The STRAIN, or Stress and Adversity Inventory, is a NIMH/RDoC-recommended instrument that efficiently and reliably assesses a person’s cumulative exposure to stress 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 well-being. Stressors occurring in early life (e.g., childhood maltreatment or neglect, parental loss/separation, etc.) are also queried in detail. 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. Presently, we have an adolescent version of the STRAIN (Adolescent STRAIN) that is available in English, and an adult version of the STRAIN (Adult STRAIN) that is available in English, Spanish, German, Swiss (High) German, Brazilian Portuguese, Croatian, and Italian (to begin using the STRAIN, complete the STRAIN Setup Form).
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 over the life course. Using this raw data, we can presently create more than 115 different cumulative life stress summary variables and life charts that summarize a person’s lifetime stress exposure. Analyses can in turn 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 occurring 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).
Several other interview-based 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 quickly and efficiently collect information about stressors occurring over the lifespan as opposed to over a few months or years. The STRAIN accomplishes this goal by combining the sophistication of an interview-based measure of life stress with the simplicity of a self-report instrument.
Stress Assessment Modules (SAMs)
The STRAIN’s 55 core questions cover a wide range of moderate-to-severe stressors that are typically experienced by most adolescent and 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 base STRAIN but can be added to the interview in the form of an additional 10 to 15-question Stress Assessment Module, or SAM. Presently, we have the following SAMs:
- Transition to College, providing additional coverage of stressors that are relevant for college students.
- Cancer, providing additional coverage of stressors that are relevant for cancer populations.
Use & Implementation
Ongoing development, maintenance, and administration of the STRAIN is supported in part by those who use the system. Additional details, cost estimates, and use consultation and instructions are gladly provided upon request.
The most recent version is Version 1.6, copyrighted and released by George Slavich on June 29, 2017. Unauthorized use is not permitted. For additional information or to get started using the STRAIN, complete the STRAIN Setup Form.