Protocol - Chronic Stress
The chronic stress scale includes a list of 51 items about common life conditions and situations (e.g., financial issues, work, love and marriage, family and children, social life). The interviewer reads each item aloud and asks the respondent to reply with not true (0), somewhat true (1), or very true (2).
The researcher may want to collect information about other types of stress (e.g., traumatic life events, other life events) to conduct a comprehensive stress assessment.
Now, Ill describe some situations that sometimes come up in peoples lives. Id like you to tell me if these things are not true, somewhat true, or very true for you at this time.
1. Youre trying to take on too many things at once.
2. There is too much pressure on you to be like other people.
3. Too much is expected of you by others.
4. You dont have enough money to buy the things you or your kids need.
5. You have a long-term debt or loan.
6. Your rent or mortgage is too much.
7. You dont have enough money to take vacations.
8. You dont have enough money to make a down payment on a home.
9. You have more work to do than most people.
10. Your supervisor is always monitoring what you do at work.
11. You want to change jobs or career but dont feel you can.
12. Your job often leaves you feeling both mentally and physically tired.
13. You want to achieve more at work but things get in the way.
14. You dont get paid enough for what you do.
15. Your work is boring and repetitive.
16. You are looking for a job and cant find the one you want.
17. You have a lot of conflict with your partner.
18. Your relationship restricts your freedom.
19. Your partner doesnt understand you.
20. Your partner expects too much of you.
21. You dont get what you deserve out of your relationship.
22. Your partner doesnt show enough affection.
23. Your partner is not committed enough to your relationship.
24. Your sexual needs are not fulfilled by this relationship.
25. Your partner is always threatening to leave or end the relationship.
26. You wonder whether you will ever get married.
27. You find it is too difficult to find someone compatible with you.
28. You have a lot of conflict with your ex-spouse.
29. You dont see your children from a former marriage as much as you would like.
30. You are alone too much.
31. You wish you could have children but you cannot.
32. One of your children seems very unhappy.
33. You feel your children dont listen to you.
34. A childs behavior is a source of serious concern to you.
35. One or more children do not do well enough at school or work.
36. Your children dont help around the house.
37. One of your children spends too much time away from the house.
38. You feel like being a housewife is not appreciated.
39. You have to go to social events alone and you dont want to.
40. Your friends are a bad influence.
41. You dont have enough friends.
42. You dont have time for your favorite leisure time activities.
43. You want to live farther away from your family.
44. You would like to move but you cannot.
45. The place you live is too noisy or too polluted.
46. Your family lives too far away.
47. Someone in your family or a close friend has a long-term illness or handicap.
48. You have a parent, a child, or a spouse or partner who is in very bad health and may die.
49. Someone in your family has an alcohol or drug problem.
50. A long-term health problem prevents you from doing the things you like to do.
51. You take care of an aging parent almost every day.
The 51-item scale may be broken down into 13 subscales as shown in the table below. For each item, a response of not true = 0, somewhat true = 1, and very true = 2. Calculate the score from each individual subscale. Of the two methods to obtain an overall score, the first is to add up all very trues or very trues and somewhat trues. However, if a person does not have a particular role (e.g., parent), then the question is scored with a zero (see subscale table for universal vs. role-specific designations). The other method is to code the items as missing if a respondent is not in the role and therefore was not asked these questions, and then take the average of all subscales. The scores cannot simply be added up because the total is confounded by the number of roles the person is in and that is a proxy for social competence, therefore cutting across the point of the scale.
Universal or Role-Specific
Money and Finance
Love and Marriage
Relationship or Marriage
Never married/currently single
Divorce or Separation
Divorced or separated only
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.
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.
|Specialized requirements for biospecimen collection
|Average time of greater than 15 minutes in an unaffected individual
Mode of Administration
Ages 18 years and older
The scale was developed to be a comprehensive listing of role-related stressors and long-term life problems tapping chronic stress.
|Logical Observation Identifiers Names and Codes (LOINC)
|Chronic stress proto
|Human Phenotype Ontology
|Triggered by stress
|PhenX PX181301 - Chronic Stress
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
The Chronic Stress Scale
Turner, R. J., Wheaton, B., & Lloyd, D. A. (1995). The epidemiology of social stress. American Sociological Review, 60(1), 104-125.
Wheaton, B. (1994). Sampling the stress universe. In W. Avison & I. Gotlib (Eds.), Stress and mental health: Contemporary issues and prospects for the future (pp. 77-114). New York: Plenum.
Wheaton, B. (1997). The nature of chronic stress. In B. Gottlieb (Ed.), Coping with chronic stress (pp. 43-74). New York: Plenum.
|You are alone too much.
|You are looking for a job and can't find the more
|One or more children do not do well enough more
|Your children don't help around the house.
|You feel your children don't listen to you.
|One of your children spends too much time more
|A child's behavior is a source of serious more
|You have a lot of conflict with your partner.
|You have a lot of conflict with your ex-spouse.
|You find it is too difficult to find someone more
|You want to change jobs or career but don't more
|You don't get what you deserve out of your more
|You don't get paid enough for what you do.
|You don't have enough friends.
|You don't see your children from a former more
|Someone in your family or a close friend has more
|Your family lives too far away.
|Someone in your family has an alcohol or more
|You have a parent, a child, or a spouse or more
|You feel like being a housewife is not more
|Your friends are a bad influence.
|You have to go to social events alone and more
|A long- term health problem prevents you more
|Your job often leaves you feeling both more
|You have a long-term debt or loan.
|You have more work to do than most people.
|You don't have enough money to make a down more
|You don't have enough money to buy the more
|You don't have enough money to take vacations.
|You don't have time for your favorite more
|One of your children seems very unhappy.
|Your partner is always threatening to leave more
|Your partner doesn't show enough affection.
|Your partner doesn't understand you.
|Your partner expects too much of you.
|Your partner is not committed enough to your more
|The place you live is too noisy or too polluted.
|There is too much pressure on you to be like more
|Your relationship restricts your freedom.
|Your rent or mortgage is too much.
|Your sexual needs are not fulfilled by this more
|Your supervisor is always monitoring what more
|You take care of an aging parent almost every day.
|You're trying to take on too many things at once.
|Too much is expected of you by others.
|You want to achieve more at work but things more
|You want to live farther away from your family.
|You would like to move but you cannot.
|You wish you could have children but you cannot.
|You wonder whether you will ever get married.
|Your work is boring and repetitive.
December 13, 2010
This measure is used to assess a person’s perception of ongoing and enduring sources of stress in his/her life conditions.
Chronic or enduring stress is measured through self-reports of whether a set of stressful conditions describe the individual’s situation. Chronic stress, as well as more typical measures of current stress, have been shown to influence physical health, mental health, aging, use of health care services, and recovery outcomes (both for health and health care).
chronic stress, Psychosocial, stress
Krebs, N. M., et al. (2016) Comparison of Puff Volume With Cigarettes per Day in Predicting Nicotine Uptake Among Daily Smokers. Am J Epidemiol. 2016 July; 184(1): 48-57. doi: 10.1093/aje/kwv341