The Perceived Stress Scale: Measure how stressed you are

The first step in tackling these problems is identifying them. Before taking any radical measures, it's good to figure out the extent to which stress is affecting you.

What's the best way to measure stress?

The Perceived Stress Scale (PSS) test can help you do just that.

Introduced by researchers Cohen, Kamarck, and Mermelstein in the Journal of Health and Social Behavior, the PSS is widely acknowledged, clinically validated, and used by many reputable medical services, such as the UK's NHS.

Here's everything you need to know about the Perceived Stress Scale, including a simple test you can do right away.

What is the perceived stress scale used for?

According to Cohen, the PSS measures the degree to which situations in your life are appraised as stressful. Although not a diagnostic instrument for stress-related disorders, the Perceived Stress Scale can give you a pretty good idea of your own perception of stress. Simply put, it can easily help you figure out whether or not your experienced stress levels are normal for you, leaving the 'how' and 'why' out of the equation for now.

Ideally, it should be used in conjunction with other stress management tools. Our own Vital Wellbeing coaching program is designed to help you relieve stress as you find new ways to grow and connect with others.

(We all get stressed from time to time. You, too, can learn to manage and control your stress over the long term. But if negative thoughts have become the norm or you suddenly feel overwhelmed by unexpected life events, seek help from a professional.)

Take the test

The original PSS comprised 14 questions (aka PSS-14), each about different thoughts and feelings the respondent has had during the past month. There's also a 10-question version of the test named PSS-10, and a 4-question version named PSS-4.

Below you'll find the original 14-part PSS, as it was administered by Cohen in 1983. The type of 5-point scale response used is known as the 5-point Likert item scale: it's a simple way of quantifying feelings that works well for surveys.

Be honest, and answer the questions without thinking about them too much. You don't have to do any counting – just go with the estimate that feels most reasonable.

To help you calculate your total score, we've broken the questionnaire into two parts.

PART 1

Answer these 7 questions first, using the scale provided below. Write down the number corresponding to your selected answer next to each question:

• 0. never
• 1. almost never
• 2. sometimes
• 3. fairly often
• 4. very often

1. In the last month, how often have you been upset because of something that happened unexpectedly?

2. In the last month, how often have you felt that you were unable to control the important things in your life?

3. In the last month, how often have you felt nervous and "stressed"?

4. In the last month, how often have you found that you could not cope with all the things that you had to do?

5. In the last month, how often have you been angered because of things that happened that were outside of your control?

6. In the last month, how often have you found yourself thinking about things that you have to accomplish?

7. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

When you're done, add up your scores.

PART 1 TOTAL SCORE:

PART 2

This is part 2 of the test. Don't get confused! The scale is the same, but please note the next 7 questions are scored in reverse. Write down the number corresponding to your answer next to each question:

• 4. never
• 3. almost never
• 2. sometimes
• 1. fairly often
• 0. very often

1. In the last month, how often have you dealt successfully with irritating life hassles?

2. In the last month, how often have you felt that you were effectively coping with important changes that were occurring in your life?

3. In the last month, how often have you felt confident about your ability to handle your personal problems?

4. In the last month, how often have you felt that things were going your way?

5. In the last month, how often have you been able to control irritations in your life?

6. In the last month, how often have you felt that you were on top of things?

7. In the last month, how often have you been able to control the way you spend your time?

When you're done, add up your scores.

PART 2 TOTAL SCORE:

Add the scores from the two parts together, and that's it – you've got your result.

FINAL SCORE:

How do you interpret the Perceived Stress Scale results?

Your individual stress score can go all the way from 0 to 56, and as you might have figured out already, higher PSS scores indicate higher levels of perceived stress:

• If you scored anywhere from 0 to 19, then your stress level would be considered low. Perhaps you took this test out of curiosity. You're likely leading a fulfilling and largely stress-free life – good for you!
• If you scored from 20 to 37, then your stress level would be considered moderate. You often worry about things that are out of your control, but you try not to let stress get the best of you. In the initial study, Cohen's data collection included two samples gathered from college students and one from a more heterogeneous demographic group. The majority of people scored somewhere in the mid twenties.
• If you scored between 38 and 56, then your stress level would be considered high. You likely spend a lot of time worrying about the future, and negative thoughts live rent-free in your head. Coping can be difficult, especially when things don't go your way. If your PSS score is nearing 50, chances are that you lead quite a stressful life. (Contact a professional if you suffer from specific depressive symptoms or periods of debilitating anxiety.)

Why was the Perceived Stress Scale developed?

By developing the PSS, Cohen hoped to deliver an alternative to the psychosocial and environmental stressors that were often used as the basis of psychometric analysis. Before Cohen's influential contribution to the field, most researchers measured stress by linking disorders to specific stressful events (e.g., unemployment, bereavement, prolonged exposure to loud noise). Such correlations offered quick estimates of the increased risk of disease associated with said events.

