Measuring stress in clinical and nonclinical subjects using a German adaptation of the Perceived Stress Scale

Background/Objective: Stress is perceived differently across individuals, which might be particularly true for nonclinical and clinical subjects. For this reason, we tested a German adaption of the 10-item Perceived Stress Scale (PSS-10) for model fit and measurement invariance in a big nonclinical and clinical sample. Method: We (1) conducted multiple confirmatory factor analysis (CFA) in 1,248 nonclinical subjects and 575 outpatients, (2) measurement invariance with multigroup CFA, (3) assessed correlations with relevant constructs and (4) calculated internal consistencies for overall stress and the subscales Helplessness and Self-efficacy. Results: In both samples, CFA revealed a robust two-factorial structure with an excellent model fit. Group comparisons revealed strict measurement invariance. Correlations with associated measures support validity. Internal consistencies were good to very good. Conclusions: We show highly satisfactory psychometric properties of the German PSS-10 for nonclinical and clinical individuals. Measurement invariance analyses demonstrated that varying stress levels of people with a different mental health status are due to true interindividual differences.     

Perceived stress,life events,dysfunctional attitudes,and depression in adolescent psychiatric inpatients

Hewitt, Flett, and Mosher (1992) examined the factor structure of the Perceived Stress Scale (PSS) and its relation to depression in adult psychiatric patients. This study sought to replicate and extend their findings, using a sample of 203 adolescent psychiatric inpatients. All patients admitted to the adolescent unit in a psychiatric hospital over a 3-year period were administered the PSS, as well as measures of depression, life events, dysfunctional attitudes, and intellectual abilities. Consistent with Hewittet al., two factors were found in the PSS, reflecting perceived distress and perceived coping ability. Regression analyses indicated that, for males, both factors account for independent variance in depression, whereas for females, only the distress factor is related to depression. In addition, for both male and female, dysfunctional attitudes account for significant variance in depression in addition to PSS, but negative life events do not. None of the variables were related to intellectual abilities. Implications for clinical assessment and intervention are discussed.     

Factor structure of the Perceived Stress Scale (PSS) in a sample from Mexico

The aim of this study was to analyze the cultural adaptation of the European Spanish version of the Perceived Stress Scale (PSS; Cohen, Kamarak, & Mermelstein, 1983), for its use in Mexican samples. Using a random sample of students, internal consistency was analyzed and the factor structure of the Spanish version of the PSS was compared with the factor structure found in the English version. Internal consistency was adequate (alpha = .83) and confirmatory factor analysis corroborated the factor structure. Factor 1 explained 42.8% of the variance and Factor 2 accounted for 53.2%. The goodness-of-fit measures also revealed an adequate fit. The cultural adaptation of the PSS was also evaluated with satisfactory results.     

Perceived Stress in Young Carers: Development of a Measure

We report the development of a 5-factor, 31-item, Young Carers Perceived Stress Scale (YCPSS) from an initial 50-item pool. The scale was developed and tested on 108 young carers aged between 12–18 years, and acceptable Cronbach Alpha values were obtained for the individual factors and the overall scale. In addition, both the overall scale and individual factors produced a pattern of correlations with social support, burden of care, psychological distress, and coping, supporting the initial validity and utility of the scale.     

Perceived social support,coping, and symptoms of distress in American and Spanish students

Abstract

The aim of this study was to test whether coping responses mediated the influence of perceived social support on symptoms of anxiety/depression, social withdrawal, and aggressive behavior in American (N=349) and Spanish students (N=437). Participants completed measures of perceived support, social stress, coping, and distress. Coping partially mediated relations between perceived support and distress, with coping mediation most evident in individuals facing high levels of social stress. Decreased use of disengagement coping by individuals with high perceived support appears to partially explain the protective value of perceived social support. Multiple group covariance structure analysis showed that models linking perceived support, coping, and distress were very similar across cultures, suggesting that the mechanisms underlying decreased risk for individuals with high perceived support may be relatively independent of cultural context, and that interventions designed to increase perceived support and decrease disengagement could be appropriate in both cultures.     

