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Perceived Stress Scale (PSS)

Individuals and healthcare providers can manage stress, but first they have to recognize and measure it. Creyos Health includes a digitized Perceived Stress Scale—a widely-used instrument for measuring a patient’s perception of stress.

How to Take the PSS Questionnaire

The PSS asks patients to share how often stress-related thoughts or feelings occurred in the past month. For example, one item asks “In the last month, how often have you felt that you were unable to control the important things in your life?” Adding up the responses on the PSS results in a total score, with higher scores indicating greater stress.

In Creyos Health’s implementation of the questionnaire, patients with scores from 14 to 25 are considered to have moderate stress, and scores above 27 indicate high perceived stress.


History of the PSS Questionnaire

The strong reliability of the PSS has been demonstrated by several studies (see Lee, 2012), and validity has been established by showing that PSS scores predict a broad range of outcomes known to be associated with stress, such as mental health, psychosomatic symptoms, and health service utilization (see Cohen & Williamson, 1998, and Baik et al., 2019).

In addition to the intensity, duration, and controllability of stress, other individual factors, such as age, gender, and personality can affect which level of stress will interfere with daily tasks (Sandi, 2013).

Because of this complexity, it is important to measure an individual patient’s stress and cognition, in order to aid in diagnosis of mental health conditions, predict whether stress reduction programs will be effective, and fully quantify the mental health outcomes of interventions such as therapy, medication, and rehab.

PSS Report

The Perceived Stress Scale (PSS) in the real world

Some stress is normal, and brief or mild stress can even be beneficial. In a fast-paced or potentially dangerous situation, stress prepares the body to act with a faster pulse, more oxygen intake, muscles ready to move, and a brain ready to think—yet those same symptoms can disrupt the body’s other systems if the stress sticks around for too long. Indeed, research has revealed that the relationship between stress and cognition is not as simple as “more stress is bad.”

Stress researchers have proposed a curved relationship between stress and performance, with very low amounts of stress associated with poor performance due to lack of arousal, medium amounts of stress at the peak of the curve, and high stress again leading to impaired performance.

Speak to us about using the PSS in your practice or study