Factors of Symptom Distress: Doctor Ratings of Anxious Neurotic Outpatients

IN A SERIES of related papers by Mattsson et al,¹ Williams et al,² and Lipman et al,³ a Symptom Distress Check List (SCL), developed by Parloff, Frank, and their coworkers,^4,5 containing items covering the spectrum of common psychoneurotic complaints, was factor-analyzed, employing the self-ratings of more then 1,500 anxious-neurotic outpatients. These Factors were tested for their sensitivity in discriminating pharmacologic and nonpharmacologic influences within the context of a double-blind, placebo-controlled trial of meprobamate in which doctor medication attitudes were experimentally manipulated via role-playing techniques.⁶

Of the five stable and clinically meaningful factors extracted from the patients' selfratings, Somatization and Fear-Anxiety proved most sensitive to main drug effects, whereas the remaining three factors—General Neurotic Feelings, Cognitive-Performance Difficulty, and Depression—were more reliably influenced by the interaction of pharmacologic and nonpharmacologic variable in the treatment context.