- Email: [email protected]
The children's life events inventory
Journalof Psychosomatic Research, Vol. 23,PP.63to 68.
0022-3999/79/o64Goo60063502.00/0
PergamonPressLtd. 1979.Printedin Great Britain.
THE CH!ILDREN’S LIFE EVENTS INVENTORY J. H.
MONAGHAN,*
J. 0. ROBINSON*
and J. A.
DODGE?
(Received 17 July 1978) Abstract-The development of a children’s Life Events Inventory is reported, using a similar method to Cochrane and Robertson’s adult Life Events Inventory. High agreement about the values of each event was found between groups of raters (paediatricians, teachers and social workers) and individual raters. The values were compared with those obtained by Coddington with American raters and again considerable agreement was found. CODDINGTON [l] has developed four children’s Social Readjustment Rating Scales, each one designed for a different age group, i.e. pre-school, 6-11, 12-16 and 16+. The list of events was selected from the literature on child development and includes a variety of types, e.g. desirable events (‘outstanding personal achievement’), undesirable events (‘serious illness of child requiring hospital treatment’), gains (‘birth of a brother or sister’), losses (‘death of a parent’). These events were rated by paediatricians, teachers and mental health workers according to how much readjustment children of different ages would need to cope with them. Holmes and Rahe’s method of scoring was adopted, i.e. the raters were asked to evaluate each event in comparison with ‘birth of a brother or sister’ which had been assigned the arbitrary value of 500. Using this type of method for scoring, one with no set upper limits, one would expect a top-heavy distribution with extreme values. Although the median would normally have been used as a measure of central tendency for this data, Coddington used the geometric mean which deals with extreme values better than either the mean or the median [2]. The rating questionnaires have been administered to a normal population of children and average scores of life events have been reported for different age groups [3]. No further studies have tested the reliability or validity of the children’s scales, although the method used for their construction was sufficiently similar to that used in the development of the adult Social Readjustment Rating Questionnaire for comments about the scale’s reliability and validity to be made. The object of the present study is to produce a British Life Events Inventory for children by adapting the American scale. There are several new features: (a) A different scoring method is used (O-100) which eliminates extreme values, enabling the median to be used as the measure of central tendency. (b) Raters were asked to add events which they considered relevant to the lives of children. (c) Raters who obviously disagreed with the majority were eliminated from analyses. (Criteria for elimination will be discussed later.) (d) Events showing variation (SE. of 5 or over) were eliminated. This Children’s Life Events Inventory would be useful to researchers in the field of childhood stress and also, should the scale be shown to be a good predictor of illness, to doctors, social workers and others.
*Department of Psychology, University College, P.O. Box 78, Cardiff CFl IXL, Wales, VDepartment of Child Health, Welsh National School of Medicine, Heath Park, Cardiff CF4 4XN. Wales. 63
64
J. H. MONAGHAN,J. 0. ROBINSONand J. A. DODGE METHOD
Coddington’s list of events for the elementary school age group (6-l 1 years) was adapted for use with British children. Two events were excluded: ‘Becoming involved with drugs or alcohol’ and ‘Having a visible congenital deformity’, since the former is extremely rare in this age group in Britain and the latter cannot strictly be classed as an event. Three events were added by the author: ‘Move to a new house’, ‘Increase in the number of arguments with brothers and sisters’ and ‘Decrease in the number of arguments with brothers and sisters’ since these would change the lives of children in several ways. In order to obtain standard scores for each event, 150 raters consisting of 68 primary school teachers, 33 paediatricians and 49 social workers snecialising in children’s cases, were contacted by letter. Tkach&s were contacted through several local primary schools, social workers through the Area Social Services and hospitals, and paediatricians were members of the Welsh Paediatric Society. All three groups were sent the following instructions, and asked to return their ratings by post: ‘Below, there is a list of events that can happen in the lives of children, some of which are desirable, others undesirable. What these events have in common is that they all involve a certain amount of readjustment on the part of the child. For example, if the child has an outstanding personal achievement, he will still have to adjust to this change, despite the fact that the change is for the better. We would like you to consider the effect that these events would have on children, aged 5-12 years. Obviously, every child will react in different ways to the events, but try to think of the average amount of readjustment required for each event. ‘Please would you read through all the items and rate them according to the amount of readjustment each would involve, using a scale from O-100. For example, if you think that an item requires little readjustment, write a low number in the blank next to it, and if it requires a great deal of readjustment, write a high number, and so on. If you think that several items require the same amount of readjustment, write the same number next to them. In scoring the events, use both personal experience and second-hand knowledge of children.’ An introductory letter was also sent with the questionnaire asking the raters to add any other events that they considered to be of significance to children. TABLE1.-SPEARMAN’s RANKORDERCORRELATION COEFFICIENTS BETWEEN GROUPSOF RATERS Social workers and paediatricians Paediatricians and teachers Social workers and teachers British geometric means and American geometric means
0.904 0.913 0.872 0.928
RESULTS Twenty-seven teachers (40 %), 16 paediatricians (48 %) and 15 social workers (31%) returned the questionnaire giving an overall response rate of 39 %. The average response rate to postal questionaires is40-50% so thefinalnumberofraters(n = 58)isasexpected.Fiveextraeventsweresuggested bythe raters: ‘Sexual assault on child’, ‘Death of a pet’, ‘Problems with a teacher or schoolwork’, ‘Psychiatric disturbance of parent’ and ‘Being obese’. This last item was rejected since it is not strictly an event, although ‘Becoming obese’ could be included under the existing event ‘Acquiring a visible deformity’. A Spearman’s correlation matrix was computed to find out whether the raters showed overall agreement about the values of the events. Three raters, 1 teacher, 1 social worker and 1 paediatrician, were found to differ significantly from the others (an arbitrary correlation of less than 0.4 was chosen as a criteria for disagreement). These scores were eliminated from further analyses. Medians for each of the three groups of raters were calculated and Spearman’s rank order correlation coefficients showed high agreement between groups (see Table l), the lowest between social workers and teachers (p = 0.872). Only one item, ‘Death of a pet’ had a standard error of more than 5 and this was eliminated from the final list of events. The Kruskal-Wallis one-way analysis of variance (as used by Coddington) was computed to find out if any of the groups differed about the values of each event. Only two of the events were rated significantly different (p < 0.05) and the Mann-Whitney U-test showed that it was the group of paediadiatricians which was in disagreement. They rated ‘Serious illness of a parent requiring hospital treatment’ lower than teachers, and ‘Acquiring a visible deformity’ lower than social workers (p < 0.05). Kendall’s coefficient of concordance was found to be 0.7, showing hiih agreement between all raters. Lastly, medians for all the raters were calculated and Table 2 shows the final values for each of the events.
The Children’s Life Events Inventory
65
TABLE~.--MEDIANVALUESGIVENTOCHILD~N'SLIFEEVENTSBYDIPP~RENTGROUPSOFRATERS
American ratingst Death of a parent Separation of-parents Divorce of parents Sexual assault on child* Acquiring a visible deformity Death of a brother or sister Prison sentence of parent for 1 year or more Serious illness of child requiring hospital treatment Discovery of being an adopted child Marriage of parent to stepparent (Psychiatric disturbance of parent)* Serious illness of parent requiring hospital treatment Being kept down a year at school Change in child’s popularity with friends Death of child’s close friend or relative Beginning school Increase in number of arguments between parents Suspension from school Increase in number of arguments with parents Birth of a brother or sister Death of a grandparent Prison sentence of a parent for 30 days or less (Problems with a teacher or school work)* Change in father’s job requiring increased absence from home Change of school Close brother or sister leaving home Mother beginning full-time work Addition of 3rd adult to family Loss of job by parent Serious illness of brother or sister requiring hospital treatment Outstanding personal achievement Increase in number of arguments with brothers and sisters* Pregnancy of unmarried teenage sister Change in parent’s financial status Move to a new house* Decrease in number of arguments between parents Decrease in number of arguments with parents Beginning another school year Becoming a fully-fledged member of a church Decrease in number of arguments with brothers and sisters*
91 78 84
Paediatricians n = 15
Teachers n = 26
90
96
69 68 67
82 81 67 57 74 64
90 86 87 80 82 79
62 52 65 -
z! 68 62
55 57 51 53 46 51 46 47 50 38 44 -
78
Social workers Total n = 14 n = 55 97
95
86 81 80 ;!i 74 77 76
74 71
;: 71
::
z:
:;
75 62 62 65 70
67 65 69 55 55
67 61 61 60 59
; 46
62 51 55
::
57 43 48
: z
:: 55 47 51 47 52 52
:: 55 42 60
55 52 51 50 50 50 49
45 46 36 44 41 38
41 45
41 39
40 27
:z -
31 33 26 31
25 27 27 25
26 19 24 22
:4 12
2 21 20
-
14
15
18
2 32 31
2:
42 1: :;I 41 41 41
t: 42 41 40 39
;: 31 27 31
*Item not derived from Coddington’s scale. Items in parentheses were added later and rated by a smaller sample of paediatricians teachers (n = 18) and social workers (n = 8). TGeometric means.
