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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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