Urban Hassles as Chronic Stressors and

Adolescent Mental Health: The Urban

Hassles Index

David B. Miller, PhD, MSW, MPH

Aloen Townsend, PhD

This paper discusses the continued development, theoretical framework, and utility of the
Urban Hassles Index (UHI), which was designed to measure stressors affecting adolescents
in the urban environment. These stressors are chronic and differ in context and content
from the more acute life events that are usually measured in adolescent stressor indices.
This paper highlights factor analysis results of the UHI and the conceptualization of the
dimensions of the index. The UHIs utility as a rapid assessment tool for practitioners and
others working with adolescents is discussed. Directions for future research are also
highlighted. [Brief Treatment and Crisis Intervention 5:8594 (2005)]

KEY WORDS: adolescence, mental health, urban hassles, major life events, chronic
stressors, scales, indices.

The urban environment presents both advan-
tages and challenges for adolescents. The study
of those challenges remains important to the
field of social welfare and social work. Many
urban adolescents face a myriad of stressors,
including poverty and exposure to violence
(Paxton, Robinson, Shah, & Schoeny, 2004;
Safyer, 1994). In order to help these adolescents
achieve their potential and to lessen the effects
From the Mandel School of Applied Social Sciences, Case
Western Reserve University, Cleveland, Ohio.
Contact author: David B. Miller, Mandel School of
Applied Social Sciences, Case Western Reserve University,
10900 Euclid Avenue, Cleveland, Ohio 44106-7164. E-mail:
dbm5@po.cwru.edu.
doi:10.1093/brief-treatment/mhi004
Brief Treatment and Crisis Intervention Vol. 5 No. 1, Oxford University Press 2005; all rights reserved.
of stress-related outcomes for them, it is critical
for those providing services and developing
programs for this population to understand the
daily stressors they encounter, their reaction to
these stressors, and the consequences of the
stressors. Additional knowledge and under-
standing of the influence of day-to-day stres-
sors or daily hassles can enhance the assessment
of the contributing factors of psychosocial
distress among urban adolescents.
This paper describes the further design and
application of a new tool, the Urban Hassles
Index (UHI) (Miller, Webster, & MacIntosh,
2002), which seeks to identify those stressors
experienced by adolescents in the urban
environment. It also identifies the effects these
hassles have on the mental health status of

85
MILLER AND TOWNSEND
a sample of adolescents, while providing
practitioners and researchers with a different
perspective of the contextual circumstances
surrounding adolescent development within
the urban environment.
Major Life Events or Daily Hassles?
Here we might ask, Is it the heaviest straw or
the last straw that breaks the camels back? It is
posited that daily hassles may be a better
indicator than major life events in the study of
causal relationships between stress and adjust-
ment (Luthar & Zigler, 1991), because indices of
life events tell us very little about the day-to-
day events that lead to stress in the lives of
people (Kanner, Coyne, Schaefer, & Lazarus,
1981).
Definition of Hassles
Lazarus (1984) defines daily hassles as expe-
riences and conditions of daily living that have
been appraised as salient and harmful or
threatening to the endorsers well-being
(p. 376). Hassles have also been defined in the
literature as irritating, frustrating everyday
experiences arising from the transactions be-
tween the individual and the environment
(Kanner et al., 1981). In the current study,
daily hassles are seen as events that occur on
a continuum, from minor, irritating events
(e.g., noisy neighbors) to more serious events/
transactions (e.g., pressure to join a gang). This
definition attempts to overcome some of the
conceptual issues identified by Hahn and Smith
(1999).
The study of daily hassles, individual per-
ceptions, and reactions to the hassle(s) may
provide a clearer understanding of coping
behaviors as well as the etiology of psycholog-
ical and physiological distress (Compas, Davis,
Forsythe, & Wagner, 1987; Kanner et al., 1981;
Lazarus, 1984) than the study of major life
86 Brief Treatment and Crisis Intervention / 5:1 February 2005
events alone. For instance, results from
Rowlison and Felner (1988) indicate that the
assessment of daily hassles in adolescents lives
appears to offer a much-needed supplement to
standard life-events methodology, which by
itself is insufficient for fully understanding the
relationship between life stress and adjustment.
Research on Stressors Experienced by
Adolescents
The empirical literature on the measurement of
stressors experienced by adolescents reflects
the experiences predominantly of white,
middle-class youth living outside of urban envi-
ronments. Additionally, the scales measure
primarily life events rather than daily hassles.
For example, in the development of the Ado-
lescent Perceived Events Scale, Compas et al.
(1987) selected 658 adolescents to identify scale
items. Less than 1% of their sample self-
identified with an ethnic minority, and most of
the sample were from rural or suburban middle-
class backgrounds. Following the identification
of significant events, both daily and major,
experienced by these adolescents, Compas and
colleagues established the reliability of the
measure on another homogeneous sample of
adolescents in Vermont, also predominantly
rural and white middle-class.
Similarly, Mullis, Youngs, Mullis, and Rathge
(1993) utilized the Life Experiences Survey to
measure the number of positive and negative
life events experienced in a sample of 1,740
high school students. These researchers in-
dicated that 88% of their sample was white. No
information was provided regarding the ethnic
composition of the remaining 12% of the
sample.
These two studies reflect the reliance of
researchers primarily on middle-class, white
samples in stress-related studies and those life
events that occur episodically within those

