3

In S. Spacapan & s. Oskamp (Eds.),

The Social Psychology of Health.
Newbury Park~ CA: Sage, 1988.
This chapter describes data on the PSS
from a lar-e nutlonal probability sample
collected by the Harria Poli. lt
includes normative .!!!!_ by gender, Perceived Str~
occupation, income, race and ethnic
background, etc.; data on the relative in a ProbabilitySample
reliabilities and validities of 4- 10- of the United States ·
and 14-item versions of the scale;
(actor analyses of the three versions
of the scale; and data relating the PSS SHELDONCOHEN
to a range of health related measures GAILM. WILLIAMSON
including symptoms, self-reported
~isease, and health practices such as
smoking and alcohol use.

S. Cohen

I
t is a common assumption among
health racarchers that stn:ssful life
evcnts are no,. in and of thcmseM:s.
sufftcicnt causes of pathology and illness behavior. lnstead. tbe potential
for evcnt-elicitcdhealth risk depcnds on a transaction betwecn the person
and the environmcnt (Lazarus. 1966; Lazarus & Folkman, 1914). This
pcnpective assumesthat persons activdy interact with theirenvironments,
appraising potentially threatening or challcnging eventa in the light of
available coping resourccs. Stressful events are assumcd to increase risk of
discase when they are appraised as threatening or otherwise demanding.
and when coping resourccs are judgiedas insuffacientto address that threat
or demand. An important part oí this view is that evcnt-elicitcddisorden
are not based solely on the intensity or any other inhemit quality oí an

AUTHORS'NOTE:Thedata1d
uKdi_li'lhitdlaplcr,...generaledl,y
LouilHarris11111
AISOCÍ11t$, lnc., undcr COftlract DHHS 212-11.()098from the Offlcc ol Dilea: PnMntion
11111
Health Promotion. The authon are apec;ially thukful lo Paul lrounsteia for helping111
obcain a copy ol lhedata tape. PffparllÍOIIol thit chaplff wa lllptlOIUdia pan l,y a NIMH
Raurch Sc:ientistDndopmnl Awant (K02 MHODnl) to die ín audlof.

JI
31 THESOCIAL PSYCHOLOGYOF HEALTH
cvcnt, but are dcpendcnt on personal and contextual íactors as wcll.
AJthough this perspc:ctiw:is widcly aa:cptcd, it hu not bc:enaccompanicd
by thc dcw:lopmcnt oí psychomctrically valid mcasurcs oí perccivcd
(appraiscd) stras to test iasvalidity.
The purpose oí this chapter is to present psydlomctric and descriptiw:
data on a scalcdcsigncd to mcasurc stress perceptions, and to cstablish that
such a scalc can predict tt: rangc oí hcalth-rclatcd outcomcs prcsumcd to
be associatcd with appraiscd stress. In thc first scction. wc discuss thc
advantagcs oí a scalc measuring gcncralizedperceptions oí stress, describe
thc Pcnxivcd Stras Scalc (PSS), and address thc controversy surrounding
thc use oí a scalc asseuing stress perceptions. In thc later scctions. we rcport
ncwandcxciting PSS data írom a largc (2.387 rcspondcnLS)probability
sample oí thc Unitcd States collcctcd by Louis Harris and Associatcs, lnc.
in 1983.Data are prcscntcd on thc psychometricqualitics oí thc scale. and
on thc relation oí thc PSS to othcr stress, hcaJth.and satisíaction measurcs.
Mean stress scorcs(nonns) are also providcd íor breakdowns oí thc sample
on a varicty oí dcmographic charactcristics.
In an carlier articlc,we argucdthat a scalc asscssingglobal pcnxptions
oí stress can serve a varicty oí valuablc íunctions (Cohcn, Kaman::k, &
Mcrmelstcin, 1983).Fint. it can provide infonnation about thc proca.ses
through which strcssfulCYCDts influenc:epathology. For cxample, it can be
uscd in conjunction with an objectiw: scalc in an cffort to determine
whcthcr appraiscd sirca mediata the rclation bctwccnobjcctivc stress and
illness. lt can similarly be uscd to usas whcther a factor known to
modcrate stras-illncsi rclations. íor cumple. social support, opcrates
through ita infiucncc on stress appraisal or through some other pathway.
Second, a pcrcci\lC!d straa scalc can be Ulcd to inwstigatc the pathogcnic
role oí ovenll strcu appraisal inlituations in which the objcctivesourocs oí
stress are diffusc or difficult to mcasure. Similarly, it can be uscd when thc
primary issue under study is the role oí appraiscd stn:ss, as opposcd to
objcctivestress lcvcl.Finally, perccivcdstress can be viewcdasan outcomc
variablc-mcasuring thc cxperienoed lcvel of slrcs5 as a íunction oí
objcctiw:strasful cw:nll, coping proocsscs,pcnonality facton, and so on.
Early Apprmdaa lo MNIIÍIII Pemi,ed Strell
Prcvious work has cmploycd a number oí approachcs to asscss both
global and ew:nt-spr.cificlew:lsoí pen:eivcdstress. For example,sevcral
Pnttiwd Slrm in• ProbobililySampk JJ
invcstigators have modifaed stn:ssf'ul lifc-event ICales in an attempt to
measurc global perceivcdstress. Thc modifacationinvolvcd asking respon-
dcnl.Sto rate thc stn:ssf'ulncss or impact of each cxperienocd cvent. In
general, life-stn::ssseores bascd on self-ratings oí cw:nt strcssíulncss are
better prcdicton oí hcalth-n:latcd outcomcs than are ICOl'CSderiwd írom
cithcr a simple counting oí events (i.e.• unit weighting)
orevent seora bascd
on weights assigncd by extemal judges (c.g.,Sarason.. Johnson. & S~l.
1978; Vinokur & Selzer, 1975). However, incn:ases in predictability
providcd by thcse ratings are small. A major rcason that any increase in
prcdictability oí a weightcd event scon: over a simple count oí cvenlS is
likcly to be small is that altemaúw: weighúng schema yield composite
seores tbat arcsubstantiallycomlatcd with the evcntcount (Lei & Sk.in.ner,
1980). Conscqucntly, this mcasuremcnt tcchniquc docs. not allow for a
single event to haw: ~ impact oí rour or five lcss signifacantones. Other
wcaknc:sscsoí global pcrceivcd stress scales tbat,are bascd on a spccifaclist
oí cvents includc insensitivity to chronic stress from ongoing lifc circum-
stances. to stn:ss írom cw:nlS occurring in the liws oí c1oseíriends and
family, írom c:xpcctationsconccming íuture cvents. and írom cvenll not
listcd on the scalc.
Subjcctiw: measurcs oí response to specifac stresson haw: a1sobeen
widcly uscd, c:.g.• mcasurcs oí pcrceivcdoccupational stress (Kahn. Wolrc,
Quino, Snock. & Rosenthal, 1964).Thcre are, however. somc practical and
theorctical limitations oí mcasurcs oí specifte strason. Practically, it is
diff1CUltand timc-consuming to dcvelop and psychomc:tricaUyvalidate an
individual mcaswecvery time a newstn:ssor is studicd. Theoretically. then:
is an issuc or whcther measun::soí pcrceiwd response to a spccifacstrasor
rcally assess evaluations oí that stn:ssor. There is. in íact, evidcncc that
pcople orten misattribute their íeelings of stn:ss to a particularly salient
source when that strcsa is actually dueto another source (Keating. 1979;
Worchcl, 1978;Worchel & Tcddlie. 1976).Anothcr problcm with measura
oí response to spccifacstrcsson is that such measu.a imply thc indcpcn-
dcnoc oí that event in thc prccipitation oí disease. Howc:ver.it is likcly that
thc illnessprocess is affectcd by global stress bel. not just by thc response
to a particular ew:nt.
Tbe Perai,ed Súell Sale
Thc PSS is a mcasure of the degrce to which situations in onc's life are
appraiscd as stressful (Cohcri et al., 1983).Jtems wercdcsignedto tap how
\
 J4 THESOC/ALPSYCHOLOGYOFHEA.LTH