(n = 8),
J. H.
66
J. 0.
MONAGHAN,
and J. A. Doooe
ROBINSON
X
X
xx
X
X
5
z
-g
‘50
40
30
I X
F
x X x
X X
x
xxk
x.
x
X x
:
x xx
X
20
14L 24
x
' 30
I 40
I 50
I 60
Am6riCon FIG.
l.-Scattergram
geometric
I 70
I 60
I. 90
I loo -'
means
of British geometric means plotted against American geometric means.
COMPARISONS
OF BRITISH AND AMERICAN
SAMPLES
Figure 1 shows a scattergram of the British geometric means for each event plotted against the American geometric means. Only two events were rated significantly different at the 0.01 level of confidence-‘Discovery of being an adopted child’ was rated higher by the British sample and Qecoming a fully-fledged member of a church’ was rated higher by the American sample. Spearman’s rank order correlation coefficients between the two groups also showed high agreement (p = 0.93). DISCUSSION
Although the British sample was small (n = 55), considerable agreement was found between individual raters, groups of raters and also across cultures. This shows that adults’ estimates of the relative severity of life events for children are very reliable. Although the groups of raters assigned different numerical values to the events, doctors giving lower weights across the items (mean = 46.41) than teachers (mean = 55.75) or social workers (mean = 52.56), their overall rank ordering of the events was constant as shown by the high Spearman’s rank order correlation coefficients. The actual value assigned to each event is to be used as a rough estimate of the amount of readjustment needed compared with a control group, rather than as a definitive quantity. The two events that the British and American samples disagreed about can perhaps be explained by comparing the two cultures. Adoption in America is encouraged and adoptive parents are given a great deal of support, both financial and social, whereas in Britain this help is not so available [4]. There may be other reasons for the difference in ratings, e.g. varying procedures involved in adoption organisations, attitudes of adoptive parents, or different advice of when and how to tell the child about adoption. These factors may all have contributed to the difference in ratings but since no comparative studies of adoption could be found in the literature, this explanation can only be speculative.
The Children’s Life Events Inventory
67
It is difficult to say why ‘Becoming a fully-fledged member of a church’ was rated higher by the American sample since again there are no comparative studies of religious attitudes reported in the literature. There have been some figures showing that church attendance is high in various parts of America, although it is difficult to compare these with figures from Britain due to differences in the areas studied. One possible reason for the differences is that in America there are a number of small churches of different religions so that a community spirit is encouraged whereas in Britain a smaller part is played by the small churches. It is possible that these differences are due to sample bias, but since the rank orders of the events are almost the same across the groups, the variation is not of great significance. Recent studies which have used the American children’s scale, have shown that various groups of children with different disorders have experienced more stressful life events than controls. For example, children with juvenile rheumatoid arthritis were found to have significantly higher scores on the American scale than did matched controls, adding support to the theory that this disorder may be aggravated by stress [5]. In a study of paediatric patients, it was found that all groups including children with arthritis, appendicitis, hernias and psychiatric disorders (but excluding haemophiliacs) had experienced more stressful life events during the year before onset than did controls [6]. The classification of a disorder has even been extended to studying accident-prone children. It was found that boys with high scores on the life event scale were significantly more accident-prone than boys with low scores [7]. This measure is generally considered to be an indirect estimate of the experience of stress and another study of chronically-ill children, i.e. children with burns, cystic fibrosis etc., has found an interesting relationship between stress and self-concept. Children with high scores on the life events scales showed poorer self-concepts than those with low scores [8]. It is evident that the Children’s Life Events Inventory would be a useful research tool for studies of children with disorders, and it could also help in our understanding of the effects of stress on personality. Since the inventory takes only 5-10 minutes to administer, doctors, social workers and others should find it useful in identifying children ‘at risk’ from either mental or physical disorders. Perhaps the most useful application of this Inventory will be in prospective studies, where factors such as the child’s illness do not bias the events reported. Acknowledgements-This work was supported awarded to the first author.
