A Global Measure of Perceived Stress

Author(s): Sheldon Cohen, Tom Kamarck and Robin Mermelstein

Reviewed work(s):
Source: Journal of Health and Social Behavior, Vol. 24, No. 4 (Dec., 1983), pp. 385-396
Published by: American Sociological Association
Stable URL: http://www.jstor.org/stable/2136404 .
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GLOBAL

MEASURE

OF PERCEIVED

385

STRESS

Richardson,
Jean,andJulieSolis
Wiggins,
Jerry
S.
1982 "Place ofdeathofHispaniccancerpatients 1973 Personality
and Prediction:Principlesof
in Los Angeles County." Unpublished
PersonalityAssessment.Reading, MA:
manuscript.
Addison-Wesley
Publishing
Co.
Stoddard,Sandol
WilderFoundation
1978 The HospiceMovement.Briarcliff
Manor,
1981 CarefortheDying:A StudyoftheNeedfor
New York:Steinand Publishers.
Hospicein RamseyCounty,Minnesota.A
Valle, R., and L. Mendoza
reportto the Northwest
Area Foundation
1978 The Elder Latino. San Diego, CA: Camfromthe AmherstH. WilderFoundation,
panilePress.
355 Washington
St., St. Paul, MN.

A GlobalMeasureofPerceivedStress
SHELDON

COHEN

Carnegie-Mellon University

TOM KAMARCK
Universityof Oregon

ROBIN MERMELSTEIN
Universityof Oregon

of Healthand Social Behavior1983,Vol. 24 (December):385-396

Journal
This paper presents evidencefrom threesamples, two of college studentsand one of participants in a communitysmoking-cessationprogram,for the reliabilityand validityof a 14-item
instrument,the Perceived Stress Scale (PSS), designed to measure the degree to which
situationsin one's lifeare appraised as stressful.The PSS showed adequate reliabilityand, as
predicted, was correlated with life-eventscores, depressive and physical symptomatology,
maintenance.In all comutilizationof health services, social anxiety,and smoking-reduction
scores.
parisons, thePSS was a betterpredictorof theoutcome in question thanwerelife-event
When compared to a depressive symptomatologyscale, the PSS was found to measure a
predictiveconstruct. Additionaldata indicateadequate reliability
different
and independently
and validityof a four-itemversionof thePSS for telephoneinterviews.The PSS is suggestedfor
examiningthe role of nonspecificappraised stress in the etiologyof disease and behavioral
disordersand as an outcome measure of experiencedlevels of stress.

It is a common assumption among health -byone's perceptionsof theirstressfulness,

researchers that the impact of "objectively" e.g., see Lazarus (1966, 1977). Surprisingly,
stressfulevents is, to some degree,determined thistheoretical
perspectivehas not been acResearchreported
inthispaperwas supported
by
grantsfromtheNationalScienceFoundation
(BNS
7923453)and the Heart,Lung and Blood Institute
(HL 29547).The authorsare indebtedto Edward
Lichtenstein
and KarenMcIntyrefortheircollaborationon thesmoking
cessationproject;thestaff
of
of Oregondormitory
University
housingfortheir
insecuring
cooperation
Student
SampleI; PamBirell
forhercooperation
inobtaining
classparticipants
for
EdSampleII; and to Susan Fiske,Lew Goldberg,
ward Lichtenstein,Karen Matthews,Michael
Scheier,and Tom Wills forcommentson earlier
draftsof thismanuscript.
Addresscommunications
to: SheldonCohen,Deof Psychology,
partment
Carnegie-Mellon
UniverPA 15206.
sity,Pittsburgh,

of psychometricompaniedby development
callyvalidmeasuresof perceivedstress.This
of objective
articlediscussesthe limitations
and subjectivemeasuresof stressused in the
assessmentof bothglobaland event-specific
stresslevels.It arguesthata psychometrically
soundglobalmeasureofperceivedstresscould
providevaluableadditionalinformation
about
therelationship
betweenstressandpathology.
Data are presentedon the psychometric
ofthePerceivedStressScale (PSS),
properties
an instrument
developedin responseto these
issues.The PSS measuresthedegreeto which
situations in one's life are appraised as
stressful.

386

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

mediatedemotional
Researchon the role of psychosocialand "event"is thecognitively
as riskfactorsin both responseto theobjectiveevent,nottheobjecstressors
environmental
illnesshastypically tiveeventitself(Lazarus,1977;Mason,1971).
physicalandpsychological
partof thisviewis thatthisreemployedrelativelyobjectivestressormea- An important
or
sures.Thisworkincludesstudiesoftheeffects sponseis notbased solelyon theintensity
qualityof the event,but
of specificstressfulevents,such as unem- any otherinherent
on personalandcontextual
is dependent
(Cobb and Kasl, 1977;Dooley and rather
ployment
Catalano, 1980; Gore, 1978), bereavement factorsas well.
of thecognitiveap(Stroebeet al., 1982),and exposureto intense The assumedcentrality
of
levels of noise (Cohen and Weinstein,1981) praisal process suggeststhe desirability
perceivedstressas opposedor in
and high levels of population density measuring
(Sundstrom,1978). In addition,thereis an additionto objective stress. For example,
validitiesof obof comparisonof thepredictive
effect
on thecumulative
literature
abundant
objectivestressfullife events (Dohrenwend jectiveand subjectivemeasurescouldhelpto
theroleof theappraisalprocessin the
1974,1981).In thesestudies, clarify
andDohrenwend,
scales (original relationship
betweenobjectivestressorsand
variousversionsof life-event
scale developedby Holmesand Rahe, 1967) illness.Perceivedstressscales could also be
withobjectivescalesinan
stressscore. usedinconjunction
are usedto producea cumulative
whetherfactorssuch as
These scoresare usuallybased on eitherthe effortto determine
the social support(Pearlinet al., 1981),hardiness
ofeventsthathaveoccurredwithin
number
(in mostcases, (Kobasa, 1979),and locusofcontrol(Johnson
specifiedtemporalframework
sixto 12months)or on a sumofeventweights and Sarason, 1979)protectpeople fromthe
effects
eventsbyalterof stressful
thatare based on judges' ratingsof thediffi- pathogenic
theprocess
appraisalorbyaltering
ingstressor
cultyof adjustingto theseevents.
toobjective or processesbywhichappraisedstressresults
Therearesomeclearadvantages
(Gore,
disorders
or behavioral
events.First,suchmea- inphysiological
measuresof stressful
surespermitan estimateof theincreasedrisk 1981).Finally,perceivedstresscan be viewed
theexperifordisease associatedwiththeoccurrenceof as an outcomevariable-measuring
ofobjective
events. Second, the mea- encedlevelofstressas a function
easily identifiable
events,copingprocesses,personality
surement
procedureis oftensimple,e.g., did stressful
thiseventoccurduringthe last six months?, factors,etc.
a
Previousworkhas employeda numberof
and in manycases, personsexperiencing
withoutthe approachesto assess bothglobaland eventeventcan be identified
particular
necessityofaskingthemabouttheoccurrence specificlevelsof perceivedstress.For examof the event,e.g., personslivingin noise- ple, severalinvestigators
have modifiedlifeThird,thesemeasure- eventscales in an attemptto measureglobal
impactedcommunities.
involved
thechanceof vari- perceivedstress.The modification
menttechniquesminimize
or
to ratethestressfulness
and askingrespondents
ous subjectivebiases in the perceptions
event.In general,
impactof each experienced
of events.
reporting
ofevent
scoresbasedon self-ratings
On theotherhand,theuse ofobjectivemea- life-stress
of healthare betterpredictors
suresofstressimpliesthateventsare,inandof stressfulness
cause of pathol- relatedoutcomesthanare scoresderivedfrom
theprecipitating
themselves,
is either a simple countingof events (unitogy and illnessbehavior.This implication
counterto theviewthatpersonsactivelyinter- weighting)or normativeadjustmentratings
poten- (Sarason et al., 1978; Vinokurand Selzer,
appraising
act withtheirenvironments,
eventsin the 1975).However,theincreasesinpredictability
or challenging
tiallythreatening
lightof availablecopingresources(Lazarus, providedby these ratingsare small. It is
thatanyincreasein predictability
1966, 1977). From this latterperspective, noteworthy
eventscoreovera simplecount
stressoreffectsare assumed to occur only ofa weighted
whenboth (a) the situationis appraisedas ofeventsis likelyto be smallsincealternative
schemesyieldcompositescoresthat
and(b) in- weighting
or otherwise
demanding
threatening
correlatedwith the event
sufficient
resourcesare availableto cope with are substantially
is thatthecausal count(Lei and Skinner,1980).In short,calThe argument
thesituation.