groups. Investigation of chronic stress among
urban disadvantaged adolescents, however, is
an important area deserving of further study.
Swearingen and Cohen (1985) developed the
Junior High Life Experiences Survey (JHLES)
in order to address some of the limitations of
previous measures of adolescent stress in that
the JHLES asks respondents to rate the severity
of experiences they have found to be stressful.
This study included two separate groups of
middle school (i.e., 7th and 8th grade) boys
and girls, with sample sizes of 48 and 233,
respectively. African American adolescents
composed 25% and 21% of the samples,
respectively. However, the events included on
the scale did not address the daily experiences
of adolescents in an urban environment. For
instance, typical experiences related to daily
safety in the community were not included in
the JHLES, such as concern over taking
different ways home each day to avoid drug
dealers and users or concern about the appro-
priate color of clothing to wear to prevent being
victimized.
Omizo, Omizo, and Suzuki (1988) found that
school-age children report experiencing multi-
ple stressors; however, as conceptualized in
that study, environmental factors contributed
relatively little to the childrens levels of stress.
Notwithstanding the studys lack of attention
to environmental factors, the researchers sug-
gested that stress does manifest in negative
outcomes in developmental trajectories.
In a study of chronic stressors in southwest-
ern Ontario, Avison and Turner (1988) found
that chronic strains significantly contributed to
psychological distress (i.e., depression). The
authors suggested that chronic strains may
have a greater effect on mental health status in
that they are unresolved, continuing difficul-
ties for the individual (p. 261). These
researchers also posited that life-event mea-
sures of stress often include items that are
actually chronic and continuous stressors. This
Brief Treatment and Crisis Intervention / 5:1 February 2005
The Urban Hassles Index
work lends support to the need to further study
chronic stressors. Although the respondents
were adults, it is conceivable that adolescents
who do not have the benefit of resources
available to adultswould experience equal if
not greater negative effects of chronic stress.
Given that the study was conducted in
southwestern Ontario, Canada, and the re-
searchers did not indicate that race or ethnic
background were variables under study, it is
presumed that members of minority groups
were not included in this study. While there are
similar chronic stressors across groups, mem-
bers of racial and ethnic groups may experience
stressors that are qualitatively different.
Lu (1991), in a prospective longitudinal study
of 50 respondents, found that daily hassles
significantly contributed to mental health
status. Lu found that respondents reporting
high levels of daily hassles had poorer mental
health outcomes at Time 1. When the sample
was measured again, daily hassles were found
to be a significant predictor of respondent
mental health status. Again, the evidence
points to the fact that chronic, daily stressors
can and do affect mental health status as much
as, if not more than, major life events. The
sample, unfortunately, did not include mem-
bers of racial minority groups, and the mean age
of respondents was 39.1 (SD 9.9).
In one of the few studies in which a large
number of adolescents of color were included,
Reynolds, OKoon, Papademetriou, Szczygiel,
and Grant (2001) found that high levels of
stressful life experiences contributed to in-
creased reports of somatic complaints. Using
a sample of 1,037 adolescents between the
ages of 11 and 15, Reynolds et al. suggested
that somatic complaints were associated with
chronic exposure to environmental stress.
These researchers sought to address only effects
that were internalized by the adolescents, and
pointed out that much of the extant literature on
stress and adolescents did not include members
87
MILLER AND TOWNSEND
of minority groups, whose contextual environ-
ments were not taken into account by the
measures heavily relied on in the studies.
Measuring Daily Stressors of Urban
Adolescents
A literature search reveals few instruments (see
Reynolds et al., 2001) relevant to the daily
experiences of disadvantaged urban adoles-
cents. Yet, the development of such instru-
ments is critical to understanding the source of
chronic stressors, the resulting psychological
distress experienced, and their effect on coping
behaviors (Kanner et al., 1981; Marsella, 1998).
The urban environment presents its own
unique set of circumstances, particularly in
disadvantaged communities. Luthar and Zigler
(1991) suggested that urban adolescents, in
general, and minority-group adolescents, in
particular, experienced daily hassles that were
quite different from and, in some instances,
more stress producing than those of majority-
group or white middle-class adolescents. Re-
searchers (Deardorff, Gonzales, & Sandler,
2003; Safyer, 1994) have posited that life in
the inner city is characterized by numerous
factors (e.g., violence, poor housing, drug use)
that can affect the development of the adoles-
cents who are exposed to those factors on
a daily basis. For example, the stressors
experienced by adolescents, particularly of
the nature and type within the urban environs,
would logically affect a students performance
in the classroom.
In summary, notwithstanding these few
studies, the effects of chronic stressors (i.e.,
daily hassles) on urban adolescents is an area in
which additional empirical research is neces-
sary but largely lacking. Additionally, there is
the need to measure those stressors that are
germane to specific contextual circumstances.
The study whose findings are reported here
attempts to integrate these two important areas.
88 Brief Treatment and Crisis Intervention / 5:1 February 2005
Method
Sample
A purposive sample of 254 adolescents was
drawn from two public schools: one a middle
school and the other a high school. Within these
two schools, students in a required health class
participated in the survey. Their parents had to
provide written consent, while the students
provided written assent.
Measures
Urban Hassles. The UHI (Miller et al., 2002)
was expanded to 32 items, based on a literature
review of the stressors germane to the urban
environment as well as discussions with pro-
fessionals working with adolescents in urban
settings. Items were developed to counter the
bias present in life-events measures developed
and standardized primarily with middle-class
white adolescents. Thinking back over the last
2 weeks, participants were directed, please
indicate how often these events have happened
to you. Responses were coded 0 never, 1
sometimes, 2 often, and 3 very often (see
the Appendix for entire 32-item scale).
Principal-components analysis and orthogo-
nal (varimax) rotation were used to select items
for the UHI. For the 32 items, six principal
components emerged with eigenvalues greater
than 1.00, accounting for 63% cumulative
variance. Inspection of the scree plot and the
factor loadings suggested retaining the initial
four components (21 items). Items loading
solely on the other two factors and items with
substantial cross-loadings among the initial four
factors were omitted. A principal-components
analysis of the 21 retained items (specifying
orthogonal rotation and four components)
indicated that all four components had eigen-
values greater than 1.00, accounting for 51%
cumulative variance.

