title: Validation of the Athens Insomnia Scale for screening insomnia in South Korean firefighters and rescue workers.
abstract: OBJECTIVE
  Sleep problems are a major cause of occupational stress in firefighters and rescue workers. We evaluated the psychometric properties of the Athens Insomnia Scale (AIS) among South Korean firefighters and rescue workers.
  
  
  METHODS
  Structured clinical interviews and self-report questionnaires were administered to 221 firefighters and rescue workers. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Short-Form 36-item Health Survey (SF36), and Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were used to examine convergent and divergent validity. Test-retest reliability was calculated from a subsample (n = 24). Analysis of internal consistency, factor analysis, and receiver operator characteristic curve analysis were conducted.
  
  
  RESULTS
  Cronbach's alpha was 0.88. The mean item-total correlation coefficient was 0.73. The test-retest reliability was excellent (ICC = 0.94). Significant correlations of the AIS with the PSQI, ISI, ESS, and SF36 confirmed convergent validity. Nonsignificant associations of the AIS with the AUDIT-C and socioeconomic status showed divergent validity. Factor analysis revealed a one-factor structure. For groups with different symptom severity, group-specific cutoff scores which may improve positive predictive values were suggested.
  
  
  CONCLUSIONS
  The AIS may be a useful tool with good reliability and validity for screening insomnia symptoms in firefighters and rescue workers.
authors.affiliation: Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors.forename: Hyeonseok S
authors.initials: HS
authors.lastname: Jeong
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.
authors.forename: Yujin
authors.initials: Y
authors.lastname: Jeon
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Ma
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.
authors.forename: Yera
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.
authors.forename: Soonhyun
authors.initials: S
authors.lastname: Ban
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.
authors.forename: Sooyeon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.
authors.forename: Bora
authors.initials: B
authors.lastname: Lee
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.
authors.forename: Jooyeon Jamie
authors.initials: JJ
authors.lastname: Im
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.
authors.forename: Sujung
authors.initials: S
authors.lastname: Yoon
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea.|Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea.
authors.forename: Jieun E
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Central Officials Training Institute, Gwacheon, Gyeonggi-do, South Korea.
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Ewha Brain Institute, Ewha W. University, Seoul, South Korea. inkylyoo@ewha.ac.kr.|Graduate School of Pharmaceutical Sciences, Ewha W. University, Seoul, South Korea. inkylyoo@ewha.ac.kr.|Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, South Korea. inkylyoo@ewha.ac.kr.
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
mesh_terms: D000328:Adult; D044466:Asian People; D005260:Female; D061388:Firefighters; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012372:ROC Curve; D015203:Reproducibility of Results; D056910:Republic of Korea; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Athens Insomnia Scale; Firefighter; Insomnia; Rescue worker; Validation