Development and Validity of the Japanese Version of the Pre-Sleep Arousal Scale

Development and Validity of the Japanese Version of the Pre-Sleep Arousal Scale

ISA OKAJIMA,^1,2 MIHO ISHII,³ MOEKO OCHI⁴ and PERRY M. NICASSIO⁵

¹Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
²Faculty of Human Sciences, Waseda University, Tokyo, Japan³Senzoku Stress Coping Support Office, Tokyo, Japan
⁴Board of Education of Sapporo City, Sapporo, Hokkaido, Japan
⁵Cousins Center for Psychoneuroimmunology, UCLA Semel Institute, Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA s

Hyperarousal, defined as increased levels of cortical activity and cognitive-emotional reactivity induced by stress, is suggested to be a key factor in insomnia. In particularly, pre-sleep arousal constitutes one of the major features of insomnia. The Pre-Sleep Arousal Scale is the best-known measure used to evaluate pre-sleep arousal. However, a well-validated Japanese version of the scale (PSAS-J) has not yet been established. The aim of this research was to develop and validate such a scale. A cross-sectional questionnaire-based study was conducted via the internet. In total, 237 of 300 participants (mean age 43.28 ± 11.19 years) completely responded to the questionnaires as followed: the PSAS-J, the Insomnia Severity Index, Ford Insomnia Response to Stress Test, and Dysfunctional Beliefs and Attitudes about Sleep Scale. In addition, the participants were divided into two groups: insomniacs and normal sleepers. As a result, the PSAS-J had a two-factor structure similar to that of the original version, i.e., somatic and cognitive arousal subscales. The internal consistency (α = 0.85 to 0.90) and test-retest reliability (r = 0.67 to 0.78) were high. Correlations between the PSAS-J and the above-mentioned scales ranged from 0.35 to 0.53. Discriminant validity showed that the PSAS-J was distinct from the Ford Insomnia Response to Stress Test and Dysfunctional Beliefs and Attitudes about Sleep Scale. The PSAS-J scores were significantly higher in insomniacs than in normal sleepers. Our results suggest that the PSAS-J has high reliability and validity and that this scale is adequate for assessing pre-sleep arousal.

Keywords —— hyperarousal; pre-sleep arousal; precipitating; predisposing; vulnerability

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Tohoku J. Exp. Med., 2020 , 252, 169-176.

Correspondence: Isa Okajima, Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, 1-18-1 Kaga, Itabashi-ku, Tokyo173-8602, Japan.

e-mail: okajima-i@tokyo-kasei.ac.jp