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Perceived Stress Scale

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Purpose

The PSS is a self-reported measure which assesses the degree to which the respondent has perceived situations in his/her life within the past month as stressful.

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Instrument Details

Acronym PSS-14

Area of Assessment

Stress & Coping

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Cost Description

Free use for non-profit, academic research, and educational purposes. All other purposes require granted permission from instrument author, which can be obtained by emailing: commoncoldproject@andrew.cmu.edu

Diagnosis/Conditions

  • Brain Injury Recovery
  • Spinal Cord Injury

Key Descriptions

  • The PSS-14 is comprised of 14 items intended to measure how unpredictable, uncontrollable, and overloaded individuals find their life circumstances. The PSS-10 is a shorter, 10-item questionnaire.
  • Individuals rate items on a 5-point Likert scale, ranging from 0 - “Never” to 4 - “Very often."
  • Scores range from 0-56, with higher scores indicating greater perceived stress.
  • The PSS-14 is not a diagnostic instrument; therefore, there are no cut-off scores.
  • Respondents’ scores on the PSS-14 are intended to be compared to the larger sample.
  • Scores are obtained by reverse scoring the positively stated items (4, 5, 6, 7, 9, 10, and 13) and then summing the scores across all 14 items.
  • The PSS-14 can be administered to anyone who has greater than a middle school education.
  • The PSS-14 can be administered in person, mailed out, or conducted over the phone.

Number of Items

14

10

Equipment Required

  • Test Form
  • Pencil and Pen

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initial review completed by Heather Wolf, Kristina Zappavigna, and Lauren Piper at the Illinois Institute of Technology (2015). Review and revisions completed by Kristian Nitsch, MS (3/4/2015).

Measurement Domain

Emotion

Considerations

Traumatic Brain Injury (TBI) (Bay, Kalpakjian & Giordani, 2012)

  • More recent research has uncovered that TBI not only affects cognitive functioning via damage to sections of the brain, but stress responses are also affected.
  • Minimal research has focused on perceived stress.

 

Spinal Cord Injury (SCI) (Gerhart, Weitzenkamp, Kennedy, Glass, & Charlifue, 1999)

Data suggests three relationships:

  • The non-existent relationship between stress and the severity of the disability among long-term spinal cord injury survivors.
  • The seemingly strong relationship between stress and other psychological outcomes, particularly depression, life satisfaction, and quality of life.
  • The lack of strong relationships between stress and medical outcomes.

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Non-Specific Patient Population

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Standard Error of Measurement (SEM)

Smoking Cessation (calculated from Cohen, Kamark, & Mermelstein, 1983)

** (n= 64, Mean Age= 38.4, SD= 11.57; were adminstered the PSS at two time points including at baseline and then again 6 weeks later. NOTE: the PSS that was adminstered at time two consisted of only 4 of the original 14 items including items 2, 6, 7, and 14).

  • Total Score: SEM= 5.37

Minimal Detectable Change (MDC)

Smoking Cessation (calculated from Cohen, Kamark, & Mermelstein, 1983)

** (n= 64, Mean Age= 38.4, SD= 11.57; were adminstered the PSS at two time points including at baseline and then again 6 weeks later. NOTE: the PSS that was adminstered at time two consisted of only 4 of the original 14 items including items 2, 6, 7, and 14).

  • Total Score at 95% CI: MDC= 14.88

Normative Data

College Students (Cohen, Kamark, & Mermelstein, 1983)

Sample One (n= 332, Mean Age= 19.01, SD= 2.75)

  • Total Score: Mean= 23.18, SD= 7.31

Sample Two (n= 114, Mean Age= 20.75, SD= 4.41)

  • Total Score: Mean= 23.67, SD= 7.79 

 

Smoking Cessation (Cohen, Kamark, & Mermelstein, 1983)

** (n= 64, Mean Age= 38.4, SD= 11.57)

  • Total Score: Mean= 25, SD= 8.00

Test/Retest Reliability

College Students (Cohen, Kamark, & Mermelstein, 1983) 

  • Excellent (r= .85), retested 82 student two days later

 

Smoking Cessation (Cohen, Kamark, & Mermelstein, 1983) 

Sample of individuals in a smoking cessation program (n= 64, Mean Age= 38.4, SD= 11.57) 

  • Adequate (r= .55); retested 64 participants 6 weeks later

Internal Consistency

College Students (Cohen, Kamark, & Mermelstein, 1983)

  • College Sample 1: Excellent (Cronbach’s Alpha= .84) 
  • College Sample 2: Excellent (Cronbach’s Alpha= .85) 
  • Smoking Cessation Group: Excellent (Cronbach’s Alpha= .86)

Criterion Validity (Predictive/Concurrent)

Predictive validity

College Students (Cohen et al., 1983) 

  • Correlation between PSS and social anxiety
    • College 1: Adequate (r= .37, p< .001)
    • College 2: Adequate (r= .48, p< .001) 
  • Correlation between PSS and physical symptomatology
    • College 1: Poor (r= .16, p< .01)
    • College 2: Poor (r= .17, p= .07) 
  • Correlation between PSS and health care utilization (physical illness visits after administration, with before administration visits partialled out)
    • College 1: Poor (r= .15, p< .007)
    • College 2: Poor (r= -.02, p= .07) 

 

Smoking Cessation (Cohen et al., 1983) 

  • Correlation between PSS and the average number of cigarettes smoked per day at one month: Adequate (r= .31, p< .01) and at three months Adequate (r= .37, p<.001) after treatment.