unprcdictable. uncontrollable. and overloadcd n::spondentsímd lheir livcs. Schafer, in press). In a cross-sc:aional study, highcr PSS_~res wcre
Thcsc thrcc issuesrepcatcdly havc been found to be central components of uwciatcd with greater vulnerability to strcssful lifc-cvcnt-cliciteddepn:s-
the cxpericnce of stress (Avcrill. 1973;Cohcn. 1978;Glus & Singcr. 1972; sive symptoms (Kuiper. Olinger. & Lyons, 1986).Thc PSS has aJsobeen
Lazarus.1966, 1m; Seligrnan, 1975).Thc scale also includes a numbcr of uscd as an outcome variable, with lile cvcn&s,coping proa:sscs, and
dircct. qucrics about cum:nt levels oí expericncedstraa. Thc PSS was personality factors prospcctivcly prcdictins changcs in pcrceived stress
designcd for UIC in community umplcs with at leasta junior lúgh school (c.g.. Linville.1987).
cducation. Thc itema are easy to undmtand, and thc n::sponscaltemativcs
are simple to grasp. Moreover, thc quescions areof a generalnature and
hcnccarerelatively free of content spcciírcto any subpopulation group.
Thc original scaJc containcd 14 jtems. Four-item (PSS4), and 10-item
(PSSI0) vcnionaof thcscalehaveaJsobeen validated.Weprescnt dataon
Dccauscit is dilflCUltto distinguish conceplually bctwccn pcn::cived
lhc:psychometricsof each version of lhc scaJcin this chapter. We will argue
stress and psychologicaldistress. the pncticalandconceptual viability of a
later thal thc PSSI0 allows lhe asscssment of perociwd suas wilhout any
perccived stress scale is controw:nial (e.g., Cohcn, 1986; Dohrenwend &
loss of psychometricquality (actually a alight pin) over thc longer PSSl4.
Shrout, 198S;Laz.arus,DeLongis, Folkman.& Gruen, l!3S). Foreum~le.
All 14items uscdin thc original sea.le
arepn:sented in Appendix A. 1Thc
feelingsof stress and ovcrload areviewcdas 1ympt~ of ~ogical
PSSI0includesitems 1-3,f>.ll,and 14,and the PSS4includesitems2.6, 7,
disorder. As a n:sult, a com:lation betweena scaleISIClll"I percc1Wld stn::ss
and 14. Thc qucstions in thc PSS ask about feelings and tboughts during
and onc asscssing psychologicaldistress may be partly or totally ~t':"but-
thc last month. In eachcut.n::spondenu are asted how often they fclt a
able to the fact that some of thc items in thc two scaks mcasureasamilaror
ccrtain way. PSS seora are obtained by revening n::sponscs(c.g., O= 4,
idcntical conccpt. In short. crosHCCtionalcorrel~tiona bctwccnpe~Wld
i = 3,2=2 )tothcsevenpositivelystateditema(itema4,5,6, 7, 9, 10,and ll) stress and psychologicaldistrcss may be totally artifactual,
andcorrclat1ons
and thcn summins acroa ali scale items.
betwccn perccivedstn:ss and physical disordcn may actualJy rdlcct an
Thc PSS docs not tic appraisal to particular situationa; it is scnsitivc to
association bctwcen psychologicaldistn:ss(u meuuredby qucstiom about
the nonoc:cum:nc:eof cvcnlS u well u to ongoins lile cin:umstanccs, to
stn:ss n::sultinsfrom evenasoccurring in the üvcsof fricnds and relativcs, perccivedstress) and physical disorder. . . .
Although appraiscd stn:ss may be symptomauc of psychologicald~
and to cxpcctations conccming future cvcnts. lt is an c:conomicalsca1ethat
when vicwcd in combination with clevatedseora on othcr symptoms. at 11
can be administcred in only a fcw minuta and is easy to scorc. Bc:causc
our contcntion that thc perccption of stress itsclf, u aac:ssedby thc PSS, is
lcvcls of appraiscdstress should be influcnccd by daily hass1cs.major
evcnts, and changa in coping resoun::cs,thc predictiYCvalidity of thc PSS is not mcrcly a mcasurc of psychological symptomatol~gy. ~int, thc PSS
contains somc items that are not typical of psychologacaldJSOrdcrscales.
cxpcctcd to faUoff rapidly after four to eight wccks.
Tbcsc includc a number of qucstions rcganting perccived control ovcr
Eviden«for fSSvolidity. lnourownwork(Cohcnetal., 198J;Cohen,
cxtcrnal dcmands. 2 Sccond, the•inevitable ovcrlap of stress and distras
1986),wefound that the PSS providcd better predictions than did lifc-cvent
scalcs rcpresents only onc of a number of domains from which thc d~
scalc:sof psychological symptoms, physical symptoms, and utiliution of
scalcs draw. Bcsidcsitems tapping perccptions oí stras, common dastress
health scrvices. Wc a1sofound that although lifc cvcn&sdid not prospec-
scalcs asscss a broad range of symptoms includins boltility, diminished
tivcly prcdict smokins a:ssation and relapsc among penons attempting to
sclf--c:stcem,dcpresscd afTca, anxiety, and psychosomaliccomplain&s(~·•·•
quit, persons with highcr PSS seores wcre lc:sslitdy to quit smokins and
PERI Demoraliution Measured~bcd in Dohrenwcnd, Shrout, Egn. &
had a grcatcr increasc in posttrcatmcnt smoking rata than did thosc with
rclatively lower seora. Othcr invcstigaton have n:portcd that relativcly Mcndclsohn, 1980;thc General Healtb Qucstionnairc dcaaibcd in Gold-
higher PSS seora wen: prospeclively associatcd with failure to quit bcrg. 1972).
Thcre is no doubt lhat evenu can be appraucd • atn:aful without
smoking (Glasaow. Klcsges.Miza, & Pechaa:k, 198S),and failure among
n::sultingin thesevarious psycholop:alsymptoms. Concmely, personacan
diabetia to control blood supr levcls (Frem:el, McCaul, Glasgow, &
,; ..•
16 iiTE SOCIAL PSYCHOLOGY OF HEA.LTH
scorc high on thc PSS without clcvatcd seores on thc othcr dimcnsions of
psychological distrcss. This contcntion is, in fact, supported by data from
sevcral studics in which concurrcolly asscsscd symptomatology was
partialcd out of tbc rclation bctwccn thc PSS and various ou&comcs.This
conscrvativc analysis attributcs any varia.na: common to both thc PSS and
psychological symptorm to thc symptoms, climinating tbc possibility thal
any rcmaining dfcct of pcrocivcd stress is attributablc to thc ovcrlap
bctwccn symptoms and thc PSS. Studics using this proccdurc indicatc that
PSS and dcprcssivc affcct scalcs intkpendmtly prcdict physical symp-
tomatology (Cohcn et al., 1983).Morcovcr, thc PSS prospcctively prcdicts
psychological symptomatology whcn concumntly asscsscd psychological
symptomatology is partialcd out of thc rclations bctwun thc PSS and thc
ou&comc(Cohcn. 1986). Finally, othcr prospcctivc analyscs indicatc that
thc PSS prcdicts both pbysical symptoms and smoking c::cssa&ion cvc:nalter
controlling for tbc influcncc of psycbological distrcss (Cohcn, 1986). In
short, thcrc is ovawhdming evidcncc that thc PSS docs not mcasurc tbc
aune thing as standardpsychological distrcss scalcs.
Othcr evidcnoc for thc indcpcndcnccof thc PSS and psychological
distrcss is providcd by studics indicalingthal psychological distrcss seores
of thosc with high lcvcls or'social support are not influcnc:cdby pcrcciYed
strcsa lc\'Cls(Cohcn, Mcnnclstcin. Kamarck, & Hobennan, 1985;Cohcn,
Shcrrod, & Clark, 1986).To thccxtcnt that a pcrccivcd stress scalcanda
psychological distrcss symptom scalc mcasurc thc samc thing, rclations
betwccn thc two scalcs would not be modcrakd by othcr variables. Yet thc
association betwccn thc PSS and disordcr is modcrakd by social support;
pcl'50nswith higb lc\'Clsof support show lc:ssdisordcr undcr higb PSS lcvcls
than do thosc with low levclsof support. In sum, high seores on thc PSS are
not tbc samc thing as clevatcd seores on psychological distrcss, but thcy do
place pcoplc at risk for futurc distrcss.
&ducing ambiguity in interpretation. Bccausc of thc potcntial ovcrlap
bctwccn pcrociYedstress and psycbologicaldistrcss, crOSHCCtionalcorrcla-
tions bctwccn thcscconccpts are subjcct to artifact, and thcrcforc are
particuJarly difflcult to intcrprct. Likc any mcasurc, pcn:ciYedstress scalcs
should be uscd in conceptual and mcthodological contcx&sthat allow
rclativcly clcar intcrprctation. Whcn intcndcd as a prcdictor of psycho-
logical distrcss, thc scalc is mos&appropria&clyuscd in prospcctivc studics
that control for initial distress lcvel. In short, wc advise avoiding cross-
sc:ctional corrclations bctwccn scalcs llw may contain sorne i&cmsllw
assc:sstbc wnc or similar conocpts.
Thc qucstion of discriminativc validity is more difflcult. Whcn a
pcrociYcdSlrc:11 sca1cis uscd as a prcdictor of a nonconfoundcd ou&comc
hrceiW!d Slrr.u in a Ptob!,l,ilily&,mple 17
(c.g., utilization of hcalth scrviccs, physical hcalth, or smoking ccssation), .
are rclations attributable to pcrocivcd stress or to psychological distrcss?
Thcrc is no dcfinitivc answcr. Bccausc psychologicaldisordcr sca1csare not
vcry good prcdictors of clinical disordcr (sec Dohrcnwcnd, Shrout. Egri, &
Mcndclsohn, 1978; Lin, Dcan,& Enscl, 1986), a good argumcnt can be
made that mcasurcs of psychological distrcss actually mcasurc pcrocivcd
stress. Conscqucntly, what psychological distress sca1cs and thc PSS
actually mcasurc depcnds to a grcat cxtcnt on how one conocptualizcs
stress and disordcr. At thc vcry lcast, it is rcasonablc to argue that thc PSS
mcasurcs what it was dcsigncd to asscss-thc pcrociw:d dcgrcc to which
cnvironmcntal dcmands cxa:cd abilitics to cope.
Finally, it is important to cmphasizc that wc ,an: no& arguing thal
pcrocivcd stress scalcs are the scalcs to use in SlrCSSn:scan:h. Scalcs should
be choscn as tools to answcr spccifac qucstions and should be uscd in
mcthodological contcxts thal hclp reduceambiguiticsin intcrprctation. As
discusscd carlier, thc PSS is cspecially appropriatc in studics inw:stigating
facton influcncing or influcnccdby stress appraisal.
In thc rcmaindcr of this chaptcr, wc prcsent and discuss PSS data from a
probabilit y samplc of thc Unitcd Sta&cs.This rcpracntative samplc allo·.,s
us to reexamine thc psychomctric characteristics of thc scalc, compare thc
uscfulncssof thc PSS 14,PSS 10,and PSS4, and describe thc distribution of
pcrociYedstress lcvcls in thc u.s.·population. Of spccial intcrcst are mean
diffcrcna:s for subpopulation ca&cgoricsbascd on gendcr, age, socio-
cconomic status, racc and cthnic background, smoking, and drinking
status. Thcsc dala provide norms for thc scalc u wcU u cvidcncc for
diffcrcnccs in pcrocivcd stress across subgroups in thc population. We are
also ablc to invcstigatc thc rclations betwcen thc PSS and a widc range of
hcalth outcomcs, including frcqucncy of illncss, scrious and nonscrious
symptomatology, utilization of hcalth scrviccs, hcalth practiccs, and life
satisfaction.
StudyPopulatioa
RcspondcnlS wcrc 960 malc and 1,427 fcmalc rcsidcnts of thc Unilcd
Statcs, 18 ycan of agc and oldcr (mean agc =42.8, standard dcviation =
17.2),who complclcd a tclcphonc intcrvicw conductcd by Louis Harris and
 JI THE SOCIAL PSYCHOLOG Y OF HEALTH
Associatcs,lnc. in 1983.Thc 2,387personsmeetingthc critcriafor inclusion
in lhc analyscsrcpn:scnled69.6% of ·,he 3,430 eligibleindividualswith
whomtclcphonccontactwasmadc(926refuscdto be intcrvicwc:d. and 117
tcnninalcd thc inlervicw prior IO complction).
SamplincTedlaiq!lm
Bascd on Burcauoí C.Cnsusinformation. a nationaJarca-probability
samplc was dcvdopcdírom lhc distribution of thc ad~ noninstitu-
tionaliu.d population oí thc Uniled •Statcs. Stratification was done
accordingto gcograpbicrcgions(East, South. Midwest,and Wcst)and by
siz.eoí rcsidcntialcommunity(c:cntralcity. non-cenlralcity. and rural
arcas). With counticsas primary samplingunits. a random dígit dialing
proa::durcwas uscd to scJccttclcphoncnumbers to be caUcdwithincacb
samplingunit. In lbe Cftnt that thcdialcdnumbcrwasbusy,il WII rcdialcd
asmanyas íour timesal IS-minutcintcrvals.For a ringingbut unanswcn:d
pbonc. up IO four call-backswcrcm~ al varyingtimesand on differcnt
daysduriog thc samplingpcriod.A total oí 7,787numbcn wcrccallcd.Oí
thcse,no coD&act wasmadcwitb 1,819.becauscthcrc was no answeraítcr
fivedialings(1,138),tbc line was busyaftcr fivecalls(142),thc dcsignatcd
rcspondcntcouJdnot be rcachcdduring lhc samplingperiod (97). or no
appropriatecontactbad bcenmadcal lhc cnd oí thcsamplingperiod,prior
to thc fourthcall-bact(442).Oí thc rcmainingnumbers,2.Sl&didnol mc:et
cligibilitycritcria;456wcrebusinessnumbcn. 1,827wercnot in se~. and
2,j5wen:anawcn:dby individualswith whomlhcrcwasa languagcbarrier
or who bad a hcalthconditionlhat prcdudcd thcir pa.rticipation.
Oncecontact wasc:stablishcd,intcrvicwcrsdcscribcdthc purposcoí lhc
study and disdosed all informationrcquircd undcr thc Privacy Ad.. To
fwther cnsurc ao unbiascdsamplc,thc intcrvicwerasted to spcak to thc .
person in thc bouscho&dwho was 18 ycan of agc:or ovcr and whosc
birthdayhad bccnmost rccent.Eachintcrvicwrcquircdapproximatcly3J
minuu:sto complete.Profc:ssionalintcrviewtechniqucsdcvelopcdby thc
Hanis organi.wion wercemploycdto minimil.Crcfusalratcs. Table 3.1
pracnu thc dcmographic profilc oí thc samplc population oblaancd
through thcseproa::dun::s &longwith comparablestatisticsfrom lhc 1980
U.S.C.Cmus.AseanbeICCII, in tboleca1egorielfor whidu:cmusdaaawerc
availablcíor comparison,thc distributionoí thc Hanis saanplcwassímilar
to that of thc U.S.C.Cnsus. Thc samplingerror ata 9S%lcvclof confidcncc
íor thc full samplcof 2,387n:spondcntswu calc11la1cd al -t or -2.()%.
h,u;MJ s,,eu in II ProbobililySomplt 39
1
Masura
Rcspondcntinformationfcll into sixmajorcatcgorics:( 1) pen:eptionsof
stress,(2) sclf-rc:portcd
hcalth and utilil.ationof hcalth se~. (l) hcalth
behaviors, (4) lifc satísíaction, (S) hclp sccking behaviors, and • (6)
dcmographicdata. Sorneof thc mcasurcswercpreviouslyvalidatcdscalcs,
somc wcrcvariationsof prcviousscalcs,and othcrs ~rc simplyindividual
qucstions.Wcíound tbatsbmc oíthc lattcrcouldbegroupcdinto scalcs.so
that rclaled information couJd be aoalyz.cdtogethcr. Each catcgory of
measun:sis discusscdin turn. .
Wc prcscntpsychometricevidcnceírom thc Ha.nissamplcin rcgard to
intcmalrcliability(Cronbacb"s alpbas)íorthoseinstnunentsinwhichitcms
are intcndcdIOmcasurcthc umc construcaand hcnc:eare cxpcctedto havc
high intcritcm corrclatÍODI.In contrlll. most insarumcnts basal on
írcqucncics of. cYCOts-for cumple. life C\'ellts,number oí illncsscs.
numbcroí nighlSin a bospital-assumc rclativcindcpcndcnceof itcmsand
an: not expcctcd IO havc higb intcritcm corrclations. Conscqucntly,
intcmal rcliabilitystatisticsarc not appropriatcíor thcse instnuncnts.
Stress nwasura. In addition to thc 14-itcmPSS. thcre werc íour
individual qucstions dcsigncd to tap thc leveloí c.xpcrienced stn:u, a
lifc-c:vcnlSscalc,anda numberoí qucstionsregardingwork-rc:latcdstress.
Thc individualqucstioosabout cxpcricncedstma werc: •
=
(l) Havcyou Cftr personallyexpcricncedstras? (1 ya. 2 =no)
(2) Are thcrc things going on in your life now that you fand very
upsettingor bothcnomc?(1 =ya, 2 =no)
(l) How much stress do you c1.pcrienccduring an aw:raacwcck?
( 1 =almos&no stressIO 4 =a lot of stress)
(◄) ComparcdIO a ycar ago, how muchs&rcss do you c1.periencenow?
(1 =lcss now, 2 =about thc samc,3 - more now)
Thc lüc-c:vcntsscaJc consi.stcdof 16 C\'elltsrepracnting poaentially
signifacantchangcs in thc rcspondcnt'slifc. In an.10 oí thc cvents arc
normallyconstrucdas ncgativc(c.g.,dcath of spousc,mate,or dosc family
mcmber,loss oí cmploymcnt,scparationor divorc:cfrom spousc,scrious
illncssor injuryof n:spondcnt).Thn:cof thcnents arc nonnallyconsidcrcd
posítive(maníage, pregnancy,reconcililúonwilh mate),and thrcc mon::
cvcntscould be considercdeithcr positivcor ncgatiw:(rctircmcnt,major
changcin hcaltb/beha~or of familymcmbcr.chaqc in incomc).Rcspon--
 \
40 THE SOCIAL PSYCHOLOGY OF HEALTH hrceillN Strus in o ProbobiJity
Somple 41

