Testing the Insomnia Coach Mobile App With Veterans With Insomnia and PTSD

A 7-item self-report questionnaire assessing the nature, severity, and impact of insomnia symptoms in the past month. Items are on a scale from 0 to 4. The seven answers are added up to get a total score, with higher scores reflecting greater insomnia severity

A 19-item self-report measure assessing qualities and problems associated with sleep in the past month. It generates seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. A global sleep quality score is obtained by summing the seven component scores. Higher scores reflect poorer sleep quality. The global score ranges from 0 to 21, with a cut-off score of 5 as distinguishing "good" sleepers from "poor" sleepers.

This 16-item self-report form assesses sleep-related impairment over the past seven days. Each question has five response options ranging in value from 1 to 5. To find the total raw score the values of the response to each question are summed. The raw scores are converted to a standardized T-score using conversion tables published on the PROMIS website (nihpromis.org), with higher scores indicating greater sleep/wake disturbances.

This 7-item measure assesses anxiety symptom severity. Items are scored from zero to three. The whole scale score can range from 0 to 21 and cut-off scores for mild, moderate and severe anxiety symptoms are 5, 10 and 15 respectively.

An 8-item self-report instrument used to assess depression severity. Since the scale is self-administered in our studies and further probing about positive responses is not feasible, the question about suicide from the PHQ-9 was removed. Items are scored 0 to 3, with the total score being the sum of the 8 items. Higher scores indicate greater depression severity, with a score of 10 or greater considered major depression, and scores of 20 or more is severe major depression.

A 20-item multidimensional, objective measure of app usability. It includes four subscales that measure an app's engagement, functionality, aesthetics, and information quality. All items are rated on a 5-point scale from "1. Inadequate" to "5. Excellent". The scores are tallied up and a mean score out of 5 is given to each of the categories scored.

A 10-item questionnaire of usability of products and services, including hardware, software, mobile devices, websites and applications. Items are on a 5-point scale numbered 1 to 5. Half of the items are worded negatively and half are worded positively. SUS yields a single number representing a composite measure of the overall usability of the system. To calculate the SUS score, the score contributions from each item are summed. Each item's score contribution will range from 0 to 4. For items 1,3,5,7,and 9 the score contribution is the scale position minus 1. For items 2,4,6,8 and 10, the contribution is 5 minus the scale position. Then the sum of the scores is multiplied by 2.5 to obtain the overall value of SU. SUS scores have a range of 0 to 100.

This 16-item self-report measures attitudes and beliefs about sleep in 4 domains: consequences of insomnia, worry and helplessness about sleep, sleep expectations, and sleep medications. Items are rated from 1 (strongly disagree) to 10 (strongly agree). An average score is calculated, with higher scores indicating stronger endorsement of unhelpful sleep cognitions.

A 20-item self-report questionnaire assessing PTSD symptoms in the past month. Items are on a scale from 0 to 4. The 20 item responses are summed to get a total score, with higher scores reflecting greater PTSD symptom severity

This 26-item self-report measure of quality of life (QOL), life satisfaction, and personal well-being assesses the broad domains of physical health, psychological health, social relationships, and environmental factors (e.g., finances, safety). Item are rated on a variety of 1 to 5 scales with domain score items being summed to generate subscale scores with higher scores reflecting more higher QOL etc.

The FoSI-SF is a 13-item self-report measure that assesses trauma-related thoughts and activities associated with sleep and the occurrence of traumas associated with the bedroom or sleep. Items are rated from 0 (not at all) to 4 (nearly every night). Total scores range from 0 to 52, with higher scores indicating greater fear of sleep.

The DDNSI is a self-report measure that assesses number of nights of nightmares, number of nightmares per week, frequency of awakenings (0 = never/rarely to 4 = always), intensity (0 = not intense to 6 = extremely severe intensity) and severity (0 = no problem to 6 = very severe problem). Scores range between 0 and 37, with a score ≥10 suggestive of nightmare disorder.