New Six-Item Scale Measures Adaptive Sleep Beliefs in Insomnia Symptoms

Researchers have validated a brief questionnaire designed to measure adaptive sleep-related cognition and behavior, the counterpart to the dysfunctional beliefs that can sustain insomnia. The study, published in BMC Psychology, tested the Adaptive Cognition and Behaviors about Sleep-6 (ACBS-6) scale in 600 people recruited through an online survey who reported insomnia symptoms. Participants also completed established measures of dysfunctional sleep beliefs, insomnia severity, and sleep-related safety behaviors, allowing the team to examine how the new instrument relates to the constructs associated with the persistence of insomnia.

Insomnia is described in the study as a chronic disorder in which dysfunctional beliefs and maladaptive safety behaviors contribute to its persistence. The ACBS-6 was developed to assess the adaptive dimension of this picture, and the new work set out to establish its psychometric properties and its associations with dysfunctional beliefs, safety behaviors, and insomnia severity.

The psychometric evaluation combined confirmatory factor analysis with item response theory, including the Rasch model and the graded response model. The confirmatory factor analysis identified a two-factor structure separating adaptive cognition from adaptive behavior, and all items showed significant factor loadings on their intended factors. Item response modeling indicated good item fit with high reliability and discrimination, although the analysis also revealed a limitation: items 3 and 4 provided limited information across the range of the latent characteristics the scale is intended to measure. Reliability was assessed using McDonald’s Omega.

The correlational findings placed the new scale within a coherent pattern of relationships. ACBS-6 scores showed a significant negative correlation with insomnia severity on the Insomnia Severity Index (r = -0.13, p < 0.01), meaning that people reporting more adaptive sleep-related cognition and behavior tended to report less severe insomnia symptoms. In contrast, the scale correlated positively with the DBAS-6 (r = 0.47) and the SRBQ-10 (r = 0.49). These are measured associations in the sample; the correlation with insomnia severity was modest in size, while the associations with the other two measures were substantially stronger.

Regression analysis extended the picture by testing whether the three measures predicted insomnia severity simultaneously. In that model, the ACBS-6 (β = -0.15), the DBAS-6 (β = 0.29), and the SRBQ-10 (β = 0.32) each significantly predicted the severity of insomnia, and the model as a whole explained 32% of the variance in symptom severity. Dysfunctional beliefs and maladaptive sleep-related behaviors carried the larger standardized weights, with adaptive cognition and behavior contributing a smaller but significant negative association.

Mediation analysis then examined whether adaptive cognition and behavior might act as a pathway linking the other constructs to insomnia symptoms. The results showed a significant indirect association between insomnia symptom severity and both dysfunctional beliefs and maladaptive sleep-related behaviors through adaptive cognition and behavior. The authors conclude that adaptive cognitions and behaviors are associated with lower insomnia symptom severity and show significant associations with dysfunctional beliefs and maladaptive safety behaviors, positioning the new scale as a brief instrument that captures this interconnected structure.

The study’s conclusions are framed around validity and reliability rather than treatment effects. The authors report that the ACBS-6 showed evidence of validity and reliability as a measure of adaptive sleep-related cognition and behavior in individuals reporting insomnia symptoms. Because the data come from a cross-sectional online survey of people reporting insomnia symptoms, the reported correlations, regression coefficients, and mediation pathways describe associations within that sample and do not establish causal directions.

The limited information provided by items 3 and 4 in the item response analysis is likewise a property of the instrument noted by the authors, not a finding about insomnia itself. With six items, a two-factor structure, and documented associations with insomnia severity, dysfunctional beliefs, and safety behaviors, the ACBS-6 performed as intended in this sample, while its psychometric profile, including the weaker performance of two items, defines the boundaries within which users should interpret scores.

Subject of Research: Validation of the ACBS-6 scale measuring adaptive sleep-related cognition and behavior in people reporting insomnia symptoms

Article Title: Validation of the adaptive cognition and behaviors about sleep-6 (ACBS-6) scale in individuals reporting insomnia symptoms and its association with sleep-related safety behaviors

Article References: Lee, J., Shahrier, M. A., Park, J., & Chung, S. (2026). Validation of the adaptive cognition and behaviors about sleep-6 (ACBS-6) scale in individuals reporting insomnia symptoms and its association with sleep-related safety behaviors. BMC Psychology. https://doi.org/10.1186/s40359-026-05683-z

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05683-z

Keywords: insomnia, ACBS-6, scale validation, psychometrics, sleep beliefs, safety behaviors, confirmatory factor analysis, item response theory, BMC Psychology, Insomnia Severity Index, Validation, adaptive