Self-reported physical stress reactions: first- and second-order factors.

Stress Inventory-6, a 72-item self-report questionnaire designed to tap 18 factors of physical stress reactions, was subjected to factor analysis. The instrument was given to 474 students (254 females, 206 males, and 14 who failed to indicate their gender). The final factor solution identified 16 first-order and 4 second-order factors. The first-order solution replicated most of the factors identified in a previous study and defined factors in terms of organ system, muscle group, and simple content. In the second-order solution, Factors I, III, and IV include symptoms that are immediate and direct, appear to be related to arousal of the somatic and sympathetic nervous system, and are marked prominently by cardiorespiratory activity. In contrast, Factor II includes symptoms that are indirect and often delayed consequences of sustained arousal (Fatigue and Lack of Energy, Headaches, Backaches, etc.). A major distinction can be made between stress arousal Factors I and III. Factor III appears to be a simple "fight or flight" arousal pattern characterized by fairly direct manifestations of striated muscle tension as well as cardiorespiratory activity. In contrast, Factor I is a complex arousal pattern characterized by diffuse autonomic arousal, self-directed attention, and possibly low self-esteem. The results of this study draw into question the extent to which popular stress inventories tap a representative sample of stress symptoms. Clinical implications are discussed.