Table3.1 Thc lasl catcgory of mcasures of potcntial stress was concerncd with
º'
Compartton Demographlc ChanlcteriaUcaol Sample
and ol 1980 u.s.Populallon
tapping charactcristics of respondcnts' cmploymcnt. lbc pcoplc who
indicatcd that thcy wcrc cmploycd (cithcr full or parl time or in thc military)
wcre first askcd how many hours thcy workcd during an average wcek.
hran, o/ INO Two more qucstions relatcd to work load (frcquency or'ovcrtimc work ancl
hreffllo/ U.S.únaa A4'JI
how oftcn work load causcd break.s and lunch hours to be skippcd) and .
~s-,,11" Popul,tllit,,,
wcre ratcd on scalcs of 1 (ncver) to S (vcry frequently). Thcse lattcr two
Su responses were combincd to yicld a mcasurc of Workload Demand.
mak )9.9 47.4 A final mcasure of job charactcristics consistcd of fivc itcms to tap
faulc 60.1 S2.6
pcrccptions of work responsibilitics, to which subjccts responded on a scalc
A&e oí 1 (agra: strongly) to S (disagn:c strongly):
~29 :M.O 26.4
l0-44 ll.6 2.11.1
4S.S4 ll.l 14.7 ( 1) 1 am hcld accountablc for thc dcvclopmcnt of othcr cmployccs.
SS-64 ll.4 14.1 (2) 1 am responsiblc for counscling my subordina&caor hclping thcm
6SA owr(cad aip) IS.7 16.S
solvc thcir problcms.
To&al.IDDllalboecbold im (3) 1 takc actions or makc dc:cisionsin my job thal affcct thc safety or
SIS,000or lea ll.l ]7.S
weU-bcingof othcl1. .
SIS,001-W,OOO 24.2 22.9
SlS,001-SlS,OOO lO.l 19.I
(4) My responsibilitics in my job are more for things than for pcoplc.
SlS.001~.000. ll.6 12.7 (Seores wcre revcrscd on this ítem.)
Moni Iban S,0,000 1.6 7.9 (S) 1 rca:ivc appropriatc rccognition for pcrforming my job wdL
E&baicori¡ja
bla (- Hilpaaic) 7.1 10.2 A principal componcnts factor analysis with varimax rotation rcvealcd two
whilc(111111
Hilpaaic) 16.S 12.7
Hilpuic l.7 S.J
factors, which, whcn combincd, aa:ountcd for 60.4%of thc total variancc.
odlcr--- 2.1 1.1 Thc first factor consistcd of itcms 1, 2, and S (39.0% of thc variancc)and
was labclcd Job Re.sponsibilitia wilh Fttdbock. ltcms J and4 compriKd
wort ... 111
cmplo,-,d 63.1 Sl.6
thc sc:cond factor (21.4% of thc variancc), which wu labclcd Job
u-,lo,at S.l 4.S Responsibilitie.1without Fttdback. Cronbach's alphawas.S6for thc Witb
Feedback mcasure and .42 for thc Without Feedback mcasure.
NOTI: Talllel.1......._CIIIIJ._1:•••••-lorwlllct.equl .... ol.__ ......... .,_ Measures o/ R/f-reported health and utilization o/ health Rrt1.«s •
... ._ _ __.H■IIIIPIIILFer111■ -.111>,...~1rlr• ,.._ .... _ ..
11ft .. _,.....,. Rcspondcnl.Swerc askcd to ratc thcir currcnl hcalth status on a fivc-point
& ,., .....- ., e + ■ b411■ H■nt■ ■--- ... u.a.e- d■I■• _.., ._ scalc ranging from 1 (cxccllcnl) to S (poor). Thcy wcre thcn askcd about
••, d••-•,... ...... _... • ..._cafc::r
,_tt■nt■ ......,
, -N=Zlll'-
·- .. utilization of hcallh scrvia:s witbin thc last year:

