CONSTRUCT VALIDATION OF THE PERINATAL RUMINATION SCALE AT NIGHT IN PREGNANT PATIENTS SEEKING INSOMNIA TREATMENT
Recommended Citation
Kalmbach D, Hirata M, Iqal JN, Bayoneto AD, Cheng P, Reffi A, Pitts D, Swanson L, Ong J, Fresco D, O’Brien L, Drake C. CONSTRUCT VALIDATION OF THE PERINATAL RUMINATION SCALE AT NIGHT IN PREGNANT PATIENTS SEEKING INSOMNIA TREATMENT. Sleep 2024; 47:A164.
Document Type
Conference Proceeding
Publication Date
5-1-2024
Publication Title
Sleep
Abstract
Introduction: Perseverating on perinatal concerns at night (nocturnal perinatal rumination) increases insomnia, depression, and suicidal ideation (SI) during pregnancy. Poorly sleeping pregnant women identify reducing nocturnal perinatal rumination as critical for alleviating insomnia during pregnancy. However, no validated measures of nocturnal perinatal rumination exist, thereby limiting research in this area. We sought to develop and validate a brief survey to assess nocturnal perinatal rumination. Methods: This study was a cross-sectional analysis of 223 pregnant women seeking insomnia treatment. Our team developed 11 questions to create the Perinatal Rumination Scale-Night (PRS-Night). Participants rated how intensely they experienced intrusive thoughts related to pregnancy while trying to sleep at night. Responses ranged from 0=not at all to 5=extremely (item examples: worry about your pregnancy or baby; have thoughts or concerns about childbirth). We conducted an exploratory factor analysis (EFA) with varimax rotation to identify the number of latent variables in our measure. Finally, we evaluated the measure's internal consistency, convergent validity, and discriminant validity. Results: 159 patients (71.3%) screened positive for clinical insomnia (insomnia severity index [ISI]≥11), 88 patients (39.5%) screened positive for PND (Edinburgh postnatal depression scale [EPDS]≥10), and 161 patients (72.2%) screened positive for high cognitive arousal (pre-sleep arousal scale's cognitive factor [PSASC]≥18). Bartlett's test of sphericity was significant (p<.001) and KMO was >.90, supporting EFA. The scree plot revealed one factor (Eigenvalue=6.10) consisting of all 11 items. Internal consistency was excellent (Cronbach's α=.92). The PRS-Night yielded good convergent validity with the PSASC (r=.56, p<.001), ISI (r=.53, p<.001), EPDS (r=.58, p<.001), and perinatal anxiety questionnaire-revised (r=.54, p<.001). SI rates were elevated for pregnant patients with high rumination (PRSNight median-split high vs low: 19.6% vs 9.5%). The PRS-Night yielded good discriminant validity with the Epworth sleepiness scale (r=.13, ns) and patient-rated chronotype (r=.10, ns). Conclusion: This study supports the psychometric validity of the PRS-Night for assessing nocturnal perinatal rumination. Given patient stakeholder interest in perinatal rumination at night, the PRS-Night has immense potential to help researchers better understand disease processes related to perinatal rumination and evaluate this construct as an important target mechanism in prenatal insomnia care.
Volume
47
First Page
A164
