Assessing functioning in adolescents with chronic fatigue syndrome: psychometric properties and factor structure of the School and Social Adjustment Scale and the Physical Functioning Subscale of the SF36. — CFSMEATLAS
Assessing functioning in adolescents with chronic fatigue syndrome: psychometric properties and factor structure of the School and Social Adjustment Scale and the Physical Functioning Subscale of the SF36.
Loades, M E, Vitoratou, S, Rimes, K A et al. · Behavioural and cognitive psychotherapy · 2020 · DOI
Quick Summary
This study tested two short questionnaires to measure how much ME/CFS affects young people's daily activities—both at school and socially, and their physical abilities. The researchers found that both questionnaires work well, are reliable, and accurately capture the impact of the illness. These tools could help doctors and researchers better track how adolescents with ME/CFS are functioning over time.
Why It Matters
ME/CFS significantly disrupts adolescents' schooling and social development, yet previously no validated instruments existed to reliably measure this impact. Establishing these validated, brief measures enables clinicians and researchers to consistently assess functioning, track disease progression, and evaluate treatment effectiveness in young people with ME/CFS.
Observed Findings
The Physical Functioning Subscale showed a 2-factor structure that fit the data well, suggesting it may function as two separate measures in adolescents with CFS.
The SSAS demonstrated satisfactory internal consistency and adequate fit with a single-factor solution.
Functioning scores showed moderate correlations with other established disability measures, supporting their validity.
No individual items in either measure were identified as problematic or redundant.
Both measures were brief enough for practical clinical use while maintaining psychometric quality.
Inferred Conclusions
The SSAS and Physical Functioning Subscale of the SF-36 are reliable and valid tools for assessing functioning in adolescents with CFS.
These measures are practical alternatives to longer questionnaires and provide efficient ways to monitor multiple domains of functioning.
The Physical Functioning Subscale can be meaningfully divided into two subscales for more detailed assessment in this population.
Remaining Questions
Do these measures accurately detect changes in functioning over time (are they longitudinally valid)?.
How do these questionnaires perform in diverse adolescent CFS populations beyond the study sample?
What This Study Does Not Prove
This study does not establish whether these measures can detect changes over time (longitudinal validity) or predict future outcomes. The cross-sectional design only demonstrates that the questionnaires work at a single time point, not how they perform in clinical practice or whether they're sensitive to meaningful changes in patient status.
Tags
Symptom:Fatigue
Phenotype:Pediatric
Method Flag:Weak Case DefinitionNo ControlsExploratory Only