dcnlS idcn~ificdthc cvcnl.Sthat had happcncd to thcm in thc last ycar and ( 1) Havc you beco a paticnt in a hospital ovcmight during thc past year?
ratcd thc ampact of cach cvent on a fivc-point scalc ranging from -2 (1 =yes, 2 =no)
(cxtn:mcly ncgativc) to ♦2 (cxtn:mcly positivc). Scparatc seores wcrc (2) lf yes, how many nighl.S?
~ulatcd bascdon thc total numbcr of lifc cvcnl.Sthat thc respondcnl (3) How many times did you pcrsonally sce a doctor about your hcalth
•ndicatcd bad happcncd, on thc sum of thc rcportcd impact of thc cvcnl.S during thc past yc:ar,not counlin& hospitalization?
and o_n~ sum of thc impac&of cvcn&srcsponden&srcported as having had
ncgallvc ampac&.
 11 THE SOCIAL PSYCHOLOGYOF HEALTH
(4) Aside from thcse visits or· when you tclcphoncd to mate an
. appointment,bow many times in the past year·did you contact a
doctor or other health professionalby ldepbone to consuJtabout
your health?
The numberof nigbllthe rapondent had spent in the hospilaJ,the number
of doctor visi1.1.·
and the number of times a doctor had becncalledwerc
swnmed to provideao indexof Hadth &trvica Utilizalion.
A compositescorcoí thrc:equcstionsrcgardingeffectsoí health status
on abililyto peñonn usual activiticswas obtaincd by askingrespondents
how manydaysduringthe past month iUnessor injuryhad causcdthem to
( 1) be absentfrom work,(2) be unablcto peñonn routineactivitics,or (3)
haft düflCUltypcrfonning routine duties. Thc measurc oí lnabüúy 10
PerformRoUliMActíwtia for health reasonswas obtained by summing
the numberof days giftn in responseto aUtluee questions.
To measun:Frequ¡mcy o/SeriousIIINss.a l l-itcmscak:listinga variety
of healthconditions(e.g.,migraineheadaches,hypcrtcnsion,heart discase,
vasculardiscase,respiratoryillness,cancer) wu .employal. Respondents
wercask:ed( J) Haft you·eftr had [thiscondition]?and (2) Haft you had it
in the past year? Seores werc -nerated for responsesto each of thesc
questions,so tbat the effccts of ever having had a particular iUnessand
havinghad it withinthe past ye.arcould be examinedseparatcly.
A fmal measun:oí sclf-reportedhealth Sblus was the Psychosomatic
Jndex, the 12--itcmsomatizationsubscaleof the Symptom Checklist90
(Dcrogatis, Rick:els.& Rock, 1976).This scalc indudes itcms such as
weakncss.sorcnc:ss.numbness. ~vy fcclings. headache, nausea. and
faintness.Respondentsindicatedthe degn:eto whicheachailment had
~thercd_t~m withinthe last montb on a scaleof 1(not at ali) to 4 (quite a
bit).A pnnapalc.:omponents factoranalysiswithvarimu rotationmaJed
thrcc factors, which,whencombincd,accounted for 48.1%oí the total
variancc.Thc flrstfactorcontaincdÍlft itcmsrclatedto nonserioushealth
condition.s(weakncss,sorcness,numbness,heavy fcclings,and pains in
lo~f back~.~ ~nd factor was composedof symptomsthat might be
considercd1ndacauwc of moreseriousiUness(faintness or diu.iness,painsin
heart or chest,and troublc¡ctting one's brcath).Thcthird factorcontaincd
itcms that migbt be seen as simply describingoold or fiu symptoms
(hcadaches,nauseaor Upsd stomach, lump in throat, hot or cold spells).
These factors.for dcscriptift simplicity,werc labeled NonsmousSymp-
'º""· Snious IIIM.u Symplonu, and F1uSymp1onu:tbe alpha rcliability
Pn-«iwd St,~11 "9o hobobilily Sompk IJ
coeflicientswere.71, .S8,and .SO,respc:ctiwcly.
Hral1hlx-haviors.Respondentsanswen:da variety of qucstions that
elicitedinformation about their healthful or unhealthful behaviors.First,
they wereaskedtwo questionsabout their sleepinghabías:( 1) 0n average.
how many bours do you sleepeachday in total, includingnaps, u wdl u
regular nightly slccpingperiods?and(2) or tbe time you spend sleeping
cachday, howmanyhoun of sleepdoyou typically¡et in the longcstsingle
periodof slcep?Sccond.subjeclswen:a.ü.cdbow often they ate bn:akfut
( l =neftí to 7 =daily).Third, informaaionwas solicitedabout frcquency
( 1=neftr to 7 =daily)and quantity( 1 =1drint to S =more than Sdrinks)
of akoholic bewcra- consumption. Fourth, ~pondenla rated thcir
cigarcttesmokinghabill on ascaleoíl =currcnllyamoke,2=onceamokcd,
but donl anymorc,or 3 =neftr smotcd. Tbose wboindicated that they
were currcntly.smoking wm asked bow many pacb of CÍglft:llel they
consumeddaily.As a fafthmcasun:of bealth bcbavior, aubjccuratedbow
oíten they exerciscdstn:nuouslyfor ll leall 20 minuta on a ICIJcoí 1
(never)to 7 (daily).
Useoí prcscriptionand/ or nonpracription medicatiomwas IDCIIIUR:d
),y responsesto the quc:stion,'"Doyou evertate ... r followedby a list of
scven categorics of drup (pracription pain rdic\us. alecpinglablcts,
tranquilizers,medicationfor stomachdistress.,diet pilla.over-thc-counter
painn:lieftrs,and over-the-countcrmedicationto n:licvesaomach dist.ress).
Two additional items asked if' other pn:scribed or over-1he-countcr
medicationswerc being laten. A factor analysis(principalcomponcnll
with varimaxrotation) yieldedtwo factors, whichtogetberaccountedfor
31.6%of the total varianc:c.The fust factorconsislcdsolclyoí pn:scription
drugs (pain rclievers,sleepingtablcts. tranquilizcrs,,andmedications for
stomachdist.ress)and accounlcdfor 18.2'.f&ofthe varianec.Nonpn:scription
drugs and pracription diet pillsmadeup the secondfactoraa:ounting for
13.4%of thc variance.Consequently,scparatc mcasureswcrederiYedby
summingthe numberof drugstaken in twocategories,one for prcscription
drugs and one for over-the-countcrmedicationspluspn:scriptiondiet pills.
For each type of drug taken 'by the respondent,,a parallcl qucation
rcquestedthat frcqucncyof usagebe ratcdon a scaJeof 1(lcssthan one day
a month)to 6 (daily).Thesedata wen:subjcctedto the samefactoranalysis
proc:eduresdcscribedprcviously,resultingin thrc:efactors,which.in total,
accountedfor 40.8%of tbe varianec.Frcqueocy-of-uscfactor J wasmadc
up oí oftr-thc-countcr pain rclincrs and other pn:scriptionand non-
prcscriptiondrugs not spccifacallymentioncd(IS.89(,oí varianoc).The
second factor indudcd pracription pain pills, slcepingpills, and tran-
 14 THE SOCUL PSYCHOLOGY OF HEALTH
qÚilizcn (12.9% of variancc); the third frcqucncy-of-use factor included
both prcscriplion and ovcr-the--counterstomach mcdications and prescrip-
tion diet pills ( 12.1%of variancc). We labclcd these facton O,lwr Dn,gs.
Depressams.and Ga.stroinlatinal/Obaily Dn,gs. Separate seores foreach
catcgory wcre dcrived by summing n::sponscsf-,r the tbrce.typc:sof drugs
within that classificatiOIL
Life mtisfactiontMasure. Using a scalc of 1 (vcry satisfted) to S (vcry
dissatisfted), n::spondcntswere asked to rate their dcgn:e of satisfaction with
( 1)their jol>,(2) themsclvcs.and (3) lifc in general. Responses to these thrce
itcms were summcd to crc:atca score of general lifc salisíaction. A principal
componcnts factor analysis produced onlyonc factor, which aa:ounted for
58.3% of the variancc. Tbc alpha codf acicntof n:liability was .63.
Measureof lwlp-s«lcing~havior. Twoquestions were asked regarding
whether. in the past year. rcspondents had considen:d sceking help for
personal or cmotional problcms. and if so, whether thcy had actually
sought that hclp. Responses to these itcms were then combincd to gcneratc
a mcasun: of help-secking and were c:odedas 1 (considcrcd and obtaincd
help), 2 (considen:d accking help. but did not), or l (did not consider
accking help).
Jkmographic data. lnaaw:wai detcrmincd the rcspondcnt's scx.,agc,
racc. lcvcl of education complcted. houschold i'ncome. and marital status.
Further questions detcrmincd tbc numbcr of pcoplc living in the respon-
dent's household andhowmany of thosc werc under 18)'CIIS of agc. Data
reganling employmcnt includedrcqucsling the n::spondent'semployment
status and if working. bis or her job lilJc or primary job dulic:s.
The data were analyztd to provide úúonnalion about the psychomctric
propcrties of the PerocivedStress Scale, the distribution of pcrccivedstress
across dcmographic facton, and the n:lation bctwcen pcn:icivedstress and a
series o( mcasurcs of bealth and hcalth bcbavior. Becausc a large numbcr of
analyscs wcre pcrformcd, a conscrvativc alpha lcvcl of p<.OOIwas set for
determining statislical signifac.ana=.Post hoc contrasls bctween group
meaos wereconsidercdexploratory,and Scheff~proa:dun::swen:cmployed
with alphas set al lhe traditional p<.OSlcvcl for these analyses.
Bccausc thc resulta n:portcd here are bascd on cross-scctional data, no
hrmwd S1rru in a hobabilily Sampl, 4J .
inferenccs of causality can be madc. In other words. for n:lations reported
bctwccn PSS seores and seores on other mcasurcs. we cannot say with any
a:rtainty whether stress lded as the causal agcnt. whcthcr stress resulted
from thosc related facto11.or whether both facton werc influena:d by other
variables.
-.ndIDkn:oml.._.
Flldor Allalyses,RdiabilityEetieNHI,
The 14-itcm Perceived Strcss Sca1cwu factor analyzcd, using a
principal components method with varimax .rotation. Thc principal
components analysis n:ftalcd tbat 10 itcms loadcd positivcly on the first
factor at .48 or above. ltcms4, S, 12, and 13 had relatively 1owloadings of
.17, .lJ .. 11, and .39. respcctivcly.Tbc analyses further malcd thal thcrc
were two facton with cigenvalues over 1.0 (Factor 1 = 3.6 and Factor
2 =2.2), which togethcr aa:ounted for 41.6% of the total varianec.
Ex.aminalionoí the highest loadings foreach itcm indicated tbat the fmt
factor (25.9% of the variancc) weighted moll beavily thosc itcms tbat were
ncgativcly worded (e.g.• bcen upsct. unablc to control tbinp. fdt ncrvous
and stressed). and the sccond fl!dor (15.7% of the varianoe)rdlected
positively phrased statcments (c.g., dcalt succ:asfully with basslc:s. effec-
tivcly coping, fclt confldcnt). For purposc:soí mcuuring pcrc:eptionsof
stress, the distinction bctween the two factora wa considen:d irrclevant.
Conscqucntly, seora for the PSS 14uscd in laler analyscs were obtaincd by
summing responses (with the appropriatc itcms revcned) lo ali 14 itcms.
Cronbach's alpha cocffacient for thc intcmal reliability of the PSSl4
was .7S.
A somcwhat shortcr version of the Peroei-S Strca ScaJe. the PSSI0.
was dcrived by dropping thc four itcms with relativcly low factor loadinp
(itcms 4, S, 12,and 13).Tbc remaining 10itcms were aubmitted to the factor
analysis proa:durcs describr:dpreyjously. In the principal componcnta
analysis of this shortcncd scalc, ali itcms loadcd positivelyon the fmt faetor
at .42 or abovc.Once again. two facton emerged with eigenvalues over 1.0
(3.4 and 1.4, rcspccti\'Cly),composcd of ncptively andpositively worded
items. Dclction of the four itcms rcsulted in a alight improvcmcnt in bolh
thc total explaincd variancc (48.9% for both facton combincd. Factor l =
34.4%. and Factor 2 = 14.5%)and intemal reliability (alpbacoeffacicnt =
.78). Thus it appcan that the PSS 10 may be at 1castu good a mcaaure of
pcrceived stress as thc longcr 14-itcmversion oí thc sca1c. •
 46 THE SOCIAL PSYCHOLOGY OF HEALTH
A more abbn:Yiated versionof tbc PSS, a four•itemscaleconsistingof
items 2, 6, 7, and 14, was prcviouslyemployedin telcphonefollow-up
intervicwsin smokingc:c:ssation studics(Cobcn, 1986;Cohcnet al., 1983).
In thcseprior studics,tbc PSS4demonstratcdadcquatcn:liabilityandwas
shownto be a uscfulmeasureoí pcrceiw:dstress'for situationsrequiringa.
veryshon sea.le.Rcspomcsto tbc four itcmsfrom tbc prescntsamplcwc:re
factor analyzcd using a principal coriaponentsmethod. Thc analysis
n:vcalcdonly one factor with an cigcnvalucovcr 1.0 (spccifally, 1.8),
whichaccounÍcdfor4.S.6%of the variancc.Thc alpha rcliabilitycodTacicnt
for the PSS4 was .fíO.
To summarizc,the thrccvcrsionsoí tbc Perceiw:dStressScalcanalyzcd
herc:all appcar to demonstratcadc:quateintcmalrcliability.Withthc largc
samplcsw: providcdby the Harrissurvcy.wcwcreablcto determinethat a
somewhal shortcnc:dvcrsion oí thc original l~tem scalc, the PSSI0,
appcarsto provideal lcut u gooda measureoí pc:RCÍw:d stressasdocs the
longcr scak. lbc rcsultsoí thc pn:a:ding analyscsalso conflrmprevious
indicationsthal thc PSS4 has adc:qualereliabilityfor use in situations
req~ a vcrybricfmcaaureof perceptionsoí stress.Normatiw:data are
reponed latcr for all thrcc \tfflÍOIII of thc Pcn:eiw:dStress Scalc(PSSl4,
PSSI0, and PSS4).
Ma111Uld SlllndlnlDmatioal
Meanseoresforthe entircsamplc(malcsand íemalc:scombincd) for the
PSSl4, PSSI0, andPSS4 wcrc 19.62,13.02,and4.49, rcspectivcly,with
standard dcvialionsof 7.49,6.3.S,and 2.96.Thc rangcsof seoresfor cach
measurewcreOto 4.S(PSSl4), Oto 34 (PSSI0), and Oto IS (PSS4).Table
l.2 pracnts the means and standard dcviationsof seores on the tbrcc
Perceiw:dStressScalcsfor cach categoryoí dcmographicvariables.
~x. As is apparent from Table l.2, on aJI thrcc mcasurc:s,rcmalcs
n:poned higher lcvcls oí pcrcciw:dstress than did mak:s. Onc•way
ANOVAs rcvcalcdthat, in aJI cases, thcse diffcrcnccswc:restatistically
signifacantal thc p(.0001 lcvclor beyond.
Ag~. PSS seores dccrcascd as qc increascd. Ncgativccorrclations
betwcenagc of respondcntand the thrcc PSS mcasurcswc:resmall but
significantatp<.001:for PSSl4,r=-.ll; for PSSI0,r=-.IJ;for PSS4,r=
-.11. Sinec the agc data are actually continuous, we havc reponed
corrclationswithperceiw:dstresahere. Howc:vcr,
nomas(meanPSS seores
hrmwd Sltta in a PtobabililySomplt 41
and standard deviations)are rc:ponedfor fivcagccategorics( 18-29,J0..44,
4S--S4, SS-64,and 65 andovcr)in Table 3.2.
lncome. WhenSf;Orcs wcrecl.usiflcdby levd oí houscholdincome,tbc
thrcc PSS measun:sproduccd the same pattcms of raults. As Tablé l.2
shows, pcrccptions of stress dcclincd linearly as household incomc:
incrcascdto tbc lcveloí SlS,000pcr ycar. BcyondSlS,000per ycar, thc
trcnd was lcssconsistent.Rcspondcntswithcamingsbetween$45,000and
SS0,000pcr ycar n:poned 1clSstress lhan did thosc in any oí the rther
catcgorics,whilcstresslcvclsof thosccamingbetweenSlS,000and $40,000
and thosc with incomesin cx.cas oí SS0,000wen:approximatclythc same
as thoscin the S2S,000.30,000 rangc.Onc-wayANOVAs indicatedthat tbc
cffcctoí householdincomcon pcrceiw:datrcsawu aigniflCaDt at p<.0001
for ali tlmle PSS scaJes.
Bccauscn:sppnsepattcrnswereYirtuallyidcnticalfor all PSS mcasures,
only tbc rcsultsof the post hoc anal)'ICIíor the PSSl4 are n:poned herc.
Schcff6tests for diffcrencesbetweengroup means indicatcd thal PSS
seoresfor thoscwithincomcsof S.S,000 or lcu MKIÍgnifacanllyhigbcrthan
the seoresoí all n:spondentswith incomcsovcr SIS,000,but did not diffcr
from thosc in the S.S,000.10,000 and SI0,OOQ.IS,000 categoría. Rcspon-
dcnts with household incomcs in the SS,000.10,000range n:poned
signifacantly highcr lcvcls oí pc:RCÍ'Wld stress than did those eaming
$25,000.30,000, SJO,OOQ.l.S,000, $4.S,000..SO.OOO.and more than SS0.000.
Only thosc whoscincomcwas $30,000.lS,OOO or $4.S,000..SO,OOO
reponed
signifacantlylcssstressthandidthoscin theSI0,000.15,000group.Noneoí
the other comparisonsbetweengroup means MK lignífant at p<.05.
Educa1ion.Thc more cducationrespondentshad, thc lowu were their
seoreson thc PSSl4, PSS 10,and PSS4.Onc,.wayANOV As showcdthat
this cffcctwas signifacantfor all tlmlemcasurcaal p(.0001 or better. Thc
SchcfféprC)(lcdure for testingdiffcrcnccsbetweengroup mcansindicatcd
that PSS seoreswcrcnot significandydiffcrenlfor thosc witb 1cssthan a
highschooldiplomaand thoscwhowcrehighschoolgraduales.Howc:vcr,
subjcctswith lcssthan a high schoolcducationreponed signifacanllymore
pcrocivcdstress than did aJI thosc with somc cducation beyond a high
schooldiploma.Oí ali the other possiblccomparisona,only the dilTcrcnec
betwecnhigh schoolgradualesand respondcnllwith an ldvanccddcgRJC
was sign.if acant.
Roce.In this samplc,minoritycthn.icoriginor racewasassociatcdwith
reportsof perceiw:dstress.Tablcl.2 showsthat respondcntswhoclassified
themsclvcsas ""whitc•had lowcrseoreson all thrcc PSS mcasuresthan did
thosc classiflcdas black, Hispan.ic,or other minority.Onc-wayANOVAs
 .._Meant'::i:>111.
f'5511J1 ana P5~ seores ana 5Ulnaara uevaauon1 ,or uemograpmc w■Htgone•

PSSU PSSJO PSS4

Cllt,rory N. M,- SD N ltlffll SD N J,/,on SD

Sex
awe 949 11.1· 6.9 926 12.1 5.9 946 4.2 2.8
fcmale 1406 20.2 7.8 13,,M 13.7 6.6 l:"14 4.7 3.1
A,e
18-29 M9 21.1 7.2 MS 14.2 6.2 6'8 4.9 3.0
30-4,4 762 19.6 7.3 750 13.0 6.2 756 4.S 2.9
45-54 298 19.1 7.1 285 12.6 6.1 290 4.4 2.9
5~ 300 18.3 8.1 282 11.9 6.9 294 4.2 3.1
65 & over 333 18.5 7.8 296 12.0 6.3 330 4.0 3.0
Annual ho1.11ehold
income
S5Kor less 170 23.1 8.S 153 16.4 7.4 162 5.9 3.5
~101( 233 21.8 8.3 216 IS.O 6.7 232 5.2 3.3
SI0-15K 309 20.9 7.4 303 14.1 6.2 308 5.0 3.0
SIS-20K '177 19.4 7.5 270 12.8 6.3 275 4.4 2.8
520-251( 2,47 19.5 7.0 2,42 12.8 6.0 2,45 4.4 2.8
SlS-301( 255 18.6 7.3 2A8 12.1 6.1 252 4.1 2.8
$~351( 181 17.8 6.6 178 11.6 5.6 181 3.8 2.6
S3s-toK 134 11.8 6.4 130 12.5 5.S 131 4.2 2.S
$40-451( 93 18.3 6.3 91 11.7 5.3 93 4.1 2.S
$45-501( 72 16.1 5.8 70 10.3 4.7 71 3.1 2.3
over SSOK 189 18.4 6.3 187 11.9 5.6 J87 3.9 2.S

