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Evaluating the responsiveness of the Warwick Edinburgh Mental Well-Being Scale (WEMWBS): Group and individual level analysis
Open accessAbstract
BACKGROUND: Mental well-being now features prominently in UK and international health policy. However, progress has been hampered by lack of valid measures that are responsive to change. The objective of this study was to evaluate the responsiveness of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) at both the individual and group level. METHODS: Secondary analysis of twelve different interventional studies undertaken in different populations using WEMWBS as an outcome measure. Standardised response mean (SRM), probability of change statistic (P(^)) and standard error of measurement (SEM) were used to evaluate whether WEMWBS detected statistically important changes at the group and individual level, respectively. RESULTS: Mean change in WEMWBS score ranged from -0.6 to 10.6. SRM ranged from -0.10 (95% CI: -0.35, 0.15) to 1.35 (95% CI: 1.06, 1.64). In 9/12 studies the lower limit of the 95% CI for P(^) was greater than 0.5, denoting responsiveness. SEM ranged from 2.4 to 3.1 units, and at the threshold 2.77 SEM, WEMWBS detected important improvement in at least 12.8% to 45.7% of participants (lower limit of 95% CI>5.0%). CONCLUSIONS: WEMWBS is responsive to changes occurring in a wide range of mental health interventions undertaken in different populations. It offers a secure base for research and development in this rapidly evolving field. Further research using external criteria of change is warranted.
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“At an individual level, a change of three or more units is interpreted as representing ‘meaningful change’. 45”
From Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing. (2023) · cites this paper as [45]
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“Cross-cultural surveys, intervention and monitoring and evaluation studies have used WEMWBS (e.g. Gremigni and Stewart-Brown 2011; Lloyd and Devine 2012; López et al. 2012; Maheswaran et al. 2012; Orgeta et al. 2013; Santos et al. 2015; Stewart-Brown 2013; Taggart et al. 2013).”
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“The scale shows broad reliability and validity (Tennant et al., 2007; Stewart-Brown et al., 2009; Maheswaran et al., 2012) as well as having been tested cross-culturally (Taggart et al., 2013), a significant consideration in Sandwell.”
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“The number of participants who demonstrated reliable change (RC) on either measure was calculated using the RC index proposed by Jacobson and Truax,(43) with values for PSS and WEMWBS calculated in prior research.(39,44) The RC index indicates whether a subject made substantial improvement in symptomatology, change th…”
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“Short Warwickshire Edinburgh Mental Wellbeing Scale (SWEMWBS) The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) is a well-validated measure of wellbeing, suitable for young people [82] and sensitive to change in mental wellbeing prevention interventions [83].”
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“Alongside a six-item StateTrait Anxiety Inventory (STAI[1][2][4]) [112] and a Short WarwickEdinburgh Mental Wellbeing Scale (SWEMWBS[1][4]) [78], VAS were implemented as validated measures to assess emotional states as unobtrusively as possible [14, 36, 64].”
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“The WEMWBS has been shown to be responsive to change following intervention at the individual and group level (Maheswaran et al. 2012).”
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“The measure has robust psychometric properties (Tennant et al., 2007) and sensitivity to change (Maheswaran et al., 2012).”
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“This 6.5-point increase shows a moderate effect size (Hedges’ g = 0.7) and is considered a meaningful improvement using the WEMWBS [93,100].”
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“The scale is reliable (Tennant et al. 2007) and adequately sensitive to change over time (Maheswaran et al. 2012).”
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“WEMWBS covers the main concepts associated with positive mental health, for example: positive affect, satisfying interpersonal relationships and positive functioning [5, 6, 10, 19].”
BackgroundShen, J.-L., Hung, B.-L., & Fang, S. (2022) · Scientific Reports · doi:10.1038/s41598-022-14534-x · Cited by 24
The Relationship Between Hope, Social Inclusion, and Mental Wellbeing in Supported Employment
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“The reported mean total score in a sample of outpatients diagnosed with schizophrenia, bipolar disorder, depression and anxiety disorders (n = 145) is M = 40.30 (SD = 9.2; Maheswaran et al., 2012).”
BackgroundInfluentialAbbott, W., Brownlee, T. E., Harper, L. D., Naughton, R. J., Richardson, A., & Clifford, T. (2019) · European Journal of Sport Science · doi:10.1080/17461391.2019.1600586 · Cited by 22
“The ≥3 point change in MW when injured is also considered to be a clinically meaningful decrease (Maheswaran et al., 2012).”
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Macdonald, G. (2017) · Primary Health Care Research & Development · doi:10.1017/s1463423617000159 · Cited by 20
“A clinically significant improvement in wellbeing is evidenced by an increase of 7 points (Maheswaran et al., 2012).”
