This test is a helpful tool to raise awareness of our own stress levels and how they might affect our health.

Taking our stress levels into account when making small and big decisions about changes will help us reflect on when would be the most helpful time to make any changes as they will often bring extra stress.

The sum of the life change units of the applicable events in the past year of an individual’s life gives a rough estimate of how stress affects health.

Understanding your results

Read Introduction to the Stress Scale Questionnaire to understand your results of the Stress Scale Questionnaire more in detail.

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Personal Info

First Name
Last Name
Gender Female
Been given a code? please enter it here
Who is completing this form?a) Myself on my own
b) Myself with help
c) Someone is completing it for me
If b or c, please state who (name and releationship)

Stress (Adults) Questionnaire

Life EventI am effected by this
1.   Death of a spouse
2.   Divorce
3.   Marital separation
4.   Death of a close family member
5.   Imprisonment
6.   Personal injury or illness
7.   Marriage
8.   Dismissal from work
9.   Marital reconciliation
10.   Retirement
Life EventI am effected by this
11.   Change of health of family member
12.   Pregnancy
13.   Business readjustment
14.   Gain a new family member
15.   Sexual difficulties
16.   Change in financial state
17.   Death of a close friend
18.   Change to different line of work
19.   Change in frequency of arguments
20.   Major mortgage
Life EventI am effected by this
21.   Foreclosure of mortgage or loan
22.   Change in responsibilities at work
23.   Child leaving home
24.   Trouble with in-laws
25.   Outstanding personal achievement
26.   Beginning or end of school
27.   Spouse starts or stops working
28.   Change of living conditions
29.   Revision of personal habits
30.   Trouble with boss
Life EventI am effected by this
31.   Change in residence
32.   Change in schools
33.   Change in working hours or conditions
34.   Change in Church activities
35.   Change in recreation
36.   Change in social activities
37.   Minor mortgage or loan
38.   Change in sleeping habits
39.   Change in eating habits
40.   Change in number of family reunions
Life EventI am effected by this
41.   Vacation
42.   Major holiday
43.   Minor violation of law