The main problem with this approach is simple: it implies that specific stressful events are the main cause of pathology and illness. Standard measurements of "objective stress", as Cohen puts it, disregard the coping resources we all use to overcome threatening or challenging events.

Sure, certain events are bound to be linked to stressful experiences, but that doesn't mean there's necessarily a causal relationship between the two. For example, not everyone who's lived through a traumatic experience develops PTSD.

We're all different, and we all employ different coping strategies when things go south. Cohen's Perceived Stress Scale doesn't dictate how specific stressful situations will, should, or might affect an individual. It simply provides us with a way to self-evaluate and self-report our own stress levels – a powerful tool that's also important for self-efficacy.

Is the Perceived Stress Scale free to use?

Yes, the Perceived Stress Scale is free to use, as long as the organization that's issuing it isn't making a profit on its use. For other commercial uses, standard fees apply, and you should contact the American Sociological Association (ASA).

What are the benefits of the Perceived Stress Scale?

The Perceived Stress Scale was invented to measure psychological stress. As we've already discussed, objective measurements can be used to predict the increased risk of disease, but they often lead to false causal attributions.

In its questionnaire form, PSS is easy to administer, and it helps both researchers and professionals understand how stress-inducing life events affect individuals. Instead of asking questions about specific events, the PSS allows respondents to self-evaluate their emotional state.

The questions are easy to understand and are of a general nature. Thus, the PSS is available to the general population, and it's also relatively free from bias. It can also safely be administered to children over the age of 12.

What is the difference between the Perceived Stress Scale and the General Health Questionnaire?

While they're both health-related questionnaires, there are significant differences between the two. The General Health Questionnaire is used to identify non-psychotic and minor psychiatric disorders. The Perceived Stress Scale, on the other hand, is a widely-used psychological instrument for measuring the perception of stress.

Outside psychiatry, the PSS has plenty more applications than the General Health Questionnaire.

How often should you complete the Perceived Stress Scale?

Whether you're taking the PSS-14 or the PSS-10, all of the questions have to do with thoughts, feelings, and emotions you've had in the past month or so. Effectively, this means you'll have to leave plenty of time between each test if you're to notice any significant changes.

Cohen states that frequent retests within a very short time (e.g., two days) will probably result in minor changes and fairly substantial correlations. The best use of the scale seems to be within a one-or two-month period.

With that in mind, Cohen suggests that monthly administrations of the scale can produce averages consisting of large sample sizes. Such averages can provide a reliable measure of chronic stress, and at the same time, function as predictors – which can help you take measures to combat varying levels of stress and burnout.

How to Prevent Stress

The PSS will help you determine how well you think you're coping with stressful events in your life. Unfortunately, preventing anxiety and managing stress isn't as straightforward. Here are some tips that can help you bring a positive change in your life.

Exercise

There's plenty of evidence to suggest a positive correlation between regular physical exercise and reduced stress levels. Exercise combats many diseases and promotes better sleep, but it can also improve your mood and boost your energy.

The good news is that you don't have to go crazy to reap the benefits of physical exercise. According to the UK Chief Medical Officers' report, 150 minutes of physical activity a week is enough to calm your nerves, as well as reduce your risk of developing many chronic diseases, such as heart disease, stroke, and type 2 diabetes.

Eat well

Unhealthy eating patterns increase stress levels and negatively affect your mood. Aim for a healthy and balanced diet that consists of complex carbohydrates (e.g., vegetables, fruits, legumes) lean proteins, and fatty acids found in fish, eggs, meat, and nuts. Avoid junk food, as well as processed and packaged foods that contain a lot of fat and sugar.

Seek social support

You're not in this alone. Instead of shutting people out and trying to solve everything by yourself, try to connect with the people closest to you. Human contact helps you calm down, reducing the levels of cortisol (stress hormone) in your blood.

Listen to your inner voice and don't be afraid to show others the real you. If you can, talk about your problems and share your worries with your friends and family. If you find that too difficult, don't hesitate to seek out a qualified therapist.

Don't forget to breathe

Stress is a natural response to events and situations we perceive as threatening. The increased heart rate, the restlessness, and the heightened senses? It's how your body would prepare for an unavoidable encounter with a wild wolf or bear.

We don't have to face off against wild animals anymore, but unexpected events that are emotionally loaded trigger the same fight-or-flight response.

This response is useful when you're in a life-threatening situation, but repeated activation over a long period of time takes a toll on the body.

When you feel overwhelmed, evaluate the situation, and give yourself a minute or so to relax. You can easily trick your mind into thinking the threat's been eliminated by practicing deep abdominal breathing. Inhale for 3-4 seconds and touch your belly as it fills with air. Hold your breath for a few more seconds, exhale slowly, and repeat until the minute has passed.

The Perceived Stress Scale can easily help you understand how you currently perceive stress in your life. That said, managing and preventing that stress might prove a little bit more challenging.