Training Dynamics and Consultants Limited

Stress Questionaire

Collection of Your Personal Information

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Part One: Your Environmental/ Pressures and Satisfactions

Scale 1: Work Changes

Think about... the past year. For each of the changes listed below, indicate how much or how little each has been a source of stress to you.

  Great Moderate Little None/ Didn’t Occur
1. New job or employer
2. New type of work
3. Change in work location or conditions
4. Change in responsibilities (promotion, demotion. or transfer)
5. Fired, laid off, quit or retired
6. Passed over for promotion
7. Change in expectations. supervisors. or job role
8. New technologies or new management team/owner
9. Major new or special project or responsibility
Scale Total:

Scale 2: Work Pressures

Think about... the past month. For each of the pressures listed below, indicate how much each has been a source of stress to you.

  Great Moderate Little None
10. Workplace is bleak, uncomfortable or depressing
11. Physically difficult or hazardous work conditions
12. Difficult or long commute
13. Too many tasks and responsibilities
14. Boring, routine tasks
15. Confused or unclear expectations
16. Conflicting or competing demands
17. No clear opportunities for promotion
18. Can't get the resources (information. help) I need for my work
19. Deadline pressures
20. Many organizational or job task changes
21. No input on decisions affecting my work
22. Responsibility for others
23. No recognition for work well done
24. Too many people telling me what to do
25. Office politics
26. Not sure where I stand with my supervisor
27. Pressured by demands from client/ customers
28. Don’t like my job
29. Job doesn't use my skills and abilities
30. No room for creativity or personal input
31. Ethical problems with my work
32. Have not gotten what I expected /wanted from my job
33. Loss of commitment or dedication to work
34. Inadequate salary
35. Conflict with workers or supervisor
36. Procedures are unfair or discriminatory
37. Too much or too little contact with people
Scale Total:

Scale 3: Work Satisfactions

Think about... the past month. For each of the satisfactions listed below, indicate how true each is for you.

  Very Somewhat Little Not at All
38. I enjoy my job
39. I like what my company or employer stands for
40. I have good relationships with people
41. I have a supervisor whom I like and trust
42. I have a good physical working environment
43. I receive adequate compensation for my work
44. I am able to get the information I need to do my job
45. I feel liked and valued by the people at work
46. My work offers me the opportunity for advancement and growth
47. I receive feedback about the quality of my work
48. I use my abilities and talents on the job
49. The commute to my job is easy
50. The hours of work are convenient to my needs
51. I participate in decisions about things at work that affect me
52. I am respected by others in the community for my job.
Scale Total:

NOTE: The term family is used generally to mean those people closest to you, your inner circle, and not necessarily a traditional family. The word, mate is generically used to mean spouse, significant other or life partner.

Scale 4: Personal Changes

Think about... the past year. For each of the changes listed below, indicate how much each has been a source of stress to you.

  Great Moderate Little None/ Didn’t Occur/ Didn’t Occur
53. Change in residence
54. Death of a close family member or friend
55. Crisis with friend/ family member (drug problem. job loss )
56. Separation or divorce of a family member
57. A new close relationship
58. Your separation or divorce
59. Home improvement or repair
60. Illness or injury keeping you at home for a week or more
61. Change in family activities
62. New family member (birth or adoption)
63. Serious illness in family
64. Financial loss or diminished income
65. Major personal achievement
66. A major purchase or new debt
67. A “falling out” in a family or friendship
68. Involvement in legal system
69. Property loss, theft, damage or accident
70. Crime victim
Scale Total:

Scale 5: Personal Pressures

Think about... the past month. For each of the pressures listed below, indicate how much each has been a source of stress to you.

  Great Moderate Little None
71. Not enough money
72. Heavy debts
73. Conflicts with mate
74. Conflict over household tasks
75. Problems with children/ housemate
76. Pressures from in-laws, family
77. Not enough time with family/friends
78. Work-family conflict
79. Sexual conflict or frustration
80. Dangerous or stressful neighborhood
81. Few friends in neighborhood
82. Time pressures with mate
Scale Total:

Scale 6: Personal Satisfactions

Think about... the people closest to you, and your experiences with them in the past month. To what degree is each of the following statements true of these relationships.

  Very Somewhat Little Not at All
83. The people around me will take time for me when I need it
84. Those closest to me understand when I am upset and respond to me
85. I feel accepted and loved by my friends/family
86. The people close to me support me to do new things and make changes in my life
87. My mate accepts my sexuality
88. Those closest to me express caring and affection to me
89. I spend high quality time with friends /family
90. I feel close and in touch with friends /family
91. I am able to give what I would like to my friends/family
92. I know that I am important to the people closest to me
93. I am honest with the people close to me and they are honest with me
94. I can ask for help from my family and friends when I need it
95. I can usually find people to "hang out" with
96. I know that others are there for me
Scale Total:

Part Two: Coping Responses/ Assests and Liabilities

Scale 7: Self Care

Think about... the past month. For each self-care practice, indicate how often each is true for you, or practiced by you.