TABLE 1. Factor Analysis of Urban Hassles Scale Rotation Sums of Squared Loadings
Component Description of Factor
1 Environmental conditions
2 Interpersonal interactions/surveillance
3 Safety concerns
4 Anticipatory victimization
Cronbachs alpha for the entire UHI was .85.
Unweighted additive subscale scores were
created from the items loading on each of the
four components (see Table I). The first subscale
consisted of seven items reflecting hassles
related to external (environmental) conditions
(e.g., loud cars and loud neighbors at night;
item loadings .53 to .76; possible range of
scores 021; a .77). The second subscale
consisted of six items reflecting hassles related
to interpersonal interactions/surveillance (e.g.,
asked to sell drugs; item loadings .46 to .80;
possible range of scores 018; a .75). The
third subscale consisted of five items reflecting
hassles related to safety concerns (e.g., worry-
ing about safety of family members; item
loadings .42 to .83; possible range of scores
015; a .75). The fourth subscale consisted
of three items reflecting hassles related to
anticipatory victimization (e.g., having to take
a longer way to school or work to avoid trouble;
item loadings .63 to .75; possible range of
scores 09; a .69). Correlations between
subscales ranged from .28 to .50, all p
.01.
Scores on the total UHI could range from 0 to 63
(a .85). Higher scores represented greater
hassles. The mean UHI score was 14.55 (SD
10.01, observed range 044).
Mental Health. Two widely used standard-
ized measures were included to assess adoles-
cents mental health. One was the Hopkins
Symptom Checklist (HSCL) (Derogatis, Lipman,
Rickels, Uhlenhuth, & Covi, 1974). The 58-item
HSCL assesses common symptoms on five
Brief Treatment and Crisis Intervention / 5:1 February 2005
The Urban Hassles Index
Total Variance, % Cumulative %
5.554 26.450 26.450
2.301 10.958 37.408
1.708 8.135 45.543
1.225 5.832 51.375
dimensions (somatization, obsessive-compulsive,
interpersonal sensitivity, anxiety, and depres-
sion). For the present study, only the anxiety
and depression items were included. The
anxiety subscale consists of 6 items assessing
symptoms and behaviors associated clinically
with high manifest anxiety (e.g., nervous or
shakiness inside, trembling). The depression
subscale consists of 10 items assessing a broad
range of symptoms and behaviors associated
clinically with depressive syndrome (e.g.,
crying easily, feeling blue or sad). For each
anxiety and depression item, participants were
asked how much that problem has bothered
them during the past 7 days (coded 1 not at
all to 4 extremely bothered). Higher scores
represented greater anxiety or depressive
symptomatology.
Both subscales of the HSCL and the total scale
showed adequate internal consistency in the
present study (a .80 for anxiety, .83 for
depression, and .87 for the total). The mean
anxiety score was 8.15 (SD 2.81, observed
range 622), the mean depressive symptoms
score was 14.97 (SD 5.21, observed range
834), and the mean total score was 23.09 (SD
7.26, observed range 1449).
The second measure of mental health was the
Adolescent Symptom Inventory (ASI), which
consists of questions from the subscales of
conduct disorder and posttraumatic stress dis-
order (PTSD). The mean score was 5.62 (SD
6.73, observed range 039). The ASI showed
adequate internal consistency in the present
study (a .88).
89
MILLER AND TOWNSEND

