Usage conditions apply. The PSS is copyrighted (Sheldon Cohen / the American Sociological Association for the original article). Permission is not required for nonprofit academic research or educational use. Any commercial or for-profit use - including apps and websites - requires permission via Mapi Research Trust (ePROVIDE) and payment of a fee.
Over the last month, how often have you been bothered by…
Never0
Almost never1
Sometimes2
Fairly often3
Very often4
Score
01In the last month, how often have you been upset because of something that happened unexpectedly?
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02In the last month, how often have you felt that you were unable to control the important things in your life?
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03In the last month, how often have you felt nervous and stressed?
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04In the last month, how often have you felt confident about your ability to handle your personal problems?
-
05In the last month, how often have you felt that things were going your way?
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06In the last month, how often have you found that you could not cope with all the things that you had to do?
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07In the last month, how often have you been able to control irritations in your life?
-
08In the last month, how often have you felt that you were on top of things?
-
09In the last month, how often have you been angered because of things that happened that were outside of your control?
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10In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
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0-3score item↑↓moveScored locally - nothing leaves this page
0 of 10
0 / 40
PSS-100 / 10
Over the last month, how often have you been bothered by…
Scored locally - nothing leaves this page
01In the last month, how often have you been upset because of something that happened unexpectedly?
02In the last month, how often have you felt that you were unable to control the important things in your life?
03In the last month, how often have you felt nervous and stressed?
04In the last month, how often have you felt confident about your ability to handle your personal problems?
05In the last month, how often have you felt that things were going your way?
06In the last month, how often have you found that you could not cope with all the things that you had to do?
07In the last month, how often have you been able to control irritations in your life?
08In the last month, how often have you felt that you were on top of things?
09In the last month, how often have you been angered because of things that happened that were outside of your control?
10In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
The Perceived Stress Scale (PSS-10) measures the degree to which a person has appraised situations in their life as stressful over the past month - specifically, how unpredictable, uncontrollable and overloaded they have found it. It does not count stressful events; it captures the respondent's appraisal of them. Ten items ask how often the person has felt or thought a certain way in the last month, each rated from 0 (never) to 4 (very often).
Because it measures appraisal rather than symptoms, the PSS-10 is not a screen for any disorder. It is used across clinical and general populations as a global index of perceived stress, and it correlates with - but is not a proxy for - measures of anxiety and depression. Six items are negatively worded (feeling upset, unable to cope) and four are positively worded (feeling confident, on top of things), the latter reverse-scored.
02 - Origin & purpose
Where it comes from.
The original 14-item Perceived Stress Scale was published by Sheldon Cohen, Tom Kamarck and Robin Mermelstein in 1983 in the Journal of Health and Social Behavior. It was grounded in the transactional model of stress: what harms people is not the event itself but the appraisal of it as taxing and exceeding one's resources. The scale was designed to be a brief, general-purpose appraisal measure requiring no more than a lower-secondary reading level.
The 10-item version was derived by Cohen and Williamson in 1988 using data from a national US probability sample of 2,387 adults. Four psychometrically weaker items were dropped, leaving the PSS-10 with slightly better internal consistency than the original. A 4-item version (PSS-4) exists for telephone interviews. The PSS-10 is now the standard version and has been translated and validated in dozens of languages.
03 - Scoring & cutoffs
How scoring works.
Each of the 10 items is rated 0 (never) to 4 (very often) for the past month. The four positively worded items - items 4, 5, 7 and 8 - are reverse-scored (0 becomes 4, 1 becomes 3, and so on) before all items are summed, giving a total of 0-40. Higher scores mean greater perceived stress. Importantly, the PSS-10 has no validated diagnostic cutoffs: the commonly cited bands (0-13 low, 14-26 moderate, 27-40 high perceived stress) are conventional descriptors, not clinically validated thresholds. For context, the 1988 US normative sample averaged around 13 points (SD 6.4), with women scoring slightly higher than men (13.7 vs 12.1).
Score
Severity
Interpretation
0–13
Low stress
Low perceived stress.
14–26
Moderate stress
Moderate perceived stress.
27–40
High stress
High perceived stress. Consider support and coping strategies.
04 - Validation evidence
How well it performs.
The PSS-10's reliability is well replicated internationally. Its factor structure typically shows two correlated factors that mirror the positively and negatively worded items - widely interpreted as a wording (method) effect rather than two constructs - and the total score remains the standard way to use the scale.
α = 0.78
Internal consistency
US probability sample, N = 2,387 (Cohen & Williamson, 1988)
α 0.74-0.91
Reliability across studies
Range across 12 international validation studies (Lee, 2012)
> 0.70
Test-retest reliability
Met in all four studies that assessed it, at intervals of 2-6 weeks (Lee, 2012)
13.0 (SD 6.4)
Normative mean
US adult norm, 1988; women 13.7, men 12.1 (Cohen & Williamson, 1988)
05 - How it compares
How it compares to the alternatives.
Instrument
Items
Time
When to reach for it
PSS-10
10
~3 min
Perceived stress appraisal over the past month; no validated cutoffs.
Reach for it when you want a screen for nonspecific psychological distress (anxiety/depression symptoms) with validated cutoffs rather than stress appraisal.
Positive wellbeing monitoring; useful counterpart to a stress measure.
DASS-21
21
~5 min
Separate depression, anxiety and stress subscales when you want all three dimensions.
06 - When to use it
Right tool, wrong tool.
Reach for it when
-Quantifying how stressed a patient feels their life is, as context for symptom measures
-Research and evaluation of stress-reduction interventions (e.g. MBSR, stress-management programmes)
-Occupational health and burnout-adjacent assessment where a validated stress-appraisal index is wanted
-Tracking perceived stress across treatment on a monthly cadence (past-month window)
Reach for something else when
-Do not use it to screen for or diagnose anxiety, depression or any disorder - use GAD-7, PHQ-9 or K10 instead
-No validated clinical cutoffs - do not treat the 0-13/14-26/27-40 bands as thresholds for action
-Weekly monitoring - the past-month window makes week-to-week change hard to interpret
-Commercial or for-profit deployment without a licence (see licensing)
07 - Confidence & precision
Reading the score with care.
No minimal clinically important difference or standard error of measurement convention has been established for the PSS-10. Small changes of a few points are likely to sit within measurement error, and the two-factor wording effect means item-level interpretation is unreliable. Interpret scores alongside the clinical picture, and treat the 1988 US norms as dated context rather than a benchmark.
08 - Limitations
What it cannot tell you.
The PSS-10 is not diagnostic and has no validated cutoffs, so it cannot classify anyone. Scores overlap substantially with negative affect and neuroticism, which inflates correlations with symptom measures. The reverse-scored positive items produce a method factor and are a known source of respondent error, particularly at lower literacy levels. The recall window is one month, making it insensitive to acute, short-lived stressors. Available norms are from 1988 US data and should not be assumed to hold today or outside the US. Finally, it is free only for nonprofit academic and educational use - commercial use requires a licence.
09 - Licensing, explained
How licensing works.
The PSS is copyrighted (Sheldon Cohen / the American Sociological Association for the original article). Permission is not required for nonprofit academic research or educational use. Any commercial or for-profit use - including apps and websites - requires permission via Mapi Research Trust (ePROVIDE) and payment of a fee.
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