Scale for assessing psychophysiological stress response Test - the question form

Questions: 38 · 7 minutes
1. Prolonged headaches.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
2. Migraines (vascular headaches).
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
3. Stomach pain.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
4. Increased blood pressure.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
5. Cold hands.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
6. Heartburn.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
7. Shallow, rapid breathing.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
8. Diarrhea.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
9. Rapid or pounding heartbeat.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
10. Sweaty palms.
1 – Never
2 – Rarely (more often than once every six months)
3 – Sometimes (more often than once a month)
4 – Often (more often than once a week)
5 – Constantly
11. Nausea.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
12. Flatulence (abdominal bloating).
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
13. Frequent urination.
1 – Never
2 – Rarely (more often than once every six months)
3 – Sometimes (more often than once a month)
4 – Often (more often than once a week)
5 – Constantly
14. Sweating of the feet.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
15. Oily skin.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
16. Fatigue/exhaustion.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
17. Enuresis (bedwetting at night).
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
18. Dry mouth.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
19. Hand tremor.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
20. Back pain.
1 – Never
2 – Rarely (more often than once every 6 months)
3 – Sometimes (more often than once a month)
4 – Often (more often than once a week)
5 – Constantly
21. Neck pain.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
22. Jaw clenching or chewing movements.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
23. Teeth grinding.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
24. Constipation.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
25. A feeling of heaviness in the chest or around the heart.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
26. Dizziness.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
27. Vomiting.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
28. Menstrual cycle irregularities.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
29. Skin blotches.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
30. Rapid heartbeat.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
31. Abdominal cramps.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
32. Asthma.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
33. Digestive problems.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
34. Low blood pressure.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
35. Hyperventilation.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
36. Joint pain.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
37. Dry skin.
1 – Never
2 – Rarely (more than once every six months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
38. Mouth sores (stomatitis) or jaw problems.
1 – Never
2 – Rarely (more than once every 6 months)
3 – Sometimes (more than once a month)
4 – Often (more than once a week)
5 – Constantly
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