title: Reliability and validity of the brief insomnia questionnaire in the America insomnia survey.
abstract: OBJECTIVE
  to evaluate the reliability and validity of the Brief Insomnia Questionnaire (BIQ), a fully structured questionnaire developed to diagnose insomnia according to hierarchy-free Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR), International Classification of Diseases-10 (ICD-10), and research diagnostic criteria/International Classification of Sleep Disorders-2 (RDC/ICSD-2) general criteria without organic exclusions in the America Insomnia Survey (AIS).
  
  
  METHODS
  probability subsamples of AIS respondents, oversampling BIQ positives, completed short-term test-retest interviews (n = 59) or clinical reappraisal interviews (n = 203) to assess BIQ reliability and validity.
  
  
  METHODS
  the AIS is a large (n = 10,094) epidemiologic survey of the prevalence and correlates of insomnia.
  
  
  METHODS
  adult subscribers to a national managed healthcare plan.
  
  
  METHODS
  None
  
  
  RESULTS
  BIQ test-retest correlations were 0.47-0.94 for nature of the sleep problems (initiation, maintenance, nonrestorative sleep [NRS]), 0.72-0.95 for problem frequency, 0.66-0.88 for daytime impairment/distress, and 0.62 for duration of sleep. Good individual-level concordance was found between BIQ diagnoses and diagnoses based on expert interviews for meeting hierarchy-free inclusion criteria for diagnoses in any of the diagnostic systems, with area under the receiver operating characteristic curve (AUC, a measure of classification accuracy insensitive to disorder prevalence) of 0.86 for dichotomous classifications. The AUC increased to 0.94 when symptom-level data were added to generate continuous predicted-probability of diagnosis measures. The AUC was lower for dichotomous classifications based on RDC/ICSD-2 (0.68) and ICD-10 (0.70) than for DSM-IV-TR (0.83) criteria but increased consistently when symptom-level data were added to generate continuous predicted-probability measures of RDC/ICSD-2, ICD-10, and DSM-IV-TR diagnoses (0.92-0.95).
  
  
  CONCLUSIONS
  these results show that the BIQ generates accurate estimates of the prevalence and correlates of hierarchy-free insomnia in the America Insomnia Survey.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA. kessler@hcp.med.harvard.edu
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Catherine
authors.initials: C
authors.lastname: Coulouvrat
authors.forename: Goeran
authors.initials: G
authors.lastname: Hajak
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Lakoma
authors.forename: Thomas
authors.initials: T
authors.lastname: Roth
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.forename: Victoria
authors.initials: V
authors.lastname: Shahly
authors.forename: Alicia
authors.initials: A
authors.lastname: Shillington
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Stephenson
authors.forename: James K
authors.initials: JK
authors.lastname: Walsh
authors.forename: Gary K
authors.initials: GK
authors.lastname: Zammit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006306:Health Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States / Q000453:epidemiology; D055815:Young Adult