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The Work and Social Adjustment Scale as a Measure of Dysfunction in Chronic Insomnia: Reliability and Validity

Published online by Cambridge University Press:  12 February 2013

Markus Jansson-Fröjmark
Markus Jansson-Fröjmark*
Affiliation:
Örebro University and Stockholm University, Sweden
*
Reprint requests to Markus Jansson-Fröjmark, Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden. E-mail: markus.jansson-frojmark@psychology.su.se
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Abstract

Background: Dysfunction is an integral part of chronic insomnia. Despite this, very little effort has yet been made to design and psychometrically validate an insomnia-specific measure of dysfunction. Aims: The purpose was to examine the psychometric properties of the Work and Social Adjustment Scale (WSAS) as a measure of dysfunction in chronic insomnia. Method: Seventy-three patients with chronic insomnia from three subsamples participated. All the patients completed the WSAS, the Insomnia Severity Index (ISI), and sleep diaries over one week. Results: An exploratory factor analysis suggested a one-factor solution for the WSAS, determining dysfunction, accounting for 73.7% of the variance. The internal consistency of the WSAS was α = .91. The test-retest reliability for the WSAS items was high at .90–.99 and for the entire scale .99. A cut-off at 17 points was established, discriminating those with subclinical versus moderate or severe clinical insomnia (88% sensitivity and 78% specificity). Evidence of convergent and criterion validity was documented via (1) a significant, positive association between the WSAS and ISI and (2) a higher WSAS score among those with severe clinical insomnia, relative to those with moderate clinical and subthreshold insomnia, as well as a higher WSAS score among those with moderate clinical insomnia relative to those with subthreshold insomnia. The WSAS was also shown to be a treatment-sensitive measure for insomnia patients. Conclusions: The WSAS appears as a reliable and valid measure of dysfunction in chronic insomnia. Additional advantages are its shortness, easiness, and treatment-sensitivity.

Keywords

Insomniadysfunctionimpairmentscale
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 42 , Issue 2 , March 2014 , pp. 186 - 198
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Ancoli-Israel, S. and Roth, T. (1999). Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep, 22, 347–353.Google Scholar
Bastien, C. H., Vallieres, A. and Morin, C. M. (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297–307.Google Scholar
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R. and Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric research and practice. Psychiatry Research, 28, 193–213.Google Scholar
Carney, C. E., Ulmer, C., Edinger, J. D., Krystal, A. D. and Knauss, F. (2009). Assessing depression symptoms in those with insomnia: an examination of the Beck Depression Inventory 2nd edition (BDI-II). Journal of Psychiatric Research, 43, 576–582.Google Scholar
Cella, M., Sharpe, M. and Chalder, T. (2011). Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale. Journal of Psychosomatic Research, 71, 124–128.Google Scholar
Davidson, J. R., Aime, A., Ivers, H. and Morin, C. M. (2009). Characteristics of individuals with insomnia who seek treatment in a clinical setting versus those who volunteer for a randomized controlled trial. Behavioral Sleep Medicine, 7, 37–52.Google Scholar
Edinger, J. D., Bonnet, M. H., Bootzin, R. R., Doghramji, K., Dorsey, C. M., Espie, C. A., et al. (2004). Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine work group. Sleep, 27, 1567–1596.Google Scholar
First, M. B., Gibbon, M., Spitzer, R. L. and Williams, J. B. W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders: clinician version. Washington, DC: American Psychiatric Press.Google Scholar
Harvey, A. G., Sharpley, A. L., Ree, M. J., Stinson, K. and Clark, D. M. (2007). An open trial of cognitive therapy for chronic insomnia. Behaviour Research and Therapy, 45, 2491–2501.Google Scholar
Hoelscher, T. J., Ware, J. C. and Bond, T. (1993). Initial validation of the Insomnia Impact Scale. Sleep Research, 22, 149.Google Scholar
Jansson-Fröjmark, M., Lind, M. and Sunnhed, R. (2012). Don't worry, be constructive: a randomized controlled feasibility study comparing behavior therapy singly and combined with constructive worry for insomnia. British Journal of Clinical Psychology, 51, 142–157.Google Scholar
Jansson-Fröjmark, M., Linton, S. J., Flink, I., Granberg, S., Danermark, B. and Norell-Clarke, A. (2012). Cognitive-behavioral therapy for insomnia co-morbid with hearing impairment: a randomized controlled trial. Journal of Clinical Psychology in Medical Settings, 19, 224–234.Google Scholar
Kline, P. (1993). The Handbook of Psychological Testing. London: Routledge.Google Scholar
Lichstein, K. L., Durrence, H. H., Taylor, D. J., Bush, A. J. and Riedel, B. W. (2003). Quantitative criteria for insomnia. Behaviour Research and Therapy, 41, 427–445.Google Scholar
Lichstein, K. L., Riedel, B. W., Wilson, N. M., Lester, K. W. and Aguillard, R. N. (2001). Relaxation and sleep compression for late-life insomnia: a placebo-controlled trial. Journal of Consulting and Clinical Psychology, 69, 227–239.Google Scholar
Lichstein, K. L., Wilson, N. M. and Johnson, C. T. (2000). Psychological treatment of secondary insomnia. Psychology and Aging, 15, 232–240.Google Scholar
Mataix-Cols, D., Cowley, A. J., Hankins, M., Schneider, A., Bachofen, M., Kenwright, K., et al. (2005). Reliability and validity of the Work and Social Adjustment Scale in phobic disorders. Comprehensive Psychiatry, 46, 223–228.Google Scholar
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A. and Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia: an update of recent evidence (1998–2004). Sleep, 29, 1396–1406.Google Scholar
Mossman, D. and Somoza, E. (1991). ROC curves, test accuracy and the description of diagnostic tests. Journal of Neuropsychiatry and Clinical Neurosciences, 3, 330–333.Google Scholar
Mundt, J. C., Marks, I. M., Shear, M. K. and Greist, J. H. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461–464.Google Scholar
Nunnally, J. C. (1978). Psychometric Theory (2nd edn.). New York: McGraw-Hill.Google Scholar
Osborne, J. W. and Costello, A. B. (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10, 1–9.Google Scholar
Riedel, B. W. and Lichstein, K. L. (2000). Insomnia and daytime functioning. Sleep Medicine Reviews, 4, 277–298.CrossRefGoogle ScholarPubMed
Roth, T. and Ancoli-Israel, , , S. (1999). Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. II. Sleep, 22, 354–358.Google Scholar
Spitzer, R. L., Williams, J. B., Kroenke, K., Linzer, M., deGruy, F. V., Hahn, S. R., et al. (1994). Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD-1000 study. JAMA, 272, 1749–1756.Google Scholar
Swets, J. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 1285–1293.Google Scholar
Tabachnick, B. G. and Fidell, L. S. (2001). Using Multivariate Statistics. Boston: Allyn and Bacon.Google Scholar
World Health Organization (2011). http://www.who.int/topics/disabilities/en. Accessed 7 December.Google Scholar
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