Abstract
Individuals with insomnia complaints often report intrusive thoughts. In this sense, strategies to cope with cognitive arousal are a key topic to be addressed. The TCQI-R is a self-reporting instrument aimed at evaluating the strategies used by individuals to control their thoughts during insomnia episodes. The aim of this study was to translate and adapt the thought control questionnaire insomnia-revised (TCQI-R) for the Portuguese population. In the current study, a community-dwelling sample of 802 participants was recruited, aged between 18 and 66 years, of whom 163 were men and 639 women (80%). The principal component analysis found five components: reappraisal, cognitive distraction, aggressive suppression, worry and behavioral distraction. Both the general questionnaire (α = 0.91) and the components showed good internal consistency (Cronbach’s α between 0.74 and 0.84). Through the analyses carried out, it was possible to conclude that the instrument has a good discriminatory capacity between individuals with and without "insomnia". It was also found that the use of worry and aggressive suppression strategies was associated with greater insomnia severity, anxiety, depression, and thought catastrophizing, whereas the use of cognitive distraction strategy was associated with lower severity of insomnia, anxiety, depression, and thought catastrophizing. The results of the current study are in line with the published literature on the TCQI-R. The TCQI-R seems to be a useful tool for the assessment of intrusive thoughts’ control strategies.
Similar content being viewed by others
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington: American Psychiatric Publishing.
American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.). Darien: American Academy of Sleep Medicine.
Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297–307. https://doi.org/10.1016/S1389-9457(00)00065-4
Buysse, D., & Harvey, A. (2017). Insomnia: Recent developments and future directions. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (6th ed., pp. 757–760). Philadelphia: Elsevier.
Clemente, V., Gomes, A., Mendes, M., Marques, D., Russo, B., Serra, J., et al. (2017). The European Portuguese version of the insomnia severity index (ISI): Reliability, validity and diagnostic accuracy [Abstract]. Sleep Medicine, 40, e67. https://doi.org/10.1016/j.sleep.2017.11.191
Clemente, V., Marques, D., Miller-Mendes, M., Serra, J., Morin, C., & Gomes, A. (2020). The European Portuguese version of the Insomnia Severity Index: Reliability, validity, and accuracy in clinical and non-clinical samples. Journal of Sleep Research. https://doi.org/10.1111/jsr.13198
Field, A. (2013). Discovering statistics using SPSS (4th ed.). London: SAGE.
Gellis, L., & Park, A. (2013). Nighttime thought control strategies and insomnia severity. Cognitive Therapy and Research, 37(2), 383–389. https://doi.org/10.1007/s10608-012-9479-y
Harvey, A. (2001). I can’t sleep, my mind is racing! An investigation of strategies of thought control in insomnia. Behavioural and Cognitive Psychotherapy, 29, 3–11.
Harvey, A. (2003). The attempted suppression of presleep cognitive activity in insomnia. Cognitive Therapy and Research, 27(6), 593–602.
Harvey, A. (2005a). A cognitive theory and therapy for chronic insomnia. Journal of Cognitive Psychotherapy: An International Quarterly, 19(1), 41–59.
Harvey, A. (2005b). Unwanted intrusive thoughts in insomnia. In D. Clark (Ed.), Intrusive thoughts in clinical disorders, theory, research and treatment (pp. 86–118). New York: The Guilford Press.
Harvey, A., & Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: Distraction with imagery versus general distraction. Behaviour Research and Therapy, 40, 267–277.
Harvey, A., Tang, N., & Browning, L. (2005). Cognitive approaches to insomnia. Clinical Psychology Review, 25, 593–611. https://doi.org/10.1016/j.cpr.2005.04.005
Jansson-Fröjmark, M., Harvey, A., & Flink, I. (2012). Psychometric properties of the insomnia catastrophising scale (ICS). Journal of Sleep Research, 21(1), 168–168.
Jansson-Fröjmark, M., Harvey, A., & Flink, I. (2020). Psychometric properties of the insomnia catastrophizing scale (ICS) in a large community sample. Cognitive Behaviour Therapy, 49(2), 120–136. https://doi.org/10.1080/16506073.2019.1588362
Kallestad, H., Hansen, B., Lansgrud, K., Hjemdal, O., & Stiles, T. (2010). Psychometric properties and the predictive validity of the insomnia daytime worry scale: A pilot study. Cognitive Behaviour Therapy, 39(2), 150–157. https://doi.org/10.1080/16506070903115317
Lichstein, K., Taylor, D., McCrae, C., & Petrov, M. (2017). Insomnia: Epidemiology and risk factors. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (6th ed., pp. 761–768). Philadelphia: Elsevier.
