the type and degree of distress of terminal cancer patients.

The index is included as Appendix B in the format presented

by Weisman, Worden, and Sobel (1980).

 The Index of Vulnerability calls for numerical ratings

on 13 vulnerability scales including hopelessness, turmoil,

frustration, depression, powerlessness, anxiety, exhaustion,

worthlessness, abandonment, denial, truculence, repudiation

of key others, and time perspective. Numerical ratings for

the overall scale can, therefore, range from 13 to 52.

 According to Weisman et al. (1980), the term vulner-

ability refers to (a) distressing emotion, such as

frustration, anxiety, or turmoil, (b) disposition to behave

in ways typical of that emotion, and (c) distress signals

indicative of an emotional state, such as weeping, pallor,

palpitations, and so forth. The authors point out that

"whenever a clinician draws a conclusion about vulnerability

the judgement is based both on what a patient says or does,

and on what the clinician observes and infers about the

emotion, problem, and major strategies" (p. 11).

 The interrater reliability coefficients reported in

Weisman et al. (1980) ranged from a low of .64 for the

powerlessness scale to a high of .92 for the truculence scale.

The reliability of the overall index was .95. For the purpose

of the present study, the four point continuum of each

vulnerability scale was divided into increments of .5