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.
Most of the time
Some of the time
Rarely
I take time for myself.
Most of the time
Some of the time
Rarely
I have stress-related symptoms (i.e. - headache, racing heart, cold hands or feet, inability to concentrate).
Most of the time
Some of the time
Rarely
My family is very supportive.
Most of the time
Some of the time
Rarely
My work is satisfying.
Most of the time
Some of the time
Rarely
I have trouble sleeping.
Most of the time
Some of the time
Rarely
I feel good about myself.
Most of the time
Some of the time
Rarely
I'm a perfectionist
Most of the time
Some of the time
Rarely
I tend to look on the bright side of life.
Most of the time
Some of the time
Rarely
I'm able to talk about my feelings.
Most of the time
Some of the time
Rarely
I get impatient and irritable with other drivers.
Most of the time
Some of the time
Rarely
I limit my intake of fat, cholesterol and junk food.
Most of the time
Some of the time
Rarely
I smoke.
Yes
No
I engage in 30 minute (or longer) sessions of moderate or rigorous exercise.
At least four times per week
Three times per week
Less than three times per week
I have conflicts with others.
Most of the time
Some of the time
Rarely
I get sick, especially with colds.
More than three times per year
Between two and three times per year
Less than twice a year
I'm happy with my social life.
Most of the time
Some of the time
Rarely
I'm happy with where I live.
Most of the time
Some of the time
Rarely
I'm happy with my partner (or with the fact that I don't have a partner).
Most of the time
Some of the time
Rarely
I'm a forgiving person.
Most of the time
Some of the time
Rarely
I drink caffeinated coffee and/or tea.
Several times a day
Once a day
Rarely or never
I have a drink of alcohol (one drink equals 1.5 oz. of spirits; 5 oz. of wine, or 12 oz. of beer)
Five or more times per day
Three to four times per day
Two times per day or less, rarely, or never
I feel overwhelmed by all that I have to do.
Most of the time
Some of the time
Rarely
I feel calm and relaxed.
Most of the time
Some of the time
Rarely
I have several good friends I can count on.
Most of the time
Some of the time
Rarely
