Stress Survey
Posted by docapc at 1:49 am
Stress Survey
1) I tend to overwork and do most things myself
Yes—-No——-
2) I have difficulty falling or staying asleep
Yes——No——
3) My nutrition is generally poor to fair
Yes——No—-
1) Have you experienced the death of a spouse in the last six months?
Yes———No——-
5) Have you experienced the death of a close friend in the last six months?
Yes——N0—-
6) Have you been divorced or seeking divorce in the last six months?
Yes———-No——-
7) Do you have a son or daughter who is experiencing serious emotional difficulties in the last year?
Yes———-No———
Has your health deteriorated significantly in the last year?
Yes———-No——-
9) Have you had difficulties in the sexual arena in the last year?
Yes——-No——-
10) Have you or your significant other lost your job in the last year?
Yes———-No——-
11) Do you or your significant other have trouble with a boss?
Yes——No—-
12) Do you often feel guilty for reasons you know are irrational?
Yes——-No———-
13) Do you frequently feel impatient when you have to wait at the supermarket, other stores?
Yes———-No———
14) Have you been fighting more often with your partner?
Yes———No——-
15) Do you feel like you are racing through each day, seldom able to slow down?
Yes———No
16) Do you have few supportive relationships?
Yes——-No——-
17) Do you tend to make more of the normal stressors in life than others you know?
Yes————-No——-
18) Do you wake each day feeling like you won’t be able to cope effectively?
Yes————-No——-
19) Do you have few calm moments during the day?
Yes———-No———
20) Do you often think you have little time for exercise, relaxation, letting go?
Yes———No———
| 1312) |
Scores of 1-6 Low Stress
Scores of 7-12 Moderate Stress
Scores of 13-17 Significant Stress
Scores of 18+ Extreme Stress
Your Score is ———————
Taken from then book The Stress Solution: Using Empathy and Cognitive Behavioral Therapy to Reduce Anxiety and Develop Resilience
