Nancy Wilner

impact of Event Scale: A Measure of Subjective Stress

&NA; Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.

Life Event Questionnaires for Measuring Presumptive Stress

&NA; Cumulative stress from the impact of life events has become an important variable in psychosomatic and psychological research. This article provides both short and long life events questionnaires that add to incidence information the remoteness or recency in time of a given experience. In the weight assignment system that leads to a single presumptive stress score, events remote in time have less influence than recent events. The reliability of weight assignment was checked in subject groups that differed by sex, age, and status. Women weighted life events as more stressful than did men; other differences in groups were less important. In spite of the sex differential, review of these data suggests use of the same weight assignments for all subgroups rather than differential weighting by sex and age. Reliability was also checked by test and retest methods in contrast to common sense expectation, a disappointingly low level of reliability was found. The implications for investigative use of life events questionnaires are discussed.

Reactions to the death of a parent. Results from patients and field subjects.

The authors studied two groups of persons who had experienced either the death of a mother or father. One group consisted of patients who had sought treatment because of pathological aspects of bereavement. The other group consisted of volunteers selected from a review of hospital death records, which indicated the recent death of their parent. The study used a nonequivalent groups design, where both groups were followed over time. The field subjects were initially seen much sooner after the death than the patients. The patient group received a time-limited dynamic therapy focused on the stress response syndrome induced by the death. At the pretherapy evaluation point, the patient sample had significantly higher levels of symptomatic distress than did the nonpatient sample. The distress declined over a 13-month period, so that patients had comparable levels of distress to that of the field subjects. After adjusting for initial values, the main difference was that patients reduced their avoidant operations more than did the field subjects. Intervening variables were assessed for the prediction of change in symptoms over time as related to the parental death. The variables that showed significant correlations to symptomatic change were cumulative negative life events from varied sources, occupation, social class, developmental level of the self-concept, identity of the deceased parent, and attribution of blame for the death. Social support did not relate to change in symptoms over time.

Intrusive and Repetitive Thought after a Depressing Film: A Pilot Study

A hypothesis of increased intrusive and repetitive thoughts after any undischarged negative emotional-ideational state was based on previous experiments which involved films which aroused fear and anger and was extended to include a film that arouses sadness. 19 university students saw a film with a separation theme and had levels of intrusions, film references, and negative affect similar to those of subjects who saw films with themes of bodily injury.

Analysis of patient states and state transitions.

Psychiatric diagnoses and formulations have classically focused on the chief complaint of the patient as part of a larger pattern of episodes and reactions. This is a form of state analysis in which the problem states of a person are carefully described and distinguished from other states. The authors suggest methods for deepening such formulations by grounding description of problem states in models of other states and models of state transitions. The resultant method of state analysis can be applied to examination of change processes during treatment as well as to initial diagnostic formulations. As an example of its use and possible extension to quantification, state analysis is applied to description of status and change in a person treated by brief psychotherapy. Because state analysis is based on observable behavior and reportable conscious experiences, it serves as a useful beginning point upon which to anchor more extended inferences about psychodynamics.

Scaling the Stressfulness of Gynecological Complaints

The present study determines the amount of agreement among staff members of a gynecology service in assessing the stressfulness of various gynecological conditions, and the efficacy of these estimates in predicting stress symptomatology among patients. Subjects were 103 patients attending a gynecology clinic during a two month period. We found that the gynecological conditions could be consensually ranked according to stressfulness by staff of the gynecology service but assessments of the magnitude of the stress differed according to the sex and professional affiliation of the rater. Judgments of stressfulness did predict the presence of certain kinds of emotional reactions among the patient group but the correlations were not high enough to warrant prediction for the individual case.