https://orcid.org/0000-0001-6928-6113
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Abstract
Background
The Work and Social Adjustment Scale (WSAS) is a self-administered measure designed to assess the level of inability to function socially as a consequence of a defined problem or disorder.
Methods
A total of 230 patients with emotional disorders completed the Danish translation of the WSAS, measures of anxiety and depression, the Level of Personality Functioning Brief Form, the Personality Inventory for DSM-5 Short Form, and the World Health Organization Five-Item Well-Being Index (WHO-5). We conducted a confirmatory factor analysis of the previously suggested factor structure of the instrument. We furthermore evaluated the construct validity of the WSAS by means of its relationship with depression, anxiety, personality functioning, and overall well-being. Finally, we evaluated the utility of the WSAS to identify those on long-term sick-leave by conducting receiver operating characteristic (ROC) curves.
Results
The instrument had a poor to average fit with the previously reported single-factor structure, but a better fit to a modified single-factor structure. Cronbach’s alpha and McDonald’s omega showed good internal scale reliability (α = .79, ωtotal = .85). WSAS was positively correlated with measures of anxiety (r = .33), depression (r = .44), and personality functioning (r = .23 and r = .20), and negatively correlated with WHO-5 wellbeing (r = –.57). The optimal cut-off point in the ROC-analyses was 23, which yielded a sensitivity of 74% and a specificity of 55% in the prediction of sick-leave status.
Discussion
The Danish WSAS shows promising psychometric properties, but has limited external validity insofar as predicting long-term sick leave in psychiatric patients with emotional disorders.
Author contributions
SA, MA, MH, SP and NR conceived the project. ABC, AE, MH and NR collected data. ORH carried out statistical calculations and was responsible for writing the first draft of the manuscript. SA, BB and NR contributed with significant analysis comments and guidance. All authors have discussed, reviewed and approved the manuscript.
Disclosure statement
No potential conflict of interest was reported by the authors.
Data availability statement
By reasonable request from the last author.
Additional information
Funding
Notes on contributors
Oliver Rumle Hovmand
Oliver Rumle Hovmand, Psychiatric Research Unit, Region Zealand Mental Health Service, Slagelse, Faelledvej 6, Slagelse, Denmark and Department of Clinical Medicine, Faculty of Health, University of Copenhagen.
Nina Reinholt
Nina Reinholt, Psychiatric Research Unit, Region Zealand Mental Health Service, Slagelse, Faelledvej 6, Slagelse, Denmark.
Anne Bryde Christensen
Anne Bryde Christensen, Eating Disorders Research Unit, Mental Health Services Capital Region of Denmark. Maglevænget 30, Ballerup, Denmark.
Bo Bach
Bo Bach, Psychiatric Research Unit, Region Zealand Mental Health Service.
Anita Eskildsen
Anita Eskildsen, Department of Affective Disorders, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Bygning K, Aarhus N.
Mikkel Arendt
Mikkel Arendt, Institute for Clinical Medicine, Aarhus University.
Morten Hvenegaard
Morten Hvenegaard, Neurocentre, Rigshospitalet, Copenhagen University Hospital, Denmark.
Stig Poulsen
Stig Poulsen, Department of Psychology, University of Copenhagen, Denmark.
Sidse M. Arnfred
Sidse M. Arnfred, Psychiatric Research Unit, Region Zealand Mental Health Service West and Psychiatric Research Unit, Region Zealand Mental Health Service, Copenhagen University Hospital – Psychiatry Region Zealand, Slagelse, Denmark & Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.