Copyright © Buckinghamshire Healthcare NHS Trust.
2026 All rights reserved
Searching for a study?
Click the icon above!
Solution building // Problem solving
Socialise with us
InSites Provider Organisation
APPRAISALS OF DISABILITY: PRIMARY AND SECONDARY SCALE (ADAPSS)
The ADAPSS (Appraisals of DisAbility: Primary and Secondary Scale) is a self-rated measure designed to capture appraisals specific to spinal cord injury (SCI). It includes two versions: a short form (ADAPSS-sf) and a long form (ADAPSS). It was initially developed at the NSIC between 2006 and 2008.
The ADAPSS is scored on a 6-point Likert scale, with 3 agree responses and 3 disagree responses. It is used to assess an individual's initial evaluation of an event or situation and their evaluation of their own coping resources. The scale covers a range of appraisal themes and is useful in the clinical setting to better understand the appraisals significant for adjustment to SCI and to tailor treatment programs for patients.
Read the guidance on measurement of appraisals in SCI.
Navigate this page to find information on:
1. Background
2. Downloads
3. Administration
4. Interpretation
5. Translation
Background
The ADAPSS was developed between 2006 and 2008, and first published in 2009 by Paul Kennedy and colleagues at the NSIC. A scale to measure the appraisals of people with spinal cord injuries (PwSCI) was important due to their role in how people understand and adjust psychologically to their SCI. This follows decades of research into the psychological factors of stress and coping, pioneered in a cognitive-behavioural model called the "Stress and Appraisal coping model" by Lazarus and Folkman (1984).
The measure was developed using a combination of lived-experience qualitative work with service users of the NSIC, and subsequent production and validation of scale items. Following publication, the ADAPPS has been used in research and clinical settings, which has furthered its validity.
There are two different versions of the ADAPSS: a short form (ADAPSS-sf) and a long form (ADAPSS). Both measures are scored on a 6-point Likert scale with 3 agree responses (strongly, moderately, and mildly) and 3 disagree responses (strongly, moderately, and mildly).
How to administer and interpret the ADAPSS
Administration
-
The ADAPPS and ADAPSS-sf are intended to be delivered by healthcare professionals, for patients to verbally self-report answers. Alternative communication methods can be used, assuming conceptual clarity can be determined using these methods.
-
The ADAPPS-sf takes roughly 5-10 minutes to complete, including the time it might take to explain how patients respond to items (by level of agreement/disagreement).
-
Services may wish to consider the conditions in which they wish to complete a full ADAPPS based on a patient's response to the ADAPPS-sf. A cut-off score of 22 on the ADAPPS-sf is used at NSIC to indicate a need to complete a full ADAPPS.
Interpretation
-
The ADAPSS-sf includes 6 items, each representing a domain/subscale from the long form; fearful despondency, overwhelming disbelief, determined resolve, negative perceptions of disability, growth and resilience, and personal agency. Total scores are generated by adding responses for each of the 6 items (minimum score = 6, maximum score = 36). It should be noted that items representing determined resolve, growth and resilience, and personal agency are reverse scored. In this way, for all items it is the case that the higher the score the more likely someone will have increased loss and decreased resilience appraisals and therefore possible difficulties adjusting to SCI/D. The ADAPSS-sf is generally used for screening purposes, and if someone scores 22 or over it is recommended to complete the long form ADAPSS.
-
-
The long-form ADAPSS can be used following the administration of the ADAPSS-sf or as a standalone measure. The long form contains 33 items. Items relate to the same 6 subscales as in the ADAPSS-sf: fearful despondency (FD; 9 items, maximum score of 54), overwhelming disbelief (OD; 5 items, maximum score of 30), determined resolve (DR; 4 items, maximum score of 24), negative perceptions of disability (NPD; 5 items, maximum score of 30), growth and resilience (GR; 5 items, maximum score of 30) and personal agency (PA; 5 items, maximum score of 30).
-
-
The 6 subscales can be further grouped into two superordinate factors: Catastrophic Negativity (Loss) and Determined Resilience (Resilience)1. The Catastrophic Negative (Loss) factor includes the subscales fearful despondency, overwhelming disbelief and negative perceptions of disability. The Determined Resilience factor includes determined resilience, growth and resilience and personal agency.
-
-
In the full ADAPSS, scores are calculated for each of the sub-scales by summing scores of the relevant items. As in the ADAPSS-sf, items from DR, GR and PA subscales are reverse scored. In the ADAPSS long form, scores of 51-54 (FD), 28-30 (OD), 21-24 (DR), 25-30 (GR), 27-30 (NPD) and 26-30 (PA) are considered high, and indicative of maladaptive appraisals in that domain.
Translating the ADAPPS
We welcome and support translations of our measures, including the ADAPPS, into your language. A number of translations have been made and some are ongoing. Check the list of downloads above to see if the ADAPPS is already available in your language, before considering translation.
When translating the ADAPPS, we strongly recommend a formal translation and back translation methodology are used, to ensure conceptual translation as well as literal. We also recommend getting in touch with us before starting, as we can provide further guidance and ensure that we can validate and approve your translation: please enquire at bht.nsicresearchpsychology@nhs.net.