TL;DR: Summary

✅ Coming soon on Bravely Connect

The PSS is a self-report measure used to assess subjective perceptions of stress. It consists of 10 questions which ask how often a client has experienced different feelings related to stress during the past month. Total scores are calculated via the summation of each item; however, some items assess one’s positive feelings of control over their life circumstances, and these items are reverse-scored. The scores on the PSS range from 0 to 40 with higher scores indicating higher levels of perceived stress. Limitations for the PSS include its inability to diagnose any specific disorder and its limited validation research involving people who are not in university environments. Even with these limitations, the PSS may be helpful for efficiently tracking patients’ perceptions of stress in their lives.

Highlights

📏 Lengths: 10 questions

📋 Administration: Self-administered

🎯 Uses: Measuring perceptions of stress

⚠️ Important Caveats: Measures general levels of stress and isn’t used for any kind of diagnosis

✅ Available in Bravely Connect? Yes

🌏 Culturally Applicable? Lots of translations available and some studies validating use in different cultures, but samples have mainly come from university environments

💬 Translations? Over 20 available via Carnegie Mellon University Laboratory for the Study of Stress, Immunity, and Disease

The PSS Question type and length

The client is presented with 10 questions asking how often they have experienced different feelings related to stress during the past month. Each question has the same selection of answers: a 5-point Likert scale ranging from 0 (never) to 4 (fairly often). Some items assess one’s positive feelings of control over their life circumstances; these items are reverse-scored when calculating the total PSS score.

Here’s an example of an item from the PSS and the range of answers:

In the last month, how often have you found that you could not cope with all the things that you had to do?

0. Never

1. Almost never

2. Sometimes

3. Fairly often

4. Very often

For the full list of questions, check out the measures on Bravely Connect, or follow the following link to the original unautomated version: PSS

What does the PSS measure

The PSS measures respondents’ subjective experiences of stress in their lives during the previous months. It assesses the degree to which an individual perceives their life as “unpredictable, uncontrollable, and overloading” (Cohen et al., 1983, p. 387). The PSS contains items directly addressing perceptions of stress and also several reverse-scored items asking about one’s confidence and sense of control. The PSS does not ask about specific events; instead, it is a general measure of how often a respondent feels that their life circumstances are demanding, threatening, and taxing on their resources (Lesage et al., 2012). In a study using a probability sample of over 2,000 US adults to validate the 10-item PSS, elevated PSS scores were found to be associated with physical illness, less sleep, cigarette smoking, binge drinking, less exercise, and more illicit drug use (Cohen & Williamson, 1988).

PSS Factor structure

The PSS was created to measure one factor: perceived stress. However, some studies conducting factor analysis on the PSS have found evidence for two separate factors or a bi-factorial model in which both factors are related to perceived stress.

One study using a sample of American college students posits that there are two factors in the PSS of perceived helplessness and self-efficacy; perceived helplessness resulted from the items asking about stress-related emotions and self-efficacy resulted from the reverse-scored items asking about coping abilities (Roberti et al., 2006). A study of Chinese adolescents found a similar structure with helplessness and self-efficacy factors (Liu et al., 2020).

Another study utilizing a sample of American Hispanic and Latino participants found evidence for a bi-factorial model which, like the two-factor model, resulted from the standard items and the reverse-worded items; however, the two factors in this study were associated with the higher-level factor that is perceived stress (Perera et al., 2017).

Still other studies conclude that the different factors that may result from the reverse-scored items are arbitrary and that the PSS is indeed unidimensional (Lesage et al., 2012).

The history and theory behind the PSS

Prior to the development of the PSS, many instruments assessing stress did so in response to specific stressful life events. In 1983, Sheldon Cohen, Tom Kamarck, and Robin Mermelstein sought to create a widely-applicable stress assessment that focused not on specific events, but instead one’s cognitive appraisals of and reactions to any life circumstances as stressful. The original 1983 scale included 14 items. A 10-item scale was developed in 1988 based on factor analysis and further validation studies. After discarding four items which had low factor loadings, the 10-item PSS was found to have improved internal reliability. The PSS authors recommend using the 10-item scale for further research (Cohen & Williamson, 1988).

PSS Scoring Interpretation

PSS scoring is calculated via the summation of item scores. Several items are reverse-coded; these items assess the respondent’s coping abilities for dealing with stress. The PSS is scored using a 5-point Likert scale ranging from 0 (never) to 4 (fairly often). Potential total scores range from 0 to 40 with higher scores indicating higher levels of perceived stress. Although PSS scores are not applicable for diagnosing specific mental health conditions, they may be used to track a client’s perception of how much stress they are experiencing over the course of treatment.

Who developed the measures, licensing and how to obtain the PSS

The PSS was developed by Sheldon Cohen, Tom Kamarck, and Robin Mermelstein in 1983 with the goal of assessing general levels of perceived stress. Items were developed based on prior research finding three central components of stress.

The PSS is free to use only for nonprofit research and educational purposes. For any profit-generating purpose, you must receive permission from PSS author Sheldon Cohen and the American Sociological Association and pay a $200 fee. This fee may be annual and recurring if your use of the PSS is online or on an app. Please click here for further information on how to obtain permission to use the PSS for profit-generating purposes.

The PSS is available on Bravely Connect as part of our automated measures. See the PSS on Bravely Connect →

There are currently over 20 translations and localisations of the PSS. If you find a version you’d like adding to Bravely Connect then just let us know here.

Limitations, biases and when you should/shouldn’t use the PSS

The PSS is a self-report questionnaire that measures respondents’ subjective experiences of stress in their lives. While the PSS is capable of measuring subjective stress levels, it is not a diagnostic instrument and there are no score cutoffs. In research studies, there are only comparisons within samples (Carnegie Mellon University, 2015); for individuals, it may be best to compare a client’s scores to their previous scores to track changes in perceived stress.

In terms of cross-cultural applicability, it is worth noting that although the PSS has been validated in a variety of countries including Turkey (Örücü & Demir, 2009), Mexico (Ramírez & Hernández, 2007), Greece (Andreou et al., 2011), Japan (Mimura & Griffiths, 2008), South Africa (Makhubela, 2020), Argentina (Miranda et al., 2020), and Brazil (Siqueira Reis et al., 2010), the majority of research working on validating the PSS has used convenience samples of university students and working-age adults. Some research has validated the use of the PSS with elderly adults in the US (Ezzati et al., 2013).

In many studies of the PSS, women tend to score higher than men (Lee, 2012). One study finds that the gender discrepancy is less a matter of bias in the PSS and more likely due to actual gender differences stemming from social, biological, or psychological factors (Lavoie & Douglas, 2011).

As with many measures developed and validated in Western cultures, we recommend that the PSS be used in conjunction with comprehensive clinical assessments taking a client’s unique sociocultural background into consideration.

As always, if you’ve found a measure you would like adding to Bravely Connect as an automated measure, just drop us a measure request here.