Chapter 3: Seasonality and the Seasonal Pattern Assessment Questionnaire (SPAQ)
“If you can’t measure something, you can’t understand it.”
— H. James Harrison
Experience with people with SAD, the winter blues and those who have no seasonal problems at all gave rise to the idea that seasonality might exist on a spectrum, such as weight or blood pressure, two other measurements of relevance to health and well-being.
Just as someone might be considered as being of normal weight, overweight or obese, so with regard to seasonality, people might be divided according to pre-determined cutoff values into those who are non-seasonal, and those who have the winter blues or full blown SAD. Such a division might be useful for epidemiological and treatment purposes.
In this chapter, we consider how we might measure seasonality and derive these potentially useful distinctions. To address this question, my colleagues and I developed a scale to measure the severity of a person’s seasonal changes in mood and behavior, which we have called seasonality.
Here I share with you some key questions to help you figure out where you or someone you know falls on this scale. Obviously, a self-diagnosis of this kind is no substitute for an expert opinion but it is a highly useful way to see where you fall in relation to other people with regard to your seasonality – something an expert is not always on hand to do!
SPAQ: A brief scale for assessing SAD and the winter blues
The scale helps determine:
- Whether you have a seasonal pattern of feeling better or worse
- How marked this pattern is
- Whether or not you experience this pattern as a problem
- Are you seasonal and if so, what is your seasonal pattern?
a) Do you feel at your worst in December, January, or February? (Note: This and the following question are geared to those living in the northern hemisphere)
If yes, you have a winter pattern of seasonality.
b) Do you feel at your worst in July or August?
If yes, you have a summer pattern of seasonality.
c) If you feel bad in both winter and summer and relatively well in between, you have a winter-summer pattern of seasonality.
d) There are other patterns of seasonal difficulties, which may be due to seasonal allergies, such as pollen or leaf mold, which can cause mood drops in spring or fall respectively. We won’t consider these variations here.
e) If you don’t feel any significant difference across the seasons, you are not seasonal, and probably don’t have SAD or the winter blues.
2. If you are seasonal, to what degree do the following change with the season?
Add up your scores for items A through F. Since the score for each item goes from 0 to 4 and there are six items, your total seasonality score must range between 0 and 24. Most people with SAD have seasonality scores of 11 or more. Most people with the winter blues have scores of 8 to 10. If your score is less than 8, you probably don’t have SAD or the winter blues but, if you answer “yes” to item #3 below, by definition that should override your seasonality score and suggests you might have SAD or the winter blues.
- If you experience changes with the season do you feel they are a problem for you? Yes ◯ No ◯
If yes, is this problem:
- Mild
- Moderate
- Marked
- Severe
- Disabling
SAD and the Winter Blues: A Continuum
Within the same person, winter difficulties often vary from year to year. As you will see, two major causes of these conditions are lack of light and stress. As you can imagine, two important causal factors that may vary significantly from year to year – environmental light levels and stress – might lead to winter blues one year and SAD the next or vice versa.
Although such variations are of clinical importance, here they are of interest because they remind us that when it comes to seasonality, we are dealing with a moving target. We must therefore accept that measurements of seasonality are likely to vary. Also, the SPAQ is an imperfect tool. In thinking about the SPAQ, however, I am reminded of Winston Churchill’s famous definition of democracy as “The worst form of government – except for all the others.” Notwithstanding the limitations of the SPAQ, it has yielded valuable information for both populations and individuals. Check it out for yourself and see how seasonal you are.
Note to Students and Researchers
There have been many studies conducted on the SPAQ in the U.S., Europe and Asia. Students and researchers have asked me how the SPAQ is scored in research studies. A fuller discussion of this is provided in articles listed in the “Further Reading” section at the end of the book, and the SPAQ itself can be found on my website at xxxxxxxxxxxxxxxxxxxxxx (note specific subpage). [Eric Needs This Info In Order To Add Here]
A separate SPAQ for children and adolescents can also be found on my website at [will place here once the material is created and web pages have been created].