by a Science Research
Council Grant B/75/2318
REFERENCES 1. CODDINGTONR. D. The significance of life events as etiological factors in the diseases of children.
-1. A survey of professional workers. J. Psychosom. Rex. 17,7 (1972). 2. MAWDA M. and HOLMEST. H. Marmitude estimations of social readjustments. J. Psychosom. Res. 11,219 (1967). 3. CODDINGT~N R. D. The significance of life events as etiological factors in the diseases of children. -11. A study of a normal nonulation. J. Psychosom. Res. 16,205 (1972). 4. G~~DACRE i. Adoption PO& and Practice.George Allen & Dnwin, London (1966). 5. HEISELJ. S. Life changes as etiological factors in juvenile rheumatoid arthritis. J. Psychosom. Res. 16, 411 (1972). 6. H-EL J. S., REAMS., RAITE R., RAPPORT M. and CODDINGTONR. D. The significan ce of life events as contributing factors in the diseases of children.-III. A study of pcdiatri c patients. J. Pediat. 83, 119 (1975).
68
J. H. MONAGHAN,J. 0. ROBINSONand J. A. DODGE
7. PALXLLA E. R., ROHSENOW J. ~~~BERGMANA. B. Predicting accident frequency in children. Pediat. 58, 223 (1976). 8. BEDELLJ. R., GIORDANIB., AMOURJ. L., TAVORMINA J. and BOLLT. Life stress and the psychological and medical adjustment of chronically ill children. J. Psychosom. Res. 21,237 (1977).
0022-3999/79/o64Goo60063502.00/0
PergamonPressLtd. 1979.Printedin Great Britain.
THE CH!ILDREN’S LIFE EVENTS INVENTORY J. H.
MONAGHAN,*
J. 0. ROBINSON*
and J. A.
DODGE?
(Received 17 July 1978) Abstract-The development of a children’s Life Events Inventory is reported, using a similar method to Cochrane and Robertson’s adult Life Events Inventory. High agreement about the values of each event was found between groups of raters (paediatricians, teachers and social workers) and individual raters. The values were compared with those obtained by Coddington with American raters and again considerable agreement was found. CODDINGTON [l] has developed four children’s Social Readjustment Rating Scales, each one designed for a different age group, i.e. pre-school, 6-11, 12-16 and 16+. The list of events was selected from the literature on child development and includes a variety of types, e.g. desirable events (‘outstanding personal achievement’), undesirable events (‘serious illness of child requiring hospital treatment’), gains (‘birth of a brother or sister’), losses (‘death of a parent’). These events were rated by paediatricians, teachers and mental health workers according to how much readjustment children of different ages would need to cope with them. Holmes and Rahe’s method of scoring was adopted, i.e. the raters were asked to evaluate each event in comparison with ‘birth of a brother or sister’ which had been assigned the arbitrary value of 500. Using this type of method for scoring, one with no set upper limits, one would expect a top-heavy distribution with extreme values. Although the median would normally have been used as a measure of central tendency for this data, Coddington used the geometric mean which deals with extreme values better than either the mean or the median [2]. The rating questionnaires have been administered to a normal population of children and average scores of life events have been reported for different age groups [3]. No further studies have tested the reliability or validity of the children’s scales, although the method used for their construction was sufficiently similar to that used in the development of the adult Social Readjustment Rating Questionnaire for comments about the scale’s reliability and validity to be made. The object of the present study is to produce a British Life Events Inventory for children by adapting the American scale. There are several new features: (a) A different scoring method is used (O-100) which eliminates extreme values, enabling the median to be used as the measure of central tendency. (b) Raters were asked to add events which they considered relevant to the lives of children. (c) Raters who obviously disagreed with the majority were eliminated from analyses. (Criteria for elimination will be discussed later.) (d) Events showing variation (SE. of 5 or over) were eliminated. This Children’s Life Events Inventory would be useful to researchers in the field of childhood stress and also, should the scale be shown to be a good predictor of illness, to doctors, social workers and others.