Educationcompleicd
less than H.S. 400 21.3 7.8 J69 13.4 6.8 399 4.9 3.4
H.S. srld 820 19.9 7.8 799 13.1 6.7 812 4.6 3.1
10mecolle¡e 580 19.6 7.5 555 13.1. 6.2 568 4.5 2.9
4 yr. colle¡e 263 18.2 6.6 262 12.0 5.6 264 4.0 2.6
10mesrld. achool 140 n.o 6.4 137 12.2 5.4 138 4.0 2.4
advanc:edde¡ree 145 17.4 6.4 142 11.4 5.2 143 3.B 2.3
Race
wtüte 1995 19.3 7.4 1924 :12.1 6.2 1974 4.4 2.9
Hispanic: 100 21.3 7.8 98 14.0 6.9 100 S.1 3.2
black 185 21.S 1.1 176 14.7 7.2 1B3 5.1 3.4
othcr minority 51 20..5 6.7 50 14.1 5.0 SI 4.9 2.3
Numbcr of peoplein bouschold
one 407 11.9 7.1 372 12.6 6.6 400 4.3 3.1
two 755 11.9 7.4 729 12.3 6.2 745 4.2 2.9
three 4'2 19.7 7.6 431 13.2 6.5' 438 4.6 3.0
four or five 627 20.4 7.3 615 13.7 6.2 623 4.7 2.9
siJ.or more l:Z.C 21.6 7.5 123 14.4 6.2 12,4 5.3 3.0
Number of childrenin ho1.11ehold
DOIX 948 19.0 7.3 911 12.5 6.1 933 4.2 2.8
one 412 20.1 7.6 406 13.4 6.S 412 4.B 3.1
two 377 20.4 7.4 371 13.6 6.2 373 4.6 2.9
three 147 20.9 7.4 146 14.0 6.4 148 5.0 3.0
four or more 60 22.6 7.1 60 15.1 6.6 60 5.6 2.9
 hrcftwd s,ms in a Probdbilúy
Sotmplt 51

Q
"'2 ~:J:J!~ Na .....--o-~
MMNf"i"""""".,¡ :i::l~~~~~~:::t on these data revcaledthat thc cffcctoí racc on PSS seora was statistically•
signiflcant for all thrcc measurcs at thc p<.001 lcvcl or bcttcr. Betwccn--
.' iroup comparisons using thc Schdfé proa:dwc íurthcr revealcd that
a1
...~ ~~~:;t;¡ r--o:f"'i~-:,.qf"'if"'i
""'••"'""'°.,..
,.qo:C?O:"'"!"l"':"l!C!
.............................. "" meansfor whitcs wcre signifteantlylowcr than wcre mcanafor blacb, but
that thc differenoesbetweenmean seoresfor all othcr possiblccomparisons
between groups wcre not statistieally signifacant(duc, •in part. to lbár
:!;;!§1111!!~ ____
.eRH'1¡!2"'!l:;; ;g.,..._
:.i;
-
:!J;.J~i
N .... - smallcr Ns). •
H'1f«hold composi1ion. The number oí people in onc'I houscbold and
thc numbcr or thcm who are children wcrealao asaocialedwith perccptions
oí stras. As Table ).2ahows, cithcr livingaloneorwith one othcr adult wu
0.101'\eo,n...,V\N-
..-.-o•- ............
,cí ,o wi ,o '°'°"'
,o ,o ,o .. lcast stn:ssíul. Al thc numbcr oí people in thchoUleboldincreascd,IO did
fi ,o " ,o ,.: ,..: ,o ,o wi wi wi wi ,ó ,o ,o ,o
PSS acon:s..Corrclations betMen thc number of peoplc •living in thc
respondent's houschold and PSS scora on thc thn:ietcalcs wae small, but
al
...=- ----- -------- ---------
~~;~: ~~~~:;;:!:l: ~a~~::1~:1~:i signifacantat thc p<.001 k:vclor bctter. for PSSl4, r = .11; for PSSI0, r =
.10; for PSS4, r = .11. A similar relationship waaevident for number oí
children and PSS raults. Thecorrdations bctMen rapondentl'peroeiwd
1::,
e :11:: !!i!:: :eli§1U1J:E~ ;eR¡5e!rJ~;!! stress and numbcr oí children wcre ali sipifacant at p<.001 or better. íor
=e PSSl4. r= .11; for PSSI0, r= .JO;íor PSS4, r= .10. Bcc1usedatacollccted
8 on thcse two dimenaions oí bouschold composition wae continuous. we
~ . have reponed correlations acora hiere.Howevcr, íor thc purposco.♦
":a• Q
"'2 ~::!~~~
"1!"1!0:C!f"':"ll;f"t~
onr---o•r-r--r--•
f"'i-Nr--,O•eo
......
..
,-=,.:,.:,o
O- n:porting mean PSS seoresandstandard deviations, Uractwo variables
wm: dividcd into thc Qtcgorics shownin Table 3.2.
~ Marilol .r101w. Pcrceptions oí stn:ssappearedto be n:latedto marital
O:C!O:"'"!"'I 111!"10:'"'C!~~"I! ~,.q-:f"'if"':'"'!C!"l"II; status. One-way ANOVAsRvealcd thal thilcffect w.aaignifacantforach
~j !!!:ftÑR !:!!!!!!:ÑRR.q !:!:!!!!!!!:RRN
111CMwc or stn:ss at p<.0001. Surprisingly,rapondcnta who wae marricd
or living with a mate did not diffcr in levelsoí pcrcciwd llR:II from thole
:11::
:?~-s~
N:!~- :!;;§1;~~!!* J:RNf.J:!:!Jft:lt
IQ ....... - - who n:ported that lbár 1pouscswere d«cascd. Tbese two groups bad the
lowcst PSS seores. and Schcfft tcsu rcvealed that Urac seora wae
signifacantlylowcr thao thc seores oí thosc who weresingle/ ncvcr married,
divon:ed, or scparatcd. Respondcnts who had ncver bccn marricd did not
differ signifacantlyírom thosc who wcredivorccd or acparaled. nor wae
theresignifacantdifferencesbd.Wl:ell mean PSS seora of acparaled(but not
divon:ed) and divorccd individuals. '
Employmen,. A final catcgory oí demographic variablesconccmed two
aspccts oí respondents' employmcnt: (l) employment status.and (2)
proíession. Mean PSS scora ror thc classüatiom within thcsc two
categoriesare shown in Table 3.2. Onc-way ANOVAl~ effccts ror
both cmploymcnt variables on PSS seora that weresipifacant at thc
p<.001 lcvelor bettcr. Thosc who said thcy wcre in thc militar)'.raimd and
not worting. employed íuU time, or homcmakcra bad PSS acora (on ali

'º
 J1 THE SOCIAL PSYCHOLOGYOF HEALTH
threc scalc:s)below the overall sample means. Seora oí respondcnlS who
wcrc cmploycd part time, studcn&s,üncmploycd, or di&ablcd/too ill to
work fcll above thc overall samplc meaos. 1bc Scheffé proocdurc íor
multiplc comparisons bctwecn groups rcvealcd scveraldiffcrcna:s bctwecn
meaos. Those n:spondcnts who werc disablcd/too ill to work reponed
significantly more stress than did those who werc in thc military, rctircd,
cmploycd (cithcr fuU or part time). or homemakcrs. Additionally,
individuals who wcrc cmploycd full time or who werc rctircd and not
working had PSS seora signifacantlylowcr lhan did part-timc cmployccs,
studcnts, and the uncmploycd. Duc, in part, to varying Ns in the groups.
thc stress lcvcls of part-timc cmployecs and milita.rypcrsonncl werc only
significantly lowcr than thosc of thc disablcd/too ill to work group, and
homcmakcrs wcrc signiflcantly lower only than those respondcnas who
wercuncmploycd or disablcd. Clc:arly,being cither cmploycd full time or
rctircd and not work.ingwu ISIOCiatcd wilh lowcr leve1a
of pcn:eivcdstress,
and being cither unemploycd or disablcd wu relatcd to highcr rcports of
atn:ss.
Data for lhosc individuals who indicatcd that they werc work.ingcither
fuUor part time wcrc íun her analyzcd aa:ording ·to the job tille or main
dutics oí their jobs. For this classifacation,the patlcms oí seora wac much
tbc samc on aU thrcc sea.les. Proprietors, agricultural workcn, proícs-
sionaJs, managers. and skillcd workcrs scorcd below the overaU samplc
mcans. Seores for sales workcrs wcn:, on all thrcc mea.sures,very closc to
thc samplc meaos. Rcspondcnts with PSS seores above the overall samplc
mcans wcn: clerical, scrvioc:,and unskillcd workcrs. Using the Scheffc!
procedurc, PSS seores íor unskillcd workers werc signifacantlyhigher than
for proprieton, proícssionals, and managers. Nonc oí tbc other compari-
sons betwecn groups was statistically signifacant.
Summary. 1bc pattcms of pcrocivcdstress seores for tbc dcmographic
variables just rcportcd indicate lhat a variety of personal charactcristics
werc associatcd with pcrocptions of stress. Reportcd stress lcvels wcrc
consistently highcr for fema.la than íor males. lbcrc was a small. but
significant. negative correlation bctwecn PSS seores and agc, suggcsting
that pcrccptions oí stress tend to decline as agc incrcascs. Whitcs n:portcd
lcss stress than did those in minority groups. although only the differcncc
betwc:cnwhitcs and bJacks wu statistically signifacant. PSS seores tended
tq decn:ase as rcspondcnlS' leve) oí formal cducation incrcascd.
Factors associatcd with one'I living and working environments werc
also found to be rclatcd to perccivcd stress. As would be expcctcd, PSS
seores gencrallydc:cruscd as housdtold incomc incrcuc:d. Reports oí stress
hrMved Strua in II hobability S.,,,,. JJ
incrcascd as the number of people living in the respondcnt's houschold
incrcascd and as thc number of childrcn in the houschold incrcascd. Peoplc
who wcrc currenlly either marricd or living with a mate and thosc whosc
spouscs had dicd rcportcd lcss stress than did thosc who had ncver bcen
marricd or who wcrc divof\".ledor scparatcd from tbcir mata. Fmally, bcing
uncmploycd and/ or disablcd was found to be rclatcd to high lcveJs of
rcportcd stress, whilc being cmployw::dfulJ time or Ktircd and not working
was associatcd with lowcr PSS seores. lndividuals whosc oa:upations
involvcd rclatively higher dcgn:cs of status and control (proprieton,
professionals, and managcrs)-and one might usumc. moreincome u
wcU-rcportcd signifacantlylcsspcn:eivcdstress lhan did Wllkillcd workcrs.
In this sed.ion. wc examine cvidcnce providcd by the Harria Poli data
rclcvant íor cstabl.ishing tbc construct validity of the PSS mcasures.
lncludcd are rclationa bctwa:n the PSS and other Ibas meuura, bcalth,
healtb scrvioe utilization. bcalth behavion, tifc satisíaction, and help-
sceking. In general, • ex:¡x.ctcdtha&incrcalcd IUal u mcuurcdby the
PSS would be associatcd with incrcascd stras u asseucd by other
instrumcnts and questiona. greatcr help-sceking, poorerbcallh, mon:
health scrvioc:utilization, and poorer life satisfaction.
For dichotomous and noncontinuous variablc:s, mean,cora on the
PSSJ4, PSSIO, and PSS4 werc calculatcd. For U>ntinue>usvariables,
seores wcre corrclatcd with PSSl4, PSSIO, and PSS4 rapoma. DMaarc
prcscntcd for thc cntirc sample. Bccause many variables wercnot rclcvant
to large numben of rcspondents, Ns varied widc:lyfrom one mcuure to
another. Sincc tbc pattcms of results wercmuch thc samc for the thrcc PSS
mciuures, only tbc rcsults for tbc PSSl4 are disalSSCdin this section.
Howevc:r,the mc:anscorc:sandcom:lations for ali thrceacabarc pracntcd
in tbc tables oí rcsults.
Comporisons iwtw«n PSS ICO"I anti #rur tnt!OIUl'a. Sincz n:spon-
dcnts wcrc askcd how oftcn in IM ltut montlr they had ex:pcricnocdtbc
circumstancesdescribcd by the PSS, it w11cx:pcctcd lhatPSS 1Cota would
be most closcly rclatcd to other measura that werc daipcd to tap
pcn::eptionsoí stress within the prcvioua montb. Conacqucntly, mcuura
with a longer time refcrcnce (such u •¡n the pul year" or "cveri werc
expcctcd to be somcwhat lesa closcly rclatcd to PSS seores. Thac
 J4 tHE SOCIAL PSYCHOLOGY OF HEALTH Pm.wwdStrm In • holMl,;lú1 s.,,,pll SJ