A GLOBAL

MEASURE

OF PERCEIVED

STRESS

387

culatingglobalperceivedstresslevelson the icalscalethatcanbe administered

inonlya few
basisofreactionsto individual
eventsassumes minutes
andis easyto score.Becauselevelsof
thatperceivedstresslevelsareveryhighly
cor- appraisedstressshouldbe influenced
bydaily
relatedwiththe numberof reportedevents. hassles,majorevents,and changesin coping
Otherweaknessesof global perceivedstress resources,thepredictive
validity
ofthePSS is
scalesthatarebasedon a specificlistofevents expectedto falloffrapidlyafterfourto eight
includean insensitivity
to chronicstressfrom weeks.
to stress from
ongoinglife circumstances,
Evidence is presented from three
in the lives of close friends samples-twoofcollegestudents
eventsoccurring
andone ofa
and family,fromexpectations
concerning
fu- more heterogeneouscommunity
group-for
tureevents,and fromeventsnotlistedon the theconcurrent
andpredictive
validities
andthe
scale.
internal
and test-retest
reliabilities
of thenew
Subjectivemeasuresofresponseto specific scale. The paper also examinesthe relative
stressorshave also been widelyused, e.g., predictivevalidityof the PSS and two lifemeasures of perceivedoccupationalstress eventinstruments.
Ourpremiseis thatthePSS
(Kahnet al., 1964).Thereare,however,some shouldprovidea betterpredictor
ofhealthoutpracticaland,theoreticallimitations
of mea- comesthandoes a globalmeasureofobjective
itis dif- stressors,
suresofspecificstressors.
suchas life-event
Practically,
scales.Thisshould
ficultand time-consuming
to adequatelyde- occur because a perceivedstressinstrument
velop and psychometrically
validatean indi- providesa moredirectmeasureofthelevelof
vidualmeasureeverytimea new stressoris stressexperienced
bytherespondent.
Presumstudied.Theoretically,
thereis an issue of ably,itis thislevelofappraisedstress,notthe
whethermeasuresof perceivedresponseto a objectiveoccurrence
oftheevents,thatdeterspecificstressor
reallyassess a person'sevalu- minesone's responseto a stressor(s)
(Lazarus,
ationsof thatstressor.Thereis, in fact,evi- 1966,1977).Also, the new measureis more
dence that people oftenmisattribute
their globalthanlife-event
scales. Thatis, it is sensourcewhen sitiveto chronicstressderiving
feelingsof stressto a particular
fromongoing
thatstressis actuallydue to anothersource lifecircumstances,
to stressfromexpectations
(Gochman, 1979; Keating, 1979; Worchel, concerning
future
events,tostressfromevents
1978; Worcheland Teddlie, 1976). Another notlistedon a particular
life-events
scale,and
problemwithmeasuresofresponseto specific to reactionsto thespecificeventsincludedon
stressors
is thatsuchmeasuresimplytheinde- any scale.
of
pendenceof thateventin theprecipitation
disease. However,it is likelythattheillness
processis affected
by a person'sglobalstress METHODS
level,notjust byhis/her
responseto a particuValidationdatawerecollectedinthreesamlar event.
- twoconsisting
of collegestudents
ples
and
The above discussion indicates the deone
of
a
more
consisting
heterogeneous
group
of developing
to meaan instrument
sirability
The
program.
sure a globallevel of perceivedstress.This enrolledin a smoking-cessation
and
samples
assessment
deprocedures
are
articlepresentsdata on the PerceivedStress
scribed
below.
Scale, a 14-itemmeasureof the degreeto
in one's lifeare appraisedas
whichsituations
stressful.
PSS itemsweredesignedto tap the Perceived Stress Scale (PSS)
foundtheirlives
degreeto whichrespondents
and overload- The 14 itemsof the PSS are presentedin
unpredictable,
uncontrollable,
ing.These threeissues have been repeatedly AppendixA. PSS scoresare obtainedby reoftheexperi- versing
foundto be centralcomponents
thescoreson thesevenpositiveitems,
ence of stress(Averill,1973; Cohen, 1978; e.g., 0=4, 1=3, 2=2, etc., and thensumming
Glass and Singer,1972;Lazarus, 1966,1977; acrossall 14 items.Items4, 5, 6, 7, 9, 10,and
Seligman,1975). The scale also includesa 13 are thepositively
stateditems.
numberof directqueriesaboutcurrent
levels
The PSS was designedforuse withcommuofexperienced
stress.The PSS is an econom- nitysampleswithat leasta juniorhighschool

