Circle
the appropriate number to show how often you have been troubled by the following:
0 = Never/rarely; 1 = Occasionally; 2 = Frequently; 3 = Always/nearly always
|
1. Constantly getting annoyed with people. |
0 |
1 |
2 |
3 |
|
2. Difficulty in making decisions. |
0 |
1 |
2 |
3 |
|
3. Loss of sense of humour. |
0 |
1 |
2 |
3 |
|
4. Suppressed anger. |
0 |
1 |
2 |
3 |
|
5. Difficulty concentrating. |
0 |
1 |
2 |
3 |
|
6. Inability to finish one task before rushing
into another. |
0 |
1 |
2 |
3 |
|
7. Feeling you're the target of other people's animosity. |
0 |
1 |
2 |
3 |
|
8. Feeling unable to cope. |
0 |
1 |
2 |
3 |
|
9. Wanting to cry at the smallest problem. |
0 |
1 |
2 |
3 |
|
10. Not
interested in doing things after coming home from work. |
0 |
1 |
2 |
3 |
|
11. Waking
up and feeling tired after an early night. |
0 |
1 |
2 |
3 |
|
12. Constant
tiredness. |
0 |
1 |
2 |
3 |
|
13. Lack
of appetite. |
0 |
1 |
2 |
3 |
|
14. Craving
for food when under pressure. |
0 |
1 |
2 |
3 |
|
15. Frequent
indigestion or heartburn. |
0 |
1 |
2 |
3 |
|
16. Constipation
or diarrhoea. |
0 |
1 |
2 |
3 |
|
17. Insomnia. |
0 |
1 |
2 |
3 |
|
18. Tendency
to sweat for no good reason. |
0 |
1 |
2 |
3 |
|
19. Nervous
twitches, nail biting, etc. |
0 |
1 |
2 |
3 |
|
20. Headaches. |
0 |
1 |
2 |
3 |
|
21. Cramps
and muscle spasms. |
0 |
1 |
2 |
3 |
|
22. Nausea. |
0 |
1 |
2 |
3 |
|
23. Breathlessness
without exertion. |
0 |
1 |
2 |
3 |
|
24. Fainting
spells. |
0 |
1 |
2 |
3 |
|
25. Impotence
or frigidity. |
0 |
1 |
2 |
3 |
|
26. Eczema. |
0 |
1 |
2 |
3 |
Remember this is only a rough guide.
Total score between 26-52 (Moderate
Stress)
Total score between 53-78 (Very High Stress)