1. Do the following infringe copyright?
- adding other questions, for example, demographic description such as age and gender: No this does not infringe copyright and is acceptable. It is envisaged that WEMWBS will frequently be included in the context of a questionnaire containing other questions so that other information about respondents can also be captured. As well as providing general information about the respondents, such data can be used in cross-tabulations with the WEMWBS data for wider analysis purposes.
- changing the text size of WEMWBS: No this does not infringe copyright and is acceptable as long as no changes to the wording, response categories or layout of WEMWBS are made.
- using the questions in a different format: The scales are validated in their original format, and any significant change will compromise the validity and may infringe copyright. Changing the size of the text is acceptable as long as no changes to the wording, response categories or layout of WEMWBS are made.
It is fine to add questions to WEMWBS as part of your study, however removing questions will mean the scale is no longer valid. If you do still wish to use any part of the scale in an altered format we request that you discuss with us first and ensure to acknowledge the source of the questions. We have not seen any evidence that the numbers in the boxes (1-5) affect response this but it should be mentioned in your report if you decide to delete the numbers because this may affect comparability with other studies. On a website, the numbers will not normally be there because the options will be buttons rather than boxes. If you are uncertain about making any changes, please contact us to discuss further.
2. Can WEMWBS be put on a website or published in a book?
If you are publishing the questionnaire on a website or in a book it should have underneath it:
Warwick-Edinburgh Mental Well-being Scale (WEMWBS) © NHS Health Scotland, the University of Warwick and University of Edinburgh, 2006, all rights reserved.
3. Do the numbers (1-5) in the boxes for WEMWBS response influence how people answer the questions?
We have not seen any evidence that the numbers in the boxes affect response this but it should be mentioned in your report if you decide to delete the numbers because this may affect comparability with other studies. On a website, the numbers will not normally be there because the options will be buttons rather than boxes.
4. Is it appropriate to provide information such as support contacts for people with low WEMWBS scores?
Providing a supplementary page with information on support contacts is perfectly acceptable, but if such information is provided then it should be available to all those who complete the questionnaire, not just to those with scores deemed to be ‘low’.
5. What is the average score for WEMWBS?
Mean scores for the general population are reported in population surveys and are generally around 51 in the UK.
6. Are there cut-off points for interpretation of WEMWBS scores?
If it is essential to present data in a categorical way, for example, for analytical purposes, the best approach to date is that used in the analysis of WEMWBS data from the Scottish Government’s Well, What do you think? 2006 survey. Scores were categorized according to the extent of their standard deviation from the mean.
A categorical variable was derived for the purposes of the report by dividing the survey population into three groups: (i) those with relatively "good mental wellbeing" (a WEMWBS score of over one standard deviation above the mean), (ii) those with "average mental wellbeing" (a WEMWBS score of within one standard deviation of the mean) and those with relatively "poor mental wellbeing" (a WEMWBS score of more than one standard deviation below the mean). This three-fold classification was used as a key analysis variable throughout the report.
7. Can the WEMWBS be used to
- assess change in mental wellbeing in individuals: WEMWBS was designed as a research tool to be used in populations. However, the WEMWBS responsiveness to change has been evaluated both at the population and the individual level and at the individual level a change of about 3 or more points can be considered significant.
- measure depression: The scale is not designed to measure depression but low scores do relate to depression. Recent studies show that you can define a cut-off point in WEMWBS score which has optimum sensitivity and specificity for depression (as measured by other scales) but wherever you put the cut-off point you will either miss some people with depression or include people who do not have depression. You would expect this from a scale that is normally distributed and designed to measure wellbeing in the general population.
- screen mental illness: The scales were not designed for this purpose. Cut points corresponding to probable or possible mental illness have been defined from studies of WEMWBS performance vis a vis mental illness measures with validated cut points (find out more). These are valid for categorising the scales in epidemiological studies.
- cover spiritual wellbeing: No, although aspects of spiritual wellbeing such as connectedness, growth and development, and purpose in life which may be regarded as part of psychological functioning are covered.
- monitor change at the individual level: Although the scales were not designed to monitor change at the individual level, they have been used in such a way because they enable conversations about mental wellbeing. Studies have now indicated that the scales could be valid for this purpose and suggested a level of change in scores that can be regarded as important (see this page for more information).
8. Can the WEMWBS be used with
- children: The scale is validated for use with individuals aged 13 to 74. There is no evidence for the use of WEMWBS with children below the age of 13. It is therefore not recommended that WEMWBS be used with children aged under 13. There is however another scale which we would recommend for children aged 8-13. This is the Stirling Children’s Wellbeing Scale. Alternatively, the Strengths and Difficulties Questionnaire is designed for use in children.
- ethnic minority groups in the UK: Use of this scale in all population groups is encouraged. It has been validated among people with a Chinese and a Pakistani family background respectively living in a city in England.
9. Have the scales been translated into other languages?
The WEMWBS has been translated into several other languages and these translations are available once you have registered to use the scale.