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Updated: Jul 5, 2026

The Social Dimension of Stress: Experimental Manipulations of Social Support and Social Identity in the Trier Social Stress Test
Published on: November 19, 2015
Measurement and interpretation of social distress using the social difficulties inventory (SDI)
Penny Wright1, Laura Marshall, Adam B Smith
1Psychosocial and Clinical Practice Research Group, Cancer Research UK Clinical Centre, Section of Oncology and Clinical Research, University of Leeds, St James's University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom. e.p.wright@leeds.ac.uk
Unlabelled:
Cancer has a significant social impact. There is a requirement to undertake formal assessment of this in research and clinical practice.
Aim:
To establish values of clinically meaningful differences and changes in social distress (SOCD) using the social difficulties inventory (SDI).
Methods:
Newly diagnosed patients treated with curative intent completed the SDI and the EORTC quality of life questionnaire (EORTC QLQ-C30) at baseline, 6, 12 and 24 months. Minimally important differences (MIDs) were estimated using anchor and distribution methods.
Results:
One hundred and eighty-eight patients participated. SOCD was elevated at baseline demonstrating the social burden of cancer on patients following diagnosis. Anchor estimates for MIDs were by age groups 3.37 and in comparison to EORTC QLQ-C30 social functioning scale from 0 to 6.27. Using distribution methods: SEM 2.01-4.92 and SD 1.67-3.57.
Conclusion:
For general guidance, an estimate of 3 (range 0-44) is recommended as a clinically important difference, illustrated by case studies and group comparisons.
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