388

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

education.The itemsare easy to understand thathad occurredon a scale ranging

from-3
posiand the responsealternatives
are simpleto (extremely
negative)to +3 (extremely
grasp.Moreover,as notedabove, the ques- tive),theformat
usedby Sarasonet al. (1978).
tionsare quite generalin natureand hence Separatescoresweregenerated
based on selfrelatively
freeof contentspecificto any sub- ratedimpactand unweighted
events.The unpopulationgroup.
weightedscore was the totalnumberof life
The data reportedin thisarticleare from eventschecked.The score based on impact
somewhatrestricted
samples,in thattheyare ratingswas the summedimpactof checked
younger,more educated,and containfewer events.Theimpactscoreis nota puremeasure
minority
members
thanthegeneralpopulation. of the occurrenceof objectiveevents,but
perIn lightof thegenerality
of scale contentand rather
takesintoaccounttherespondents'
of languageand responsealterna- ceptionsof theevents.
simplicity
StudiesDetives,we feel thatdata fromrepresentative The CenterforEpidemiologic
samplesof the generalpopulationwouldnot pressionScale (CES-D) was employedas a
below. measureof current
differ
fromthosereported
level of depressivesympsignificantly
tomatology(Radloff,1977). Twentyitems,
or not
a statecharacteristic
each representing
College Student Sample I
ofa depressedperson,are rated
characteristic
scale to indicatethefrequency
on a four-point
The respondents
were 332 (121 male, 209 of theiroccurrenceduringthelast week. Refemale,two withsex not specified)freshman sponseoptionsrangefrom"rarelyor noneof
at the thetime"to "mostor all of thetime."
college studentslivingin dormitories
of Oregon.The mean age of the
was measuredby
University
Physicalsymptomatology
deviationof the Cohen-Hoberman
Inventoryof Physical
samplewas 19.01witha standard
2.75. All respondentsgave writtenconsent Symptoms
(CHIPS). The CHIPS is a listof39
allowingaccess to theirstudenthealthcenter common physical symptoms(Cohen and
records.
Hoberman, 1983). Items were carefully
ofan obviously
Measures. Respondentscompleted five selectedto excludesymptoms
scales: one measuredlifeevents;anotherso- psychological
nature,e.g., feltnervousor demade
cial anxiety; a third depressive symp- pressed.Thescale,however,is primarily
suchas headache,backache,
tomatology,
fourth,
physicalsymptomatology;
up ofsymptoms,
and finallyperceivedstress(thePSS). All in- acid stomach,that have been traditionally
Each itemis rated
struments
were completedduringa one and viewedas psychosomatic.
forthedegreeto whichthatproblembothered
one-half
hoursession.
thepasttwo
A modifiedversionof the CollegeStudent ordistressed
during
theindividual
scalefrom
Life-Event
Scale (CSLES) was usedas a mea- weeks.Itemsareratedonfive-point
The CHIPS has
sureof stressful
lifeevents;theoriginalscale "not at all" to "extremely."
and to
was developedby Levineand Perkins(1980). beenfoundto haveadequatereliability
Thisscale is composedof99 itemsthatrepre- predictuse of studenthealthservicesin the
ofthe
completion
periodfollowing
senteventsthatfallinto14different
categories seven-week
samples).
theadjustment
demandsofcol- scale(r = .29and.22inindependent
characterizing
lege students,e.g., academic affairs,male- The Social Avoidanceand DistressScale
matters.
Nine (SADS) was used to measuresocial anxiety
femalerelationships,
andfamily
itemsdealingwithhealth-related
issues were (Watson and Friend, 1969). This 28-item
not used in calculatinglife-stress
scores be- true-false
scale taps boththe desireto avoid
of
thattheseitemswere others(socialavoidance)andtheexperience
cause of thepossibility
(socialdistress).
measuringthe same thingas items in the distressin socialinteractions
of thestudenthealthcenterwas
Utilization
symptomchecklists.Analysesincludingthe
are restudents
All university
monitored.
also
did
unuseditemsindicated
thattheirexclusion
quiredto paya feethatprovidesforoutpatient
notaffecttheresultsreported
below.
wereaskedto indicatewhether medicalcare. The physiciansat the student
Respondents
fillout a standardized
each eventhad occurredduringthelastyear. healthcenterroutinely
theproblem(s)forwhichthe
Theywereasked to ratetheimpactof events formdescribing

GLOBAL

MEASURE

OF PERCEIVED

STRESS

studentwas treatedat each visit.The formis

389

weresolicProgram.Participants
ing-Control

and radio
newspaper,television,
based on the International Classification of itedthrough
in
Diseases, 9thRevision (Commissionon Profes- advertisements.
To qualifyforparticipation

