Rehab Measures Database
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  2. Work and Social Adjustment Scale

Work and Social Adjustment Scale

Last Updated

Purpose

The WSAS is a simple self-report questionnaire that assesses an individual’s level of impairment in social functioning. 

Acronym WSAS

Area of Assessment

Activities & Participation
Mental Functions

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

CDE Status

Not a CDE—last searched 6/14/2024

Populations

Mixed Conditions
Neurologic Conditions

Key Descriptions

  • 5 items, uses a Likert Scale from 0 (Not impairment at all) – 8 (Very severe impairment) marked by client’s self-report
  • Sum score range: 0 - 40
  • Scores above 20 suggest moderately severe or worse psychopathology. Scores 10 - 20 are associated with significant functional impairment but less severe clinical symptomatology. Scores below 10 appear to be associated with subclinical populations.

Number of Items

5

Equipment Required

  • Questionnaire
  • Paper and pencil/pen

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Doctor of Occupational Therapy students Jessica Bailey, Emma Chakravarty, Tessa Chung, Sophia DeLise, and Grace Miller under the direction of Pey-Shan Wen, PhD, MHS, OTR/L, Associate Professor, Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professionals Programs at Georgia State University

ICF Domain

Participation
Activity

Measurement Domain

General Health
Activities of Daily Living

Professional Association Recommendation

None found—last searched 6/14/2024

Considerations

  • Several language variations have been validated and should be used when appropriate.
  • WSAS is only applicable to adults; however, Work and Social Adjustment Score for Youth (WSASY) and Work and Social Adjustment Score for Parent Report (WSASP) are available for younger populations.

Mixed Conditions

back to Populations

Internal Consistency

Breast cancer, HIV, and Inflammatory diseases: (Thandi et al., 2017; n = 554; female = 72.5%; mean age = 48.3 years)

  • Excellent: Cronbach's α = 0.93

 

Neurologic Conditions

back to Populations

Internal Consistency

Chronic Fatigue Syndrome (Cella et al., 2011; n = 1023 (Cohort 1: 639 patients with Chronic Fatigue Syndrome (CFS) in the Pacing, graded Activity and Cognitive behavior therapy: a randomized Evaluation (PACE) trial, mean age = 38.3 (11.8) years; Cohort 2: 384 patients with CFS in a secondary care specialist clinic, mean age = 39.1 (10.1) years)  

  • Adequate to Excellent: Cronbach’s α = 0.79 for cohort 1 and 0.89 for cohort 2 at initial assessment
  • Excellent: Cronbach’s α = 0.93 post-treatment and 0.94 at both 6 and 12 month follow-up for cohort 2
  • Adequate to Excellent: Spearman-Brown split-half coefficient = 0.73 for cohort 1 and 0.85 for cohort 2 at initial assessment
  • Excellent: Spearman-Brown split-half coefficient =  0.90 post-treatment, 0.93 at 6 months, and 0.94 at 12 months for cohort 2

Construct Validity

Convergent validity:

Chronic Fatigue: (Cella, 2011; n = 639)

Correlations between the WSAS and other measures: 

  • Adequate correlation with the Chalder Fatigue Scale (r = 0.329, p < 0.001)
  • Poor correlation with the Hospital Anxiety Depression Scale - Anxiety (r = 0.169, p < 0.001).
  • Adequate correlation with the Hospital Anxiety Depression Scale - Depression (r = 0.411, p < 0.001).
  • Poor correlation with the Patient Health Questionnaire (r = 0.253, p < 0.001).
  • Poor correlation with the Jenkins Sleep Scale (r = 0.114, p < 0.001).
  • Poor correlation with the number of Center for Disease Control symptoms total (r = 0.183, p < 0.001).

 

Discriminant validity:

Chronic Fatigue: (Cella, 2011; n = 639)

  • Adequate negative correlation with the Short Form Health Survey (SF-36) (r = -0.381, p < 0.001)

Responsiveness

Chronic Fatigue Syndrome: (Cella et al., 2011, n=114)

  • Statistically significant reduction in WSAS scores across four assessment points F(2.3,262.3) = 42.81, p < .0001, η? = 0.28
  • Statistically significant reduction in WSAS scores between initial and post-treatment F(1,113) = 41.4, p < .0001, η? = 0.27
  • Statistically significant reduction in WSAS scores between initial and post-treatment and first follow-up F(1,113) = 23.8, p < .0001, η? = 0.17

 

Bibliography

Cella, M., Sharpe, M., & Chalder, T. (2011). Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale. J Psychosom Res, 71(3), 124-128. https://doi.org/10.1016/j.jpsychores.2011.02.009

Jansson-Fr?jmark, M. (2014). The work and social adjustment scale as a measure of dysfunction in chronic insomnia: reliability and validity. Behav Cogn Psychother, 42(2), 186-198. https://doi.org/10.1017/s135246581200104x

Mataix-Cols, D., Cowley, A. J., Hankins, M., Schneider, A., Bachofen, M., Kenwright, M., Gega, L., Cameron, R., & Marks, I. M. (2005). Reliability and validity of the work and social adjustment scale in phobic disorders. Compr Psychiatry, 46(3), 223-228. https://doi.org/10.1016/j.comppsych.2004.08.007

Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry, 180, 461-464. https://doi.org/10.1192/bjp.180.5.461

Pedersen, G., Kvarstein, E. H., & Wilberg, T. (2017). The Work and Social Adjustment Scale: Psychometric properties and validity among males and females, and outpatients with and without personality disorders. Personal Ment Health, 11(4), 215-228. https://doi.org/10.1002/pmh.1382

Thandi, G., Fear, N. T., & Chalder, T. (2017). A comparison of the Work and Social Adjustment Scale (WSAS) across different patient populations using Rasch analysis and exploratory factor analysis. J Psychosom Res, 92, 45-48. https://doi.org/10.1016/j.jpsychores.2016.11.009

Tolchard, B. (2016). Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers. J Addict Nurs, 27(4), 229-233. https://doi.org/10.1097/JAN.0000000000000141

Zahra, D., Qureshi, A., Henley, W., Taylor, R., Quinn, C., Pooler, J., Hardy, G., Newbold, A., & Byng, R. (2014). The work and social adjustment scale: reliability, sensitivity and value. Int J Psychiatry Clin Pract, 18(2), 131-138. https://doi.org/10.3109/13651501.2014.894072

 

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