Derogatis, Leonard R.
Psychosocial Adjustment To Illness Scale (PAIS/PAIS-SR)
Clinical Psychometric Research Inc.,
1228 Wine Spring Lane, Towson, MD 21204
Year Developed: 1975, 1978
Primary Measurement Constructs: Principal constructs underlying adjustment to
medical illnesses and their sequelae.
The Psychosocial Adjustment to Illness Scale (PAIS) is a 46-item, multiple domain,
semistructured interview designed to assess the quality of a patient's psychosocial
adjustment to a current medical illness or the sequelae of a previous illness. With slight
variations in format, the PAIS may also be used to measure the nature of spouses', parents'
or other relatives' adjustment to the index patient's illness, or their perceptions of the
patients' adjustment to his/her own illness.
The PAIS is designed to be completed as an integral aspect of a personal interview with the
respondent, conducted by a trained health care professional or interviewer. The PAIS
interview typically requires 20 to 25 minutes to complete. When conducted as part of a
broader interview, PAIS items must be presented consecutively, without the interjection of
external items or queries associated with the broader examination. Typically, the PAIS is
available in reusable booklets which are supplied in conjunction with separate answer
sheets and score/profile forms.
In addition to the PAIS interview, there is also a self-report version of the instrument known
as the PAIS-SR. The PAIS-SR is designed to be completed by the respondent, with the
test and instructions printed in a consumable booklet. The PAIS-SR is also composed of 46
items, designed to match the items of the PAIS interview as closely as possible. On
average, it requires 20 to 25 minutes for completion of a PAIS-SR.
Norms based upon samples with minimum Ns ? 100 have been developed for the following
illness groups: For the PAIS, norms are available for lung cancer, renal dialysis, essential
hypertension, burn patients, and gynecologic cancer patients; for the PAIS-SR, norms
based, upon heterogeneous cancer, cardiomyopathies, diabetes and multiple sclerosis
have been completed.
The PAIS and PAIS-SR measure psychosocial adjustment to illness in terms of 7 primary
domains of adjustment: Health Care Orientation, Vocational Environment, Domestic
Environment, Sexual Relationships, Extended Family Relationships, Social Environment
and Psychological Distress. Each PAIS/PAIS-SR item is rated on a 4-point (0 thru 3) scale
of adjustment, with higher ratings indicating poorer adjustment status. On the PAIS-SR,
scale direction is alternated on every other item to help reduce position response biases.
The 7 primary PAIS domains were developed through a combination of rational-deductive
and empirical-analytic procedures. The domain constructs have been repeatedly identified
as having high predictive relevance and clinical utility concerning adjustment to illness. The
7 domain scores of the PAIS/PAIS-SR are summed to generate a PAIS Total Adjustment
Score. A respondent's PAIS/PAIS-SR raw dimension and Total scores may be transformed
into any of 9 sets of illness-specific standardized area T-scores through the PAIS normative
library. Because area T-scores represent a "normalizing" transformation, PAIS/PAIS-SR
norms provide a true actuarial assessment of the respondent's adjustment status.
Clinical/Research Instrument, Interview & Self-Report
English, Italian, Portuguese, Hebrew, Danish, Norwegian, French, Japanese, Chinese,
Korean, Icelandic, Hungarian, Spanish, Swedish & Taiwanese
The PAIS and the PAIS-SR are each comprised of 46 items. In the case of the former,
items are cast in a semi-structured interview with ratings organized along 4-point Likert
scales. For the self-report inventory, 4-point Likert scales are also used.
In three published studies internal consistency reliability estimates (Coefficients _ ) for the
domain scores of the PAIS-SR were: .63-.80; .68-.93; and .47-.85. Interrater reliability
coefficients for the PAIS interview ranged from .74-.86 and .33-.82 in two published studies,
with coefficients for the PAIS Total Adjustment Score being .86 and .83 respectively.
Validation of the PAIS has been extensive, with studies of convergent, predictive and
construct validity, as well as confirmation of dimensional structure, reviewed thoroughly in
Derogatis & Derogatis (1990) and Derogatis & Fleming (1996).
How to Obtain
The PAIS and PAIS-SR are exclusively distributed by Clinical Psychometric Research, 1228
Wine Spring Lane, Towson, MD 21204. Phone 1-800-245-0277 ; 1-(410) 321-6165; FAX 1-
Leonard R. Derogatis, Ph.D.
Derogatis, L.R. (1986) The Psychosocial Adjustment To Illness Scale (PAIS). J.
Psychosom. Res. 30, 77-91.
Derogatis, L.R. & Derogatis, M.A. (1990) PAIS & PAIS-SR: Administration, Scoring &
Procedures Manual-II Clinical Psychometric Research, Baltimore, MD.
Derogatis, L.R. (1990) PAIS/PAIS-SR: A Bibliography of Research Reports 1975-1994.
Clinical Psychometric Research, Baltimore, MD.
Derogatis, L.R. & Fleming, M.P. (1996) Psychosocial Adjustment To Illness Scale. In B.
Spilker (Ed.) Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd Ed. Raven
Press, New York, NY.
|1228 Wine Spring Lane, Towson, MD 21204, USA Phone: 1-800-245-0277 Fax: 1-410-321-6341
Powered, Maintained, and Operated by: Ennovative-Designs