1980)andallows theprogram,
sionalandHospitalActivities,
subjectseitherhadto be married
each visit to be classifiedas illness-relatedor livingwitha partner.The meanage of the
and poisoning-relatedsubjects was 38.4 years (s = 11.57). Thirty(codes 001-779),injury(codes 800-999),or "other"(V codes), e.g., sevenpercentofthesamplemadeover$25,000
vaccination.
receiveprophylactic
peryear,and 74 percenthadformaleducation
For each student,the numberof visitsin beyondhighschool.Theyhad been smoking
each ofthethreecategorieswas recorded.Up foran averageof20.9 years(s = 11.82).Only
werestudents;all of
to three symptomsor problemscould be threeof theparticipants
25 to 31 years
checkedforany individualvisit.If theprob- theseweregraduatestudents,
baselinesmoking
lemswereall in thesame category,onlyone old. Themeanself-monitored
visitwas recordedforthatcategory.If the ratewas 25.6 cigaretsa day.
categories,a sepaproblemswerein different
Treatment.Treatmentgroupsmet for six
foreachofthepertinent consecutiveweeklysessionslastingapproxratevisitwas recorded
categories.Whentotalvisits(collapsingover imatelytwo hourseach. The targetquitting
session.Intervencategories)were calculated,each visit was dateoccurredon thefourth
of whether
there tion strategies included behavioral selfcountedas one, irrespective
anda
ofproblems management
nicotine-fading,
techniques,
was a singleproblemor a number
ofill- cognitive-behavioral
categories.Boththenumber
in different
relapse preventionproness visitsand thenumberof totalvisitsare gram.Overall,64 percent(N = 41) ofthesubanalyzedin thisreport.
at theend of treatment.
jects wereabstinent
testing
Measures. Duringa pretreatment
ofvisitswas calculatedforeach
The number
scale,
of two independent
timeblocks:the44 days session,subjectscompleteda life-event
checklist(CHIPS), and
precedingthetestingsessionand the46 days a physical-symptom
scale consistedof 71
thetesting
session.The initial44-day thePSS. The life-event
following
ofthebase-rate normatively
negativeeventschosenfromthe
periodwas usedas an indicator
of visits.
UnpleasantEventsSchedule(Lewinsohnand
1979).This scale replacedtheone
Talkington,
with
student
samplesbecauseitprovided
used
College Student Sample II
to the community
an itempool appropriate
the eventsthat
inthesecondsamplewere114 population.Subjectsidentify
Respondents
ofa class in introductory
personality have happenedto themin thelast six months
members
60males,andonewith and ratetheimpactofeach eventon a seven(53females,
psychology
to
fromextremely
negative
whoreceivedclass creditfor pointscale,ranging
sex notspecified)
positive.As in thecollegestudent
inthestudy.The meanage ofthe extremely
participating
samplewas 20.75witha standarddeviationof samples,boththe numberof eventsand the
scoreswereanalyzed.
4.41. These studentscompletedthesamefive event-impact
SubjectscompletedthePSS and theCHIPS
as thosein thepreviousstudy
questionnaires
sessionand at the
hoursessionduring priorto thefirsttreatment
duringa one and one-half
Bothtestswere
the secondweek of the SpringQuarter.For endofthesix-weektreatment.
in
manner
as withthe
administered
the
same
thissample,thedataon healthservicesutilizationwere dividedintothe 90 days preceding collegestudentsamples,exceptthatwiththe
the testingsessionand the46 days following groupof smokers,a one-weektimeframewas
thetesting
session.The90-dayperiodwasused used fortheCHIPS.
as an indicatorof thebase-rateof visits.
RESULTS
Smoking-CessationSample

Means, Variance and ReliabilityEstimates

Subjects.Subjectswere27 malesand 37 feMean scores on the PSS forthe complete

ina smoking-cessation
malesparticipating
proof OregonSmok- samples(males and femalescombined)were
gramrunby theUniversity

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

390

23.18and23.67inthestudent
samplesand25.0 andfemalesin each sample.The relativemagformales and feinthesmoking-cessation
sample.Standardde- nitudesof the correlations
viationswere7.31,7.79,and 8.00,and ranges maleswitheach ofthecriteria
werecompared
were6 to 50, 5 to 44, and 7 to 47. Mean PSS by transforming
the correlations
to z scores
scoresforfemaleswere23.57and 25.71inthe (Fisher'stransformation)
and dividingthedifstudentsamplesand 25.6 in the communityferencebetweenthez scoresby thestandard
sample.Standarddeviationswere7.55, 6.20, errorof the difference
betweenthe z coeffi1965).None oftheresultand 8.24. Mean PSS scores formales were cients(cf.Guilford,
22.38and21.73inthestudent
samplesand24.0 ingz scoresweresignificantly
different
from0
inthecommunity
sample.Standarddeviations at thep < .05 level. Since therewereno difwere 6.79, 8.42, and 7.80, respectively.
betweenmalesandfemales,onlydata
Al- ferences
thoughthe meanPSS score forfemaleswas fortheentiresampleare reported
below.
slightly
thanthemeanscoreformalesin
higher
Separatecorrelations
betweenthePSS and
criteriawerealso calculatedforthose
all threesamples,thisdifference
did not ap- validity
proachstatistical
in any sample. below and above medianage in the smoking
significance
Age was unrelated
to PSS in all threesam- cessationsample.These analysesseemedunples. Since theage distribution
in thecollege ncessaryin thestudentsamples,since98 perstudentsampleswas severelyskewed,a cor- centof the studentswerebetween16 and 25
relation
betweenthePSS andagewas unlikely. years old. The 31 personsin the "young"
Thecorrelations
grouprangedfrom22 to 35. The 33
betweenageandPSS were.04 community
and -.08 in thecollege samples and -.02 in the personsin the"old" grouprangedfrom36 to
70. Correlations
smoking-cessation
sample.
foryoungand old werecomCoefficient
forthePSS was paredwiththesameprocedure
alphareliability
inthe
described
.84, .85, and .86 in each of thethreesamples. foregoing.
Onlyone ofthesecomparisons
indiFor a state measure,test-retest
correlations cateda statistically
difference
at the
significant
shouldbe muchhigher
forshortretestintervals p < .05 - actuallyp < .01 - level. Data on
thanforlongerones. For thePSS, twointer- thiscomparison
arepresented
in theapproprivalsareavailable,twodaysandsixweeks.The atesectioninthefollowing
andaddressedinthe
PSS was administered,
on twooccasionssepa- discussionsection.
ratedby two days,to 82 collegestudentsenCorrelations between PSS and Life-Event
rolledin coursesat theUniversity
ofOregon; Scores. Since perceivedstressshouldgenerwhen respondingto the retest,the subjects ally increase with increases in objective
wereasked to striveforaccuracyratherthan cumulativestresslevels, the PSS shouldbe
for consistencyacross time.The test-retestrelatedtothenumber
oflifeevents.Moreover,
inthissamplewas .85,whereasthe thesecorrelations
correlation
shouldbe higherwhenthe
scores are based on the self-rated
correlation
was only.55 forthe64 subjectsin life-event
thesmoking
studywhowereretestedaftersix impactof theevents,sinceimpactscoresreflectsomeofthesamestressorappraisalmeaweeks.
suredby thePSS. As apparentfromTable 1,
thereis a smallto moderatecorrelation
beEvidence for Concurrentand
tweennumber
Predictive Validity
oflifeeventsand thePSS in all
threesamples.Moreover,in all butone case,
increaseswhenthescale score
betweenthePSS and thatcorrelation
Separatecorrelations
thevaliditycriteriawerecalculatedformales takesintoaccounttherespondent's
perception
TABLE 1. CorrelationsbetweenLife-EventScores and PSS

Number of Life Events

Impact of Life Events
*p<.Ol.