Analysis Plan Gender Differences in Total Hassles

Pearson correlations were used to assess the
bivariate relationships between urban hassles
and mental health. An independent-group t test
was used to evaluate differences in mean hassles
by gender. To further investigate the relation-
ship between hassles and mental health, scores
on the UHI were divided into three groups (low,
moderate, and high). Low scores (n 86),
ranging from 0 to 9, represented the bottom
third of the distribution; moderate scores (n
79), ranging from 10 to 17, represented the
middle third of the distribution; and high
scores (n 73), ranging from 18 to 44,
represented the top third of the distribution.
The three UHI groups were then used as the sole
predictor in one-way analyses of variance
(ANOVAs), with mental health (anxiety, de-
pression, antisocial behavior, or PTSD) as the
outcome. Levenes F was used to evaluate the
ANOVA assumption of homogeneity of vari-
ances. Dunnetts C was then used to test for
post-hoc differences between the three groups,
because their variances were not homogeneous.
Participants with missing information were
excluded from analyses. Thus, the number of
valid cases varied by analysis (N 175 to 238).
There was a significant gender difference on
hassles, t(230) 1.98, p .05. The magnitude
of the difference was small, eta2 .02. Males
reported higher hassles than females (M
15.67, SD 10.71, vs. M 13.12, SD 8.73,
respectively).
Correlations Between Hassles and Mental
Health Measures
As shown in Table II, a higher total score on the
UHI was significantly and moderately corre-
lated with a higher total score on the HSCL and
a higher total score on the ASI. Greater hassles
on each of the four UHI subscales also were
consistently related to poorer mental health.
The magnitude of the correlations varied,
however, depending on which subscale of
hassles and which measure of mental health
was considered. For example, scores on in-
terpersonal interactions/surveillance hassles
were more strongly correlated with scores on
the total ASI than with scores on the total HSCL
or its anxiety and depression subscales. Hassles
from external environmental conditions, how-
ever, were nearly equally strongly correlated
with all mental health measures.

