Cross-Cultural Adaptation And Psychometric Validation Of The Youth Self-Rating Insomnia Scale (Ysis) Into Bangla

Abstract

Background: Insomnia in adolescence is common and half of adolescents with insomnia also report comorbid psychiatric disorders. Insomnia has many adverse general and mental health impacts in adolescents in different domains like physical health, school performance, behavioral and cognitive function, delinquency, substance use, depression, self-harm behavior, suicidal ideation, etc. There is lack of any structured instrument for assessment of insomnia in adolescents in the Bangladesh context.

Aim of the study: The goal of this study was to adapt and determine the psychometric properties of the Youth Self-Rating Insomnia Scale (YSIS) Bangla version in a sample from Bangladeshi adolescents.

Methods: This was a cross-sectional validation study that took during the period of October 2021 to September 2023. Beforehand, study approval was granted by Institutional Review Board (IRB). At first, Bangla adaptation of the scale was done by following standard procedures – forward translation, synthesis, backward translation, expert committee review and pretesting. By purposive sampling, a total of 84 adolescents with insomnia complaint were enrolled from Bangabandhu Sheikh Mujib Medical University. After taking their informed written consent, sociodemographic and relevant information like age, sex, family type, educational level, history of mental illnesses, etc. were collected. Then they were requested to fill Bangla adapted version of YSIS. Data were collected by face-to-face interview and analyzed using SPSS 26.0 and CBID software.

Result: The expert committee approved the Bangla version of the YSIS questionnaire. Internal consistency was assessed using Cronbach's alpha and yielded a high value of xiii 0.935, indicating good reliability. Each item of the questionnaire exhibited strong positive correlations (above 0.7) with the total score. Confirmatory factor analysis supported both a one-factor and a two-factor model based on satisfactory comparative fit index (CFI) and Tucker-Lewis Index (TLI) values (>0.90). However, the chi square/df and Root Mean Square Error of Approximation (RMSEA) values suggested that the model fit was not ideal. To explore the underlying structure of the observed measurements, an exploratory factor analysis using the principal component analysis method was conducted. It revealed a one-factor solution with eigenvalues exceeding 1.0, which was further supported by parallel analysis. Together, this factor structure accounted for 69.8% of the variance. No changes were made to the item structure since removing any item did not significantly impact the Cronbach's alpha value. Conclusion: Considering all the results, the YSIS Bangla questionnaire was deemed valid and reliable.