Duke Social Support and Stress Scale (DUSOCS)

Abstract

The Duke Social Support and Stress Scale (DUSOCS) is a widely utilized psychometric instrument developed by G. R. Parkerson Jr. and colleagues in 1989. Its primary function is to concurrently assess perceived levels of social support and personal stress originating from specific individuals within an individual’s social network. The scale is structured into two main components: one focusing on supportive relationships (Support Score) and the other on relationships that induce stress (Stress Score). The DUSOCS is particularly valuable in clinical and research settings, especially primary care, for understanding the intricate relationship between interpersonal dynamics and overall functional health status.

Keywords

Social support, stress measurement, family stress, personal support, social network, psychometrics, functional health, primary care.

Authors

G. R. Parkerson Jr., J. L. Michener, L. R. Wu, W. E. Broadhead, C. K. J. Tse.

Purpose

The fundamental purpose of the DUSOCS is to quantify the degree of support and stress experienced by an individual from key people in their immediate environment. Unlike scales that measure general perceived support, DUSOCS specifically identifies the sources of both positive and negative interpersonal influence, categorized into family members and non-family members. This instrument is designed to provide rapid screening information regarding the psychosocial context of a patient.

This dual measurement approach allows clinicians and researchers to analyze how imbalances in support versus stress, particularly within the family unit, correlate with various health outcomes. The scale was initially developed for use in primary care settings to screen patients whose health status might be influenced by high levels of family or interpersonal stress, enabling targeted interventions.

Construct

The DUSOCS measures two distinct, yet related, psychological constructs: perceived social support and perceived personal stress, both defined relationally by the source of the interaction. Social support is assessed based on the degree to which individuals feel supported by their network members, encompassing emotional, informational, and potential instrumental aspects of support.

Personal stress is assessed by the degree to which network members are currently causing strain, difficulty, or negative emotions for the respondent. The scale is notable for its relational focus, dividing sources into six categories of family relations and four categories of non-family relations, plus specific questions regarding the single most supportive and single most stressful person.

Validity

Validation studies, such as those conducted by Parkerson, Broadhead, and Tse (1991), confirm the scale’s utility. The DUSOCS scores have demonstrated strong criterion validity by showing significant associations with measures of functional health and quality of life. Specifically, higher support scores typically correlate positively with better health outcomes, while higher stress scores are predictive of adverse health-related outcomes.

The instrument’s ability to predict health outcomes independently of other established psychological scales suggests robust predictive validity. Research has consistently highlighted perceived family stress, as measured by DUSOCS, as a potent predictor of functional health status among primary care patients.

Reliability

Although the DUSOCS is a brief screening instrument, it has demonstrated acceptable reliability in various research applications. The structure of the scale, which addresses specific relational sources, contributes to its internal consistency, though detailed psychometric properties are typically reported in accompanying academic literature (e.g., test-retest reliability is often reported as adequate for stability over short measurement periods).

Factor Analysis

Empirical factor analyses of the DUSOCS generally support the conceptual bi-dimensional structure underlying the scale. The items clearly load onto their respective factors: the Support factor (I. People Who Give Personal Support) and the Stress factor (II. People Who Cause Personal Stress). This clean separation reinforces the scale’s design to measure these two independent constructs, allowing for separate scoring and interpretation of supportive and stressful relationships within a patient’s network.

Instrument

Test Type: Self-report questionnaire / Screening instrument

Format: Structured short-form questionnaire using a 3-point Likert-type scale for quantitative items, plus dichotomous (Yes/No) and open-ended items for identifying specific individuals.

Language Available: Primarily English (Validated translations may exist in specific research contexts).

Population Group: General adult population, particularly those seeking care in primary care settings.

Age Group: Adults (18+).

Population Details: Has been extensively used in studies involving patients with chronic conditions, various demographic groups, and those undergoing health interventions.

Test Methodology: Respondents rate the level of support or stress they receive from 10 categories of network members (family and non-family). Scoring assigns weights: “none” = 0, “some” = 1, “a lot” = 2, “yes” = 2, “no” = 0, and “there is no such person” = 0. Total scores are calculated separately for the support and stress sections.

Keywords

DUSOCS, psychosocial assessment, interpersonal relations, family medicine, support networks, psychological measure.

Authors

Author ORCID Identifier: Not publicly standardized or provided in source material.

Affiliation Email addresses: Contact Duke University Department of Community and Family Medicine for current information.

Correspondence Address: Correspondence is typically directed to G. R. Parkerson Jr. at Duke University (based on 2002 user guide reference).

Permissions & Fee and Test Year

The scale was initially published and validated in 1989. For usage permissions and potential licensing fees, users must contact the copyright holder, typically associated with Duke University or the principal author, G. R. Parkerson Jr. The use of this instrument in research and clinical settings often requires obtaining explicit permission.

The original PDF describing the instrument and context can be downloaded here: www.a4ebm.org/sites/default/files/Measuring%20Health.pdf

Reference’s

• Parkerson, GR, Jr., Michener, JL., Wu, LR. et al. (1989). Associations among family support, family stress, and personal functional health status. Journal of Clinical Epidemiology, 42(3):217–229.
• Parkerson, GR, Jr., Michener, JL., Wu, LR., et al. (1989). The effect of a telephone family assessment intervention on the functional health of patients with elevated family stress. Med Care, 27(7):680–693.
• Parkerson, GR, Jr., Broadhead, WE., Tse, CKJ. (1991). Validation of the Duke Social Support and Stress Scale. Family Medicine, 23(5):357–360.
• Parkerson, GR, Jr., Broadhead, WE., Tse, CKJ. (1992). Quality of life and functional health of primary care patients. Journal of Clinical Epidemiology, 45:1303–1313.
• Parkerson, GR, Jr., Broadhead, WE., Tse, CKJ. (1995). Perceived family stress as a predictor of health-related outcomes. Arch Fam Med, 4:253–260.
• Parkerson, GR, Jr. (2002). User’s guide for Duke health measures. Durham, NC: Duke University Department of Community and Family Medicine.
• McDowell, Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires, Third Edition. OXFORD UNIVERSITY PRESS.

Items of the Duke Social Support and Stress Scale (DUSOCS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Scoring key: “none” = 0, “some” = 1, “a lot” = 2, “yes” = 2, “no” = 0, and “there is no such person” = 0.