Development of the Sleeping Pills Ambivalence and Indecisiveness Scale-6 Among the General Population

Background and Objective The objective of this study was to develop a self-report rating scale to assess ambivalence toward taking sleep medication. Additionally, the study sought to examine whether intolerance of uncertainty and cognitive fusion are associated with this ambivalence.Methods A total of 550 participants from the general population were recruited for the study. Items designed to measure ambivalence toward taking sleep medication were collected and subjected to factor analysis, resulting in the development of a rating scale. The reliability of the scale was assessed through McDonald’s omega, while convergent validity was evaluated using the Insomnia Severity Index, Metacognitions Questionnaire for Insomnia-6, Adaptive Cognition and Behaviors about Sleep-6, Dysfunctional Beliefs and Attitudes about Sleep-6, Intolerance of Uncertainty Scale-12 (IUS-12), Cognitive Fusion Questionnaire (CFQ), and sleep indices such as the questionnaire version of the Discrepancy between desired time in Bed and desired total Sleep Time (DBSTq-2).Results The Sleeping Pills Ambivalence and Indecisiveness Scale-6 (SPAIS-6) was developed, showing strong internal consistency (McDonald’s omega=0.929) and good model fit (comparative fit index=0.979, Tucker-Lewis index=0.965, root mean square error of approximation=0.102, standardized root mean square residual=0.021). Linear regression identified age and DBSTq-2, CFQ, and IUS-12 outcomes as significant associations. Mediation analysis indicated that intolerance of uncertainty and cognitive fusion partially mediated the association between DBSTq-2 outcomes and the SPAIS-6.Conclusions The SPAIS-6 is a reliable and valid instrument designed to assess ambivalence toward the use of sleep medication.