The Social Readjustment Rating Scale: a cross-cultural study of Japanese and Americans.

BEGINNING in this laboratory in 1949, a systematic study of the quality and quantity of life events empirically observed to cluster at the time of disease onset has been carried out in over 5000 patients. This experience has generated forty-three unique life event items which are either indicative of the life style of the individual or of occurrences involving the individual. Evolving mostly from ordinary social and interpersonal transactions, these events pertain to major areas of dynamic significance in the social structure of the American way of life. These areas include family constellation, marriage, occupation, economics, residence, group and peer relationship, education, religion, recreation and health. Some events are socially undesirable; others are socially desirable and are consonant with the American values of achievement, success, materialism, practicality, efficiency, future orientation, conformism, and self-reliance. These life events have one theme in common: the occurrence of each usually evokes or is associated with some adaptive or coping behavior on the part of the involved individual. The emphasis is on change from the existing steady state, and not on psychological meaning, emotion, or social desirability. In a recent report [I] a method was defined for quantifying the amount of change in life adjustment required by these forty-three categories of life events. The method, derived from psychophysics, consisted of a self-administered instrument, The Social Readjustment Rating Questiomraire (SRRQ), containing the items to be scaled. One item was used as the module. It was arbitrarily selected and assigned a numericalvalue. The subjects were asked to compare each of the items in turn with the module and its given magnitude and assign to it a numerical value which was proportionate to that of the module. The arithmetic mean score derived for each item was the magnitude of change in adjustment required by the life event. As expected, because of cultural homogeneity, this method yielded high consensus on the magnitude and rank order of the life events among white, middle class, third generation, Protestant Americans. Because of obvious sociocultural differences from the American middle class, it was anticipated that minority status subjects such