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The Work and Social Adjustment Scale: a simple measure of impairment in functioning
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Background: Patients' perspectives concerning impaired functioning provide important information. Aims: To evaluate the reliability and validity of the Work and Social Adjustment Scale (WSAS). Method: Data from two studies were analysed. Reliability analyses included internal scale consistency, test – retest and parallel forms. Convergent and criterion validities were examined with respect to disorder severity. Results: Cronbach's α measure of internal scale consistency ranged from 0.70 to 0.94. Test – retest correlation was 0.73. Interactive voice response administrations of the WSAS gave correlations of 0.81 and 0.86 with clinician interviews. Correlations of WSAS with severity of depression and obsessive–compulsive disorder symptoms were 0.76 and 0.61, respectively. The scores were sensitive to patient differences in disorder severity and treatment-related change. Conclusions: The WSAS is a simple, reliable and valid measure of impaired functioning. It is a sensitive and useful outcome measure offering the potential for readily interpretable comparisons across studies and disorders.
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“In addition, a positive correlation has been found between WSAS and the grading of depressive symptoms [52]: a mean WSAS score of 25 coincides with major depression (measured by the Hamilton Depression Rating Scale), a mean score of 15.5 corresponds with mild to moderate depression, and a mean WSAS of 6.5 indicates subclinical symptoms.”
From Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial (2024) · cites this paper as [52]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For patients with obsessive compulsive disorder or depression, a WSAS total score of 20–40 is reported to indicate moderate to severe psychopathology, a score of 10–20 is associated with failure in functional level but not with severe symptoms, while scores less than 10 are not associated with clinical populations [52].”
From Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial (2024) · cites this paper as [52]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Work and Social Adjustment Scale (WSAS) 60 is a five-item self-report measure of impaired functioning that has been found to be reliable (Cronbach ' s α = 0.7 -0.94) and valid in typically developing individuals.”
From Guided self-help for depression in autistic adults: The ADEPT feasibility RCT (2019) · cites this paper as [60]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The Work and Social Adjustment Scale (WSAS) is a valid and reliable self-report measure of a person's perceived functional impairment attributable to an identified problem (Mundt et al., 2002), in this case, MS.”
From Neuropsychology intervention for managing invisible symptoms of MS (NIMIS-MS) group: A pilot effectiveness and acceptability study (2024) · cites this paper as Mundt et al., 2002
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“The scale has been found to have high internal reliability and sensitivity to change.”
The cited source says what the claim attributes to it.
In the citing paper
“It has been found to be a simple, reliable and valid measure of impaired functioning that is sensitive to change (Mundt et al. 2002).”
From Brief psychological intervention for distress tolerance in an adult secondary care community mental health service: an evaluation (2020) · cites this paper as Mundt et al. 2002
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“This five-item self-report measure assesses functional impairment resulting from a clinical problem from the patient perspective. Scores range from 0 to 40, with lower scores reflecting better functioning. The measure has demonstrated reliability and validity in mental health samples, including OCD [15].”
From Testing the psychometric properties of the illness perceptions questionnaire for OCD (IPQ-O) (2019) · cites this paper as [15]
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“At the main outcome point, mean scores on each of the primary outcomes for the CBT group had reduced to either below (CSS), or very close to (WSAS) the scale thresholds for clinical significance (11, 17).”
From Cognitive–behavioural therapy for adult attention-deficit hyperactivity disorder: a proof of concept randomised controlled trial (2018) · cites this paper as [17]
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“Further, the mean score on the WSAS was n = 13.35 which also is above the clinical threshold, indicating significant impairment (Mundt, Marks, Shear, & Greist, 2002).”
From An ACT self-help intervention for adults with a visible difference in appearance: A pilot feasibility and acceptability randomized controlled study. (2023) · cites this paper as Mundt, Marks, Shear, & Greist, 2002
In the citing paper
“The Work and Social Adjustment (WSA) questionnaire [79] is a simple, reliable, and valid measure of impaired functioning.”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [79]
In the citing paper
“It is a five-item self-report measure that provides an experiential impact of a disorder from the patient’s point of view.”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [79]
In the citing paper
“The WSAS is a simple, reliable and valid measure of impaired functioning.”
In the citing paper
“with adequate psychometric properties [47]”
In the citing paper
“Although patients in both groups exhibited improvement on these scores at post-treatment and follow-up, the scores remained relatively low in comparison with those in the general healthy population [47, 71].”
In the citing paper
“quality of life was assessed using the Work and Social Adjustment Scale (Mundt et al. 2002).”
From A randomised clinical trial to evaluate the acceptability and efficacy of an early phase, online, guided augmentation of outpatient care for adults with anorexia nervosa (2020) · cites this paper as Mundt et al. 2002
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Metadata
- Authors
- Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M.
- Affiliations
- Healthcare Technology Systems (US)
- King's College London (GB)
- University of Pittsburgh (US)
- Corresponding author
- Mundt, James C.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2002-05
- Volume
- 180
- Issue
- 5
- Pages
- 461-464
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2096230543
- Semantic Scholar
- bdec1e745f421277c7d27e7bcb707e04a523f9ed
- Cited by
- 2,515
- References
- 13
- Citations by year
- 2026: 188 · 2025: 201 · 2024: 221 · 2023: 234 · 2022: 204 · 2021: 227 · 2020: 160 · 2019: 134 · 2018: 112 · 2017: 116 · 2016: 106 · 2015: 93 · 2014: 88 · 2013: 89 · 2012: 61
- FWCI
- 16.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Keywords
- Work and Social Adjustment Scale, impaired functioning, social adaptation, work functioning, psychometric validation, reliability statistics, validity, depression severity, obsessive-compulsive disorder, patient-reported outcomes, treatment outcome assessment
- MeSH terms
- Mental Disorders, Depressive Disorder, Follow-Up Studies, Humans, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Psychometrics, Social Adjustment, Reproducibility of Results, Treatment Outcome
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