expcctations were confirmed, A t--tcstRVCaledthat mean PSS seores for TalM3.3

subjccts who indicatcd that they had twrexpcrien&Zd stress (mean= 19.J) BelweenPSS14, PSS10, andPSS48cDIN
ComtlaUOM
were significantly(p<.0001) lower than seora oí those who said thcre Wl:re. andStreu......,,_
things in lifc now that were upsetting or bolhersomc (mean = 23.2).
Similarly. as Table 3.3shows, PSS seores wcrccorrclatcd with n:ports oí
.,,.,,_.,,., l'SS14 •rss10 l'SS4

thc amount oí slress cxpcricnced during an average week(r = .36, p<.0001) durina•
H- muchSiras do JGUeapaicDDe
and thc amount oí llresl cxpcricnced now u compan.d to a ycarago•
(r = .26, p<.0001). • -· ICOICI:
(hi¡II wcck1mon:... ) .J6 .l9 .29
(1697) (lffl) (1613)
Cohen, K.amarck,and Mennelstcin ( 1983)found thll PSS seores Wl:rc
Compved lo a y,ra ..,_ bow_...,_do JGU
modcrately correlatcd with the number oí life cvents that rcspondans capcricna:DOW7
indicatcd thcy hadcxpcricnced within the last year. Thcy also found that (lup ICOICI: IDOIClhtlS) .l6 .l6 .2J
thc correlation inaasc:d whcn respondcnts'pcrceptions oí thcevcnts werc (16M) (1653) (1618)
takcn into accounL Al shown in Table 3.l, PSS seora wcrccorrclatcd with (jfc-nnblClia
N...tla'alnata JO .J2 JI
numbcr oí lifc C\'altl (r = .JO, p<.0001). HoWCffl',in the praent study, (2JSS) (2210) (2J]IJ)
consíderation oí rcspondcnts"reporta oí thcimpactof thcseC'fflllsdid not Owerall
..... alcWIIII -.10 -.09 -111
increasc thc correlation, although. as would be cxpccted, thc corrclation
betwecnpcrceivcdstressandnegativcimpact(r=-.27,p<.OOOl)washigher Ncp1M..... al CWIIII
. (176S)
-:n
(1'111)
-.rt
(1746)
-.26
• ('992)
than thc comlation bet'M'lCnPSS acores and ovcrall impact (r -.10, = How-, a.n,wea do,- woctT
(10)4)
-.10 -.11
(1015)
-.12
p<.0001). Thc life-evcnts meuures· uscd in thc Cohcn et al studics (MIS) (lffl) (1412)
consisted of 99 items related to adjmting to thc dcmands ol coUcgoc life Job raponsibililiclala
...
...
(collcge student samplc) and 71 ilcms matcd to negativc lifc evcnts (hip lCOll:I= .. ...,......1,
(smoking cmation samplc). 0n thc other hand, thc lifc-ew:ntsmcasurc Wilbíelldi.::t .14 . 14
uscd in thc pn:scnt study containcd only 16C\'altl, somc oí which w.:re .,.
(ll7S) (IJSI)
.m.-
(IJ62)

...
WilhcM!tr.tbll:k .
ncgativc, somc positivc, and somc ambiguous. lt may be that this much (1421) (IJJI) (1411)
abbreviatcd scaJcwas not u scmitivc a mcasureoí pcroeptionsoí lifeevcnts Worlload......
u thosc uscd pieviously. • (hipDftl=llipdemand) m.-. m.-
A final catcgory oí mcasurcs of potcntial sttm had to do with catain (1221) (l»s) (1217)
characteristics oí employcd rcspondents' jobs. Comlations bctwccn PSS
seores and thcsc meuura ~ shown in Table 3.3. Numbcr oí houn per
NOft: llle.....,•h 11$1tJ11•1111wtu••••ll---lll.p02a1I
Ulllllu•l•--IIMllcllN.llw:: f 1 ■■ ~cl»• ,.,,<.........
UL

=
wcck workcd was inversely relatcd to pcn:e.ivcdst.ras (r -.10, p<.0001), -,<.1111;.~............
indicating that thc more hours pcr weck a pcnon spent working. thc lower
we~ pcn:cptions oí atras. This relation was consistent with the finding Surprisingly, thc measurc oí Work.load Demand wu not relalcd to
~portcd above that part-timc workcn n:portcd mo~ stress than did PSS seores oí rcspondcnta who wen: cmploycd íull time (r .03, n.s.): =
íull-timc workcn. Apparcntly,job n:sponsibilitie:sthal cause an cmplo)U to work ovcrtirnc
The two íacton oí thc Job Rcsponsibilitic:sScalc, rcsponsibiliticswith 1nd miss lunchcs and breaks wae not generally UIOCiatcd witb thc
feedback and n:sponsibilitieswithout feedback,both com:latcd positi~ly cmployec's pcrocptionsoí strcsa.
with PSS n:spomc:s, indicatingthat thc lessn:sponsibilitya workerhad,the In summary, PSS seores weremoderalely fflatal to lapcNm:I on othcr
highcr ~n: pcrocptions oí stress. Furthcr, thc correlation bctwcen PSS mcasuresoí appraixd stress. u well as to mcaswa oí poCenlial aoun.u oí
scon:s and n:sponsibilitieswith íeedback (r =.14, p<.0001) was highcr than Sll'ffl as asscsscdby evcnt fn:quenc:y.
lt also appeand that jobs with more
=
for R:Sponsibiliticswithout feedback (r .07, p<.002). responsibilitíes,cspcciallythosc in which thc cmplo)U ruávcd feedback
 J6 THE SOCIAL PSYCHOLOGY OF HEALTH Ptrttlwd Sttm In II Probtlbilhys.n,,k $1

about pc:rfonnance, wcrc associatcd with lo'Wtl' levels of stress. Howc:ver, . Table3.4
oí employmcnt thal might typically be considered stressfut.
a:rtain aspc::cts Correlatlona Belwll~nPSS14,PSS10,and PSS4SCON9and
such as work.ingovcrtime and missing lunches and brab, were not relatcd . Sell-Reported Healttland HeallhSet'ik:es Ullllzatlon.Mwuree
to pc:ra:ptions of stress. ,ssu rss10 ISS4
/,ll'O.fl/ff
ComparisonsbetWttn PSS seores11,d se/f-teporl«l heolth ond utiliza.
tion o/ heallh servias. As Table 3.4 shows, the •individual question Howia your healthT
.23 .2l JO
rcgarding health status was conelatcd with reports of stress (r = .23, ( 1 : i:ac:dlenl lo S :: poor)
(23S3) (2268) (2327)
p<.0001 ); the poorer that respondents pc:ra:iwd their health to be, the
llldc1oí ínabiJily10 pa{ona routinc:
actmúcl
more stress thcy reportcd. Similarly, on the individualquestion about (high sc:on:s=IIICft r~ diO"acully) .21 .23 .M
hospitalization. respondents who reportcd being hospitalimt during the (404) (J97) (G))
prcvious ycar had higher PSS seores (mean= 20.3) than did thosc who had llldc1oícwrhmn1hldmÍCIUlillMD
not bccn in lhe hospital (mean= 19.S),although these diJTercnca wercnot (high IClOla :: mon:illnieaa) .IS .16 .ll
(23") (2210) (23lO)
significant at our sel criterion of p<.001 (Cor PSSl4, p<.lO; for PSSIO,
llldcaoí IClicMa iUneltiDllll ,ar
p<.01; CorPSS4,p<.OS). .14 .IS ..12
(higllIClOla: ,aon: ill,iira:a)
As expc:ctcd, seores on the Health Sema:s Utilization Scale were (23») (2210) (2330)
positivcly com:latcd with PSS seores (r =.21,p<.0001), as were responses Psydlosomalic
imle1trmon
to the measllfC of inability to perfonn routine activities (r = .21,p<.0001). (high~ =IIIClfe bothererl)
Non«rioul symptoms .31 .32 .26
Furthcr, the numbcr of scrious illnesxs respondents had ever had (r = .15, (2340) (2251) (2316)
p<.0001 ), as well • lhe number of scrious illncsscs ex.pc:riena:d witbin the Scriolllilnea .,._ .n .21 .2l
last ye.ar(r =.14,p<.0001) werebothposilivcly relatcd to pen::eptionsoí (2350) (2265) (2)25)
stress. Au IJIIIPIOIIII .32 .34 ·.n
Thc thrce factors of the Psychosomatic lndex werc also rclatcd to PSS (2337) (22SI) (2314)
seores. Symptoms of potcntially serious illnes.swerepositiw:lycom:Jatcd Hcakhmw:a Uliliz.. ien ale
with pc:rceiwd stress (r = .27, p<.0001), and the conelation was slighlly
(lligh1C01a =IIIIIIOft'Ulilizlfien) .21 .22
·"
..-
(lll) (271) (217)
highcr for both facton conccrnal with 1ymptonv. indicatiw: of lcss serious

...................
Gliw4a f ., .., .............. ,_ .. 111
health conditions. for the Nonserious Symptoms factor, the comlatioa NOTE:'1111
.....
was .31 (p<.0001), and for symptoms possibly associatcd with Ou. the
conelalion was .32 (p<.0001).
~ .....
,
8 ..... Wi I O 71- le S •"f1t<.III ......

In summary, these resulla clearly demonstrate an assotjation betwecn

sclf-rcported physical illnes.sanddevatcd strcss asmeasured by the PSS. ·
Both frcqucncy of physical illnesa and symptoms of physical illness werc
positivcly n:lalcd lo reports of slrc.ss. Morcovcr, pc:rcciwd stress was
almos~ as closcly relatcd to scrious symptomatology as to nonserious
symptoms. Bccausc these com:lations are cross-sc:ctional,no infercncesof
causalitycan be made. Althoughslress may havccauscd health problems, it
is also possible that poor health elcvated strcss. or thal a third factor, for
cxamplc sociocconomic status, inllucnccd bolh stress and health.
Comparison.rMtw«n PSS score, ond heollh MhaYiors. In general,
rclations betwecn mcasures of varioua health behaviors and pc:ra:ptionsof
stn:s., wen: not impn:ssivc, as shown in Table 3.5.
First, for the entire sample, the total number of hours of slcep pc:rday
w~ not correlated with PSS seores (r = -.01, n.1.). Further, when the
samplc was stratutcd by age grouping. none of theconelatiom reachcd our
critcrion of p<.001, although Correspondents6S yean of ageandoldcr, the
ncgatiw: correlation of -. ll approachcdsignuac::ancie lll •p<.008. The
ncgativccom:lation of the PSS with number of boun in the longat pc:riod
oí slccp pc:r day was small, although statistically signifant (r = -.08,
p<.0001), suggesting a generaltendency for strc:sato be asaocialcd with a
shortcr period of slccping. W.hen these datawereanalyzcdby age group,
only PSS seores oí respondcnts bctween 18 and 29 yean of age wcn:
significantly com:latcd with-number of houn in the longat pc:riodof 1lccp
 $1 THE SOCIAL PSYCHOLOGYOF HEALTH s.,,-
Pm:riwds,,m ... l'tobtlbl/My ,,
Table3.5 (r = -.13, p<.001). For subjecta betMeR 30 and 44 yan of agic, thc
Comtlatlont Belween PSS Sconta and Heahb a....... ........ correlation wasmarginal (r =-.09, p<.007).
M~ l'SS/4 l'SSIO l'SSI
Sccond, thc frequcncywith which subjectaaleblakfatl wu aJsordatcd
to PSS seores (r::: -.09, p<.0001). 1bis ncpti• condationindícala lhat
In total.bow-, lloln/a, do ,ou ...,, -.01•• -.G2.nl .01.- pcople under stras eat breakfutlesaoftca tban do lholc cxpericncing
(2347) (2264) (2322)
Howm111y11o1nia Uw:1oept period al .. lower kMls of Sllas.
eacbdayT -.111 -.111 -.os.• Third, for thc total sample of both drinken andnondrinken, frequency
(2lOI) (2231) (2111) of drinking alcohol wasnot rclated to PSS ICOl'a (r =-.04, 11.1.).Amona
Howofka do ,ou al bratfatT rcspondentswho indicated that thcydrank alcohol at aU.numbcr of dónb
(1 = ancr lo 7 = daity) -.09 -.09 -J11 per day was positivdy rclatcd to highcr PSS scon:a (r =.10. p<.0001).
(23.st) (2269) (2321)
Howofka do ,ou drinkll0oholT However, thcrc was a marginal invcnc rclation betwocn how many days
(1 : DMr lo 7: daily) alcoholicbeveraga wercconsumcdand ~ of pen:aW'ld llff:ll(r=-.f11,
Total~ -.oc.- -.CM.111 -.06 p<.002). These data suggat thal incn:ucd drinting undcr ltlelllOCll:Ufflld
(DSOJ (2265) (23M) on spccifac•drinkingª days of thc Mek, pcrhapl on MJtbada
Driabnaaly -.0.,. -.111• -.rt7• • A fourth category of bca1tbbehaYionCOIICl:lned apn,ae11DODD1 A
(1'61) (ISJO) (ISS6)
Whn JOUdrial. bow1111111
drinb pa dar'
one-way ANOVA rcvealed thal rcspondenCI wbomi tbey were cunmdy
.10 .111 .09
smoking had margioally(p<.004) highcr PSS 1COrc1tbantholewbohad
u,....._• ...,,....padaJT
(U49)
.OJ.•
(ISll) (IS.JI)
.02.na .03.• quit smoking or had nevusmokcd. Table 3.6 presentamean PSSICOR:S for
(104) (61)) (697) this mcasurc. Howcver, among smokcn, thcrc wu no n:lation betwccn
. Howofkado ,- CKR:ÍIII:llrenuoUllyrar 20mia.ar pen:cptions of stras and how many pacb of c:igarctta per day were
loa,Fl'r
smokcd (r =.03,n.1.). Fifth. there wu a small ud marginally aipifacant
(1 =DMrlo7=dlity) -.06• -.06• -.os.- comlation bet-.en frequcncy of cxcrcise and PSS n:apon1t1(r = -.06,
(2]3S) {22,6) (2313)
Licildru, ..- sale: p<.003). with incrascd stras associaledwith infRCluent phyúcalcxcn:ilc.
Total aumberal drvplaba .17 .19 .IS Finally. usagc of licit drup, u measurcd by (1) number of diffcmd
(m,S) (22'JD) (DJO) drup laten and (2) fRqucncy of USIF, WII comparedto PSS ICOl'CI.
pacripliea ... .ll .12
(2347)
.16
(2262) (2Jll)
Pcn:eivedltlal wu corrclatc:d witbtotal aumbcr of drup laten (r =.17,
owr~drvp .12 .13 .10 p<.0001), u wdl u with thc two subcategories:numbcr of presriplion
(2349) (2266) (232') drup(r=. 13.p<.0001) and ower-the-counterdrup(r= .12, p<.0001). lnall
...
...
Fniqumty al al_,.