Dimensionality of stress experiences: Factorial structure of the Perceived Stress Questionnaire (PSQ) in a population‐based Swedish sample

We investigated the factorial structure of the Perceived Stress Questionnaire (PSQ‐recent; Levenstein, Prantera, Varvo et al., 1993) in a large (N = 1516; 35–95 years) population‐based Swedish sample (Nilsson, Adolfsson, Bäckman et al., 2004; Nilsson, Bäckman, Erngrund et al., 1997). Exploratory principal components analysis (PCA) was conducted on a first, randomly drawn subsample (n = 506). Next, the model based on the PCA was tested in a second sample (n = 505). Finally, a third sample (n = 505) was used to cross‐validate the model. Five components were extracted in the PCA (eigenvalue > 1) and labeled “Demands,” “Worries/Tension,” “Lack of joy,” “Conflict,” and “Fatigue,” respectively. Twenty‐one out of the 30 original PSQ items were retained in a confirmatory factor analysis (CFA) model that included the five (first‐order) factors and, additionally, a general (second‐order) stress factor, not considered in prior models. The model showed reasonable goodness of fit [χ²(184) = 511.2, p < 0.001; CFI = 0.904; RMSEA = 0.059; and SRMR = 0.063]. Multigroup confirmatory factor analyses supported the validity of the established model. The results are discussed in relation to prior investigations of the factorial structure of the PSQ.     

Dimensions of perceived control: A factor analysis of three measures and an examination of their relation to activity level and mood in a student and cross-cultural patient sample

Abstract

This study investigated whether measures of three perceived control (PC) concepts tapped independent dimensions, were invariant to population characteristics of health and culture, were differentially sensitive to health outcomes, and were discriminable from self-report disability. The Multidimensional Health Locus of Control, Generalized Self-efficacy, and Perceived Health Competence (PHC) Scales were administered to 106 Scottish students and 145 Scottish, Spanish and Irish patients, who also completed versions of the Sickness Impact Profile. Principal Components analyses revealed five factors reflecting scale constructions for students and six factors for patients, as PHC items fell on two factors. Disability items fell on a separate factor from all PC items. Results suggest: (a) PC is multidimensional regardless of health and culture; (b) adequate assessment requires multiple PC measures; and (c) it is meaningful to consider PC as a possible influence on disability.     

Stress reactivity and coping in seasonal and nonseasonal depression

Stress, stress reactivity, and coping skill use were examined in individuals with seasonal depression, nonseasonal depression, and nondepressed controls. Although participants in the two depressed groups reported using more avoidance coping strategies than controls, only participants in the seasonal depressed group reported using more season-specific coping (i.e., light-related strategies) than participants in the nonseasonal depressed and control groups. Individuals in the seasonal depressed group also reporting using acceptance coping strategies less frequently than individuals in the control group. Only participants in the nonseasonal depressed group, however, exhibited greater psychophysiological arousal in reaction to a laboratory stressor (i.e., unsolvable anagram task) when compared to participants in the seasonal and nondepressed control groups. Participants in both depressed groups reported greater impact of negative life events during the past 6 months than did controls. Similarities and differences in the two types of depression may have implications for the conceptualization and treatment of seasonal depression.     

Coping and emotional distress in a sample of Swedish unemployed.