College Student
Sample I

College Student
Sample II

.20*
.35*

.17
.24*

Smoking-CessationStudy
Beginningof
End of
Treatment
Treatment
.38*
.49*

.39*
.33*

A GLOBAL

MEASURE

OF PERCEIVED

STRESS

391

TABLE 2. Correlations
ofStressMeasureswithDe- than that the stress caused the symppressiveSymptomatology
tomatology.
In regard to establishingthe validityof the
CollegeStudentCollegeStudent PSS, it is importantto note the substantialcorSampleI
SampleII
relations between the scale and both sympNumberof
tomatologymeasures. There is probablysome
LifeEvents
.18*
.14
between what is measured by the deoverlap
Impactof
pressive symptomatologyscale and what is
LifeEvents
.29*
.33*
Perceived
measured by the PSS, since the perceptionof
.76*
.65*
StressScale
stress may be a symptomof depression. This
*p<.001.
may, to some degree, account for the magnitude of that correlation.In lightof the very
of the events. Hotelling t-tests, testing the high correlation between the PSS and the
statisticalsignificanceof differencesbetween CES-D (depressive symptomscale), it is desircorrelations,indicate that this increase is sig- able to demonstratethat these scales are not
nificant(p < .05) forStudentSample I and for measuringthe same thing.Hence, partialcorthe smoking-cessationsample at the beginning relationswere calculated; in these, depressive
symptomatology
was partialledout of the corof treatment.
relations
between
the PSS and physical sympThere was a differencein the correlation
and
the
tomatology,
PSS was partialledout of
between PSS and numberof negative events
for young and old participantsin the smoking the correlation between depressive sympcessation sample. For the young, the correla- tomatologyand physical symptomatology.In
tion was .65 (p < .05); forthe old, it was .19. the case of PSS and physicalsymptomatology,
PSS Versus Life Events as a Predictor of the correlationwas .16, p < .01, for sample I
Symptomatology. As noted earlier, we ex- and .17, p < .07, for sample II. In the case of
the
pected thatthe PSS would be a betterpredictor the CES-D and physical symptomatology,
<
correlation
was
in
I
.31,
p
.01,
sample
and
of the various health outcomes than would
stressfullife-eventscores. The data presented .38,p < .01, in sample II. Hence, even withthe
in Tables 2 and 3 supportthispredictionin the very high correlation between the PSS and
case of both depressive and physical symp- CES-D, both scales still independentlypretomatology.Hotellingt-test(p < .05) provide dicted physical symptomatology.
PSS Versus Life Events as a Predictor of
statisticalsupport for these differencesin all
Utilization
of Health Services. Table 4 precases. Since these are cross-sectionalcorrelasents
the
correlations
between the PSS and
tions, no causal inferencesare implied. For
utilization
of
health
services,
both beforeand
example, it is possible that increased symptomatology caused increased stress, rather afteradministrationof the scale. In Sample I,
the PSS significantly
predictedutilizationduring the five-weekperiod aftercompletingthe
TABLE 3. Correlations*
of StressMeasureswith
PhysicalSymptomatology
of PSS and HealthCenter
TABLE 4. Correlations
Beforeand AfterCompleting
Utilization
College College SmokingScale
Student Student Cessation
SampleI SampleII Studya
Student Student
Numberof
I SampleII
Sample
Life Events
.40
.31
.36
Impactof
BeforeScale Administration
Life Events
.23
.32
.51
-.06
.08
PhysicalIllnessVisits
Perceived
.11*
-.05
All Visits
.65
Stress Scale
.52
.70
AfterScale Administration
.04
.17**
a Sincethelife-events
was adminis- Physical Illness Visits
questionnaire
.20***
.12
All Visits
tered only at beginning of treatment,only
data are presentedso that
beginning-of-treatment
*p<.05.
PSS and life-event
correlations
are equivalent.
**p<.0l.
* p <.001 forall correlations.
***p <.001.

392

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

alpha reliability
scale. In SampleII, therewas a nonsignificantcoefficient
estimatefor the
correlation
betweenthePSS andall visitsafter four-item
PSS was .72. The test-retest
reliabiladministration
of the scale. Correlationbe- ityof the four-item
scale over a two-month
tweenthePSS and physicalillnessvisitsafter intervalwas .55.
scaleat one monthwas correof the scale, withbefore-ad- The four-item
administration
lated(.31,p < .01)withtheaveragenumber
of
ministration
visitspartialled
out,was .15,p <
.007, for Sample I and -.02 for Sample II. cigarettes
smokedper day at one month;the
Similarpartialcorrelation
forthePSS and all latterinformation
was froma self-report
convisitsafteradministration,
withall preadmin- firmedwith a carbon monoxidemeasure.
thefour-item
scale at threemonths
istration
visitspartialled
out,was .16,p < .01, Similarly,
forSampleI and .13forSampleII. Thesecor- was correlated(.37, p < .001) withsmoking
of rate at threemonths.Finally,the shortPSS
relationssuggestthatthePSS is predictive
Correla- scale at one monthaftertreatment
changesin healthcenterutilization.
predicted
ratethreemonths
aftertreatment
(.39,
tionsoflife-event
were smoking
scoreswithutilization
notsignificant
in bothsamplesforbothphysi- p < .001). In all cases, the greaterthe PSS
smoked.A number
cal illness and all visits; these correlations score,themorecigarettes
ofpartialcorrelations
werecalculatedtoclarify
rangedfrom-.04 to +.03.
betweenthe
PSS Versus Life Events as a Predictor of the natureof the relationship
rate.
Social Anxiety.Levels of perceivedstressin abridgedversionofthePSS and smoking
should In the firstpartialcorrelation,the end-ofcollegestudents,especiallyfreshmen,
PSS score and smokingrate were
be relatedto theirabilityto becomeintegrated treatment
betweenthe
We wouldex- partialledout of the correlation
intotheuniversity
community.
rateat one month
PSS and smoking
thegreater four-item
pectthatthepoorertheintegration,
The partialcorrelation
theperceivedstress.The social anxietyscale followingtreatment.
providesa traitmeasurethatpresumably
taps was .29,p < .01.In thesecondcorrelation,
the
inmaking
friends
andsocialcontacts, four-item
PSS and smoking
rateat one month
difficulty
out of the
intothecommunity.following
treatment
werepartialled
i.e., theabilitytointegrate
In bothstudentsamples,increasesin social correlation
betweenthe four-item
scale and
rateat threemonths.The partialcoranxietywereassociatedwithincreasesin per- smoking
ceivedstress(.37 and .48,p < .001forboth). relationwas .34,p < .01. Theseanalysesindinumberoflifeeventswas unrelated cate thatchanges-in
perceivedstressas meaAlthough
ofchangesin
to social anxietyin bothsamples,therewere suredby thePSS are predictive
rate.Another
indismallcorrelations
betweeneventimpactand smoking
partialcorrelation
PSS predicted
social anxiety(-.13, p < .02, -.26, p < .01). catedthattheabridged
changes
rateovera two-month
period.Spedata and no insmoking
Again,theseare cross-sectional
of .26 (p < .05) was
cifically,a correlation
causal inferences
are implied.
PSS and Smoking-ReductionMaintenance: foundwhen smokingrate at the one-month
was partialled
outofthecorrelation
The Four-Item Scale. To examine the role of follow-up
the PSS as a predictorof maintenanceof betweenthefour-item
PSS at one monthand
smoking-rate
reduction,
perceivedstresslevel smoking
rateat threemonths.Thesedatasugwas also assessed one and threemonthsfol- gestthatthefour-item
scale providesa useful
Since posttreatment
lowingtreatment.
data measureof perceivedstressforuse in telewerecollectedbytelephone
interview,
a short phoneinterviews
and othersituations
wherea
versionof the scale, consistingof the four veryshortscale is required.
items(numbers2, 6, 7, and 14)thatwerecorrelatedmosthighly
withthe14-item
scale,was
employed.The mean score on the four-itemDISCUSSION
scale was 5.6 at one monthand 5.9 at three
The PSS has adequate internaland testmonths.Standarddeviations
were3.6 and4.0,
andthescoresrangedfrom0 to 15and0 to 14. retestreliability
and is correlatedin the exMean PSS scoresformaleswere4.8 at one pectedmannerwitha rangeof self-report
and
monthand 5.9 at three,whilemeanscoresfor behavioralcriteria.
Moreover,thePSS is more
femaleswere 6.2 and 5.9, respectively.
The closely relatedto a life-event
impactscore,

