Skip to main content
Log in

A prospective study of daily stressors and symptomatology in schizophrenic patients

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

There has been very little research on the ability of a measure of daily stressors such as the Hassles Scale to predict symptomatology in schizophrenia. We examined this issue in a group of 55 outpatients with a DSM-III-R diagnosis of schizophrenia. The patients were assessed on a monthly basis for a minimum of 12 months. The Hassles Scale was used to assess daily stressors and the indices of symptomatology included the Scale for the Assessment of Positive Sympotoms, the Scale for the Assessment of Negative Symptoms, the Beck Depression Inventory, the Self-Evaluation Questionnaire, and the General Health Questionnaire. Longitudinal data on the relationship between Hassles score and symptomatology were analyzed for each patient. Statistically significant correlations of symptoms with stressors for the previous month were found in a greater number of patients than would be expected by chance. There was some reduction in the number of significant correlations when the possible role of prior symptomatology was statistically controlled for.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Al Khani M, Bebbington P, Watson JP, House F (1986) Life events and schizophrenia: a Saudi Arabian Study. Br J Psychiatry 148: 12–22

    Google Scholar 

  • Andreasen NC (1983) The Scale for the Assessment of Negative Symptoms (SANS). The University of Iowa, Iowa City

    Google Scholar 

  • Andreasen NC (1984) The Scale for the Assessment of Positive Symptoms (SAPS). The University of Iowa, Iowa City

    Google Scholar 

  • Andreasen NC (1987) The diagnosis of schizophrenia. Schizophr Bull 13: 9–22

    Google Scholar 

  • Arndt S, Alliger RJ, Andreasen NC (1991) The distinction of positive and negative symptoms: the failure of a two-dimensional model. Br J Psychiatry 158: 317–322

    Google Scholar 

  • Beck AT (1978) Beck Depression Inventory. Harcourt Brace Javonovich, New York

    Google Scholar 

  • Beck JC, Worthen K (1972) Precipitating stress, crisis theory and hospitalization in schizophrenia and depression. Arch Gen Psychiatry 26: 123–129

    Google Scholar 

  • Carpenter WT, Heinrichs DW, Wagman AM (1985) On the heterogeneity of schizophrenia. In: Alpert M (ed) Controversies in schizophrenia: changes and constancies. Guildford, New York, pp 25–37

    Google Scholar 

  • Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98: 310–319

    Google Scholar 

  • Day R, Nielsen JA, Korten A, Ernberg G, Dube KC, Gebhart J, Jablensky A, Leon C, Marsella A, Olatawura M, Sartorius N, Stroemgren E, Takahashi R, Wig N, Wynne LC (1987) Stressful life events preceding the acute onset of schizophrenia: a cross-national study from the World Health Organization. Cult Med Psychiatry 11: 123–205

    Google Scholar 

  • DeLongis A, Folkman S, Lazarus RS (1988) Hassles, health, and mood: psychological and social resources as mediators. J Pers Soc Psychol 54: 486–495

    Google Scholar 

  • Diener E, Eammons RA (1985) The independence of positive and negative affect. J Pers Soc Psychol 47: 1105–1117

    Google Scholar 

  • Dohrenwend BS, Dohrenwend BP, Dodson M, Shrout PE (1984) Symptoms, hassles, social supports and life events: problem of confounded measures. J Abnorm Psychol 93: 222–230

    Google Scholar 

  • Donovan JM, Dressler PM, Geller RA (1975) Psychiatric crisis: a comparison of schizophrenic and non-schizophrenic patients. J Nerv Ment Dis 161: 172–179

    Google Scholar 

  • Falloon IRH (1984) Relapse: a reappraisal of assessment of outcome in schizophrenia. Schizophr Bull 10: 293–299

    Google Scholar 

  • Foulds G, Bedford A (1975) Hierarchy of classes of personal illness. Psychol Med 5: 181–192

    Google Scholar 

  • Goldberg D (1978) Manual of the General Health Questionnaire. NFER-Nelson, Windsor

    Google Scholar 

  • Goldstein JM, Santangelo SL, Simpson JC, Tsuang MT (1990) The role of gender in identifying subtypes of schizophrenia: a latent class analytic approach. Schizophr Bull 16: 263–275

    Google Scholar 

  • Hardesty J, Falloon IRH, Shirin K (1985) The Impact of life events, stress and coping on the morbidity of schizophrenia. In: Falloon IRH et al. (eds) Family management of schizophrenia: a study of clinical, family and economic benefits. John Hopkins University Press, Baltimore

    Google Scholar 

  • Holtzman WH (1963) Statistical models for the study of change in the single case. In: Harris CW (ed) Problems in measuring change. University of Wisconsin Press, Madison

    Google Scholar 

  • Huber G, Gross G (1989) The concept of basic symptoms in schizophrenia and schizoaffective psychoses. Recenti Prog Med 80: 646–652

    Google Scholar 

  • Kanner AD, Coyne JC, Schaefer C, Lazarus RS (1981) Comparisons of two modes of stress measurement: daily hassles and uplifts versus major life events. J Behav Med 4: 1–39

