This test is a helpful tool to raise awareness of our own, or our child’s stress levels and how they might affect our or our’s child 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 or your child’s 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 (Non-Adults) Questionnaire

Life EventI am effected by this
1.   Death of a parent
2.   Unplanned pregnancy/abortion
3.   Getting married
4.   Divorce of parents
5.   Acquiring a visible deformity
6.   Fathering a child
7.   Jail sentence of a parent for over one year
8.   Marital separation of parents
9.   Death of a brother or sister
10.   Change in acceptance by peers
Life EventI am effected by this
11.   Unplanned pregnancy of sister
12.   Discovery of being an adopted child
13.   Marriage of parent to stepparent
14.   Death of a close friend
15.   Having a visible congenital deformity
16.   Serious illness requiring hospitalization
17.   Failure of a grade in school
18.   Not making an extracurricular activity
19.   Hospitalization of a parent
20.   Jail sentence of parent for over 30 days
Life EventI am effected by this
21.   Breaking up with boyfriend or girlfriend
22.   Beginning to date
23.   Suspension from school
24.   Becoming involved with drugs or alcohol
25.   Birth of a brother or sister
26.   Increase in arguments between parents
27.   Loss of job by parent
28.   Outstanding personal achievement
29.   Change in parent's financial status
30.   Accepted at college of choice
Life EventI am effected by this
31.   Being a senior in high school
32.   Hospitalization of a sibling
33.   Increased absence of parent from home
34.   Brother or sister leaving home
35.   Addition of third adult to family
36.   Becoming a full-fledged member of a church
37.   Decrease in arguments between parents
38.   Decrease in arguments with parents
39.   Mother or father beginning work