Measurement Characteristics of the Perceived Stress Scale in Individuals With Spinal Cord Injury

      The original Perceived Stress Scale (PSS) is a 14-item self-report measure designed to assess the extent to which individuals judge their life circumstances as stressful.1 PSS items are not bound to a specific life event or clinical condition; therefore, assessment of stress is broad, allowing for use in diverse populations and across different contexts.2 Respondents are asked to contemplate the past month and then indicate how often they have felt that their lives are unpredictable or uncontrollable using a 5-point Likert-type scale, with a response set ranging from 0 (never) to 4 (very often). Although the PSS-14 has demonstrated adequate psychometric properties, 2 short-form versions have also been developed: a 10-item version,2. 3. derived from the 14-item scale using factor analysis techniques, and a 4-item version for use in brief interview situations.1. 4. Exploratory and confirmatory factor analyses support a 2-factor structure, with the first encompassing positive, coping-related questions and the second involving negatively worded, stress-related questions.5 The PSS has shown to be a reliable and valid measure of perceived psychosocial stress,6 demonstrates adequate to excellent criterion and construct validity with similar measures of life experience and stress,1 and has been used in a diverse range of clinical and nonclinical populations.2. 3. 4. 5. 6. 7. 8. 9. 10. In addition, versions of the PSS have been translated and validated in more than 25 languages.11
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the PSS in people with spinal cord injury, including reliability, validity, standard error of measurement, minimum detectable change, and interpretation of the results.
      A full review of the PSS and reviews of more than 300 other instruments can be found at Please address correspondence to [email protected] .
      • 1.
        Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983;24:385-96.
      • 2.
        Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health. Newbury Park: Sage; 1988. p 31-67.
      • 3.
        Taylor J. Psychometric analysis of the Ten-Item Perceived Stress Scale. Psychol Assess 2015;27:90-101.
      • 4.
        Warttig S, Forshaw M, South J, White A. New, normative, English-sample data for the Short Form Perceived Stress Scale (PSS-4). J Health Psychol 2013;18:1617-28.
      • 5.
        Ezzati A, Jiang J, Katz M, Sliwinski M, Zimmerman M, Lipton R. Validation of the Perceived Stress Scale in a community sample of older adults. Int J Geriatr Psychiatry 2014;29:645-52.
      • 6.
        Lee E. Review of the psychometric evidence of the Perceived Stress Scale. Asian Nurs Res 2012;6:121-7.
      • 7.
        Wu S, Amtmann D. Psychometric evaluation of the Perceived Stress Scale in multiple sclerosis. Int Sch Res Not Rehabil 2013;2013.
      • 8.
        Gerhart K, Weitzenkamp D, Kennedy P, Glass C, Charlifue S. Correlates of stress in long-term spinal cord injury. Spinal Cord 1999;37:183-90.
      • 9.
        Mitchell A, Crane P, Kim Y. Percevied stress in survivors of suicide: psychometric properties of the Perceived Stress Scale. Res Nurs Health 2008;31:576-85.
      • 10.
        Pbert L, Doerfler L, DeCosimo D. An evaluation of the Perceived Stress Scale in two clinical populations. J Psychopathol Behav Assess 1992;14:363-75.
      • 11.
        Laboratory for the Study of Stress, Immunity and Disease Web site:∼scohen/. Accessed February 16, 2016.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the United States Department of Education. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024).