    Google Scholar 

  • Kobasa SC, Puccetti MC (1983) Personality and social resources in stress resistance. J Pers Soc Psychol 45: 168–177

    Google Scholar 

  • Liddle PF (1987) The symptoms of chronic schizophrenia: a reexamination of the positive-negative dichotomy. Br J Psychiatry 151: 145–151

    Google Scholar 

  • Liddle PF, Barnes TR (1990) Syndromes of chronic schizophrenia. Br J Psychiatry 157: 558–561

    Google Scholar 

  • Liddle PF, Fiston KJ, Frith CD, Hirsch SR, Jones T, Frackowrak RSJ (1992) Patterns of cerebral blood flow in schizophrenia. Br J Psychiatry 160: 179–186

    Google Scholar 

  • Malla AK, Norman RMG (1994) Prodromal symptoms in schizophrenia: a prospective analysis. Br J Psychiatry 164: 487–493

    Google Scholar 

  • Malla A, Cortese L, Shaw T, Ginsberg B (1990) Life events and relapse in schizophrenia: a one year prospective study. Soc Psychiatry Psychiatr Epidemiol 25: 221–224

    Google Scholar 

  • Malla AK, Norman RMG, Williamson P, Cortese L, Diaz F (1993) Three syndrome concept of schizophrenia: a factor analytic study. Schizophr Res 10: 143–150

    Google Scholar 

  • Meehl PE (1962) Schizotaxia, schizotypy, schizophrenia. Am Psychol 17: 827–838

    Google Scholar 

  • Monroe SM (1983) Major and minor life events as predictors of psychological distress: further issues and findings. J Behav Med 6: 189–205

    Google Scholar 

  • Norman RMG, Malla AK (1991a) Subjective stress in schizophrenic patients. Soc Psychiatry Psychiatr Epidemiol 26: 212–216

    Google Scholar 

  • Norman RMG, Malla AK (1991b) Dysphoric mood and symptomatology in schizophrenia. Psychol Med 21: 897–903

    Google Scholar 

  • Norman RMG, Malla AK (1993a) Stressful life events and schizophrenia I: a review of the research. Br J Psychiatry 162: 161–166

    Google Scholar 

  • Norman RMG, Malla AK (1993b) Stressful live events and schizophrenia II: conceptual and methodological issues. Br J Psychiatry 162: 166–174

    Google Scholar 

  • Norman RMG, Malla AK (1994) Correlations over time between dysphoric mood and symptomatology in schizophrenia. Compr Psychiatry 35: 34–38

    Google Scholar 

  • Nuechterlein KH, Dawson ME (1984) A heuristic vulnerability/stress model of schizophrenic episodes. Schizophr Bull 10: 300–312

    Google Scholar 

  • Reich WP, Parrella DP, Filstead WJ (1988) Unconfounding the Hassles Scale: external sources versus internal responses to stress. J Behav Med 11: 239–249

    Google Scholar 

  • Spielberger CD, Gorsuch RL, Lushene R (1968) Self-Evaluation Questionnaire. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  • Spitzer RL, Williams JBW, Gibbon M (1985) Instruction manual for the structured clinical interview for DSM-III-R (SCID). Biometrics Research Department, New York State Psychiatric Institute, New York

    Google Scholar 

  • Valsiner J (1986) Between groups and individuals: psychologists' and layperson's interpretations of correlational findings. In: Valsiner J (ed) The individual subject and scientific psychology. Plenum, New York

    Google Scholar 

  • Ventura J, Nuechterlein KH, Lukoff D, Hardesty JP (1989) A prospective study of stressful life events and schizophrenic relapse. J Abnorm Psychol 98: 407–411

    Google Scholar 

  • Wagner BM, Compas BE, Howell DC (1988) Daily and major life events: a test of an integrative model of psychosocial stress. Am J Community Psychol 16: 189–205

    Google Scholar 

  • Weinberger DR (1990) The neuroanatomy of schizophrenia. Paper presented at Schizophrenia 1990: An International Conference, Vancouver, BC

  • Weinberger DR, Bigelow LB, Kleinman JE, Klein ST, Rosenblatt JE, Wyatt RJ (1980) Cerebral ventricular enlargement in chronic schizophrenia: an association with poor response to treatment. Arch Gen Psychiatry 37: 11–13

    Google Scholar 

  • Williams R, Zyzanski SJ, Wright AL (1992) Life events and daily hassles and uplifts as predictors of hospitalization and outpatient visitation. Soc Sci Med 34: 763–768

    Google Scholar 

  • Zarski JJ (1984) Hassles and health: a replication. Health Psychol 3: 243–251

    Google Scholar 

  • Zubin J, Spring B (1977) Vulnerability — a new view of schizophrenia. J Abnorm Psychol 88: 103–126

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Norman, R.M.G., Malla, A.K. A prospective study of daily stressors and symptomatology in schizophrenic patients. Soc Psychiatry Psychiatr Epidemiol 29, 244–249 (1994). https://doi.org/10.1007/BF00802047

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00802047

Keywords

Navigation