*Department of Psychology, University College, P.O. Box 78, Cardiff CFl IXL, Wales, VDepartment of Child Health, Welsh National School of Medicine, Heath Park, Cardiff CF4 4XN. Wales. 63
64
J. H. MONAGHAN,J. 0. ROBINSONand J. A. DODGE METHOD
Coddington’s list of events for the elementary school age group (6-l 1 years) was adapted for use with British children. Two events were excluded: ‘Becoming involved with drugs or alcohol’ and ‘Having a visible congenital deformity’, since the former is extremely rare in this age group in Britain and the latter cannot strictly be classed as an event. Three events were added by the author: ‘Move to a new house’, ‘Increase in the number of arguments with brothers and sisters’ and ‘Decrease in the number of arguments with brothers and sisters’ since these would change the lives of children in several ways. In order to obtain standard scores for each event, 150 raters consisting of 68 primary school teachers, 33 paediatricians and 49 social workers snecialising in children’s cases, were contacted by letter. Tkach&s were contacted through several local primary schools, social workers through the Area Social Services and hospitals, and paediatricians were members of the Welsh Paediatric Society. All three groups were sent the following instructions, and asked to return their ratings by post: ‘Below, there is a list of events that can happen in the lives of children, some of which are desirable, others undesirable. What these events have in common is that they all involve a certain amount of readjustment on the part of the child. For example, if the child has an outstanding personal achievement, he will still have to adjust to this change, despite the fact that the change is for the better. We would like you to consider the effect that these events would have on children, aged 5-12 years. Obviously, every child will react in different ways to the events, but try to think of the average amount of readjustment required for each event. ‘Please would you read through all the items and rate them according to the amount of readjustment each would involve, using a scale from O-100. For example, if you think that an item requires little readjustment, write a low number in the blank next to it, and if it requires a great deal of readjustment, write a high number, and so on. If you think that several items require the same amount of readjustment, write the same number next to them. In scoring the events, use both personal experience and second-hand knowledge of children.’ An introductory letter was also sent with the questionnaire asking the raters to add any other events that they considered to be of significance to children. TABLE1.-SPEARMAN’s RANKORDERCORRELATION COEFFICIENTS BETWEEN GROUPSOF RATERS Social workers and paediatricians Paediatricians and teachers Social workers and teachers British geometric means and American geometric means
0.904 0.913 0.872 0.928
RESULTS Twenty-seven teachers (40 %), 16 paediatricians (48 %) and 15 social workers (31%) returned the questionnaire giving an overall response rate of 39 %. The average response rate to postal questionaires is40-50% so thefinalnumberofraters(n = 58)isasexpected.Fiveextraeventsweresuggested bythe raters: ‘Sexual assault on child’, ‘Death of a pet’, ‘Problems with a teacher or schoolwork’, ‘Psychiatric disturbance of parent’ and ‘Being obese’. This last item was rejected since it is not strictly an event, although ‘Becoming obese’ could be included under the existing event ‘Acquiring a visible deformity’. A Spearman’s correlation matrix was computed to find out whether the raters showed overall agreement about the values of the events. Three raters, 1 teacher, 1 social worker and 1 paediatrician, were found to differ significantly from the others (an arbitrary correlation of less than 0.4 was chosen as a criteria for disagreement). These scores were eliminated from further analyses. Medians for each of the three groups of raters were calculated and Spearman’s rank order correlation coefficients showed high agreement between groups (see Table l), the lowest between social workers and teachers (p = 0.872). Only one item, ‘Death of a pet’ had a standard error of more than 5 and this was eliminated from the final list of events. The Kruskal-Wallis one-way analysis of variance (as used by Coddington) was computed to find out if any of the groups differed about the values of each event. Only two of the events were rated significantly different (p < 0.05) and the Mann-Whitney U-test showed that it was the group of paediadiatricians which was in disagreement. They rated ‘Serious illness of a parent requiring hospital treatment’ lower than teachers, and ‘Acquiring a visible deformity’ lower than social workers (p < 0.05). Kendall’s coefficient of concordance was found to be 0.7, showing hiih agreement between all raters. Lastly, medians for all the raters were calculated and Table 2 shows the final values for each of the events.