.....
...,...._,...,
... .16
(2127)
:n
(374)
....
{»59)
.2'
(JS7)
.14
.IS
(2110)
.21
(361}
.12
cases, taking more varieties of mcdication wu rclatc:dto highcr reports of
stras. FRquency of all drug usagie also inc:reascdwith inc:n:ucd PSS ICOrcl
(r =.16. p<.0001), as did usagie orthc thn:c aubc:atcgoria of drugs: othcr
drup. r = .09, p<.0001; deprcsaanll, r =:r,,p<.0001; psltoinlatinal/
(111) (71S) (799) obesity drup, r =.14, p<.0001.
Cldtcrdrup .09 .10 .111 In summary. pcrceptions of stn:ss wereonly alightly rclatc:dto ldf.
(200) (1977) (2027) reports of health behavion. Small but stalisticallysignifant corrclatíons
,NOTe Tht....._at,...a •ita1nwti---..11.,_111,_ ... 1111 wereobscrved betwocnelevatcdPSS ICOR:land(1) shona'periodaof sleep.
............................... , ......... ..... p<.1111• ........ (2) infRqucnt c.onsumptionof bratfast, (3) inc:n:ucd quantity of alcohol
• p < JIII; M• ,_, 111
p C:1111. consumption, (4) usagc of more licitdrup, and (S) frequcncyof licit drug
usagc:.Marginal rclationswcrcaJsofound betMeRstras and smokiq. lack
of physicalcxercise, and fewerdays pcr wcek of alcohol consumpti~ (for
 60 THE SOCUL PSYCHOLOGY OF HEALTH hrfflwd Smm,ln o hobobilily Somplt 6/

Table3.6 . rnulls is that pcoplelhink aboutgettinghclp only for problema~ uc

Mean PSS Scor9s for Respondenl Smoking Status bnthcrsomecnoüghto be strc:ssíul.Pcrhapsthosewhohadnotconsidcn:d
SIMIO PSSl4 pss, M:Cking aid had no seriouscmotionalor personalproblcmsin lhc pastycar
PSSIO
andso actuallyexpcrienccdlittlcstras..
Cum:nalyll'IIOU 20.4 • 13.7 4.1
(JO&) (616) (700)
OnacIIIIObcl. Mil quil 19.1 12.6 4.2
{616) {.513) (605)
Ncwr lmObd 19.4 12.1 u
(1021) (991) (1022)
NOTl':'llle.....,,.aa; .............. .._.,...,,,a The major goals of this chaptcr included(1) providingpsychometric
data on lhc lhrccdíffen:ntversionsoí thc PSS, (2) dcscribing
varialionsin
stresslcw:lsfor subgroups oí thc U.S. population. and providingPSS
those who drink).SmokersrcportedhigherIIMlsoí perceivedstressthan normsroreachsubgroupíor use in evaluatingscom from otbcrsamplcs.
did nonsmokers.Perceptionsoí stn:sswercnol associatcdwithtotalhows (l) cómparingperceiw:d stn:ssscom to seoreson othc;r strc:ssmcaswa.
slept per day nor. among smokers, with number oí packs oí cigamtes and(4) examiningthc associationbctweenthe PSS scalesanda wideruge
smokedpcrday. Howcvcr.associationsbetwccnstressand hcalthpractica oí mcasura oí hcalthand hcallh behavior.In this sr:ction. wc dilcuss the
may be undercstimato;Ibccauscselí-Rportsof many oí thc:5ebehaviors, evidcnc:ercporteclin regardto thc:5eissucs,makingn:commendations whc.1
particularly alcohol and drug comumption, may be subjecl to social appropriate.
desirabilitydfc:cts.
Comparison o/ PSS /ICOlll and Lije Satisfaction Scale. l..ew:lsoí
pen::eivcdsiras should be inverselyrclatedto rcports oí satisíactionwith WlaldlSale Is lest!
self,job, and lifc in general.11úscxpa:tation was confmned. High PSS
seores werc corrclated with rcports oí increaseddissatisfaction(r :: .47, Thepsychometricacteptability oíthe PSSl4 w• supportedbyevidenee
p<.0001). Howcvcr,to aomc extent.,this corrclationmay be artiíactual, n:ponedin an earlierpapcr(c.ohcnet al., 1983)and similllrtysupportedin
sinc:cit is possiblethal the two ~ may be tappingthc u.me underlying lcrms oí reliabilityami constl\lCIvalidity by thc data reponedin this
conccplS. chaptcr.One oí thc uniquc goals of this chapter wu to compare thc
Comparisonl betWttn PSS 1core1 anti wwa.rura o/ M/p-Sttkint 115ychomctric qualiticsoí thc shol1erw:rsionsoí thc PSS withtheoriginal
beluwior. We assumcdthat thc ncc:dfor hclp incrcascswith an incrcasing J4.¡1cmscalc.Withthc Jargesamplesizcprovidcdbythe Harriasun,:y, wc
stress levelaod hcnccprcdicteda positiverclation betwccnlhc PSS and wcrcablclo determinethat thc PSS10providc:s• adcquatea measuRoí
hclp-sccking:Table l. 7 presentamean PSS seores for thc hclp«eking pcrceiw:dstressu thc longcrscale.Moreovcr,thc PSSI0 hada aomcwhal
mcasurc. A onc-wayANOVA reveaJcdthat rcspondentswho reponed 1igh1críactor slructurc and a slightlybella' intemal seliabilityIban the
havingconsidercdscekinghclp in thc pasayear for personalor cmotional PSSl4. and corrclationsbctweenthc PSSI0 and variousoutcoma wcre
problems(whctherthcy actuallygol hclp or not), had highcr PSS seores equivalen& to those íound with the original scale. For this aason.wc
lhan did those whohad not lhoughtabout gctlinghclp(p<.0001). Scheffc m:ommenduseoíthc PSSI0 in futmeraean:h. The PSS4demonstrated a
tests íor differcnccsbetwccngroup means reveaJéd lhal, those who had moderatelossin rcliabiJity,but its factoratnac:tmeand pralictiw validity
gottcn hclp did not diffcr írom those who considercdhclp bul íailcdlo wercgood. Althoughwc n:commendUR oí the l~lCln acalewhcntime
receivcil, but seores for bolh lhcse groups wcR highcr lhan seoresoí allows,lhe PSS4is appropriatcror use in 1ituatio111 n,quiringa wry brief
individualswhohad not considercdscekingaid.Oneinterprc&ation ofthesc measureoí stresapcn:q,tions.
 62 THE SOCIAL PSYCHOWGY OF HEALTH
Table3.7
Mean PSS1C.PSS10, and PSS4 Scorel for ttMtlleau19
of Help-Seeldng Behavlor
PSSIO l'SS#
COMidcndAollcaiaedllldp 22.1 16.0
(lll) (111) ()19)
23.6 16.6
(1.16) (llS)
Did11111ciomida---,llldp 11.7 12.1
(178') (1'109) (1765)
· NOTE:............. ,11111111&lt ... __._11..._.._,_,..1111
DistrilNldoll
olPen:dffd Slrl!IIIn die Populatioa
We view thc distribution or pcn:eivcdstn:ss ac:rossdcmographic
charactcristicsas indicativeoí thc Jikelihoodthat spccif11:groupsof pcoplc
cncountcr strcssful life cvcnts and/ or appraisc eneountm:d nc:nts as
stressful. Our data are consisten,with traditionalconc:cptionsorgroups
who should be cxpcricncinggrcatcrstressbccauscor thc dcmandsoí 1heir
environmentsand thc lack of adcquatc rcsoun:esCorcoping withcvenls.
Thcsc includc pcrsons with n:Jativelylow sociocconomicstatus (lower
incomc,lcss cd~tion, more childrcn,more pcrsons in houschold),the
unemployedand disablcd,those in occupatioriswithrclativelylowdegra:s
of status and control,thosc whoare divorced.scparatcd.or never11'UU1ied,
racial and cthnic minoritics.femak:s,and thc young.
Thcrc are n:latively rcw data on thc distribution oí stress in the
population to comJ>I."with thc:sc.An exccption is ·work rcportcd by
Hendcrson.Bymc.and Duncan--Jones(1981) on thc distributionoí lírc
cvents in a community samplc oí 756 adults rcsiding in Canbcrra.
Australia.In thcir work,distributionsoí cvcntswerecalculalcdfromdata
collcctcdfrom a 73-itcmstress(ul lifc<venlintervícw.Data for bolhcvent
frcqucncyand cvent impact wcrcsimilar, hcnc:conly thc Jaucr (closcrto
pcra:ivcdstress)is discusscdhcrc. Consistentwith thc rcsults prcscnted
carlicr, event impact was found to decrcasewith age, and to be grcatcr
amonglhc single,divorced,and separatcdthan thc marricdand widowcd.
However,no diffcrcnccswercfound in ~heAustralianstudy Corcithcrsex
or incomc.Morcover,in contras&to our findingoí a dccn:ascin pcrceivcd
stress with grcatcrcducation in thcir study, nent impact incre.acdwitb
increasedcducation.Thc discrcpancicsbetweenthc two studics may be
aurihutablcto diffcrcm in thc aensitivityoí thc llras acales,cultural
diffcrcnccs,anddiffcrcnca in thc nngc oí thc dcmographicvariablesundcr
con!.idcration(e.g.,i~mc rangedfrom las thatlSI,000to Óva-SIS,000in·
thc Australiansamplccomparcdwilh lesathatl SS,000to om- $50,000in
S.6 lhc U.S.samplc).
6.1
(ll6t PmtlYedSll'tll ud Odlll'Sá81 Me1 118
4.2
In order to íurthcr atablish thc construct Vlllidityoí thc PSS. •
cuminec:Ithc rclationof'thc PSS141 PSSIO,and PSS4 with othcr ilctm
andscalcsassc::ssing strcsawithinthc suawy.Aaexpeded, PSS ICOR:I wi:n:
modcratelyrclalcdto n:sponsa on othcr me.mura of lllal. • wd.l• to
mcasum oí potcntial soun:es oí stn::ss. Howner, catain apecta of
cmploymcntthal mighttypicallybeconsidcn:d ltn\'.IIÍW. IUCh• workins
ovcrtimcandmissinglunchcsandbrab. waenot rclatcdtopm:cptionsof
strns. lt alsoappcaml thatjobs withmoreraponaibilitics.apccially thOIC
in which thc employec reccivcd fc:edbllckaboul performance, wi:n:
a.\.\Ociatcdwith/ottlfflcYclsoí stn::ss.lhia. of coune, is consistcntwilh thc
ideathat pcnons withgn:atcrcontrolow:rffl:1111 arelaa litcly to pcroci-ve
themas strcssíul.
Pmliffll Slnls, Halda, ud Hcallltlella,ton
1tis gcncrallybclicvcdthat stressddrimentallyinfluena::shcalthstatus
and inacrfcrcswilh thc performanceoí hcalth practil;:a.AJthoughthc
crnss-scct.ional naturc oí our data did no& allow causalanalyses,we
Clamincdthcconcurn:ntdataror~c:onsistcnt withthcsehypothca.
f rtt1ucncyof seriousillncsscs,and both seriousandnomcrious symptoml
or illncsswcrcpositivelyrclalcdto pcrocivcdstn::sa.Smallcorn:lationswere
alsoobscrvcdbctweenpcn:eivcdstn:ssand hcalthpnctica. Elevatcd PSS
!Coreswcrc associatcdwith: (1) shortcr pcriods oí slecp, (2) inrn:quent
consumptionof break:fast,(3)smokingcigan:ttcs,(4) dcc:realcd frcqucncy
hut incn:ascdquantityor alcoholconsumption,(S) las fn:quentphysical
cxcrcise,and (6) incrcascdfn:qucncyand varietyof licitdrug use. 0n thc
othcr hand, pcra:ptionsof stresswcrcnot associatcdwith lOlll houn of
slttp pcr day or numbcroí pacb orcigarctta unokcd per day.
 64 THE SOCUL PSYCHOLOGY OF HEALTH Pmdwd Slml ilt II hohabllb1 s.n,,lt '5

