• ADAPSS primary scale assesses ‘an individual’s initial evaluation of an event or situation’. Its secondary scale assesses ‘an individual’s evaluation of their own coping resources, the possibility of these resources being adequate, and the likelihood that these resources can be employed effectively’.
  • The scale consists of 6 subscales:
    1) Fearful Despondency
    2) Overwhelming Disbelief
    3) Determined Resolve
    4) Growth and Resilience
    5) Negative Perceptions of Disability
    6) Personal Agency
  • A short-form version was introduced in 2009 by Dean and Kennedy (Dean and Kennedy 2009).

Clinical Considerations

  • Appraisals are important psychosocial variables in SCI populations as they have been found to be good predictors of emotional adjustment. The ADAPSS is useful in the clinical setting to better understand the appraisals which are significant for adjustment to SCI and thus to tailor treatment programs for patients.
  • The ADAPSS is a SCI-specific appraisal scale. The questions are straightforward and the scale covers a range of appraisal themes.
  • A self-administered format is recommended but an interviewer or proxy could be used in the case of severe physical disability. The assessment seems easy to administer and score.

ICF Domain

Body Function ▶ General Functions

Administration

  • Patient-reported; self-administered questionnaire
  • Participants are asked to rate their agreement/disagreement with the statements on a Likert Scale.

Number of Items

  • Original version: 33 items
  • Short-form version: 6 items

Equipment

None

Scoring

The authors do not provide scoring instructions; however it seems that subscale scores are reported (sum the score from each item of a subscale to get the subscale score).

Languages

English

Training Required

Does not require advanced training

Availability

The ADAPSS can be found by contacting the author (Paul Kennedy, paul.kennedy@hmc.ox.ac.uk).

Measurement Property Summary

Number of studies reporting psychometric properties: 6

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))

  • No information is given regarding norms or meaningful cut-off scores for the SCI population.
  • 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)

Reliability – Moderate to High

Number of studies reporting reliability data: 3

  • Moderate to High internal consistency for the ADAPSS subscales (Personal Agency): α=.70
  • Moderate to High internal consistency for the ADAPSS subscales (Fearful Despondency): α= .85
  • Moderate to 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 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
  • High correlation between the Hospital Anxiety and Depression Scale – Anxiety subscale and the ADAPSS Fearful Despondency subscale: ρ=.649 (p<.01)
  • 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))

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

Dean RE, Kennedy P. Measuring Appraisals Following Acquired Spinal Cord Injury: A Preliminary Psychometric Analysis of the Appraisals of Disability. Rehabilitation Psychology 2009;54(2): 222-231.
http://www.ncbi.nlm.nih.gov/pubmed/19469614

Deane KC, Chlan KM, Vogel LC, Zebracki K. Use of Appraisals of DisAbility Primary and Secondary Scale-Short Form (ADAPSS-sf) in individuals with pediatric-onset spinal cord injury. Spinal Cord. 2020;58(3):290-297
https://pubmed.ncbi.nlm.nih.gov/31700146/

Eaton R, Jones K, Duff J. Cognitive appraisals and emotional status following a spinal cord injury in post-acute rehabilitation. Spinal Cord. 2018;56(12):1151-1157.
https://pubmed.ncbi.nlm.nih.gov/29895873/

McDonald SD, Goldberg-Looney LD, Mickens MN, Ellwood MS, Mutchler BJ, Perrin PB. Appraisals of DisAbility Primary and Secondary Scale-Short Form (ADAPSS-sf): Psychometrics and association with mental health among U.S. military veterans with spinal cord injury. Rehabil Psychol. 2018;63(3):372-382.
https://pubmed.ncbi.nlm.nih.gov/30047748/

Mignogna J, Christie AJ, Holmes SA, Ames H. Measuring disability-associated appraisals for veterans with spinal cord injury. Rehabil Psychol. 2015;60(1):99-104.
https://pubmed.ncbi.nlm.nih.gov/25706194/

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