The authors report on development and validation of their Index of Affective Suffering (IAS), an explicit measure of subjective symptom severity, constructed as a typological system, rather than a multifactorial scoring system, with combinations of "intensity" (degrees of distress per given time) and "extensity" (duration and frequency of episodes, and number and variety of life events and activities that are pervaded by distress) item rankings. Seven levels of severity appeared to have both face value and empirical justification. Further conceptual and methodological advances would enhance the development and evaluation of treatments for geriatric mental disorders and chronic diseases in general.