The study investigated the associations between coping and symptoms of emotional distress within a sample of 166 unemployed men and women (mean age 40 +/- 10 years, range 22 to 63 years, 52% males). All variables were measured with a questionnaire comprising sociodemographic background, length of unemployment, financial strain, coping style ("Ways of Coping Checklist"), and emotional distress (Hopkins Symptom Check List-25). Emotional distress was positively related to financial strain and more common among younger subjects, divorced subjects and those with foreign background, but less frequent among subjects who had been unemployed for more than three years. After controlling for age, gender, education, foreign background, length of unemployment and financial strain, hierarchical regression analyses showed that emotion-focused coping, i.e. self-blame and wishful thinking, was positively related to emotional distress. Problem-focused coping and cognitive restructuring were negatively associated with emotional distress. Younger subjects and divorced subjects made frequent use of both emotion-focused and problem-focused coping. Female subject and subjects with mandatory school made frequent use of emotion focused coping, if exposed to high financial strain. Problem-focused coping was less frequent among subjects with a low education coupled with low financial strain. Cognitive restructuring was less common among subjects who had been unemployed for more than three years. Younger subjects who were also divorced made less use of both problem-focused coping and cognitive restructuring. The results confirm that coping style has importance for the mental health of the unemployed, and indicate a differential use of coping strategies among subjects with different sociodemographic backgrounds and different levels of financial strain.     

Moderating Effects of Religious/Spiritual Coping in the Relation Between Perceived Stress and Psychological Well-Being

Although the relationship between stress and depressive symptoms is well documented, less is known about the role of coping strategies, in particular strategies for coping via religious or spiritual means. To investigate the relationships among these factors, data was collected with questionnaires completed by 127 MSW students at a northeastern university in 2003. Significant Stress×Religious/Spiritual Coping buffer interactions were found in the relationship between stress and depression. EQS 6.1 and hierarchical moderated regression analysis showed that religious/spiritual coping reduced the impact of stress on depression. Implications for practice are discussed.     

Perceived threat and depression among patients with cancer: the moderating role of health locus of control

Illness perception was found to be a better predictor of psychological outcome among cancer patients than the objective characteristics of illness. The current study explored the association between the perceived threat of illness (a major aspect of illness perception) and depression among cancer patients. We examined the hypothesis that this association will be higher for persons with low External (others) or internal (self) Health Locus of Control (HLC) than for those with high HLC. The study took an exploratory approach regarding the role that different sources of control (external and internal) may assume. Fifty-seven cancer patients completed self-report measures of Perceived Life Threat (PLT), HLC and Depression. The possible moderating role of HLC on the relationship between PLT and Depression was examined. A significant relationship between perceived threat and depression was found only among participants reporting low levels of internal locus of control. The results support the hypothesis that perception of cancer as life threatening is important factor in determining the level of depression among cancer patients. The results also support the differentiation between internal and external HLC and suggest that internal HLC may be more relevant than external HLC in managing perceived threat. Internal locus of control can be interpreted as having a sense of agency and mastery which is important in managing the cognitive perception of the threat of illness. Further research is needed in order to determine the role of external HLC in managing perceived or actual threats.     

留守儿童生活压力与孤独感、幸福感的关系:心理资本的中介与调节作用

采用问卷法对971名农村儿童进行入户调查,以考察生活压力与留守/非留守儿童孤独感、幸福感的关系以及心理资本在此关系中的作用。结果显示:与非留守儿童相比,留守儿童的生活压力与孤独感较高,心理资本与幸福感较低;生活压力对留守/非留守儿童的孤独感有正向预测性、幸福感有负向预测性,心理资本对此起部分中介作用,且在两群体中的中介过程一致;心理资本仅能有效缓冲生活压力对留守儿童孤独感、幸福感的不利影响。     

Perceived utility of emotion: the structure and construct validity of the Perceived Affect Utility Scale in a cross-ethnic sample

This study introduces a new measure of the perceived utility of emotion, which is the degree to which emotions are perceived to be useful in achieving goals. In this study, we administered this new measure, the Perceived Affect Utility Scale (PAUSe), to a sample of 142 European American and 156 East Asian American college students. Confirmatory factor analyses provided support for a new, culturally informed parsing of emotion and for perceived utility of emotion to be distinguishable from ideal affect, a related but separate construct. Next, we explored the potential importance of perceived utility of emotion in cultural research. Through path analyses, we found that: (a) culturally relevant variables (e.g., independence) played a mediating role in the link between ethnic group and perceived utility of emotion; and (b) perceived utility of emotion played a mediating role in the link between culturally relevant variables and ideal affect. In particular, perceived utility of self-centered emotions (e.g., pride) was found to be associated with independence and ideal affect of those same emotions. In contrast, perceived utility of other-centered emotions (e.g., appreciation) was found to be associated with interdependence, dutifulness/self-discipline, and ideal affect of those same emotions. Implications for perceived utility of emotion in understanding cultural factors are discussed.     

