A nationwide study of stressful life events in Mainland China.

The Stressful Life Events Rating Scale, a recently developed instrument specifically designed for the measurement of stressful life events in Mainland China, was administered along with the Chinese version of the Hopkins Symptom Checklist to 4054 Chinese "normal" subjects who were sampled from 24 sites across Mainland China. "Problems with Interpersonal Relationship" was the most commonly encountered psychosocial stressor in Chinese daily life. At least once a year, about 34% of normal Chinese subjects were stressed by being misunderstood or berated; 17% of married persons experienced difficulties with child rearing; 15% of married women had troubles with mothers-in-law. These stressors strongly influenced the well-being of Chinese residing in Mainland China. Stressors in the categories of "Study" and "Health" also contributed substantially. The life events experienced and stressfulness perceived varied in different life stages. Similarly, the major patterns of psychological responses obtained from the Hopkins Symptom Checklist differed in age groups. Similar to reports from other cultures, death of spouse is the most stressful life event in China. On the other hand, the rank order of stressfulness of several other stressful life events differed significantly across cultures. The impact of divorce was ranked more highly in most previous Western studies, whereas among the Chinese, death of a close family member received the second highest ranking. The total score of the Stressful Life Events Rating Scale for 99% of normal Chinese was below 74. A score over 74 suggests that the individual's psychosocial stress may be perceived as excessive or an overload and may be associated with a heightened risk of psychological and/or psychophysiological dysfunction(s).