A GLOBAL

MEASURE

OF PERCEIVED

STRESS

393

whichis to somedegreebased on therespon- eventscales willbe predictive

long
overfairly
dent'sappraisalof theevent,thanto themore periods,such as severalmonthsto several
objectivemeasureofthenumber
ofeventsoc- years.2 We have examined the predictive
curring
withina particular
timespan.The PSS abilityofthePSS overfourto 12weekperiods
also provedto be a betterpredictor
of health afteradministration.
These data suggestthat
and health-related
occur withina one- or
outcomesthaneitherofthe the best predictions
two life-eventscales. Finally,the PSS, al- two-month
period.It is ourfeelingthatas this
of
though highlycorrelatedwith depressive periodis lengthened,
validity
thepredictive
symptomatology,
was foundto measurea dif- thescale willfall.Afterall,perceivedlevelsof
ferent
and independently
by dailyhassles,
predictive
construct. stressshouldbe influenced
It is noteworthy
thatthelevelofcorrelation major-events,
of
andchangesintheavailability
betweenthe life-event
scales and the symp- copingresources,all of whichare quitevaritomatological
outcomes(.18 to .36 range)is able over a shortperiod.In fact,test-retest
inequivalentto,'ifnotbetterthan,similarcorre- reliability
analysesindicatethattest-retests
lationsreportedin the literature
(cf. Rabkin volvinga veryshorttime(twodays) resultin
andStruening,
whereasadmin1976;Tausig,1982).Hence,the fairlysubstantial
correlations,
ofthePSS is notattrib- istrations
sixweekslaterproducemoremodersuperior
predictability
utableto psychometric
weaknessesinthelife- ate test-retest
correlations.
eventscales thatwereemployedor to idiosyn- As mentioned
earlier,thePSS canbe usedto
craticaspects of the samplesunder study. determinewhether"appraised" stressis an
Moreover,froman absoluteperspective,
the etiological(or risk)factorin behavioraldisPSS correlations
withsymptomatological
mea- ordersor disease. It can also be used to look
suresare quitehigh(.52 to .76). However,in morecloselyat theprocessby whichvarious
the case of depressivesymptomatology,
the moderators
oftheobjectivestressor/pathology
correlation
operate.For example,we could
maybe somewhatinflated
by the relationship
one
of per- determine
overlapin the operationaldefinitions
whether
socialsupportprotects
of stressful
events
ceived stress and of depressive symp- fromthepathogenic
effects
etal., 1978;Gore, by altering
tomatology
(cf.Dohrenwend
theappraisalof thoseeventsor by
1981).
theprocessbywhichappraisedstress
altering
In general,the relationships
betweenPSS causesan illnessoutcome.Thissecondkindof
andthevalidity
to thedegreethat
wereunaffected
criteria
bysex analysis,however,is limited
or age. The one exceptionwas thestrongre- thePSS reflects
responsesto eventsoutsideof
oflife thosemeasuredby theobjectiveeventinstrubetweenthePSS andnumber
lationship
eventsforthe youngand the lack of such a ment.Thatis, itis limitedto thedegreethatit
meafortheold.Thesedatamayreflect is moreglobalthantheobjectivestressor
relationship
a difference
in theroleof lifeeventsin deter- sure.Finally,thePSS can be used as an outstresslevelsforthesetwoage groups. come variable, measuringpeople's experimining
ofobjective
Thatis, otherchronicstressors,
expectations, encedlevelsofstressas a function
etc. maybe moreimportant
fortheolderre- stressful
events,copingresources,personality
spondents.
factors,etc.
The PSS differs
The four-item
versionofthePSS providesa
fromlife-event
scales in a
numberof ways. First,thePSS asks abouta usefultool whendata mustbe collectedover
shorterperiod,one monthas opposedto the the phone. This scale makes repeatedmeausualsix to 12monthscoveredby typicallife- sures of perceivedstress in large samples
eventscales.1It is worthnotingthatwitha feasible.It shouldbe noted,however,thatbesubjectivescale, theshorter
periodshouldbe cause of the limitednumberof items,the
and
reliability
ininternal
sufficient
sinceperceivedstressduring
thelast abridgedscale suffers
of
monthshouldreflect
anyobjectiveeventsthat thusprovidesa lessadequateapproximation
are stillaffecting
stresslevels.
perceivedstresslevelsthantheentirescale.
respondents'
A seconddifference
betweenthePSS and a
Althoughnottestedin thisstudy,thePSS
life-event
scale is theperiodof timeafterad- mayalso providean economicaltool forasministration
thatthescaleprovidespredictions sessing chronic stress level. Either the
of health-related
outcomes.Presumably,
life- abridgedversionof the PSS or thecomplete

