Development of a revised version of the SCRAM questionnaire to evaluate sleep, circadian rhythms, and mood characteristics

Sleep quality, chronotype, and mood may be closely interconnected processes. Typically, such constructs are measured independently, leaving out important information regarding their intrinsic relationships. The Sleep, Circadian Rhythms, and Mood (SCRAM) questionnaire is a promising tool for measuring sleep, chronotype, understood as diurnal preference, and depressive symptomatology, and the interrelationships between them. Anxiety has also been linked to sleep quality, chronotype, and depression, but there is currently no scale that measures these constructs together. This study aims to validate a revised version of the SCRAM questionnaire (rSCRAM), incorporating items to measure anxious mood. 486 Italian participants were involved in two studies. In Study 1, principal component analysis (PCA) identified representative anxiety elements from validated questionnaires. In Study 2, after adding the anxiety elements, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) established a 4-factor, 16-item model. The rSCRAM demonstrated excellent psychometric properties: high internal consistency (alpha = 0.72-0.90) and a strong test-retest reliability of the scales over 2 weeks (r = 0.73-0.82), a high correlation for convergent validity, and low correlations for divergent validity. The rSCRAM questionnaire measures the constructs for which it was created and revised. Including the anxiety scale enhances its utility in assessing mental health constructs within a single instrument.