Dimensions of life stress in psychiatric patients

A combined checklist and interview methodology was developed to assess the occurrence of life events among psychiatric patients. In addition to identifying events, patients were asked to rate them on 11 dimensions assumed to be important in mediating the impact of life stress. A factor analysis of ratings of 479 events from 64 patients, yielded three factors, reflecting the desirability of events, perceived control over their occurrence, and the readjustment required by events. However, ratings of social support available for help in coping with events and prior experience with similar events did not load on any of these factors. These dimensions should be treated as separate and potentially important influences. Three judges, blind to the patients' ratings, also made "normative" judgements of a subset of 154 events on the dimensions of desirability, control, and readjustment. Agreement among judges and between judges and patients was high with regard to desirability and control but low when rating readjustment. Judges tended to overestimate the amount of readjustment as described by patients.