BackgroundStewart-Brown, S. L. (2014) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2014.08.004 · Cited by 20
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Recovery in Mind: A Recovery College's journey through the Covid‐19 pandemic
Yoeli, H., Ryan, A., Hensby, C., Habermehl, F., Burton, S., & Sin, J. (2022) · Health Expectations · doi:10.1111/hex.13635 · Cited by 19
“This difference is nearly five times the MCID of 3 points on WEMWBS.33 WEMWBS has been compared to the Centre for Epidemiological Studies Depression Scale (CES‐”
MethodInfluentialHooper, P., Kleeman, A., Edwards, N., Bolleter, J., & Foster, S. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2023.100807 · Cited by 23
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Mental health and resilience: Arts on Prescription for children and young people in a school setting
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“6 following various interventions [62].”
Socio-environmental influences on Nordic walking participation and their implications for well-being
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“range of mental health intervention trials undertaken in different populations [13, 33].”
BackgroundKrogh, S. C. (2021) · Young · doi:10.1177/11033088211009128 · Cited by 16
“The validity of both the 14- and 7-item versions of the WEMWBS was shown in several studies, both among the general population (Castellví et al., 2014; Maheswaran et al., 2012; Smith et al., 2017; Stewart-Brown et al., 2009; Tennant et al., 2007) and among adolescents (Clarke et al., 2011).”
MethodAzcurra, D. S. (2015) · Acta Colombiana de Psicología · doi:10.14718/acp.2015.18.1.8 · Cited by 17
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“At an individual level, a change of 3 or more units (1 SEM) has been interpreted as important [36].”
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Caregiver wellbeing during Covid-19: does being hopeful play a role?
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“The measure reports good reliability and validity data (Maheswaran et al 2012) and history of use with caregiver populations (e.g. Sin et al 2021).”
Kolster, A., Heikkinen, M., Pajunen, A., Mickos, A., Wennman, H., & Partonen, T. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1208858 · Cited by 15
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Primary care chaplaincy: an intervention for complex presentation
Macdonald, G. (2018) · Primary Health Care Research & Development · doi:10.1017/s1463423618000737 · Cited by 14
“An increase of between 3–8 points in WEMWBS is seen as evidence of clinically important and statistically meaningful improvement (Maheswaran et al., 2012).”
BackgroundMethodMirea, D.-M., Martin-Key, N. A., Barton‐Owen, G., Olmert, T., Cooper, J. D., Han, S. Y. S., Farrag, L. P., Bell, E., Friend, L. V., Eljasz, P., et al. (2020) · JMIR Mental Health · doi:10.2196/23813 · Cited by 18
“Nonetheless, the well-being improvement of 6 WEMWBS points over 12 months is comparable with the average effect size of different psychological interventions [46].”
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“This scale has been shown to be responsive to change following mental health interventions [45].”
BackgroundSohanpal, R., Pinnock, H., Steed, L., Heslop-Marshall, K., Kelly, M. J., Chan, C. L., Wileman, V., Barradell, A. C., Dibao-Dina, C., Gilabert, P. F., et al. (2023) · Health Technology Assessment · doi:10.3310/pawa7221 · Cited by 14
Metadata
- Authors
- Maheswaran, H., Weich, S., Powell, J., & Stewart-Brown, S.
- Affiliations
- University of Warwick (GB)
- University of Oxford (GB)
- Corresponding author
- Maheswaran, Hendramoorthy
- Venue
- Health and Quality of Life Outcomes
- Published
- 2012
- Volume
- 10
- Issue
- 1
- Pages
- 156
- ISSN
- 1477-7525 (ISSN-L)
- PMC
- PMC3560098
- OpenAlex
- W2139610815
- Cited by
- 265
- References
- 44
- Citations by year
- 2026: 20 · 2025: 29 · 2024: 27 · 2023: 28 · 2022: 22 · 2021: 27 · 2020: 23 · 2019: 19 · 2018: 14 · 2017: 19 · 2016: 12 · 2015: 15 · 2014: 4 · 2013: 6
- FWCI
- 10.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Health and Quality of Life Outcomes (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- NHS Health Scotland
- University of Warwick
- University of Bath
- University of Edinburgh
- Topics
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- Warwick-Edinburgh Mental Well-being Scale, responsiveness to change, psychological well-being, mental health interventions, standardized response mean, standard error of measurement, psychometric properties, outcome measurement
- MeSH terms
- Adolescent, Adult, Aged, Female, United Kingdom, Humans, Male, Mental Health, Middle Aged, Personal Satisfaction, Psychometrics, Surveys and Questionnaires, Reproducibility of Results, Confidence Intervals, Young Adult
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