Abstract
BackgroundThe World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widespread measure of disability and functional impairment, which is bundled with the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) for use in psychiatry. Administering psychometric scales via the Internet is an effective way to reach respondents and allow for convenient handling of data.ObjectiveThe aim was to study the psychometric properties of the 12-item self-report WHODAS 2.0 when administered online to individuals with anxiety and stress disorders. The WHODAS 2.0 was hypothesized to exhibit high internal consistency and be unidimensional. We also expected the WHODAS 2.0 to show high 2-week test-retest reliability, convergent validity (correlations approximately .50 to .90 with other self-report measures of functional impairment), that it would differentiate between patients with and without exhaustion disorder, and that it would respond to change in primary symptom domain.MethodsWe administered the 12-item self-report WHODAS 2.0 online to patients with anxiety and stress disorders (N=160) enrolled in clinical trials of cognitive behavior therapy, and analyzed psychometric properties within a classical test theory framework. Scores were compared with well-established symptom and disability measures, and sensitivity to change was studied from pretreatment to posttreatment assessment.ResultsThe 12-item self-report WHODAS 2.0 showed high internal consistency (Cronbach alpha=.83-.92), high 2-week test-retest reliability (intraclass correlation coefficient=.83), adequate construct validity, and was sensitive to change. We found preliminary evidence for a three-factorial structure, but one strong factor accounted for a clear majority of the variance.ConclusionsWe conclude that the 12-item self-report WHODAS 2.0 is a psychometrically sound instrument when administered online to individuals with anxiety and stress disorders, but that it is probably fruitful to also report the three subfactors to facilitate comparisons between studies.Trial RegistrationClinicaltrials.gov NCT02540317; https://clinicaltrials.gov/ct2/show/NCT02540317 (Archived by WebCite at http://www.webcitation.org/6vQEdYAem); Clinicaltrials.gov NCT02314065; https://clinicaltrials.gov/ct2/show/NCT02314065 (Archived by WebCite at http://www.webcitation.org/6vQEjlUU8)
Highlights
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) [1,2] is an assessment tool developed by the World Health Organization (WHO) to measure disability and functional impairment in accordance with the International Classification of Functioning, Disability and Health [3]
We found preliminary evidence for a three-factorial structure, but one strong factor accounted for a clear majority of the variance
We conclude that the 12-item self-report WHODAS 2.0 is a psychometrically sound instrument when administered online to individuals with anxiety and stress disorders, but that it is probably fruitful to report the three subfactors to facilitate comparisons between studies
Summary
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) [1,2] is an assessment tool developed by the World Health Organization (WHO) to measure disability and functional impairment in accordance with the International Classification of Functioning, Disability and Health [3]. Several large-scale studies have suggested that the 12-item WHODAS 2.0 is a reliable and valid instrument when administered as an interview [5,6] or in a pencil-and-paper format [7,8] As to dimensionality, both a one-factor structure [6,8] and a second-order model that specifies the six WHODAS 2.0 domains of functioning as subfactors to an overarching disability variable [5,6] have been suggested. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widespread measure of disability and functional impairment, which is bundled with the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) for use in psychiatry. Administering psychometric scales via the Internet is an effective way to reach respondents and allow for convenient handling of data
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