Reliability and Validity of the Work and Social Adjustment Scale in Treatment-Seeking Problem Gamblers.

BACKGROUND: Problem gambling is a growing concern as governments become more reliant on gambling revenue particularly from increases in gambling casinos. It is widely reported that problem gamblers experience both high levels of comorbid mental health issues and subsequent disability that comes with such. To date, there have been few measures tested with problem gamblers that are a good measure of this disability. The Work and Social Adjustment Scale (WSAS) is a five-item measure of disability, which is used widely in a number of clinical settings including gambling. METHOD: The reliability and validity of the WSAS were examined in 171 outpatient problem gamblers who presented to a cognitive behavior therapy service in Adelaide, Australia. Subjects were assessed by trained cognitive behavior therapists and offered individual outpatient, group, or inpatient treatment. All subjects signed consent for their clinical data to be used and completed a battery of outcome measures at assessment, discharge, and 1-, 3-, and 6-month follow-up. RESULTS: The internal consistency of the WSAS was excellent among problem gamblers. A principal component analysis generated a single factor of disability. The WSAS has good concurrent validity with measures of gambling and comorbid anxiety and depression. The WSAS also shows promise as a measure of improvement in a clinical service. CONCLUSION: The WSAS has excellent reliability and sound validity among a treatment-seeking problem gambling population. Understanding disability related to gambling may offer insights into the long-term success of gamblers completing treatment. This instrument needs further refinement in a more rigorous experimental setting.