The structure of the Hospital Anxiety and Depression Scale: Theoretical and methodological considerations

The Hospital Anxiety and Depression Scale (HADS; Zigmond - Snaith, 1983) is widely used; however, its factor structure is unclear, with studies reporting differing unidimensional, two-factor and three-factor models. We aimed to address some key theoretical and methodological issues contributing to inconsistencies in HADS structures across samples. We reviewed existing HADS models and compared their fit using confirmatory factor analysis (CFA). We also investigated methodological effects by comparing factor structures derived from Rasch and Principal Components Analysis (PCA) methods, as well as effects of a negative wording factor. An Australian community-dwelling sample consisting of 189 females and 158 males aged 17–86 (M = 35.73, SD = 17.41) completed the 14-item HADS. The Rasch Analysis, PCA and CFA all supported the original two-factor structure. Although some three-factor models had good fit, they had unacceptable reliability. In the CFA, a hierarchical bifactor model with a general distress factor and uncorrelated depression and anxiety subscales produced the best fit, but the general factor was not unidimensional. The addition of a negative wording factor improved model fit. These findings highlight the effects of differing methodologies in producing inconsistent HADS factor structures across studies. Further replication of model fit across samples and refinement of the HADS items is warranted.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

The Dark Night of the Soul: spiritual distress and its psychiatric implications

The Dark Night of the Soul is an expression describing phases in a person's spiritual life associated with a crisis of faith or spiritual concerns about the relationship with God, and which has intrinsic aspects of spiritual growth. This paper is concerned with the way in which those going through periods of angst and disillusionment do not see them as pathological phenomena. On the contrary, through a process of attribution of religious meaning they view them as opportunities for reflecting on their lives and as agents for beneficial change. Similarities and differences between the Dark Night and a depressive episode are discussed and illustrated using the accounts of five important religious figures. Their narratives have been constructed using original texts and their biographies. The Dark Night has clinical implications owing to the risk of its being pathologised, serving as a reminder of the importance of incorporating existential issues into clinical practice.     

The Anxiety Sensitivity Index for Children: factor structure and relation to panic symptoms in an adolescent sample

This study examines the factor structure underlying the Anxiety Sensitivity Index for Children (ASIC. J Anxiety Disord, 12 (1998) 307) in an adolescent sample. Three-hundred-and-eight adolescents, aged 12 to 18, completed the ASIC and measures of anxiety and depression. Factor analysis of the ASIC items resulted in a two-factor structure that is similar to that reported by Laurent et al. These two factors included a physical concerns dimension and a mental concerns dimension similar to those found in studies of adult anxiety sensitivity. Subscales measuring these two factors demonstrated concurrent validity, showing particularly close associations with measures of panic symptoms. In addition, both of these subscales showed incremental validity in predicting panic symptoms after controlling for the other anxiety sensitivity subscale and a measure of depression. These results provide evidence that the anxiety sensitivity construct is applicable during adolescence and support the use of the ASIC.     

压力对大学生抑郁的影响机制:领悟社会支持与应对方式的中介作用

基于心理应激理论、素质-压力三模式以及社会支持主效果模型考察领悟社会支持、积极应对方式和消极应对方式在压力与抑郁关系中的链式中介效应,使用压力量表、领悟社会支持量表、应对方式量表和抑郁量表对抽取的641名大学生进行调查。研究显示:(1)领悟社会支持中介了压力对大学生抑郁的影响;(2)积极应对方式、消极应对方式中介了领悟社会支持对大学生抑郁的影响。因此,领悟社会支持以及应对方式在压力与大学生抑郁之间起链式中介作用。