  Almost Always Sometimes Rarely Never
97. Eat breakfast
98. Maintain desirable weight
99. Avoid Sugar
100. Avoid fat
101. Avoid salt
102. Do vigorous aerobic exercise
103. Do stretching or yoga
104. Enjoy or appreciate my body
105. Aware of tension in my body when it occurs
106. Brush teeth
107. Fasten seat belts in car
108. Have a physician I trust who knows me well
109. Would seek help for an emotional or health problem
110. Relax and take time off
111. Avoid smoking
112. Avoid excessive use of alcohol
Scale Total:

Scale 8: Direct Action

Think about... the past month. For each statement, indicate to what degree it describes your behavior or intentions.

  Almost Always Sometimes Rarely Never
113. I finish what I set out to do
114. I deal with things soon after they come up
115. I find it hard to anticipate difficulties
116. I do as good a job as I can under the circumstances
117. I avoid challenges and new situations
118. I am cautious and shy away from new tasks
119. I work to satisfy myself more than others
120. I anticipate and plan ahead to meet challenges
121. I find it hard to get involved in what I am doing
122. I know how to say 'no'
123. I negotiate so that some tasks are more manageable or convenient
124. I do minor tasks to avoid doing major ones
125. When things are difficult I get tired or lose concentration
Scale Total:

Scale 9: Support Seeking

Think about... the past month. For each statement, indicate to what degree it describes your behavior or intentions.

  Almost Always Sometimes Rarely Never
126. I find someone to work on projects with me
127. I seek information I need from others
128. I try to find someone who can handle a difficult situation
129. I talk over difficult situations with someone I trust
130. I seek advice and support from others
131. I am willing to talk about problems with a doctor or counsellor
132. I let people know about uncomfortable feelings that are getting in the way of our work
133. I let people know when a task is too much or I am too busy.
Scale Total:

Scale 10: Situation Mastery

Think about... the past month. For each statement, indicate to what degree it describes your behavior or intentions.

  Almost Always Sometimes Rarely Never
134. I am able to take time for myself
135. I find it hard to make time for personal errands
136. I eat rapidly and finish my meals before other people
137. I get impatient when someone is doing a job that I could do quicker
138. I find time for hobbies or outside interests
139. I hurry even when I have plenty of time
140. I set unrealistic deadlines for myself
141. I push to finish a task, even when I am tired
142. I am hard driving and competitive
143. Other people set standards for me
144. I'd rather do things myself than get help
145. I find it hard to wait
146. I put other people before myself
147. I get Almost Always satisfaction from my accomplishments
Scale Total:

Scale 11: Adaptability

Think about... the past month. For each statement, indicate to what degree it describes your behavior or intentions.

  Almost Always Sometimes Rarely Never
148. I decide certain problems are not worth worrying about
149. I relax myself when tension builds up
150. I can see the humorous side of situations
151. I often put things aside for awhile to get perspective on them 3
152. I reward myself when I finish a job
153. I put pressures in their place and do not let them overwhelm me
154. I make several alternate plans to deal with situations
155. When I face a problem, I try to get a clear focus on what I could do about it
Scale Total:

Scale 12: Time Management

Think about... the past month. For each statement, indicate to what degree it describes your behavior or intentions.

  Almost Always Sometimes Rarely Never
156. I use my time efficiently
157. I avoid doing important things
158. I find it difficult to complete things
159. Distractions keep me from doing what I want
160. People tend to dump tasks on me, and I accept them
161. I know what I want to be doing
162. I miss appointments or forget important things
163. I move from task to task with no reason
164. There is time to accomplish what I expect to do
165. I do more than I have to on tasks, rather than get on to the other things
166. I am so busy helping others that I don't get my own work done
Scale Total:

Part Three: Inner World/ Thoughts and Feelings

Scale 13: Self-Esteen

Think about... the past month. For each statement, indicate how much each represents the way you think or feel about yourself.

  Very Much Like Me Somewhat Not Very Much Not at All
167. I minimize my abilities
168. I wish I were another person
169. I make demands on myself that I would not make on others
170. I expect others to fault my work
171. I blame myself when things do not work out the way I expect
172. When I succeed I do not think I deserve it
173. I like who I am
174. Under pressure, I think of all the ways things can go wrong
Scale Total:

Scale 14: Positive Outlook

Think about... the past month. For each statement, indicate how much each fits the way you think about the world.