Results
ANOVA Results
The level of hassles reported on the total UHI
Background Characteristics of Sample
(low, moderate, or high) was significantly
The sample was evenly divided by gender. Of related to all three mental health measures, as
the 254 participants, 248 reported their gender. shown in Table III. The higher the level of
The study had 122 males (49%) and 126 females hassles, the more anxiety and depression and
(51%). The average age of the participants was the higher the ASI score the adolescents
13.76 (SD 2.05), with a range of 1020 years. reported. On every outcome, adolescents expe-
Racial classification was reported for 245 of riencing a low level of hassles reported signi-
the participants. African Americans were the ficantly better mental health than adolescents
majority (n 156, 64%), while whites were the experiencing either a moderate or a high level
next largest group (n 55, 22%). Native of hassles. Similarly, adolescents experiencing
Americans, Asian/Pacific Islanders, and Latinos/ a moderate level of hassles reported sig-
Hispanics made up the remainder (n 34, 14%). nificantly better mental health than those

90 Brief Treatment and Crisis Intervention / 5:1 February 2005

 The Urban Hassles Index

TABLE 2. Bivariate Correlations Between the Urban Hassles Index and Measures of Adolescents Mental Health
(N 254)

Environmental Interpersonal Safety Anticipatory

Total Conditions interactions/Surveillance Concerns Victimization
Score Subscale Subscale Subscale Subscale

Mental Health Measures Urban Hassles Index

Hopkins Symptom Checklist

Total score .48**
Anxiety subscale .42** .38** .14* .36** .37**
Depression subscale .47** .44** .20** .41** .31**
Adolescent Symptom Inventory
Total score .48** .
Antisocial behavioral .50** .44** .45** .28** .26**
subscale
Posttraumatic stress .48** .45** .198* .428* .35**
disorder subscale
*p
.05, **p
.01.

experiencing a high level of hassles. The
relationship (eta2) between level of hassles and
mental health was consistently strong.
Discussion
Findings of this study suggest that practitioners
must take into account the myriad of daily
stressors that youths in urban settings must
confront and the manner in which these youths
adapt to and cope with them. By understanding
these stressors, practitioners and advocates can
articulate to policymakers the need to reverse
the community and environmental degradation
experienced by many youths and their families
within the urban milieu.
The stressors identified by the UHI may
provide practitioners with a tool that can serve
as a rapid assessment of events affecting ado-
lescents social functioning. From a research per-
spective, these findings provide an alternative

TABLE 3. Mean (SD) Mental Health Scores by Level of Hassles

Level of Hassles
Significant
Mental Health Measure 1 Low 2 Moderate 3 High F(df) eta2 Contrastsa

Hopkins Symptom Checklist

Anxiety subscale 7.07 (1.82) 7.84 (2.15) 9.82 (3.61) F(2, 225) = 22.12 .16 1<2<3
Depression subscale 12.51 (2.79) 14.48 (4.46) 18.40 (6.25) F(2, 235) = 32.63 .22 1<2<3
Adolescent Symptom Inventory
Antisocial behavior subscale 2.20 (2.17) 4.98 (6.14) 10.38 (8.13) F(2, 172) = 27.72 .24 1<2<3
Posttraumatic stress disorder 19.59 (4.12) 22.30 (5.98) 28.05 (8.62) F(2, 235) = 25.58 .23 1<2<3
subscale
a
Using Dunnetts C.
p
.001.

