Development and psychometric evaluation of the Hypnotic-Use Urge Scale

Hypnotic dependence is a major concern for long-term hypnotic use, but is not consistently reported in empirical studies. The inconsistent findings may be in part due to individual differences in the psychological processes of hypnotic use. To further the understanding of this issue, the current study developed the Hypnotic-Use Urge Scale (HUS) to measure the urge to take hypnotics at bedtime. Insomnia patients with a history of hypnotic use (n = 202; mean age = 46.4 years) were included in the study. Participant’s agreement with 37 statements regarding anticipation, desire, and feelings about hypnotic use at bedtime was rated using Likert-type scales. An exploratory factor analysis identified 20 statements to be included as items of the HUS, which were categorized into three subscales: Factor 1—anticipated effects of hypnotic use; Factor 2—compelling desire to use hypnotics; and Factor 3—preoccupation and pleasurable feelings from hypnotic use. The total scale and subscales demonstrated good internal consistency and test–retest reliability. The scale scores correlated significantly with the frequency of hypnotic use. Intriguingly, although Factor 1 accounted for the highest portion of the total variance, Factor 2 was identified to be the best predictor for the frequency of hypnotic use. The results support the use of the HUS as a valid and reliable measure to assess the urge to use hypnotic at bedtime. It could be used to measure the psychological processes associated with hypnotic dependence in both research and clinical settings.