Stress in the Clinical Setting: The Brief Encounter Psychosocial Instrument

J Fam Pract. 1988 May;26(5):533-9.


Integration of knowledge regarding the relationship between stress and illness into clinical practice has been slowed by a lack of clarity in the definition of stress and the difficulties involved in rapid assessment of stress in a busy office setting. The stimulus, response, and interactional models of stress are discussed, and the development of a new stress measure, the Brief Encounter Psychosocial Instrument (BEPSI), is detailed. The reliability of this six-item instrument is demonstrated (Cronbach's alpha .80). Validity is measured through correlation with a variety of instruments measuring stress, including depression (r = .52, P less than .001), anxiety (r = .61, P less than .001), life change (r = .56, P less than .001), bodily expression of stress (r = .56, P less than .001), and a total stress score (r = .67, P less than .001). The BEPSI also demonstrated appropriate negative correlations with family cohesion (r = .29, P = less than .01) and support (r = .31, P = less than .01). When the single open-ended item is strongly positive, 77 percent of patients also score high on the BEPSI. A negative response to the same question corresponds to a low BEPSI value 52 percent of the time. Suggestions are made regarding clinical and research applications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Evaluation Studies as Topic
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychological Tests*
  • Retrospective Studies
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / etiology