Appraisals of Disability: Primary and Secondary Scale (ADAPSS)

Measurement Property Summary

Number of studies reporting psychometric properties: 8

Interpretability

• High scores on the Fearful Despondency, Overwhelming Disbelief, and Negative Perceptions of Disability subscales represent greater agreement with the appraisals; respondents with higher scores on these subscales are more likely to appraise their injury in terms of loss and threat and to perceive their injury as unmanageable.
• Low scores on the Determined Resolve, Growth and Resilience, and Personal Agency subscales represent greater agreement with the appraisals (though the range of scores is not provided). Respondents with lower scores on these subscales were more likely to appraise their injury in terms of loss and threat and to perceive their injury as unmanageable.
• The correlation between injury level and the ADAPPS-sf total score are low (β value = 0.153 [p<0.051])

(Mignogna et al. 2014; n=98; 94 males, 4 females; mean (SD) age: 18.3 (13.1) years; tetraplegia (low): n=14, tetraplegia (high, AIS A,B,C): n=6, AIS D: n=41; traumatic injury: yes (77), no (21))

• Threshold values: Research has suggested cut-off scores for the ADAPSS-sf ranging from ≥22 to ≥27; indicating catastrophic negative based on 85th percentile cutoff.

(Eaton et al. 2018; n=371; 261 males, 110 females; non-traumatic and traumatic; injury level: Cervical-sacral; AIS A-D)
(Deane et al. 2020; n=115; age: 18 years or younger at time of SCI, initially interviewed at age 19 or older, and followed annually)

• MCID: not established in SCI population
• SEM: not established in SCI population
• MDC: not established in SCI population

Typical Values

Mean scores reported for the ADAPSS-sf have varied from 13.94 to 19.21 (SD = 6.10-7.44)

(Eaton et al. 2018; n=371; 261 males, 110 females; non-traumatic and traumatic; injury level: Cervical-sacral; AIS A-D)
(Mignogna et al. 2014; n=98; 94 males, 4 females; mean (SD) age: 18.3 (13.1) years; tetraplegia (low): n=14, tetraplegia (high, AIS A,B,C): n=6, AIS D: n=41; traumatic injury: yes (77), no (21))
(Dean et al. 2020; n=115; age: 18 years or younger at time of SCI, initially interviewed at age 19 or older, and followed annually)
(McDonald et al. 2018; n=262; 92% males; median age: 59 years; traumatic and non-traumatic SCI; 51% AIS D; paraplegia and tetraplegia)

Mean (SD) scores reported for the ADAPSS long form subscales are:

• Fearful Despondency: 31.27 (9.43).
• Overwhelming Disbelief: 13.18 (5.32)
• Determined Resolve: 8.36 (3.82)
• Growth and Resilience: 12.32 (4.79)
• Negative Perceptions of Disability: 17.59 (5.89)
• Personal Agency: 12.05 (4.37)

(Kennedy et al. 2016; n=44; 37 males, 7 females; mean age: 33.3 years; level of injury: 46% cervical, 34% thoracic, and 20% lumbar; AIS level: 60% complete and 40% incomplete injuries; mean (range) time since injury: 23.1 (21-24) years; 22/44 participants were deceased)

Reliability – High

Number of studies reporting reliability data: 3

• High internal consistency for the ADAPSS subscales:
  • Personal Agency: α=.70
  • Fearful Despondency: α= .85
• High test-retest reliability for the ADAPSS subscales: α=.74-.86

(Dean & Kennedy 2009; n=237; 162 males, 75 females; mean age = 47 (range: 18-81); tetraplegia: 37%, paraplegia: 56%, unknown: 7%)

Validity – Low to High

Number of studies reporting validity data: 4

• Low to Moderate correlation between the Perceived Manageability Scale – Needs Assessment Checklist and the following ADAPSS subscales:
  • Fearful Despondency: ρ=-.597
  • Overwhelming Disbelief: ρ=-.468
  • Determined Resolve: ρ=-0.599
  • Growth and Resilience: ρ=-.345
  • Negative Perceptions of Disability: ρ=-.533
  • Personal Agency: ρ=-.519
• Moderate correlation between the Hospital Anxiety and Depression Scale – Anxiety subscale and the ADAPSS Fearful Despondency subscale: ρ=.649 (p<.01)
• Low to Moderate correlation between the Hospital Anxiety and Depression Scale – Anxiety subscale and the ADAPSS subscales:
  • Overwhelming Disbelief: ρ=.597 (p<.01)
  • Determined Resolve: ρ=.347 (p<.01)
  • Negative Perceptions of Disability: ρ=.496 (p<.01)
  • Personal Agency: ρ=.393 (p<.01)
• Low correlation between the Hospital Anxiety and Depression Scale – Anxiety subscale and the ADAPSS Growth and Resilience subscale: ρ=.187 (p<.01)

(Dean & Kennedy 2009; n=237; 162 males, 75 females; mean age = 47 (range: 18-81); tetraplegia: 37%, paraplegia: 56%, unknown: 7%)

• High correlation between the ADAPPS-sf total score and life satisfaction: β value = -.72 (p< .001)
• Low correlation between the ADAPPS-sf total score and controlling for depressive symptoms: β value = .05 (p<.604)

(Mignogna et al. 2014; n=98; 94 males, 4 females; mean (SD) age: 18.3 (13.1) years; tetraplegia (low): n=14, tetraplegia (high, AIS A,B,C): n=6, AIS D: n=41; traumatic injury: yes (77), no (21))

• Low to Moderate correlation between all subscales of appraisals of disability and all the subscales of the Multidimensional Acceptance of Loss Scale and the Heartland Forgiveness Scale: r = -0.244 to -0.647 (p < 0.01)

(Byra et al. 2020; n=163; 100 males, 63 females; mean (SD) age: 39.6 (9.38) years; injury level: 26 C1-C4 nonambulatory, 104 C5-C8 nonambulatory, 33 non-cervical, nonambulatory; mean time since injury: 12.05)

• Moderate to High correlation between the ADAPSS subscales and Beck Depression Inventory:
  • Fearful despondency: r = .660, p = .001
  • Overwhelming disbelief: r = .697, p = .001
  • Determined resolve: r = .814, p = .001
  • Negative perceptions of disability: r = .509, p = .016
  • Personal agency: r = .627, p = .002).

(Kennedy et al. 2016; n=44; 37 males, 7 females; mean age: 33.3 years; level of injury: 46% cervical, 34% thoracic, and 20% lumbar; AIS level: 60% complete and 40% incomplete injuries; mean (range) time since injury: 23.1 (21-24) years; 22/44 participants were deceased)

Responsiveness

No values were reported for the responsiveness of the ADAPSS for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the ADAPSS for the SCI population.

Reviewers

Dr. Vanessa Noonan, Dr. Carlos L. Cano-Herrera, Elsa Sun

Date Last Updated

December 31, 2024