Form Structure: Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD
This form structure is an organized set of data definitions for a form that has not been copyrighted
Resource:
FITBIR
Title:
Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD
Short Name:
PSQIA
Description:
Sleep disturbances reflect a core dysfunction underlying Posttraumatic Stress Disorder (PTSD). Specifically, disruptive nocturnal behaviors (DNB) may represent PTSD-specific sleep disturbances. The Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A) is self-report instrument designed to assess the frequency of seven disruptive nocturnal behaviors (DNB).
References: Anne Germaina, Martica Halla, Barry Krakowb, M. Katherine Sheara, Daniel J. Buyssea, A brief Sleep Scale for Posttraumatic Stress Disorder: Pittsburgh Sleep Quality Index Addendum for PTSD http://dx.doi.org/10.1016/j.janxdis.2004.02.001
Disease:
General (For all diseases)
Organization:
NIH
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2015-06-09
Version:
1.1
Date Created:
2015-05-08
Owner:
Number of Data Elements:
23
eForms:
N
Logically grouped data elements with defined frequency at which they repeat.
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | GUID | Global Unique ID which uniquely identifies a subject | GUID | Required | CDE |
2 | Subject identifier number | An identification number assigned to the participant/subject within a given protocol or a study. | SubjectIDNum | Optional | CDE |
3 | Age in years | Value for participant's subject age recorded in years. | AgeYrs | Recommended | CDE |
4 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE |
5 | Site name | The name of the site for the study | SiteName | Recommended | CDE |
6 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE |
7 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE |
8 | General notes text | General notes | GeneralNotesTxt | Optional | CDE |
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Repeat Infinitely)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE |
2 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE |
3 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE |
4 | Data source other text | The free-text field related to Data source specifying other text. Source of the data provided on the case report form | DataSourceOTH | Recommended | CDE |
PSQIA (Repeat Infinitely)
# | Title | Short Description | Variable Name | Required? | Type |
---|---|---|---|---|---|
1 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Hot flash scale | The scale to which the subject had hot flashes in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAHotFlashScl | Recommended | CDE |
2 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - General nervous scale | The scale to which the subject had feelings of nervousness in general in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAGeneralNervousScl | Recommended | CDE |
3 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Trauma memory nightmare scale | The scale to which the subject experienced trauma memory nightmares in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIATraumaMemNightmreScl | Recommended | CDE |
4 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Unrelated trauma nightmare scale | The scale to which the subject had bad dreams, not related to traumatic memories in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAUnrelateTrauNightmreScl | Recommended | CDE |
5 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Unrelated trauma anxiety panic scale | The scale to which the subject had severe anxiety or panic, not related to traumatic memories in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAUnrelateTrauAnxPanicScl | Recommended | CDE |
6 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Terror scream during sleep scale | The scale to which the subject had episodes or terror or screaming during sleep in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIATerrorScreamSleepScl | Recommended | CDE |
7 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Physical movement during dream scale | The scale to which the subject had physical movement during dreams in the past month, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAPhysMoveDreamScl | Recommended | CDE |
8 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Trauma memory nightmare anxiety scale | The scale to which the subject had anxiety in relation to memories/nightmares, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIATrauMemAnxMemoryScl | Recommended | CDE |
9 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Trauma memory nightmare anger scale | The scale to which the subject had anger in relation to memories/nightmares, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIATrauMemNightmreAngScl | Recommended | CDE |
10 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Memory nightmare time scale | The scale which represents the time of night in which most of the memories/nightmares occur, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAMemNightmreTimeScl | Recommended | CDE |
11 | Pittsburgh Sleep Quality Index (PSQI) addendum PTSD - Global score | Global score, as part of the Pittsburgh Sleep Quality Index (PSQI) addendum for PTSD. | PSQIAGlobalScore | Recommended | CDE |
Keywords