Stress Quiz

On this page you will find a stress quiz designed to offer you insight into how much stress is negatively affecting your body.

1. This questionnaire is a subjective assessment of stressors and related symptoms and complaints. The questions have assigned scores/point values. Add the scores of each section and make a printout to give to your doctor for evaluation.
2. If you score Moderate to High on Part A, answer yes once in Part B, and score 151 or more on Part C, Adrenal Stress Index test may be required.

Part A
To obtain score, multiply points (column 1) by duration (column 2).

Column 1		Column 2
Adrenal Related Problems		Duration (Years)				Score
Excessive Fatigue	10	x	1/2	1	2	________
Dry & Thin Skin	10	x	1/2	1	2	________
Nervous/Irritability	9	x	1/2	1	2	________
Low body temperature	8	x	1/2	1	2	________
Premenstrual tension	8	x	1/2	1	2	________
Inability to concentrate	x8	x	1/2	1	2	________
Mental depression	8	x	1/2	1	2	________
Food allergies & sensitivities	7	x	1/2	1	2	________
Craving for sweets	7	x	1/2	1	2	________
Headaches	6	x	1/2	1	2	________
Alcohol intolerance	6	x	1/2	1	2	________
Poor memory	5	x	1/2	1	2	________
Heart palipitations	5	x	1/2	1	2	________
Total Score						________

30 or less: Minimal probability of Adrenal Axis-Stress related problem.

31 to 50: xModerate probability of Adrenal Axis-Stress related problem. ASI Test worth consideration.

51 and up: High probability of Adrenal Axis-Stress related problem. ASI Test recommended.

Part B
Do you have chronic pain: o Yes o No

Do you have chronic inflammation: o Yes o No

Part C - Social Readjustment Rating Scale*

Circle YES or NO to each life event in this list that happened in the last twelve months. For every "Yes" that applies, give yourself the points as listed. Upon completion, total the score and enter in box below.

LIFE EVENT	ANSWER	POINTS
Death of spouse	Yesxx No	100
Divorce	Yesxx No	73
Marital seperation	Yes xxNo	65
Jail term	Yes xxNo	63
Death of close family member	Yes xxNo	63
Personal injury or illness	Yesxx No	53
Marriage	Yesxx No	50
Fired from work	Yesxx No	47
Marital reconciliation	Yes xxNo	45
Retirement	Yes xxNo	45
Change in family members health	Yes xxNo	44
Pregnancy	Yes xxNo	40
Sex difficulties	Yes xxNo	39
Addition to family	Yesxx No	39
Business readjustment	Yes xxNo	39
Change in financial status	Yes xxNo	38
Death of close friend	Yesxx No	37
Change in line of work	Yes xxNo	36
Change in # of marital arguements	Yesxx No	35
Mortgage or loan over $10,000	Yes xxNo	31
Foreclosure of mortgage or loan	Yes xxNo	30
Change in work responsibilities	Yesxx No	29
Son or daughter leaving home	Yesxx No	29
Trouble with in-laws	Yes xxNo	29
Outstanding personal achievement	Yesxx No	28
Spouse begins or stops work	Yes xxNo	26
Starting or finishing school	Yes xxNo	26
Change in living conditions	Yes xxNo	25
Revision of personal habits	Yes xxNo	24
Trouble with boss	Yes xxNo	23
Change in work hours, conditions	Yesxx No	20
Change in residence	Yesxx No	20
Change in schools	Yesxx No	20
Change in recreational habits	Yesxx No	19
Mortgage or loan under $10,000	Yes xxNo	18
Change in sleeping habits	Yesxx No	16
Change in eating habits	Yesxx No	15
Vacation	Yesxx No	13

POINTS TOTAL
_________________________________________________________
150 or less 37% chance of illness within the next two years.

151 - 299 50% chance of illness within the next two years. ASI test worth consideration.

300 or above 80% chance of illness within the next two years. ASI test recommended.

If you scored Moderate to High on Part A, answered yes once in Part B, and scored 151 or more on Part C, the Adrenal Stress Index test is highly advised.

* Holmes, TH and Rahe, RH Booklet for Schedule of Recent Experience (SRE)
Seattle, University of Washington, 1967