Structural validity of the Insomnia Severity Index: A systematic review and meta-analysis
Abstract
The factor structure of the Insomnia Severity Index (ISI) is discussed, with examples being drawn from about 13 disparate reported models. A systematic appraisal of procedural details of studies investigating the dimensionality of the ISI was performed. The databases CINAHL, Cochrane Library, Embase, Medline, and PsycINFO were searched thoroughly, and all articles in English, published, and/or available online as of 14th March 2019, were included. Meta-analyses of Cronbach's alpha and structural validity measures were performed. Several inadequacies or omissions were found in analyses using the three groups of measures. Fifteen out of 20 studies did not employ either EFA or CFA, 10 studies did not report CFA, while five did not report EFA. The most common omissions related to multivariate normality, final model selection based on consideration of fit indices, parsimony, and failure to consider the theoretical construct in the final model selection. Meta-analysis showed that CFA outcome is more robust compared to EFA, two-factor solution is the vigorous presentation of dimensionality compared to a three-factor solution, and ISI has a high pooled Cronbach's alpha. Further validation of the disparate models of the ISI is needed with more comprehensive reporting guidelines, such as the one suggested in the present review.
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The ISI has acceptable psychometric properties in various countries worldwide.
“Previous research shows that this scale has acceptable psychometric properties in various countries worldwide [27–31]”
From The Psychological Flexibility in Epilepsy Questionnaire (PFEQ): Psychometric properties of the Persian version (2022) · cites this paper as [28]
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- Authors
- Manzar, M. D., Jahrami, H. A., & Bahammam, A. S.
- Affiliations
- Majmaah University (SA)
- Ministry of Health (BH)
- King Saud University (SA)
- Corresponding author
- Manzar, Md Dilshad
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 60
- Pages
- 101531
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W3191158440
- Cited by
- 138
- References
- 79
- Citations by year
- 2026: 28 · 2025: 38 · 2024: 27 · 2023: 23 · 2022: 22
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Majmaah University (R-2021-40)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- Insomnia Severity Index, factor structure, dimensionality, structural validity, confirmatory factor analysis, exploratory factor analysis, Cronbach's alpha, psychometric validation, reporting guidelines
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Psychometrics, Reproducibility of Results
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