Construct Validity

College Students (Cohen et al., 1983) 

Two samples of undergraduate college students: (1) College Sample (n= 332, Mean Age= 19.01, SD= 2.75), (2) College Sample (n= 114, Mean Age= 20.75, SD= 4.41) 

  • Correlation between PSS and Number of Life Events (Life Event Scale): 
    • College Sample 1: Poor (r= .20, p< .01)
    • College Sample 2: Poor (r= .17, p= n.s.) 
  • Correlation between PSS and Impact of Life Events (Life Event Scale): 
    • College Sample 1: Adequate (r= .35, p< .01)
    • College Sample 2: Poor (r= .24, p< .01)

Spinal Injuries

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Normative Data

Spinal Cord Injury (SCI) (Gerhart, Weitzenkamp, Kennedy, Glass, & Charlifue, 1999) 

** ( sample: n= 187; Mean Age= 53.6) 

Overall Sample: Mean= 18.02, SD= 8.43 

Age Groups:

  • <50: Mean= 18.68, SD= 8.17 
  •  50-59: Mean= 18.76, SD= 8.99
  • 60-69: Mean= 16.47, SD= 7.72
  • >69: Mean= 13.27, 6.66 

Gender: 

  • Men: Mean= 17.76, SD= 8.57
  • Women: Mean= 19.62, SD= 7.45 

Impairment Group:

  • Tetra ASIA ABC: Mean= 18.16, SD= 9.23 
  • Para ASIA ABC: Mean= 18.01, SD= 7.90
  • All ASIA D: Mean= 17.81, SD= 8.65

Criterion Validity (Predictive/Concurrent)

SCI (Gerhart et al., 1999) 

Concurrent Validity

**(Assessed a sample of individuals with SCI to assess the relationship between severity of disability and perceived stress, and to identify correlates of future stress and outcomes of previous stress at two time points: Baseline (1993) and three year follow-up (1996); n = 187, Mean Age= 53.6 years) 

Baseline (1993)

  • Life Satisfaction (LSI-Z): Poor (r= -0.275)
  • Depression (CES-D): Excellent (r= 0.645)
  • Psychological Well-being: Adequate (r= 0.461)
  • Perceived Quality of Life: Adequate (r= -0.353) 

Three Year Follow-Up (1996)

  • Life Satisfaction (LSI-Z): Adequate (r= -0.374) 
  • Depression (CES-D): Excellent (r= 0.713) 
  • Psychological Well-being: Adequate (r= 0.536)
  • Perceived Quality of Life: Adequate (r= -0.444)

Brain Injury

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Normative Data

Traumatic Brain Injury (TBI) (Bay, Kalpakjian, & Giordani, 2012) 

** (n= 159 traumatic brain injury patients; Mean Age= 37.81, SD= 11.91) 

Younger Sample (n= 81; Age <10)

  • Total Score: Mean= 26.14, SD= 8.91 

Older Sample (n= 78; Age< 78)

  • Total Score: Mean= 26.13, SD= 26.12

Internal Consistency

Traumatic Brain Injury (TBI) (Bay, Kalpakjian & Giordani, 2012)

Patients with mild or moderate TBI 1 to36 months post-injury (n= 159, Mean Age= 37.81, SD= 11.91) 

  • Excellent (Cronbach’s Alpha= .87)

Criterion Validity (Predictive/Concurrent)

TBI (Bay et al., 2012) 

  • PSS significantly predicted self-reported memory complaints: Adequate(B= .59, p= .01)

Bibliography

Bay, E., Kalpakjian, C., & Giordani, B. (2012). Determinants of subjective memory complaints in community-dwelling adults with mild-to-moderate traumatic brain injury. Brain Injury, 26(7/8), 941-949.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4)4 385-396.

Gerhart, K. A., Weitzenkamp, D. A., Kennedy, P., Glass, C. A., & Charlifue, S. W. (1999). Correlates of stress in long-term spinal cord injury. Spinal Cord, 37(3), 183.

Warttig, S. L., Forshaw, M. J., South, J., & White, A. K. (2013). New, normative, English-sample data for the Short Form Perceived Stress Scale (PSS-4). Journal of Health Psychology, 18(12), 1617-1628.