Select one answer for each of the statements below that best reflects your situation. Please keep in mind that this is a general assessment of your stress levels. Further and more
in-depth assessment may be obtained from your health care or mental health care provider.
| I handle changes with ease. |
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| I take time for myself. |
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| I have stress-related symptoms (i.e. - headache, racing heart, cold hands or feet, inability to concentrate). |
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| My family is very supportive. |
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| My work is satisfying. |
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| I have trouble sleeping. |
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| I feel good about myself. |
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| I'm a perfectionist |
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| I tend to look on the bright side of life. |
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| I'm able to talk about my feelings. |
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| I get impatient and irritable with other drivers. |
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| I limit my intake of fat, cholesterol and junk food. |
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| I smoke. |
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| I engage in 30 minute (or longer) sessions of moderate or rigorous exercise. |
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| I have conflicts with others. |
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| I get sick, especially with colds. |
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| I'm happy with my social life. |
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| I'm happy with where I live. |
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| I'm happy with my partner (or with the fact that I don't have a partner). |
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| I'm a forgiving person. |
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| I drink caffeinated coffee and/or tea. |
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| I have a drink of alcohol (one drink equals 1.5 oz. of spirits; 5 oz. of wine, or 12 oz. of beer) |
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| I feel overwhelmed by all that I have to do. |
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| I feel calm and relaxed. |
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| I have several good friends I can count on. |
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