  Very Much Like Me Somewhat Not Very Much Not at All
175. Other people rarely 'come through' for me
176. I usually hope for the best
177. I find it hard to look on the bright side of things
178. I am a naturally positive person
179. I have been continually frustrated in my life because of bad breaks
180. The future will probably be better than things are now
181. I seem to get the short end of the stick
182. Very Not Very Much in life is fair or equitable.
Scale Total:

Scale 15: Personal Power

Think about... the past month. For each statement, indicate how much each fits the way you think or feel about yourself

  Very Much Like Me Somewhat Not Very Much Not at All
183. When things are not going my way, I think it is useless to try to change them
184. My stress seems to be unpredictable
185. I find ways to accomplish what I want
186. I am not able to give what I want to people close to me
187. I find myself in situations I feel helpless to do anything about
188. I run into problems I cannot solve
189. I do not think I have control over things in my life
190. I like to take on new challenges
Scale Total:

Scale 16: Connection

Think about... the past month. For each statement, indicate how much each is like the way you think or feel about.

  Very Much Like Me Somewhat Not Very Much Not at All
191. My work is empty and has no meaning
192. I feel satisfied with my work
193. My work feels routine and boring
194. I fell satisfied with my personal life
195. Not much is new or unpredictable in my life
196. My life has a central purpose or goal
197. My life does not meet my deepest needs
198. My life is taken up with burdens and responsibilities
199. I believe there is a higher force or guiding purpose in humanity
Scale Total:

Scale 17: Expression

Think about... the past month. For each statement, indicate how much each is like the way you think or feel about.

  Very Much Like Me Somewhat Not Very Much Not at All
200. I keep my feelings to myself
201. I let others know when I am under pressure
202. I do not like to let people know that I disagree with them
203. When I am upset, I avoid other people and go off alone
204. I hold in my anger and frustration
205. I feel much better when I talk about my feelings
206. I am afraid of losing control of my feelings
207. I let others know when I feel angry or disappointed with them.
Scale Total:

Scale 18: Compassion

Think about... the past month. For each statement, indicate how much each like the way you think or feel about.

  Very Much Like Me Somewhat Not Very Much Not at All
208. When I am upset, I blame someone else for things
209. I accept other people's differences
210. I blow up with Not Very Much warning
211. I feel jealous of others' success
212. I easily become nasty or irritable
213. When I feel pressured or frustrated, I fall apart emotionally and lose control
214. I never know what I will say when I feel angry
215. I make allowances for other people's limitations
216. I can put myself in other people's shoes
Scale Total:

Part Four: Signals of Distress

Scale 19: Physical Symptoms

Think about... the past month. For each of the symptoms listed, indicate how often it has occurred for you.

  Nearly Every Day Every Week Once or Twice Never
217. Muscle tension
218. Back pain
219. Headache
220. Grinding teeth
221. Stomach ache or upset
222. Heartburn
223. Diarrhea
224. Constipation
225. Abdominal pain
226. Cold or hayfever
227. Chest pain
228. Shortness of breath
229. Skin rash
230. Dry mouth or sore throat
231. Laryngitis
Scale Total:

Scale 20: Behavioral Symptoms

Think about... the past month,  Indicate how often you have done or experienced each of the items listed below.

  Nearly Every Day Every Week Once or Twice Never
232. Loss of appetite
233. Overeating
234. No time to eat
235. Smoking
236. Drinking alcoholic beverages
237. Taking tranquilizers
238. Taking aspirin and other pain relievers
239. Taking other drugs
240. Withdrawing from close relationships
241. Criticizing, blaming or ridiculing others
242. Feeling victimized or taken advantage of
243. Watching TV (over 2 hours a day)
244. Overwhelmed by work
245. Difficulty meeting commitments or completing tasks
246. Resent people I encounter at work
247. Hard to pay attention to work tasks
248. Accidents or injuries
249. Distant and uninvolved at work
Scale Total:

Scale 21: Emotional Symptoms

Think about... the past month. For each of the symptoms listed, indicate how often it has occurred

  Nearly Every Day Every Week Once or Twice Never
250. Nervousness or anxiety
251. Tremor or trembling
252. Twitch or tic
253. Keyed up feeling
254. Cannot turn off certain thoughts
255. Worrying
256. Unable to keep still; fidgeting
257. Irritable, angry emotional outbursts
258. Fatigue
259. Low energy
260. Apathetic, nothing seems important
261. Emotionally drained
262. Loss of sexual interest or pleasure
263. Depressed
264. Fearful
265. Hopeless
266. Crying easily
267. Insomnia
268. Difficulty awakening
269. Too much sleep (over 9 hours)
270. Difficulty concentrating
271. Mind going blank
272. Forgetting important things.
Scale Total: