Donald Byrne

Measuring social relationships The Interview Schedule for Social Interaction

It is generally recognized that social relationships occupy a central position in psychiatry. To examine the role of social relationships in the onset of minor psychiatric morbidity it is necessary to construct an instrument which will meet the need for a valid, reliable and comprehensive index of social relationships. Such an instrument has now been developed and used in a sample of the general population. The Interview Schedule for Social Interaction arose from a research need, and was constructed to assess the availability and perceived adequacy for any individual of a number of facets of social relationships. These consist both of persons and of the provisions obtained through them. Data from a general population sample suggest this instrument to be sufficiently valid and reliable, and also sensitive to predictable variations between sociodemographic groups, to justify its use in clinical and epidemiological studies, both in psychiatry and general medicine.

Psychiatric disorder in Canberra. A standardised study of prevalence.

A standardised survey of prevalence has been carried out in a general population. The epidemiological method employed is innovative in its use of two established instruments, the GHQ and the PSE, harnessed together in a two‐phase design. 756 persons were interviewed, giving a response rate of 85 % in phase 1. 157 were then interviewed with the PSE in phase 2 within a few days, giving a response rate of 92 % in this weighted subsample.

Personality, stress and the decision to commence cigarette smoking in adolescence

Adolescent cigarette smoking is an increasing health risk behaviour in many societies. The reasons why adolescents commence smoking are patently complex, though it has been suggested that young people take up this behaviour as a means of stress reduction during the difficult and challenging time of adolescence. This paper reports data which suggests that adolescent stress, broadly defined, does indeed relate to the decision to commence smoking by young people. Moreover, though the personality attribute of neuroticism is independently associated with this decision, it does not mediate the association between stress and smoking onset. The implications of these data for adolescent smoking prevention programs are discussed.

Life events and myocardial infarction revisited: the role of measures of individual impact.

&NA; This study was conducted to test the hypothesis that patients with MI are distinguished from persons with a less serious illness, more by subjective interpretations of the emotional impact of life events than by exposure to a surfeit of life events that purportedly representative samples of the population have judged to be inherently stressful. Life events data consisting of frequency of events in the year prior to illness onset, cumulative weights of life change and distress derived from magnitude estimation scales, and visual analogue scales assessing the individually interpreted impact of events were collected for 120 patients with unequivocal MI, and contrasted with the same data collected for 40 patients admitted to coronary care but rapidly discharged without a diagnosis of MI or other serious illness. Differences between the two groups were not evident for life event frequency, magnitude estimation scales of life change and distress, or individual impact scales of life change. Individual impact scales of emotional distress did, however, distinguish between the two groups at a statistically significant level, suggesting that patients with MI have interpreted their life event exposure in the year prior to illness onset as being particularly emotionally distressing. While there may be methodological criticism of the research strategy used in the study, it is suggested that due regard for the experiential uniqueness of life event data has strengthened the relationship between life events and MI, which would not have become apparent with the application of a more conservative research strategy.

Adolescent stress: Evaluation of the factor structure of the Adolescent Stress Questionnaire (ASQ-N)

The present study reports an evaluation of the factor structure of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N) among 723 students. Principal components analysis (PCA) revealed nine internally consistent dimensions of adolescent stress. Scales constructed from this PCA correlated positively with measures of depression and anxiety and negatively with self-esteem. Girls reported higher stress levels than boys in seven of the nine scales and age was also positively correlated with the scale scores of adolescent stress. The results revealed that the instrument has potential for measuring adolescent stress. The stability of the ASQ-N needs to be tested repeatedly, across cohorts and over time, to establish the adequacy for use in Norwegian adolescent studies.

Adolescent stress and future smoking behaviour: a prospective investigation.