Marques, D., Correia, A., & Nóbrega, C. (2018). Escala de catastrofização da insónia [ICS]. Aveiro: Universidade de Aveiro.
Marques, D., Gomes, A., Clemente, V., Santos, J., & Castelo-Branco, M. (2015). Hyperarousal and failure to inhibit wakefulness in primary insomnia: “Birds of a feather”? Sleep and Biological Rhythms, 13, 219–228. https://doi.org/10.1111/sbr.12115
Morin, C., Davidson, J., & Beaulieu-Bonneau, S. (2017). Cognitive behavior therapies for insomnia I: Approaches and efficacy. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (6th ed., pp. 804–812). Philadelphia: Elsevier.
O’Connor, B. (2000). SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behavior Research Methods, Instruments, & Computers, 32(3), 396–402. https://doi.org/10.3758/BF03200807
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a portuguese version of the hospital anxiety and depression scale. Psychology, Health & Medicine, 12(2), 225–237. https://doi.org/10.1080/13548500500524088
Palagini, L., Ong, J., & Riemann, D. (2017). The mediating role of sleep-related metacognitive processes in trait and pre-sleep state hyperarousal in insomnia disorder. Journal of Psychosomatic Research, 99, 59–65. https://doi.org/10.1016/j.jpsychores.2017.03.001
Pavlova, M., & Latreille, V. (2019). Sleep disorders. The American Journal of Medicine, 132(3), 292–299. https://doi.org/10.1016/j.amjmed.2018.09.021
Perlis, M., Ellis, J., Kloss, J., & Riemann, D. (2017). Etiology and pathophysiology of insomnia. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (6th ed., pp. 769–784). Philadelphia: Elsevier.
Pollak, C., Thorpy, M., & Yager, J. (2010). The encyclopedia of sleep and sleep disorders (3rd ed.). New York: Facts on File.
Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Groselj, L., Ellis, J., et al. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675–700. https://doi.org/10.1111/jsr.12594
Ree, M., Harvey, A., Blake, R., Tang, N., & Shawe-Taylor, M. (2005). Attempts to control unwanted thoughts in the night: development of the thought control questionnaire-insomnia revised (TCQI-R). Behaviour Research and Therapy, 43, 985–998. https://doi.org/10.1016/j.brat.2004.07.003
Schmidt, R., Harvey, A., & Van der Linden, M. (2011). Cognitive and affective control in insomnia. Frontiers in Psychology, 2(349), 1–12. https://doi.org/10.3389/fpsyg.2011.00349
Schmidt, R., Gay, P., Ghisletta, P., & Van der Linden, M. (2010). Linking impulsivity to dysfunctional thought control and insomnia: A structural equation model. Journal of Sleep Research, 19, 3–11. https://doi.org/10.1111/j.1365-2869.2009.00741.x
Schmidt, R., Gay, P., & Van der Linden, M. (2009). Validation of a French version of the thought control questionnaire-insomnia revised (TCQI-R). Revue Européenne de Psychologie Appliquée, 59(1), 69–78. https://doi.org/10.1016/j.erap.2007.08.002
Sella, E., Tona, G., & Beni, R. (2016). Il Metacognitions Questionnaire-Insomnia (MCQ-I) e Il Thought Control Questionnaire Insomnia-Revised (TCQI-R): Adattamento italiano di due questionari metacognitivi per la valutazione dei disturbi del sonno. Psicoterapia Cognitiva e Comportamentale, 22(2), 139–167. https://doi.org/10.1037/t63791-000
Straten, A., Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C., & Lancee, J. (2018). Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Medicine Reviews, 38, 3–16. https://doi.org/10.1016/j.smrv.2017.02.001
Well, A., & Davies, M. (1994). The thought control questionnaire: A measure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy, 32, 871–878.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1186/1477-7525-1-29
Acknowledgments
The authors would like to thank all the participants for their availability.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Nóbrega, C., Correia, A.L., Gomes, A.A. et al. European Portuguese Validation of the Thought Control Questionnaire Insomnia-Revised (TCQI-R). J Rat-Emo Cognitive-Behav Ther 39, 355–374 (2021). https://doi.org/10.1007/s10942-020-00377-w
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10942-020-00377-w