Cella, Matteo, Sharpe, Michael, Chalder, Trudie · Journal of psychosomatic research · 2011 · DOI
This study tested whether a simple questionnaire called the Work and Social Adjustment Scale (WSAS) accurately measures how much ME/CFS affects a person's daily life and ability to work. Researchers gave this questionnaire to over 1,000 ME/CFS patients and found it was reliable and valid—meaning it consistently measured disability and actually reflected real-world functioning.
Having a validated, reliable tool to measure disability in ME/CFS is important because it allows researchers to accurately evaluate whether treatments work and helps clinicians objectively track patient progress. This study confirms the WSAS is appropriate for use in ME/CFS research and clinical settings, standardizing how disability is assessed across studies.
This study does not prove that the WSAS is sensitive to post-exertional malaise or other ME/CFS-specific features; it only validates general disability measurement. Correlation between WSAS scores and depression/anxiety does not establish which causes which. The study does not compare the WSAS to other disability measures to determine if it is superior.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Cella, Matteo, Sharpe, Michael, & Chalder, Trudie (2011). Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2011.02.009
BibTeX
@article{mecfsatlas-cella-2011-measuring-disability,
author = {Cella, Matteo and Sharpe, Michael and Chalder, Trudie},
title = {Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale.},
journal = {Journal of psychosomatic research},
year = {2011},
doi = {10.1016/j.jpsychores.2011.02.009},
note = {PubMed: 21843745},
url = {https://www.mecfsatlas.com/evidence/cella-2011-measuring-disability},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/cella-2011-measuring-disability
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