Brief Treatment and Crisis Intervention / 5:1 February 2005 91

MILLER AND TOWNSEND

framework for investigating the nature and
effects of cumulative stress as well as another
area to investigate regarding the possible
etiology of maladaptive coping skills.
Future research must seek further validation
of the UHI across different samples. Addition-
ally, the age range to which the UHI may be
applied could be expanded to include young
adults. Some hassles (e.g., being pressured to
carry weapons) have a consistently negative
impact across all mental health domains, while
others have a selective impact (e.g., working to
help with finances of home). The magnitude
and circumstances of the differing effects is an
area needing further investigation.
The limitations of this study were its cross-
sectional design, along with the purposive
sampling strategy. The findings, while inter-
esting, cannot be generalized beyond the
sample from which these data were collected.
The effects of long-term exposure to chronic
stressors could not be established, nor could we
control for events that may have interacted
with the stressors that contributed to poor
mental health outcomes. Future research would
be well served to employ a prospective longi-
tudinal approach so that the effects of and
reaction to chronic stressors can be examined
across developmental milestones.
As this study and other research studies may
suggest, chronic stressors or what this studys
authors describe as daily hassles can negatively
affect mental health status. Although the
evidence is limited at this time, understanding
these chronic and ubiquitous stressors is
essential for social work practitioners, social
science researchers, and public policymakers.
Interventions that do not consider the environ-
mental context in the day-to-day lives of urban
adolescents and young adults are doomed
at best to offer a temporary respite; at worst,
to fail.

APPENDIX. The Urban Hassles Scale

Directions: How often do the following happen to you? Thinking back over the last 2 weeks, please
indicate how often these events have happened to you. Please circle the number that best describes
how often an event happened to you.

0 = Never 1 = Sometimes 2 = Often 3 = Very Often

1. Asked for money by drug addicts 0 1 2 3

2. Taken a longer way to school or work to avoid 0 1 2 3
trouble
3. Pressured to join a gang 0 1 2 3
4. Made fun of because of good grades 0 1 2 3
5. Worried that someone will try to take your 0 1 2 3
clothes, shoes, or money
6. Pressured for sex by boyfriend/girlfriend 0 1 2 3
7. Working to help pay bills at home 0 1 2 3
8. Nervous about gunshots at night 0 1 2 3
9. Nervous about sirens at night 0 1 2 3
10. Worrying about safety of friends 0 1 2 3
11. Worrying about safety of family members 0 1 2 3

92 Brief Treatment and Crisis Intervention / 5:1 February 2005

 The Urban Hassles Index

APPENDIX continued. The Urban Hassles Scale

0 = Never 1 = Sometimes 2 = Often 3 = Very Often

12. Worrying about your own safety 0 1 2 3

13. Keeping your worries about safety secret from 0 1 2 3
friends
14. Being stopped and questioned by police 0 1 2 3
15. Asked to sell drugs 0 1 2 3
16. Asked to hide or carry drugs 0 1 2 3
17. Being followed in department stores by 0 1 2 3
salespeople
18. Not being able to go into convenience 0 1 2 3
stores. . .with friends because of rule against
more than 2 students/teens at a time in the
store
19. Being unable to go to parties or games with 0 1 2 3
friends because of transportation problems
20. Teased about the clothes you wear 0 1 2 3
21. Walking past abandoned buildings and lots 0 1 2 3
22. Pressured by friends to fight 0 1 2 3
23. Made fun of because of bad grades 0 1 2 3
24. Pressured to carry a weapon for protection 0 1 2 3
25. Having something stolen or having your house 0 1 2 3
or car broken into
26. Being concerned about living in an unsafe area 0 1 2 3
27. Fear of confrontation with strangers 0 1 2 3
28. Loud, noisy cars and neighbors at night 0 1 2 3
29. People hanging around on street corners or in 0 1 2 3
front of stores
30. Waiting for bus near dirty, smelly bus stops 0 1 2 3
31. Having problems or conflicts with teachers 0 1 2 3
32. Parent(s) being nosey about what you do 0 1 2 3
2001 by David B. Miller. Reproduction prohibited without permission of author.

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