The Children’s Life Events Inventory
65
TABLE~.--MEDIANVALUESGIVENTOCHILD~N'SLIFEEVENTSBYDIPP~RENTGROUPSOFRATERS
American ratingst Death of a parent Separation of-parents Divorce of parents Sexual assault on child* Acquiring a visible deformity Death of a brother or sister Prison sentence of parent for 1 year or more Serious illness of child requiring hospital treatment Discovery of being an adopted child Marriage of parent to stepparent (Psychiatric disturbance of parent)* Serious illness of parent requiring hospital treatment Being kept down a year at school Change in child’s popularity with friends Death of child’s close friend or relative Beginning school Increase in number of arguments between parents Suspension from school Increase in number of arguments with parents Birth of a brother or sister Death of a grandparent Prison sentence of a parent for 30 days or less (Problems with a teacher or school work)* Change in father’s job requiring increased absence from home Change of school Close brother or sister leaving home Mother beginning full-time work Addition of 3rd adult to family Loss of job by parent Serious illness of brother or sister requiring hospital treatment Outstanding personal achievement Increase in number of arguments with brothers and sisters* Pregnancy of unmarried teenage sister Change in parent’s financial status Move to a new house* Decrease in number of arguments between parents Decrease in number of arguments with parents Beginning another school year Becoming a fully-fledged member of a church Decrease in number of arguments with brothers and sisters*
91 78 84
Paediatricians n = 15
Teachers n = 26
90
96
69 68 67
82 81 67 57 74 64
90 86 87 80 82 79
62 52 65 -
z! 68 62
55 57 51 53 46 51 46 47 50 38 44 -
78
Social workers Total n = 14 n = 55 97
95
86 81 80 ;!i 74 77 76
74 71
;: 71
::
z:
:;
75 62 62 65 70
67 65 69 55 55
67 61 61 60 59
; 46
62 51 55
::
57 43 48
: z
:: 55 47 51 47 52 52
:: 55 42 60
55 52 51 50 50 50 49
45 46 36 44 41 38
41 45
41 39
40 27
:z -
31 33 26 31
25 27 27 25
26 19 24 22
:4 12
2 21 20
-
14
15
18
2 32 31
2:
42 1: :;I 41 41 41
t: 42 41 40 39
;: 31 27 31
*Item not derived from Coddington’s scale. Items in parentheses were added later and rated by a smaller sample of paediatricians teachers (n = 18) and social workers (n = 8). TGeometric means.
(n = 8),
J. H.
66
J. 0.
MONAGHAN,
and J. A. Doooe
ROBINSON
X
X
xx
X
X
5
z
-g
‘50
40
30
I X
F
x X x
X X
x
xxk
x.
x
X x
:
x xx
X
20
14L 24
x
' 30
I 40
I 50
I 60
Am6riCon FIG.
l.-Scattergram
geometric
I 70
I 60
I. 90
I loo -'
means
of British geometric means plotted against American geometric means.
COMPARISONS
OF BRITISH AND AMERICAN
SAMPLES
Figure 1 shows a scattergram of the British geometric means for each event plotted against the American geometric means. Only two events were rated significantly different at the 0.01 level of confidence-‘Discovery of being an adopted child’ was rated higher by the British sample and Qecoming a fully-fledged member of a church’ was rated higher by the American sample. Spearman’s rank order correlation coefficients between the two groups also showed high agreement (p = 0.93). DISCUSSION
Although the British sample was small (n = 55), considerable agreement was found between individual raters, groups of raters and also across cultures. This shows that adults’ estimates of the relative severity of life events for children are very reliable. Although the groups of raters assigned different numerical values to the events, doctors giving lower weights across the items (mean = 46.41) than teachers (mean = 55.75) or social workers (mean = 52.56), their overall rank ordering of the events was constant as shown by the high Spearman’s rank order correlation coefficients. The actual value assigned to each event is to be used as a rough estimate of the amount of readjustment needed compared with a control group, rather than as a definitive quantity. The two events that the British and American samples disagreed about can perhaps be explained by comparing the two cultures. Adoption in America is encouraged and adoptive parents are given a great deal of support, both financial and social, whereas in Britain this help is not so available [4]. There may be other reasons for the difference in ratings, e.g. varying procedures involved in adoption organisations, attitudes of adoptive parents, or different advice of when and how to tell the child about adoption. These factors may all have contributed to the difference in ratings but since no comparative studies of adoption could be found in the literature, this explanation can only be speculative.
