DSM-III-R AXIS-IV - CLINICIAN RELIABILITY AND COMPARABILITY TO PATIENTS REPORTS OF STRESSOR SEVERITY

STRESS has long been considered an important precipitant to the develo pment or exacerbation of psychopathology (Selye 1980), However, it has been difficult to reach agreement on how to measure stressors reliabl y, and whether stressors should be assessed using an objective clinica l rating or a subjective appraisal (Mature and Druss 1995), When the D SM-III multiaxial diagnostic system was derived, Axis IV was designed to provide a mechanism for objectively rating the severity of psychoso cial stressors that contributed to the development or exacerbation of psychiatric disorders (Williams 1985), With the continued use of this nosological system, DSM-III-R Axis IV has become the most commonly use d assessment of stressors in clinical settings today, The current work focuses on whether DSM-III-R Axis IV can be used reliably by clinicia ns generating objective ratings, and on whether these objective rating s reflect patients' appraisals of the severity of their psychosocial s tressors. Based on this work, options for future use of Axis IV are di scussed.