394

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

predictivevaliditiesof the PSS

14-item
scale couldbe used. Monthly
adminis- independent
scale.
trations
ofthescale couldbe summedor aver- and a depressive symptomatology
aged,providing
a reliable,i.e., basedon more Hence,thePSS can be viewedas assessinga
samples,measureofchronicstress,as wellas a statethatplaces peopleat riskof,i.e., is andisordereven
predictor
thatrepresents
a longertermthanthe tecedentto, clinicalpsychiatric
though
thatstateis also partofa diversesetof
one-month
periodcoveredby the scale.
of
Two commonly used measures of feelingsand statesthatare characteristic
nonspecificpsychologicaldistress,the nine- disorder.
In sum, the PSS is a briefand easy-toscale, 54-itemPERI Demoralization
Measure
measureof the degreeto which
(Dohrenwendet al., 1980) and the 28-item administer
in one's lifeare appraisedas stressGeneral Health Questionnaire(Goldberg, situations
1972),includea number
ofitemsthatare simi- ful.It has been provento possess substantial
and validity;thus, it providesa
lartothoseinthePSS. Thesescales,however, reliability
issues aboutthe
are muchbroaderin scope.Theyaredesigned potentialtool forexamining
of
as epidemiological measures of symp- roleofappraisedstresslevelsintheetiology
tomatology,
andbothincludea broadrangeof disease and behavioraldisorders.
itemstappingcommonpsychiatric
symptoms,
such as hostility,
diminished
self-esteem,
de- NOTES
pression,and anxiety,as well as psychosomaticcomplaints.Althoughappraisedstress 1. There are two recentlydevelopedlife-event
scales thatassess eventsovera one-month
peof psychological
disorder
maybe symptomatic
riod,theHassle Scale (Kanneret al., 1981)and
when viewed in combinationwithelevated
the UnpleasantEventsScale (Lewinsohnand
Talkington,
1979).
itis our
scoreson otherpsychiatric
symptoms,
of stressitself, 2. Pearlinetal. (1981)havepointedoutthatthereis
contention
thattheperception
no singletimeframethatis optionalforobservas assessed by the PSS, is not a measureof
ingtheeffects
ofdiverselifeevents.However,
This contenpsychologicalsymptomatology.
existingworks,includingthe Pearlinet al.
study,examineratherlongperiods.
tionis, infact,supported
bythedataindicating
APPENDIX A:
Items and Instructionsfor PerceivedStressScale

andthoughts
thelastmonth.In each case,
The questionsinthisscale ask youaboutyourfeelings
during
youwillbe askedtoindicate
a certainway.Although
someofthequestionsare
howoftenyoufeltorthought
similar,
thereare differences
betweenthemandyoushouldtreateach one as a separatequestion.The best
approachis toanswereachquestionfairly
oftimesyoufelt
quickly.Thatis,don'ttrytocountup thenumber
a particular
thatseemslikea reasonableestimate.
way,butratherindicatethealternative
For each questionchoosefromthefollowing
alternatives:
0. never
1. almostnever
2. sometimes
3. fairlyoften
4. veryoften
1. In thelastmonth,
howoftenhaveyoubeenupsetbecauseofsomething
thathappenedunexpectedly?
2. In thelast month,howoftenhave youfeltthatyou wereunableto controltheimportant
thingsin
yourlife?
3. In thelast month,howoftenhave youfeltnervousand "stressed"?
4*a In thelast month,
howoftenhaveyoudealtsuccessfully
withirritating
lifehassles?
5.a In thelastmonth,
howoftenhaveyoufeltthatyouwereeffectively
copingwithimportant
changesthat
wereoccurring
in yourlife?
6.a In the last month,how oftenhave you feltconfident
aboutyourabilityto handleyourpersonal
problems?
7.a In thelast month,howoftenhave youfeltthatthingsweregoingyourway?
8. In thelastmonth,
howoftenhaveyoufoundthatyoucouldnotcope withall thethingsthatyouhad
to do?
9.a In thelast month,
howoftenhave youbeenable to controlirritations
in yourlife?
10.a In thelastmonth,
howoftenhave youfeltthatyouwereon top of things?

A GLOBAL MEASURE OF PERCEIVED STRESS

395

APPENDIX A (Continued)
11. In thelast month,how oftenhave you been angeredbecause of thingsthathappenedthatwere outsideof
your control?
12. In thelast month,how oftenhave you foundyourselfthinking
about thingsthatyou have to accomplish?
13. aIn the last month,how oftenhave you been able to controlthe way you spend your time?
14. In thelast month,how oftenhave you feltdifficulties
were pilingup so highthatyou could notovercome
them?
a

Scored in the reverse direction.