OBJECTIVE Adolescent stress has been retrospectively associated with various measures of smoking behaviour in school-aged samples. The present study sought to extend this to a prospective investigation in order to examine the possibly formative influences of stress on the onset of smoking in adolescents. METHOD A 12-month follow-up study related sources and degree of adolescent stress measured at study commencement with the onset of smoking behaviour 12 months later in a large cohort of adolescents attending Australian secondary schools. RESULTS Adolescent stress was only weakly related to smoking onset in adolescent males and even this could possibly be explained by other factors. In adolescent girls, however, prospective associations were stronger and more broadly represented across the various domains of adolescent stress, suggesting that stress may exert a formative influence on smoking onset for girls. CONCLUSION Management strategies for adolescent stress may be an affective target for smoking prevention programs among adolescent girls.

Sources of adolescent stress, smoking and the use of other drugs

Stress is an established correlate of smoking behaviour in regular adult smokers and has been related to the use of alcohol and other drugs as well. Empirical data supporting these assertions are entirely consistent with theoretical conceptions of both smoking and other substance use behaviours. Despite both supportive theory and empirical evidence with adults, however, little work has been done to extend such views to adolescent smoking and the use of other substances, where the evolution of these health risk behaviours is still plastic and potentially amenable to intervention. The present study reports associations between sources of adolescent stress assessed by an instrument purposely constructed for that exercise and both smoking behaviour and the use of alcohol and other substances. Some sources of stress in the self-reported experience of adolescents statistically related both to current smoking and to the use of alcohol and other drugs. Associations were generally stronger for smoking than for other substances and both stronger and broader for girls than for boys. Stress arising from compulsory school attendance was broadly associated with substance use for both boys and girls and this was in line with past evidence; for girls, however, associations extended to stressors arising from other sources and particularly those to do with the family. The theoretical bases for these findings are discussed in the context of the stress reduction properties of smoking and other substance use, and the implications for intervention through targeted stress management are raised. Copyright

Investigating adolescent stress and body image.

Adolescent stress is clearly implicated in the development of mental health problems. However, its role in dysfunctional body image, which rises markedly in adolescence, has not been investigated. The present study examined the link between stress and body image, as well as self-esteem and depressive symptoms, in 533 high school students in grades 7 to 10. Results indicated that stress accounts for a sizeable proportion of variance in body image, and the best exploratory model included stress, self-esteem, and gender. Further, specific domains of stressors related to body image differently: peer pressure and school attendance were significant correlates of body image in both genders, while future uncertainty and romantic relationships were significant for males alone. Grade differences in primary variables were also evident for females. This study helps to elucidate the role of adolescent stress in dysfunctional body image and provides insight for future prevention and intervention programs in schools.

Dimensions of illness behaviour in survivors of myocardial infarction

Abstract Psychological responses to illness of 120 survivors of myocardial infarction were examined using the Illness Behaviour Questionnaire (IBQ). All patients were seen in general hospital medical wards, 10–14 days after admission to hospital. Principal components analysis of the data with varimax rotation yielded 8 clinically meaningful factors accounting for 61.5% of the variance. These were interpreted as somatic concern, psychosocial precipitants, affective disruption, affective inhibition, illness recognition, subjective tension, sick role acceptance and trust in the doctor. These factors are consistent with common preconceptions of the experience of myocardial infarction and are similar, in part, to responses after myocardial infarction reported in a small number of previous studies. They are, however, only marginally similar to patterns of illness behaviour reported for other illnesses, which suggests that the nature of myocardial infarction imparts a unique quality to illness behaviour developed after it. The significance of these factors was discussed in terms of the contributions they might make to the more effective structuring of psychotherapeutic components of rehabilitation and secondary prevention following myocardial infarction.

The Concept of Stress

Any notion or concept of stress should fulfil the following requirements. First, the definition should be readily communicable both to professionals and the community at large. Second, the concept should be readily converted into constructs which are suitable for research. In this latter regard it is easier to present and discuss a stress model. This model differentiates a number of factors which, although interdependent, are conceptually distinct. By adequately discriminating between these factors, operational criteria may be defined and a systematic assessment of the effects of stress will be facilitated. A model is thus presented which describes the stress process.