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Development and psychometric evaluation of the Hypnotic-Use Urge Scale

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Abstract

Hypnotic dependence is a major concern for long-term hypnotic use, but is not consistently reported in empirical studies. The inconsistent findings may be in part due to individual differences in the psychological processes of hypnotic use. To further the understanding of this issue, the current study developed the Hypnotic-Use Urge Scale (HUS) to measure the urge to take hypnotics at bedtime. Insomnia patients with a history of hypnotic use (n = 202; mean age = 46.4 years) were included in the study. Participant’s agreement with 37 statements regarding anticipation, desire, and feelings about hypnotic use at bedtime was rated using Likert-type scales. An exploratory factor analysis identified 20 statements to be included as items of the HUS, which were categorized into three subscales: Factor 1—anticipated effects of hypnotic use; Factor 2—compelling desire to use hypnotics; and Factor 3—preoccupation and pleasurable feelings from hypnotic use. The total scale and subscales demonstrated good internal consistency and test–retest reliability. The scale scores correlated significantly with the frequency of hypnotic use. Intriguingly, although Factor 1 accounted for the highest portion of the total variance, Factor 2 was identified to be the best predictor for the frequency of hypnotic use. The results support the use of the HUS as a valid and reliable measure to assess the urge to use hypnotic at bedtime. It could be used to measure the psychological processes associated with hypnotic dependence in both research and clinical settings.

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Acknowledgements

This study was supported by the National Science Council, Taiwan (NSC101-2410-H-004-082-MY3).

Author information

Authors and Affiliations

  1. Sleep Laboratory, National Chengchi University, 64 Sec. 2, Chih-Nan Rd., Taipei, 11605, Taiwan

    Chun-Hui Jen, Chang-Wei Chen & Yu-Shuan Lai

  2. Department of Psychology, National Chengchi University, 64 Sec. 2 Chih-Nan Rd., Taipei, 11605, Taiwan

    Chien-Ming Yang, Chang-Wei Chen, Hsiu-Ting Yu & Yu-Shuan Lai

  3. Research Center of Mind, Brain, and Learning, National Chengchi University, 64 Sec. 2, Chih-Nan Rd., Taipei, 11605, Taiwan

    Chien-Ming Yang

  4. Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing St., Taipei, 11031, Taiwan

    Hsin-Chien Lee

  5. Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, 291 Jhongjheng Rd., Jhonghe, New Taipei, 23561, Taiwan

    Hsin-Chien Lee

  6. Department of Neurology, Wan Fang Hospital, Taipei Medical University, 111 Sec. 3, Xinglong Rd., Taipei, 11696, Taiwan

    Jia-Ying Sung

  7. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei, 11031, Taiwan

    Jia-Ying Sung

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  1. Chun-Hui Jen
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Correspondence to Chien-Ming Yang.

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Ethical approval

This study has been approved by the TMU-Joint Institutional Review Board (Permission number: 201205052).

Appendix

Appendix

Hypnotic-Use Urge Scale

Instructions

This scale consists of statements describing experiences related to the use of sleeping pills. The term “sleeping pills” in this scale refers to the prescribed medications you took to help with your sleep problems. Please rate your level of agreement with each statement based on your general experience during the past month by circling the number next to the statement, ranging from 1 (strongly disagree) to 7 (strongly agree). There are no right or wrong answers. Please respond to the statements according to your true feelings.

 

Strongly disagree

     

Strongly agree

1. Taking sleeping pills before going to bed makes me feel good

1

2

3

4

5

6

7

2. I can go without taking sleeping pills for many days

1

2

3

4

5

6

7

3. I don’t want to take sleeping pills before going to bed

1

2

3

4

5

6

7

4. Taking sleeping pills before going to bed helps me calm down

1

2

3

4

5

6

7

5. I can hardly stop myself from taking sleeping pills

1

2

3

4

5

6

7

6. Before going to bed, all I want are sleeping pills

1

2

3

4

5

6

7

7. I feel better physically if I take sleeping pills before going to bed

1

2

3

4

5

6

7

8. Taking sleeping pills before going to bed makes me less likely to think too much about things

1

2

3

4

5

6

7

9. I have enough willpower to control myself to not take sleeping pills

1

2

3

4

5

6

7

10. Before going to bed, I enjoy the feelings that sleeping pills bring

1

2

3

4

5

6

7

11. Taking sleeping pills before going to bed is very satisfying

1

2

3

4

5

6

7

12. Taking sleeping pills before going to bed makes me less anxious

1

2

3

4

5

6

7

13. I must take sleeping pills before going to bed

1

2

3

4

5

6

7

14. Taking sleeping pills before going to bed helps me settle down

1

2

3

4

5

6

7

15. At bedtime, I enjoy taking sleeping pills as they help me fall asleep faster

1

2

3

4

5

6

7

16. Taking sleeping pills before going to bed makes me feel relaxed

1

2

3

4

5

6

7

17. Before going to bed, my head is full of thoughts related to sleeping pills

1

2

3

4

5

6

7

18. At bedtime, I enjoy taking sleeping pills as they help me sleep through the night

1

2

3

4

5

6

7

19. Taking sleeping pills before going to bed helps me worry less about insomnia

1

2

3

4

5

6

7

20. At bedtime, I feel the sleeping pills tempting me

1

2

3

4

5

6

7

  1. Scoring:
  2. Reverse-scored items: #2, #3, and #9
  3. Total Scale: sum the scores for all the items
  4. Factor 1—Anticipated effects: sum of the item scores of #1, #4, #7, #8, #12, #14, #15, #16, #18, and #19
  5. Factor 2—Compelling desire: sum of the item scores of #2, #3, #5, #6, #9, and #13
  6. Factor 3—Preoccupation and pleasurable feelings: sum of the item scores of #10, #11, #17, and #20

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Jen, CH., Yang, CM., Chen, CW. et al. Development and psychometric evaluation of the Hypnotic-Use Urge Scale. Sleep Biol. Rhythms 17, 63–72 (2019). https://doi.org/10.1007/s41105-018-0183-5

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  • DOI: https://doi.org/10.1007/s41105-018-0183-5

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