Am J Psychiatry 1989; 146:61-66
Copyright © 1989 by American Psychiatric Association
Use of DSM-III axis IV in clinical practice: rating etiologically significant stressors
AE Skodol and PE Shrout
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
This study compared the etiologically significant stressors listed on
DSM-III axis IV (severity of psychosocial stressors) with life events
elicited by the Psychiatric Epidemiology Research Interview (PERI).
Multiaxial evaluations of a diagnostically heterogeneous group of 362
patients were made, and all patients were subsequently administered the
PERI by interviewers blind to the clinical assessments. The results
indicated that axis IV functions well as a shorthand method for identifying
the more severe psychosocial stressors. However, the DSM- III requirement
that the stressor be important in the development or exacerbation of the
current disorder resulted in discrepancies between the axis IV and PERI
assessments.
