Using item response theory to identify key symptoms of insomnia in a sample of university students with probable eating disorders

Kara A. Christensen Pacella, Brianne N. Richson, Nicole A. Short, Angeline R. Bottera, Leah A. Irish, Victoria L. Perko, Kelsie T. Forbush
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Abstract

Purpose

Researchers have theorized that interactions between appetitive and circadian disruptions result in increased eating disorder (ED) symptoms and insomnia. However, it is unclear how specific insomnia symptoms present among people with EDs and if the latent structure of insomnia in this population is similar to that of people with insomnia disorder.

Methods

We conducted a secondary analysis of data collected on ED and insomnia symptoms using a subset of students (N = 547; 79.52% female) with probable EDs at a large Midwestern American university. Item response theory (IRT) for polytomous items was performed to identify item difficulty, discrimination, and information parameters for the Insomnia Severity Index (ISI). IRT parameters were compared to those established in a 2011 study of people diagnosed with insomnia disorder by Morin and colleagues.

Results

Clinically significant insomnia symptoms were common among students with ED pathology and symptom endorsement for each ISI item ranged from 40.77 to 86.65%. ISI items assessing insomnia-related impairment and distress showed better discriminative capacities and had higher item information than items assessing sleep behavior alterations (i.e., difficulties falling asleep, difficulties maintaining sleep, waking too early). Item discrimination was largely similar among the ED sample compared to previous IRT analyses in an insomnia disorder sample.

Conclusion

Insomnia symptoms are common among university students with probable EDs and similar to those reported by people with insomnia disorder. When considering insomnia assessment, items assessing sleep behaviors alone are likely inadequate to provide information about insomnia severity among people with EDs.

Level V

Evidence obtained from a cross-sectional descriptive study.

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利用项目反应理论识别可能患有饮食失调症的大学生样本中的主要失眠症状
目的研究人员推测,食欲和昼夜节律紊乱之间的相互作用会导致进食障碍(ED)症状和失眠症的加重。方法我们利用美国中西部一所大型大学中可能患有饮食失调症的学生子集(N = 547;79.52% 为女性),对收集到的饮食失调症和失眠症状数据进行了二次分析。对多项式项目采用项目反应理论(IRT)来确定失眠严重程度指数(ISI)的项目难度、区分度和信息参数。IRT参数与Morin及其同事在2011年一项针对失眠症患者的研究中确定的参数进行了比较。结果在患有ED病症的学生中,有临床意义的失眠症状很常见,ISI各项目症状认可度从40.77%到86.65%不等。与评估睡眠行为改变(即入睡困难、维持睡眠困难、过早醒来)的项目相比,评估失眠相关损害和痛苦的 ISI 项目显示出更好的辨别能力和更高的项目信息。与之前对失眠症样本进行的 IRT 分析相比,ED 样本的项目辨别能力基本相似。在考虑失眠评估时,仅评估睡眠行为的项目可能不足以提供有关 ED 患者失眠严重程度的信息。
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来源期刊
CiteScore
6.50
自引率
10.30%
发文量
170
审稿时长
>12 weeks
期刊介绍: Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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