Sununaryand Condulion 2. sometina

). flirly oftc:n
... wayoftcn
Perccivcd stress is ass.umcd to be an important mediator of thc pathway
linking strcssful events to poorer hcalth and health practica. 1bc -data
rcportcd in thls chapter cstablish associations betwccn pera:ivcd stress and l. In the last month. how oflen have you becnupaetIJecaureoí lOIDdhina that
happcncd uncapccúdlyT ,
illness, illness symptoms, and a wide range oí health behaviors. lbcy also
2. 111the lut month,how often haw )'OU fch that youwcrcunableto control the
indicate that persons with lcss powcr and wcalth in our society are more important th.inp in your lifc:7 •
prone td generalizc:d perocptions of stress. Thesc data support the l. In the last month, how ollcn haw you fclt nervGUI and -......:1'1 '
traditional viewlregardingthedistribution of stn:ss and cffects of stress on 4. In the last month, how oítcn haw you dea.11IUCCellfullywilb day to da)'
hcalth. problems and annoyanc:a7
1bc analyses in this chapter also provide evidence that thc PSS docs an S. In the last month, how oftcn haw you íclt that you wcrcdfa:tivcly CIOpUII
adcquate job of mcasuring appraised stn:ss. With thc possible cxccption of with imponant chyga that wm: ooc:urriagin your lile?
lifc satisfaction, and minor physicaJsymptoms. there is little orno ovcrlap 6. In the last month, how oftcn haw you ldt conftdr:at about your ability to
betwecn thc constructs measun:d by thc PSS and what is asscssc:d by the handle your personal problcms7
outcomcs scales in this study. Hence thcse rclationship data are not subjcct 7. In the last month, how oftcn haw you fck that thingswae goingyour way7
to a •confounding"explanation. 1bc work is, howncr, crou-sectional and 8. In the lut montl1.,how oí&cnhaw )'OU found that youcould not copewithalJ
the lhinp that you had to do?
thcrcforc no causal infcrence is implicd in our rcport.
9. In the lut monlh, how oflal luiw )'OU becnallle tocontrolinitllioM in your
'Finally, thc PSS scalc has been cstablishcd asan cconomical tool for liíc? •
assessing perceivcd stn:ss in thc population. We rciteratc, howc\'Cr, that 10. In the last month, how oftcn haw you feltthat you wae on top oí thiap7
perceivcd stn:ss scalesarenot alwaysappropriatc. Scalcs should be choscn 11. In the last month, how oftcn haw you becn IIDgaodIJecaureoí thin,pthat
to address specificquc:stionsbeing posa! in a n:sc:archprojcct, and uscd in happcncd that WCR outsidcOÍ yourcontroff
mcthodologicaJ contcxts in which altcmati\'C cxplanations are minimizcd. 12. In the lut month, how oítcn haw you foundJOlll1IClf thinkiaaaboullhiap
As discusscd earlicr, pera:ivcd stress scales should not be uscd in cross- thal you haw to aa:omplish?
scctionaJ studics oí thc rclation bet-..:en siras and psychological distn:ss. 13. lnthelutmonth,howoítenhawyoubecnabletocoatrolthewayyouap:nd
yourtime? ,
14. In the lut month, how oítcn haw you Celadifíacultieswcrcpiling up ID biah
that you could not own:omc them?
APrENDIXA
NOTE:..._.._,. .. 7,,, lt,_. U _ __,_._~ ......
ltems and lnslrudionsfor PfffflYedStnss Scale
The queslions in this scalcaskyou about your ícelingsand lhoughts during the
last monlh. 1n each case, you wiUbe asted to indicalc ltow oft~n you fclt or thought
a certain way. Although somc of the qucstions ue similar, therc:ue diffcrc:nca
bctween thcm and you should trut each onc: u a separatc qucslion. The bcst
approach is to answer íairly quictly. That is, don\ try to counl up the numbcr oí Nota
times you íclt • particular way; rather indicate the lhematiw that sccmslite •
rcuonableesaimatc.
For each qucstion chOOIC
from the íollowing altcmatiw:s: l. Tbe PSStcaleÍI rq,riatcd withpennmionallhe Aaric:M SociolAp:alAllociMion.
íromCohen, S., Kamuck, T., MIi Mcnnclltcia,R. (1911).A pobal ae-.e of pera:iWld
llms. 1-- o/ Ht!OblrMd SacW &lwwo,,14, 316-396.
o. neve, 2. 0ne could arpe that ltms iuelf is a aympcomof diltn:a.,hence,ftlll if a pldicular
l. alfflOICnncr dimensionia nol lappcd in bolh 1a11a, il lhould be.
 66 THESOCULPSYCHOWGYOFHEALTH hrttiwd Strm •• hoWlllq ~ 61

oíthe rtlalionthip betwem neptiw lifenaa aiwl.,,_._ 1""""""o/H...., Slna.

11. 149-ISl.
Lazarua..R.S.(1966). h~11ra1•dtitftlfÑIWl"'Offlf. NewYoñ: Mc:Grn-Hil.
copilla i11allp'_,.11111 ~ 1• Z. J.
Laurm. R. S. (1911). l'lycholopcal llraa 11111
AW?rill,J. R. (1973).Pmonal C011trol OWC1' u
nienivelltilllllliancl ldalionship lo ltfflll. Lipowski,D. R. Lipsi,,1 P.C. Whylnw(Eds.).~~CinfflflnMI..
l'Jyd,olo,n/ JWlttlllt. lO, 216-JO). .
. NewYork: Oúord UftMl'IÍly Prm. •
Cohen, S. (1978).En~ load11111 lhe allocalionofattenlion.I• A. lawn, J. Siftter,
Laurm, R. S., Delongis, A., Folkma. S., ,1 Gruea, ll. (ltl5). S... w1 lld.,,..ioall
A S. Valína (Eds.), A~ .. ,,. ... ., • ..,. ~ (Vol 1). Hilldlllc. NJ:
outcoma: The p,oblrm ol confoundtd wnt. A"""'- f'IJ,d,olorVI. «J. 710-T19.
Lawma Erhwn.
Luarua. R. S.,.t. Folkmu, S. (19N). Snu, ~. _ ...,..__ New York: Spñllll:f,
s:
Cohen. (1916).ConcFlltffll lhe .._..... IC:ale 111dlhe pen,m,ed llrm 1C:a1e: Who'III rally
Lei,H.,.t:Skinner,H.A.(19IO).Aplydwtric1tudyoflifenaiu_,IOáalre.tjullt■at.
IIIC&'IUñlll lpprllÍled 11n::11? A1911fritwtt ~ 41. 111-111.
JOUl'fttllo/ h~ ~ 14.57-65.
Cohcn.S., l.anuud, T., ,1 Mciraic:bCcitl, R. (lftl). A p,W naswe of pen,m,ed lln:a.
J--1 o/ Hftlll, .,J S«iil/ lttlwtmÓr,1'. llS.J96. U., N., 0ean. A., A Ewl, W. (Ede.). (1916). &dtt/ ...... ifl'ftllMfl. -4 ...,_._
Ortando, FL: Acadnnic Prm. ' '
Coiten, S., Menndltein, ll., I.IUllll'Ck,T., A HollertnM, H. (lftS). Meeniqahe functiaul
U.wilte, P. W. (1917)Sdf-QMapleÚIJ • acapiliwelluffel-...... ...,...... _ _.
c:ompoaenlsof IOáal 1111ppo1t;In l. G. Slnloft ,1 l. ll. S.- (Eds.). S«iil/ ..,_r:
Tlwory, m,wd, .,J..,,.._ The Hapr, Ndhcdands: Martinua Nijhoff.
dep,asion. J--1 af l'motwlil1-' S«wll':qcltolor,. 11.66J.676.
S.-. l. G., Jolulloe, J. H., A Sqd. J. M. (1971). A---. die -,..:t ttllife-.S:
Cohm,S.,Shemicl,D.R.,AO.k,M.S.(1916).Socialltilllllllldahe~rolieof
Dnelopfflenl ol llic: lile Uperieaa MW:y. lt1fJfflJIII af 0.-. .. .,J cw.l
IOC:ial suppo,t. l--1 o/ l'fnolwlily.,J s«wl h,cl,oloo, JO.96J..91l.
l>eroglllil,L, Riddt. l.., A Rock. A. (1916).The SCIAO 11111d lhe MMPI: A llep in die /'J,cl,olt,o, "· 9l2-M6.
Sdigmu. M.EP. (1915). ~ a,. ,l,p •""" ._ ... ,..., ..,¡ ...._ S..
Yalídlllionola 11CWd«paft--. llrllldt.,__o/ h,cltit,I,,, 111,290-1.119.
franc:ÍICO: W. H. F-.
Dolumwmd~ 8. P., A SllnNI. P. E. (lftS). •H.aa" in lhc CIOfllEleplualizalion anc1
Vinolur, A., .t: Sdm, M. L (1915). Dl'iliraWew ~ lile nai11: Their
nasumiac of life 11n::11...nawa. Allli!ntM hy,cl,alosi#, «J. 780-78S.
Rlatiomhip to lllell .. dlcellllldillfta. JOWflllll af hr114A..,y.,J &dt,l l',ydtoloa,
DollrnMnll, 8. P., Shroul. P. E., Eari, G., A Mendellohn, F. S. (1971). W1aa1 ,s,chilllric
lfflllmin1 _.. - M lhc F-.1 populalÑÍe: P.c 1: Jet-. F,_,._ conc:q,t of
JtJ29-ffl. .
~- 111S. Suid-(Ed.). l'hlc.'IN.. :, ofllw .,,.,, .,,.._ c.,...,.., o/ Warchcl, S. (1911). Redtacialtaewd-. wilhcNc~.,..:
IIClributioMIthe-otyol Clftldins.
5-J. •rll _,,._ ol •
J_,,,,¡ o/ ftlpilllllltoit. /, 216-2.JO..
Hftllle 3-y ll"1totil,. WIÑillCloa. DC: Nlllioul O:nlicrfor Hnlch Sllllillia.
Wordld, S.,.t: Teddlie,C.(1976).Theapcrialaeof~ A hlOflá.orCMoly.,,,..,,,,,
Dohm1wmd, B. P~ Sllroul. P. E., qri, G,. A Mndellolut,. F. S. (19IOJ.W1aa1 ,-,dlialric
lfflltllffll ICllla w in lhc ..... ,.,.._ Part 11: The compooau o1 o/ tmo,,,,llly .,J Sodlll ,.,,,..,,, "· JIMO. •
demofalir.alion "7CIIIIÚ'IIII •h oda ---- el ,-,cltopalhalo&,. Ardlhn af
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