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Item Value
100
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65
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YES
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SCORE
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Life Event
Death of Spouse
Divorce
Marital Separation
Jail Term
Death of Close Family Member
Presonal Injury or Illness
Marriage
Fired at Work
Marital Reconciliation
Retirement
Change in Health of Family Member
Pregnancy
Sexual Difficulties
Addition of New Family Member
Business Readjustment
Change in Financial State
Death of Close Friend
Career Change
Change in Number of Arguments with Spouse
Mortgage Over $40K
Foreclosure of Mortgage or Loan
Change in Work Responsibilities
Child Leaving Home
Trouble with In-Laws
Outstanding Personal Achievement
Spouse Starts or Stops Working
Begin or End School
Change in Life Conditions
Revision of Personal Habits
Trouble with Boss
Change in Work Hours or Conditions
Change in Residence
Change in Schools
Change in Recreation
Change in Church Activities
Change in Social Activities
Mortgage or Loan less than $50K
Change in Sleeping Habits
Change in Number of Family Get-Togethers
Change in Eating Habits
Vacation
Christmas
Minor Violations of the Law
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Total Score for 12 Months ____________
Evaluation:
The more stressors you've marked the higher your score and the more likely you are to get physically sick or to benefit from some form of mental health related treatment.
* Over 300 - Major Life Stress, high likelihood of physical illness in the near future. Possible Adjustment Disorder, Clinical Depression or Anxiety Disorder. Possible grief/loss issues. Possible relationship issues.
* 299 - 150 - Moderate Life Stress - Moderate likelihood of physical illness in the near future and possible benefit from counseling for Adjustment Disorder, Moderate Level Depression, Anxiety, Grief/Loss or Relationship.
* 149 - 0 - Low Life Stress - Least likely to get physically sick in the near future or require counseling though any one of the above stressors could cause emotional symptoms that could benefit from treatment.
(This survey can be found in "The Anxiety & Phobia Workbook" by Edmund J. Bourne, Ph.D. Click on the title to learn more about this book or to order it from Amazon.Com).
Article Updated 1/18/01
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