Quality of Life Concepts

Secondary Health Conditions

Tenesee Self-Concept Scale (TSCS)

Description: A global measure of self-concept (subjective well-being), where the respondent answers self-descriptive items by means of which an individual portrays what he or she is, does, likes, and feels. As well as providing an overall assessment of self-esteem, the TSCS measures five external aspects of self-concept (moral-ethical, social, personal, physical, and family) and three internal aspects (identity, behavior, and self-satisfaction) [1].

Format: 100 items ranked on a five-point scale:

1 = Always False
2 = Mostly False
3 = Partly False and Partly True
4 = Mostly True
5 = Always True

Scoring: The TSCS allows two scoring systems (see details below on where to obtain). The counseling form yields 14 profiled scores: self-criticism, 9 self-esteem scores (identity, self-satisfaction, behavior, physical self, moral-ethical self, personal self, family self, social self, and total), 3 variability of response scores (variation across the first 3 self-esteem scores, variation across the last 5 self-esteem scores, and total), and a distribution score.

The clinical and research form yields 29 profiled scores: the 14 scores in the counseling form and the following 15: response bias, net conflict, total conflict, 6 empirical scales (defensive positive, general maladjustment, psychosis, personality disorder, neurosis, personality integration), deviant signs, 5 scores consisting of counts of each type of response made.

Administration and Burden: Interviewer-administered; Self-administered. Approximately 15-20 minutes.

Psychometrics for SCI: Not available.

Language(s): English.

QoL Concept: The TSCS is a measure of Subjective Well-Being, which corresponds to Box E (subjective evaluations and reactions; self-esteem) of Dijker’s Model.

Permissions/Where to Obtain: Copyrighted; The TSCS can be purchased from Western Psychological Services at: http://portal.wpspublish.com


  1. Fitts WH. Manual for the Tennesse Self Concept Scale. Nashville TN: Counselor Recordings and Tests; 1965.


Pressure Ulcer SCI Studies:  One cross-sectional observational study:

  1. Anderson TP, Andberg MM. Psychosocial factors in pressure sores. Arch Phys Med Rehabil 1979; 60:341-6.

Sensitivity to Impact: Anderson and Andberg (1979) found that factors related to quality of life (QoL; as assessed by a study specific questionnaire - Satisfaction with Activities of Life [SATIS]) and psychological well-being may be predictive of pressure ulcer development and maintenance in persons with spinal cord injury (SCI; N = 141). As well, they found that perceived satisfaction (using a non-standardized measure) contributed most to the incidence of pressure ulcers after SCI, and particularly so for persons with paraplegia.  Self-esteem, measured using the Tennessee Self-Concept Scale (TSCS), only approached significance in their models predicting pressure ulcer occurrence, and it is unclear whether they examined associations with pressure ulcers and the TSCS sub-scales.

Suggestions for Use: Although the TSCS has been used in several SCI studies [1-5], the psychometric properties of the TSCS have not been established for the SCI population nor has the scale shown to be sensitive to the impact of pressure ulcers. However, the construct of self-esteem in relation to body image has been highlighted as being negatively affected by pressure ulcers [6]. Based on this evidence, it may be prudent to use the TSCS in conjunction with another measure of subjective well-being/self-esteem that has been validated for the SCI population and/or is domain-specific (i.e., body image) when investigating the impact of pressure ulcers.

Additional References:

  1. 2. Green BC, Pratt CC, Grigsby TE. Self-concept among persons with long-term spinal cord injury. Arch Phys Med Rehabil 1984;65:751-4.

  2. Yetzer EA, Schandler S, Root TL, Turnbaugh K. Self-concept and body image in persons who are spinal cord injured with and without lower limb amputation. SCI Nursing 2003;20:18-23.

  3. Guest R, Klose K, Needham-Shropshire B, Jacobs P. Evaluation of a training program for persons with SCI paraplegia using the ParastepS1 ambulation system: Part 4. Effect on physical self-concept and depression. Arch Phys Med Rehabil 1997;78:804-7.

  4. DeHaan CB, Wallander JL. Self-concept, sexual knowledge and attitudes, and parental support in the sexual adjustment of women with early- and late-onset physical disability. Arch Sex Behav 2005;17:145-61.

  5. Koehler ML. Relationship between self-concept and successful rehabilitation. Rehabil Nurs 1989;14:9-12.

  6. Mayer JD, Eisenberg MG. Self-concept and the spinal-cord-injured: an investigation using the Tennessee Self-Concept Scale. J Consult Clin Psychol 1982;50:604-5.


2 READER COMMENTS  [post comment]  [show comments]