Stress Questionnaire

This questionnaire has been designed to help assess your present stress level. It has been shown that stress is accumulated over a period of time. Having one major life event might raise your stress level (for example 60) but it takes possibly 12 months under normal conditions to reduce this previous levels again. Many people don't realise that something else happening during this 'recovery' period will add to the level taking it even high. The higher the level the more likely it is that you will experience negative or even physically damaging affects. Even minor levels of stress sustained over a prolonged period can lead to stress related problems but higher levels can lead to physical ailments and more severe psychological disorders.

Please note this form is only to provide an indication of the possible stress level you may be experiencing in order to help you assess what, if any, action you might like to take.

Place a tick next to those items below that apply to you and click submit form to view your personal result.

Death of spouse 100
Divorce 73
Marital separation 65
Jail term 63
Death of close family member 63
Personal injury or illness 53
Marriage 50
Being fired from work 47
Marital problems 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain of new family member 39
Business readjustment 39
Change in finances 38
Death of close friend 37
Change to different line of work 36
Change in number of arguments with spouse 35
Mortgage or loan for major purchase (such as a home) 31
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Son or daughter leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Beginning or finishing school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in work hours or conditions 20
Change in residence 20
Change in school 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Mortgage or loan for lesser purchase (such as a car or tv) 17
Change in sleeping habits 16
Change in number of family get-together's 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violations of the law 11

 

Martyn J. Shrewsbury BA, BSc, FRAI, FHRS
The Brooklands Clinic, 24 Brooklands Terrace, Mount Pleasant, Swansea, SA1 6BS
(South Wales, UK)
telephone: 01792 455 364 E-mail:

A fully qualified team of practitioners providing a comprehensive range of Natural Health, Complimentary and Natural Therapies

Counselling, Homeopathy, Hypnotherapy, Physiotherapy,
Reiki, Massage, Aromatherapy, Reflexology