The work and social adjustment scale: Reliability, sensitivity and value

Abstract

Objective. To investigate the psychometric properties of the Work and Social Adjustment Scale (WSAS) as an outcome measure for the Improving Access to Psychological Therapy programme, assessing its value as an addition to the Patient Health (PHQ-9) and Generalised Anxiety Disorder questionnaires (GAD-7). Little research has investigated these properties to date. Methods. Reliability and responsiveness to change were assessed using data from 4,835 patients. Principal components analysis was used to determine whether the WSAS measures a factor distinct from the PHQ-9 and GAD-7. Results. The WSAS measures a distinct social functioning factor, has high internal reliability, and is sensitive to treatment effects. Conclusions. The WSAS, PHQ-9 and GAD-7 perform comparably on measures of reliability and sensitivity. The WSAS also measures a distinct social functioning component suggesting it has potential as an additional outcome measure.

Key words::

• IAPT
• WSAS
• Anxiety
• Depression
• Social adjustment

Acknowledgements

This work was conducted as part of the South West of England IAPT Evaluation Project, commissioned by the South West Strategic Health Authority, with additional contributions from the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula. The views expressed in this paper are those of the authors and not necessarily those of the NHS or the NIHR. The authors would like to thank Katie Denman for her administrative support, Elliot Carter for technical support, and David Fitzpatrick-Cockram, Clinical Lead for Bournemouth and Poole Primary Care Trust. The authors would also like to thank two anonymous reviewers for their comments on an earlier version of this paper which have added to clarity and the interpretation of our results.

Statement of interest

None of the authors reports conflicts of interest.

Notes

¹This figure is lower than the number of patients with two clinical contacts with WSAS information recorded, as patients were required to have WSAS, PHQ-9, GAD-7 and treatment information recorded in each of their two clinical contacts to be part of the analyses.

²Sex of four patients was unreported.