Stress and Adversity Inventory (STRAIN)

The STRAIN, or Stress and Adversity Inventory, is an efficient and reliable way to assess exposure to stress occurring over the life course. The measure is entirely online and systematically inquires about a diverse array of acute life events (e.g., deaths of relatives, job losses, negative health events) and chronic difficulties (e.g., ongoing health problems, work problems, relationship problems, financial problems, etc.) that have implications for human health and wellbeing. Stressors occurring in early life (e.g., childhood maltreatment or neglect, parental loss/separation, etc.) are also queried. Respondents are asked to rate the severity, frequency, timing, and duration of each stressor they endorse. Questions that are inappropriate (based on a participant’s demographic characteristics) are automatically omitted from the interview (e.g., female reproductive health questions for male participants, questions about children for persons without children). The instrument can be self-administered by users at a computer or can be administered by an interviewer who follows a series of simple on-screen prompts. Because the STRAIN is embedded in an automated, online interviewing environment, the interview can be completed almost anywhere, including in the clinic, research laboratory, or classroom. When used in a clinical environment, the system can deploy tailored social-psychological interventions based on a user’s unique life stress profile. Respondents reporting high levels of social isolation or rejection, for example, can receive a brief social belonging intervention, whereas those reporting high levels of entrapment stress can receive a brief problem solving intervention.

The average time needed to complete the STRAIN is 25 minutes, with a range of approximately 18-30 minutes based on the population being interviewed. Because there are multiple follow-up questions for each endorsed stressor (i.e., that assess severity, frequency, timing, and duration), there are approximately 220 questions that can be asked in all. Based on this information, the system produces 455 variables that are used to assess an individual’s cumulative exposure to stress. Syntax is provided for creating 114 different cumulative life stress summary variables. Analyses can be based on a number of factors, including stressor severity and/or the timing of stress exposure (e.g., Early Adversity vs. Distant vs. Recent Life Stress). More sophisticated analyses can be performed by focusing on stressors that occur in particular life domains (e.g., Housing, Education, Work, Health, Marital/Partner) or that have particular core characteristics (e.g., Interpersonal Loss, Physical Danger, Humiliation, Entrapment, Role Change).

Development

The STRAIN is designed to assess cumulative life stress in a way that combines the sophistication of an interview-based measure of life stress with the simplicity of a self-report instrument. For example, although participants are asked questions regarding more than 90 types of stress, the on-screen user interface is very simple and straightforward. Moreover, questions that are irrelevant for certain participants are automatically omitted from the question cue, as they would be by a life stress interviewer. Several state-of-the-art measures have been developed for assessing life stress over relatively short periods of time (e.g., a few months or years). The STRAIN is not a substitute for these systems, but rather is an alternative that can be used when the goal is to collect information about stressors occurring over the lifespan, as opposed to over a few months or years.

The STRAIN’s 96 core questions cover a wide range of moderate and more severe stressors that are typically experienced by most adult populations. Questions that are tailored to particular populations (e.g., children, college students, older adults, caregivers, cancer survivors), or that assess specific life domains in a more nuanced way, are not included in the basic version but can be added to the interview in the form of an additional 10 to 15-question SAM, or Stress Assessment Module. Additional information is available by request and in the STRAIN Technical Report.

Ongoing development, maintenance, and administration of the STRAIN is supported in part by those who use the system. Additional details and cost estimates provided upon request.

Extensive documentation is available for the STRAIN. The most recent version is Version 1.44, copyrighted and released by George Slavich on June 1st, 2016. Unauthorized use is not permitted.

  • Time Window: Cumulative (lifetime) stress exposure (i.e., early adversity + adulthood stressors)
  • Administration: Online, either self- or interviewer-administered
  • Time: Interview = 18-30 minutes/subject; Ratings = automatic
  • Estimated Cost: Variable depending on collaborative arrangement, please inquire

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