Synopsis of the Psychological Adjustment To Illness Scale


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

Leonard R. Derogatis, Author

Source: Clinical Psychometric Research Inc., 1228 Wine Spring Lane, Towson, MD and MAPI Research Trust, 27 rue de la Villette 69003, Lyon, France

Instrument Development
Year Developed: 1975, 1978
Primary Measurement Constructs: Principal constructs underlying adjustment to medical illnesses and their sequelae.

Description of PAIS

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 of PAIS

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

PAIS and the PAIS-SR 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.

PAIS-SR Psychometrics

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

The PAIS and PAIS-SR are co-distributed by Clinical Psychometric Research, 1228 Wine Spring Lane, Towson, MD 21204 Phone 410-321-6165 and MAPI Research Trust, 27 rue de la Villette, 69003, Lyon, France,

Derogatis Measurement Assessments, LLC is the Copyright Owner

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.