disorder." Psychological Bulletin

87:450-68.
Averill,J. R.
Glass, David C., and JeromeE. Singer
and
1973 "Personalcontroloveraversivestimuli
1972 UrbanStress:Experiments
on Noise and
to stress." Psychological
its relationship
Social Stressors.New York: Academic
Bulletin80:286-303.
Press.
Cobb, Sidney,and StanleyV. Kasl
Gochman,I.
1977 Termination:The Consequencesof Job
1979 "Arousal, attribution
and environmental
OH:
Loss. ReportNo. 76-1261.Cincinnati,
stress."Pp. 67-92in IrwinG. Sarasonand
forOccupationalSafety
NationalInstitute
CharlesD. Spielberger
(eds.), Stressand
and Health,Behavioraland Motivational
Vol. 6. Washington:
Anxiety,
Hemisphere.
FactorsResearch.
Goldberg,David P.
Cohen,S.
1972 The Detectionof PsychiatricIllness by
load and theallocationof
1978 "Environmental
Questionnaire.
London:OxfordUniversity
attention."Pp. 1-29 in AndrewBaum,
Press.
E. Singer,and StuartValins(eds.), Gore,S.
Jerome
Psychology, 1978 "The effect
Advances in Environmental
ofsocialsupport
inmoderating
Vol. 1. Hillsdale,NJ:Erlbaum.
the health consequences of unemployCohen,S., and H. Hoberman
ment."Journalof Healthand Social Be1983 "Positive events and social supportsas
havior19:157-65.
of lifechangestress."Journalof
buffers
functions
of social sup1981 "Stress-buffering
13:99-125.
AppliedSocial Psychology
of reports:An appraisaland clarification
Cohen,S., and N. Weinstein
searchmodels."Pp. 202-22in BarbaraS.
effects
of noiseon behavior
1981 "Nonauditory
Dohrenwendand Bruce P. Dohrenwend
and health." Journalof Social Issues
(eds.), StressfulLife Events and Their
37:36-70.
Contexts.New York:Prodist.
andHospitalActivities Guilford,
Commission
on Professional
JoyPaul
ofDiseases,9th
Classification
1980 International
and
1965 Fundamental
Statisticsin Psychology
ICD.9.CM, Vol.
rev.,ClinicalModification
Education.New York:McGraw-Hill.
on Profes- Holmes,T. H., and R. H. Rahe
1. AnnArbor,MI: Commission
sionaland HospitalActivities.
scale." Journalof
1967 "The social adjustment
BarbaraS., and Bruce P. DohrenDohrenwend,
Medicine11:213-18.
Psychosomatic
wend(eds.)
J. H., and I. G. Sarason
Johnson,
LifeEvents:TheirNatureandEf1974 Stressful
1979 "Moderatorvariables in life stress refects.New York:Wiley.
search."Pp. 151-68inIrwinG. Sarasonand
Life Eventsand TheirContexts.
1981 Stressful
CharlesD. Spielberger
(eds.), Stressand
New York:Prodist.
Vol. 6. Washington:
Anxiety,
Hemisphere.
A. R. Askenasy, Kahn, RobertL., Donald M. Wolfe,RobertP.
B. S., L. Krasnoff,
Dohrenwend,
and B. P. Dohrenwend
Quinn, J. Diedrick Snoek, and Robert A.
of a methodforscaling
1978 "Exemplification
Rosenthal
lifeevents:The PERI LifeEventsScale."
1964 Organizational
Stress:StudiesinRoleConJournalof Health and Social Behavior
flictand Ambiguity.
New York:Wiley.
19:205-29.
Kanner,A. D., J.C. Coyne,C. Schaefer,
andR. S.
B. P., P. E. Shrout,G. Egri,and F.
Dohrenwend,
Lazarus
S. Mendelsohn
1981 "Comparison
of twomodesof stressmeascreeningscales mea1980 "What psychiatric
surement:
Daily hasslesand upliftsversus
surein thegeneralpopulation:
PartII: The
majorlifeevents."Journalof Behavioral
of demoralization
by contrast
components
Medicine4:1-39.
with other dimensionsof psychopathol- Keating,J.
ogy." Archives of General Psychiatry 1979 "Environmental
stressorsmisplacedem37:1229-36.
phasis."Pp. 55-66inIrwinG. Sarasonand
Dooley,D., and R. Catalano
CharlesD. Spielberger
(eds.), Stressand
1980 "Economicchangeas a causeofbehavioral
Vol. 6. Washington:
Anxiety,
Hemisphere.
REFERENCES

396

JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

Kobasa, S. C.
and J. M. Siegel
Sarason,I. G., J. H. Johnson,
1979 "Stressfullife events, personality,and
1978 "Assessingtheimpactof lifechanges:Deintohardiness."Journal
health:An inquiry
survey."
of thelifeexperiences
velopment
of Personalityand Social Psychology
andClinicalPsycholofConsulting
Journal
37:1-11.
ogy46:932-46.
Lazarus,RichardS.
Seligman,MartinE. P.
Stressand the CopingPro1966 Psychological
1975 Helplessness: On Depression,Developcess. New York:McGraw-Hill.
mentand Death. San Francisco:W. H.
stressandcopinginadapta1977 "Psychological
Freeman.
tion and illness." Pp. 14-26 in Z. J. Stroebe,W., M. S. Stroebe,K. J. Gergen,and M.
Lipowski,Don R. Lipsi, and Peter C.
Gergen
Medicine:
on mortality:
(eds.), Psychosomatic
Whybrow
of bereavement
1982 "The effects
CurrentTrends.New York: OxfordUniA social psychologicalanalysis." Pp.
versityPress.
527-61 in J. RichardEiser (ed.), Social
Lei, H., and H. A. Skinner
and BehaviorMedicine.New
Psychology
studyof lifeeventsand
1980 "A psychometric
York:Wiley.
social readjustment." Journal of Sundstrom,
E.
Research24:57-65.
process:Review
Psychosomatic
as a sequential
1978 "Crowding
Levine,M., and D. V. Perkins
of researchon the effectsof population
1980 "Tailor makinglife events scale." Preon humans."Pp. 32-116inAndrew
density
PsyoftheAmerican
sentedat themeeting
Baum and Yakov Epstein(eds.), Human
chologicalAssociation,Montreal.
Response to Crowding.Hillsdale, NJ:
Lewinsohn,P. M., and J. Talkington
Erlbaum.
ofunpleasant Tausig,M.
1979 "Studieson themeasurement
ofHealth
events and relationswith depression."
lifeevents."Journal
1982 "Measuring
3:83Measurement
AppliedPsychological
and Social Behavior23:52-64.
101.
Vinokur,
A., and M. L. Selzer
lifeevents:
1975 "Desirableversusundesirable
Mason,J. W.
to stressandmentaldisTheirrelationship
of the conceptof 'non1971 "A re-evaluation
and Social
tress." Journalof Personality
in stresstheory."Journalof
specificity'
32:329-77.
Psychology
Research8:323-33.
Psychiatric
E. G. Menaghan, Watson,D., and F. Friend
Pearlin,L. I., M. A. Lieberman,
anxi1969 "Measurementof social-evaluative
and J. T. Mullan
ety." Journalof Consultingand Clinical
ofHealthand
1981 "The stressprocess."Journal
33:448-57.
Psychology
Social Behavior22:337-56.
Worchel,S.
Rabkin,J. G., and E. L. Struening
1978 "Reducing crowdingwithoutincreasing
1976 "Life events,stress,and illness."Science
ofan attributional
space: Someapplications
194:1013-20.
ofPopulation
Journal
theoryofcrowding."
L.
Radloff,
1:216-30.
depression Worchel,S., and C. Teddlie
1977 "The CES-D scale:A self-report
scale forresearchin the generalpopulaA twofactor
ofcrowding:
1976 "The experience
tion."AppliedPsychosocialMeasurement
and Social
of Personality
theory."Journal
1:385-401.
34:30-40.
Psychology