The Children’s Life Events Inventory
67
It is difficult to say why ‘Becoming a fully-fledged member of a church’ was rated higher by the American sample since again there are no comparative studies of religious attitudes reported in the literature. There have been some figures showing that church attendance is high in various parts of America, although it is difficult to compare these with figures from Britain due to differences in the areas studied. One possible reason for the differences is that in America there are a number of small churches of different religions so that a community spirit is encouraged whereas in Britain a smaller part is played by the small churches. It is possible that these differences are due to sample bias, but since the rank orders of the events are almost the same across the groups, the variation is not of great significance. Recent studies which have used the American children’s scale, have shown that various groups of children with different disorders have experienced more stressful life events than controls. For example, children with juvenile rheumatoid arthritis were found to have significantly higher scores on the American scale than did matched controls, adding support to the theory that this disorder may be aggravated by stress [5]. In a study of paediatric patients, it was found that all groups including children with arthritis, appendicitis, hernias and psychiatric disorders (but excluding haemophiliacs) had experienced more stressful life events during the year before onset than did controls [6]. The classification of a disorder has even been extended to studying accident-prone children. It was found that boys with high scores on the life event scale were significantly more accident-prone than boys with low scores [7]. This measure is generally considered to be an indirect estimate of the experience of stress and another study of chronically-ill children, i.e. children with burns, cystic fibrosis etc., has found an interesting relationship between stress and self-concept. Children with high scores on the life events scales showed poorer self-concepts than those with low scores [8]. It is evident that the Children’s Life Events Inventory would be a useful research tool for studies of children with disorders, and it could also help in our understanding of the effects of stress on personality. Since the inventory takes only 5-10 minutes to administer, doctors, social workers and others should find it useful in identifying children ‘at risk’ from either mental or physical disorders. Perhaps the most useful application of this Inventory will be in prospective studies, where factors such as the child’s illness do not bias the events reported. Acknowledgements-This work was supported awarded to the first author.
by a Science Research
Council Grant B/75/2318
REFERENCES 1. CODDINGTONR. D. The significance of life events as etiological factors in the diseases of children.
-1. A survey of professional workers. J. Psychosom. Rex. 17,7 (1972). 2. MAWDA M. and HOLMEST. H. Marmitude estimations of social readjustments. J. Psychosom. Res. 11,219 (1967). 3. CODDINGT~N R. D. The significance of life events as etiological factors in the diseases of children. -11. A study of a normal nonulation. J. Psychosom. Res. 16,205 (1972). 4. G~~DACRE i. Adoption PO& and Practice.George Allen & Dnwin, London (1966). 5. HEISELJ. S. Life changes as etiological factors in juvenile rheumatoid arthritis. J. Psychosom. Res. 16, 411 (1972). 6. H-EL J. S., REAMS., RAITE R., RAPPORT M. and CODDINGTONR. D. The significan ce of life events as contributing factors in the diseases of children.-III. A study of pcdiatri c patients. J. Pediat. 83, 119 (1975).
68
J. H. MONAGHAN,J. 0. ROBINSONand J. A. DODGE
7. PALXLLA E. R., ROHSENOW J. ~~~BERGMANA. B. Predicting accident frequency in children. Pediat. 58, 223 (1976). 8. BEDELLJ. R., GIORDANIB., AMOURJ. L., TAVORMINA J. and BOLLT. Life stress and the psychological and medical adjustment of chronically ill children. J. Psychosom. Res. 21,237 (1977).