysis. In addition, convergent and divergent against the Athens insomnia scale (AIS) and general anxiety disorder (GAD) were conducted. Results The Arabic-translated form of the APSQ expresses excellent internal consistency with a value of 0.91 for both Cronbach's α and McDonald's ω. The test-retest reliability of a subsample showed an excellent coefficient of 0.93 (p<0.01). A good fit of the APSQ was observed by CFI = 0.93, TLI = 0.91, SRMR = 0.05, and RMSEA = 0.1. Convergent and divergent against AIS and GAD showed statistically significant correlations of 0.85 (p<0.01) and 0.69 (p<0.01), respectively. Our sample showed a mean APSQ score of 31.28 ± 8.31, and the mean age was 23.62 ± 7.5. Conclusion The Arabic APSQ is reliable and valid for measuring anxiety and preoccupation with sleep in Arabic countries. Using translated APSQ for clinical diagnosis and research is currently trustworthy.
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Affiliation(s)
| | | | | | - Meshari Salem Alzahrani
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Salma Yasser Abu-Saleh
- Department Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology, and Psychology: Physical Activity, Health, and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
| | - Hadeel Ghazzawi
- Nutrition and Food Science Department, Agriculture School, The University of Jordan, Amman, Jordan
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia
| | - Nicola Bragazzi
- Human Nutrition Unit (HNU) and Department of Food and Drugs, University of Parma, Medical School, Building C, Parma, Italy
| | - Ahmed S BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, King Saud University, Riyadh, Saudi Arabia
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Haitham Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Department of Psychiatry, Government Hospitals, Manama, Bahrain
| | - Maha M AlRasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Sunada N, Nakano Y, Otsuka Y, Tokumasu K, Honda H, Sakurada Y, Matsuda Y, Hasegawa T, Omura D, Ochi K, Hagiya H, Ueda K, Kataoka H, Otsuka F. Characteristics of Sleep Disturbance in Patients with Long COVID: A Retrospective Observational Study in Japan. J Clin Med 2022; 11:jcm11247332. [PMID: 36555948 PMCID: PMC9783729 DOI: 10.3390/jcm11247332] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine the clinical and endocrinological features of sleep disturbance in patients with long COVID. METHODS This study was a single-center retrospective observational study for patients who visited the COVID-19 aftercare outpatient clinic (CAC) established in Okayama University Hospital in Japan during the period from 15 February 2021 to 29 July 2022. The long COVID patients were divided into two groups based on the presence or absence of sleep disturbance, and the clinical and laboratory characteristics of the patients were analyzed. RESULTS Out of 363 patients with long COVID, after excluding 6 patients, 60 patients (16.5%) (55% males, median age of 38 years) complaining of sleep disturbance were compared with 303 patients (83.5%) (43% males, median age of 40 years) without sleep-related symptoms. Although there were no significant differences in clinical backgrounds and severities of COVID-19 between the two groups by the multivariate analysis, the percentage of long COVID patients with sleep disturbance was significantly increased among patients infected in the Omicron-dominant phase. In addition, the prevalence rate of sleep disturbance in patients when infected in the Omicron phase (24.8%) was two-times higher than that in patients infected in the Delta phase (12.8%). Of note, the percentages of patients with sleep disturbance who also complained of general fatigue, headache, concentration loss, anxiety, low-grade fever, and brain fog symptoms were higher than the percentages of patients without sleep disturbance who had the same complaints. Among the types of sleep disturbance, the percentage of patients who complained of loss of sleep induction (75%) was much higher than the percentage of patients with early-awakening sleep disturbance (6.7%), and many of the patients with mid-awakening types of insomnia had brain fog symptoms. Endocrine examinations revealed that long COVID patients with sleep disturbance had significantly higher levels of plasma adrenocorticotropin and lower levels of serum growth hormone, suggesting the presence of hypothalamic-pituitary stress. CONCLUSION The prevalence of sleep disturbance has been increasing in long COVID patients infected in the Omicron phase with a certain clinical and endocrine trend.
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Affiliation(s)
- Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Daisuke Omura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kanako Ochi
- Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hitomi Kataoka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
- Correspondence: ; Tel.: +81-86-235-7342
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Huynh G, Nguyen HV, Vo LY, Le NT, Nguyen HTN. Assessment of Insomnia and Associated Factors Among Patients Who Have Recovered from COVID-19 in Vietnam. Patient Prefer Adherence 2022; 16:1637-1647. [PMID: 35837086 PMCID: PMC9275485 DOI: 10.2147/ppa.s371563] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/01/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has been affecting the lives of millions of people globally. Patients recovering from COVID-19 are facing, not only the symptom of long COVID, but also psychological problems, such as sleep disturbance. This study aims to assess the proportion of COVID-19 recovered adult patients that suffer from insomnia and associated factors in Vietnam. METHODS A cross-sectional study was performed between January and March 2022 among patients who have recovered from a COVID-19 infection. Data were collected based on a self-administered questionnaire that included sociodemographic and standardized questionnaires from the Hospital Anxiety and Depression Scale (HADS), the Perceived stress scale (PSS) and the dependent variable using Insomnia Severity Index (ISI). Multivariable logistic regression was conducted to explore factors associated with the patients' insomnia disorder. RESULTS A total of 325 participants were included in this analysis, 34.5% of participants had insomnia. According to multivariable logistic regression, participants who were equal to and over 50 years of age, feeling alienated from others, and were not supported by families or relatives, reported significantly higher levels of insomnia disorders over those aged under 50 years, having closer ties with family and had received support from family or relatives. Besides, respondents who recorded mental health problems that included anxiety, depression and stress were more likely to get insomnia disorders than those without mental health symptoms (OR 2.7, 95% CI 1.1-6.6) (OR 4.5, 95% CI 2.3-8.9) (OR 2.3, 95% CI 1.1-5.3), respectively, all p < 0.05. CONCLUSION There was a remarkable rate of COVID-19 recovered patients experiencing insomnia disorders. Older age, alienated relationships and not being supported by families or relatives, as well as had mental health problems, are factors that affected the patients' insomnia, which showed that these sleep issues need to be screened and managed among adults who have recovered from COVID-19.
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Affiliation(s)
- Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hau Viet Nguyen
- Emergency Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Correspondence: Hau Viet Nguyen, Emergency Department, University Medical Center Ho Chi Minh City, 215 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam, Tel +84918764092, Email
| | - Lan Y Vo
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ngoc Thi Le
- Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Han Thi Ngoc Nguyen
- Infection Control Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Han Thi Ngoc Nguyen, Infection Control Department, University Medical Center Ho Chi Minh City, 201 Nguyen Chi Thanh Street, District 5, Ho Chi Minh City, Vietnam, Tel +84397975519, Email
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