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 persons 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.

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




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.


Chinese, English

Logical Observation Identifiers Names and Codes (LOINC) Perceived stress proto 64394-0 LOINC
Human Phenotype Ontology Triggered by stress HP:0025226 HPO
caDSR Form PhenX PX180801 - Perceived Stress 6189450 caDSR Form
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

Protocol Name from Source

Perceived Stress Scale


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 Name Variable IDVariable DescriptiondbGaP Mapping
PX180801070000 In the last month, how often have you been more
able to control irritations in your life? show less
Variable Mapping
PX180801090000 In the last month, how often have you been more
angered because of things that were outside of your control? show less
PX180801060000 In the last month, how often have you found more
that you could not cope with all the things that you had to do? show less
PX180801100000 In the last month, how often have you felt more
difficulties were piling up so high that you could not overcome them? show less
Variable Mapping
PX180801040000 In the last month, how often have you felt more
confident about your ability to handle your personal problems? show less
Variable Mapping
PX180801030000 In the last month, how often have you felt more
nervous and stressed? show less
Variable Mapping
PX180801080000 In the last month, how often have you felt more
that you were on top of things? show less
PX180801050000 In the last month, how often have you felt more
that things were going your way? show less
Variable Mapping
PX180801020000 In the last month, how often have you felt more
that you were unable to control the important things in your life? show less
Variable Mapping
PX180801010000 In the last month, how often have you been more
upset because of something that happened unexpectedly? show less
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

Measure Protocols
Protocol ID Protocol Name
180801 Perceived Stress

Hitz, M.M., Conway, P.G, Palcher, J.A., McCarty, C.A. (2014) Using PhenX toolkit measures and other tools to assess urban/rural differences in health behaviors: recruitment methods and outcomes. BMC Research Notes. 2014 November; 7(847). doi: 10.1186/1756-0500-7-847