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Synopsis of the Psychological Adjustment To Illness Scale


Derogatis, Leonard R.

Psychosocial Adjustment To Illness Scale (PAIS/PAIS-SR)

Clinical Psychometric Research Inc., 
1228 Wine Spring Lane, Towson, MD 21204

Instrument Development
	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.

Normative Populations
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.

Instrument Type
Clinical/Research Instrument, Interview & Self-Report

Languages Available
English, Italian, Portuguese, Hebrew, Danish, Norwegian, French, Japanese, Chinese, 
Korean, Icelandic, Hungarian, Spanish, Swedish & Taiwanese

Item Format
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-
(410) 321-6341.

Copyright Owner
Leonard R. Derogatis, Ph.D.

Principal Citations

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
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