Psychology RootsFatigue Severity Scale
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About Fatigue Severity Scale
Scale Name
Fatigue Severity Scale
Author Details
Lauren B. Krupp, Nicholas G. LaRocca, Joanne Muir-Nash, and Alfred D. Steinberg
Translation Availability
English
Background/Description
The Fatigue Severity Scale (FSS) is a concise self-report instrument designed to assess the impact of fatigue on daily functioning, particularly in individuals with chronic illnesses or neurological conditions. Developed in 1989 by Lauren B. Krupp and colleagues, the FSS was created to address the need for a reliable, standardized measure of fatigue severity that could distinguish it from related symptoms like depression or sleepiness. Initially validated in populations with multiple sclerosis (MS) and systemic lupus erythematosus (SLE), the FSS has since been widely adopted across various medical and psychological contexts, including chronic fatigue syndrome, Parkinson’s disease, and cancer-related fatigue.
The FSS consists of nine items, each rated on a 7-point Likert scale (1 = “strongly disagree” to 7 = “strongly agree”), focusing on the physical, social, and cognitive consequences of fatigue. Examples include statements like “Fatigue interferes with my physical functioning” and “Fatigue causes frequent problems for me.” The total score is the mean of the nine items (range: 1-7), with higher scores indicating greater fatigue severity; a score of 4 or higher often suggests clinically significant fatigue. Its brevity and clear wording make it accessible to patients, while its sensitivity to fatigue’s functional impact aids clinicians in assessing its burden.
Psychologists, neurologists, and primary care providers value the FSS for its ability to quantify a subjective symptom that significantly affects quality of life. It supports screening, treatment planning, and outcome evaluation for interventions like cognitive-behavioral therapy, exercise programs, or pharmacological management. The scale’s extensive translations enhance its global utility, enabling professionals to address fatigue across diverse populations with precision and empathy.
Administration, Scoring and Interpretation
- Obtain a copy of the Fatigue Severity Scale from a reputable source, such as peer-reviewed journals or authorized medical research platforms, ensuring proper use permissions.
- Explain the purpose of the FSS to the respondent, noting that it measures the impact of fatigue on daily life to guide care or research, emphasizing its quick completion.
- Provide instructions, asking the respondent to rate each of the nine statements based on their experiences over the past week, using the 1-7 scale, and to answer honestly.
- Approximate time for completion is about 2-5 minutes, owing to its concise format and straightforward questions.
- Administer the scale in a private, comfortable setting, using paper or digital formats, to ensure candid and accurate responses.
Reliability and Validity
The Fatigue Severity Scale exhibits robust psychometric properties, supporting its use in clinical and research settings. Internal consistency is excellent, with Cronbach’s alpha values ranging from 0.88 to 0.94, indicating strong cohesion across its nine items. Test-retest reliability is high, with correlations of 0.80-0.89 over short intervals in stable populations, reflecting consistent measurement of fatigue severity.
Convergent validity is demonstrated by significant correlations with other fatigue measures, such as the Visual Analog Scale for Fatigue (r = 0.60-0.75) and the Fatigue Impact Scale (r = 0.65-0.80). Discriminant validity is supported by weaker associations with depression scales, like the Beck Depression Inventory (r = 0.40-0.50), and sleepiness measures, like the Epworth Sleepiness Scale (r < 0.40), confirming its specificity to fatigue. Criterion validity is evidenced by its ability to differentiate fatigue severity in clinical groups (e.g., MS, SLE) from healthy controls and its sensitivity to changes following interventions like amantadine or physical therapy. These qualities, as reported by Krupp et al. (1989), affirm the FSS’s reliability and validity.
Available Versions
09-Items
Reference
Krupp, L. B., LaRocca, N. G., Muir-Nash, J., & Steinberg, A. D. (1989). The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of neurology, 46(10), 1121-1123.
Important Link
Scale File:
Frequently Asked Questions
What does the FSS measure?
It measures the severity and impact of fatigue on daily functioning.
Who can use the FSS?
Clinicians, psychologists, and researchers assessing fatigue in medical settings.
How long does the FSS take to complete?
It takes about 2-5 minutes.
Is the FSS specific to one condition?
No, it’s used for various chronic illnesses and fatigue-related conditions.
Can the FSS track treatment outcomes?
Yes, it’s sensitive to changes from interventions like therapy or medication.
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