Protocol - Perceived Stress

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This 10-item self-administered scale is used to measure an individual’s level of perceived stress in the past month. As a result, it measures only current (not chronic) levels of perceived stress. The response options for each feeling or thought indicate the frequency with which it occurred: 0 = Never; 1 = Almost Never; 2 = Sometimes; 3 = Fairly Often; 4 = Very Often.

Specific Instructions:

The 10-item Perceived Stress Scale (PSS) and scoring are available from Dr. Cohen’s laboratory through the Carnegie Mellon University Department of Psychology website. Permission for use of scales is not necessary when use is for nonprofit academic research or educational purposes.

The PSS is not a diagnostic instrument, and there are no cut-offs for classification of responders into "high," "medium," or "low" stress. It is generally used as an ordinal scale or count measure.

Psychometric properties have not been collected on other time periods.

The PSS was designed for use with community samples with at least a junior high school education.

There are also 4- and 14-item versions of this scale available. The 10-item scale is recommended because it has been psychometrically tested, has been used in large population-based studies, and represents low respondent burden.


The Perceived Stress Scale includes 10 questions about the person's feelings and thoughts during the past month. The response options for each feeling or thought indicate the frequency with which it occurred: 0 = Never; 1 = Almost Never; 2 = Sometimes; 3 = Fairly Often; 4 = Very Often. Scoring instructions are available on the Carnegie Mellon website.

Protocol Name from Source:

Perceived Stress Scale


Publicly available

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

These questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. A laptop computer/handheld computer will be needed to administer a computer-assisted questionnaire.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered or interviewer-administered questionnaire

Life Stage:



Ages 18 years and older

Selection Rationale

The Perceived Stress Scale (PSS) is the most widely used index of perceived stress. The scale has good reliability and validity and has been used in many settings.



Common Data Elements (CDE) Perceived Stress Scale Questionnaire Number Score 2199495 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Perceived stress proto 64394-0 LOINC
Derived Variables


Process and Review

Expert Review Panel 4 (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.

Guidance from ERP 4 included the following:

· No changes


Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont Symposium on applied social psychology. Newbury Park, CA: Sage.

General References

Cohen, S. (1986). Contrasting the hassle scale and the perceived stress scale. American Psychologist, 41, 716-719.

Cohen, S., & Janicki-Deverts, D. (2012). Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009. Journal of Applied Social Psychology, 42(6), 1320-1334.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.

Cole, S. (1999). Assessment of differential item functioning in the Perceived Stress Scale-10. Journal of Epidemiology & Community Health, 53, 319-320.

Extremera, N., Durán, A., & Rey, L. (2009). The moderating effect of trait meta-mood and perceived stress on life satisfaction. Personality and Individual Differences, 47(2), 116-121.

Hamer, M., Molloy, G. J., & Stamatakis, E. (2008). Psychological distress as a risk factor for cardiovascular events: Pathophysiological and behavioral mechanisms. Journal of the American College of Cardiology, 52(25), 2156-2162.

Yu, R., & Ho, S. C. (2010). Psychometric evaluation of the perceived stress scale in early postmenopausal Chinese women. Psychology, 1, 1-8.

Protocol ID:


Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX180801_Able_To_Control_Irritations PX180801070000 In the last month, how often have you been able to control irritations in your life? Variable Mapping
PX180801_Angered_By_Things_Outside_Control PX180801090000 In the last month, how often have you been angered because of things that were outside of your control? N/A
PX180801_Could_Not_Cope_With_AllThings PX180801060000 In the last month, how often have you found that you could not cope with all the things that you had to do? N/A
PX180801_Difficulties_Piling_Up PX180801100000 In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? Variable Mapping
PX180801_Felt_Confident_To_Handle_Problems PX180801040000 In the last month, how often have you felt confident about your ability to handle your personal problems? Variable Mapping
PX180801_Felt_Nervous_And_Stressed PX180801030000 In the last month, how often have you felt nervous and "stressed"? Variable Mapping
PX180801_Felt_On_Top_Of_Things PX180801080000 In the last month, how often have you felt that you were on top of things? N/A
PX180801_Felt_Things_Going_Your_Way PX180801050000 In the last month, how often have you felt that things were going your way? Variable Mapping
PX180801_Unable_To_Control_Important_Things PX180801020000 In the last month, how often have you felt that you were unable to control the important things in your life? Variable Mapping
PX180801_Upset_Because_Of_Unexpected PX180801010000 In the last month, how often have you been upset because of something that happened unexpectedly? N/A
Measure Name:

Perceived Stress

Release Date:

December 13, 2010


This is a measure of the degree to which situations in one’s life in the past month are appraised as stressful.


The Perceived Stress Scale (PSS) is a nonspecific stress appraisal. The results may be used to examine the association between stress and the etiology of disease and/or behavioral disorders. Perceived stress has been associated with cardiovascular disease morbidity and mortality and premature death. PSS has also been seen as relevant to health and illness behaviors (e.g., the use of formal health care).


Psychosocial, stress