The STRAIN, or Stress and Adversity Inventory, is a NIMH/RDoC-recommended instrument that efficiently and reliably assesses a person’s cumulative exposure to life stress. 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 the simple on-screen prompts. Because the STRAIN is embedded in an automated, online interviewing environment, the interview can be completed almost anywhere, including in a clinic, research laboratory, or classroom. Presently, we have an adolescent version of the STRAIN (Adolescent STRAIN) and an adult version (Adult STRAIN), both of which are available in several languages (see below). Although the STRAIN was originally designed to assess stressors occurring over the entire lifespan, we have since developed additional versions that focus on the same stressors but over shorter time periods (e.g., past 6 months, past year; see below). To begin using the STRAIN, complete the STRAIN Setup Form.
The average time needed to complete the STRAIN is 18-25 minutes, depending 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. 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 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).
Other interview-based measures have been developed for assessing life stress that require an independent rating team. The STRAIN is not a substitute for these more involved systems but rather is an alternative that can be used when the goal is to collect substantial information about health-relevant stressors in a relatively quick, efficient, and reliable manner. 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.
Main References
Adolescent STRAIN: Slavich, G. M., Stewart, J. G., Esposito, E. C., Shields, G. S., & Auerbach, R. P. (2019). The Stress and Adversity Inventory for Adolescents (Adolescent STRAIN): associations with mental and physical health, risky behaviors, and psychiatric diagnoses in youth seeking treatment. Journal of Child Psychology and Psychiatry, 60, 998-1009. doi: 10.1111/jcpp.13038
Adult STRAIN: Slavich, G. M., & Shields, G. S. (2018). Assessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation. Psychosomatic Medicine, 80, 17-27. doi: 10.1097/PSY.0000000000000534
- Brazilian Portuguese: Cazassa, M. J., Oliveira, M. D. S., Spahr, C. M., Shields, G. S., & Slavich, G. M. (2020). The Stress and Adversity Inventory for Adults (Adult STRAIN) in Brazilian Portuguese: Initial validation and links with executive function, sleep, and mental and physical health. Frontiers in Psychology, 10:3083. doi: 10.3389/fpsyg.2019.03083
- German: Sturmbauer, S. C., Shields, G. S., Hetzel, E. L., Rohleder, N., & Slavich, G. M. (2019). The Stress and Adversity Inventory for Adults (Adult STRAIN) in German: An overview and initial validation. PLoS One, 14(5):e0216419. doi: 10.1371/journal.pone.0216419
Use & Implementation
Initial development of the STRAIN was generously supported by a non-profit organization (i.e., Branco Weiss Fellowship) grant to George Slavich, and subsequent ongoing system maintenance, security, and administration 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 STRAIN is copyrighted by George Slavich and the most recent version (i.e., Version 1.8) was released on January 5th, 2021. Unauthorized use is not permitted. For additional information or to get started using the STRAIN, complete the STRAIN Setup Form.
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| LIFETIME STRAIN |  | |
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| RECENT STRAINS | Recent STRAIN | 1 Month | |
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| Recent STRAIN | 6 Months | | |
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| Recent STRAIN | 9 Months | | ||
| Recent STRAIN | 1 Year | | |
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| LIFETIME STRAIN TRANSLATIONS | Spanish | |
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| Spanish (Peru) | |
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| Brazilian Portuguese | |
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| Simplified Mandarin Chinese | |
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| Korean | |
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| German | |
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| Russian | |
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| French | | |
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| Italian | |
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| Swiss | |
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| Swiss French | |
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| Norwegian | |
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| Polish | |
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| Turkish | | |
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| Romanian | | |
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| Hindi | |
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| STRAIN STRESS ASSESSMENT MODULES (SAMs) | Transition to College SAM (Available in English, German, Italian, Croatian, Swiss) | |
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| Sport SAM (Available in English) | |
STRAIN Publications
| Number | Publication | Download |
|---|---|---|
| 38 | Gillespie, S. L., Christian, L. M., Mackos, A. R., Nolan, T. S., Gondwe, K. W., Anderson, C. M., Hall, M. W., Williams, K. P., & Slavich, G. M. (in press). Lifetime stressor exposure, systemic inflammation during pregnancy, and preterm birth among Black American women. Brain, Behavior, and Immunity. | |
| 37 | Allison, G. O., Kamath, R. A., Carrillo, V., Alqueza, K. L., Pagliaccio, D., Slavich, G. M., Shankman, S. A., & Auerbach, R. P. (in press). Self-referential processing in remitted depression: An event related potential study. Biological Psychiatry Global Open Science. doi: 10.1016/j.bpsgos.2021.12.005 | |
| 36 | Hamlat, E. J., Laraia, B., Bleil, M. E., Deardorff, J., Tomiyama, A. J., Mujahid, M., Shields, G. S., Brownell, K., Slavich, G. M., & Epel, E. S. (in press). Effects of early life adversity on pubertal timing and tempo in Black and White girls: The National Growth and Health Study. Psychosomatic Medicine. | |
| 35 | McLoughlin, E., Arnold, R., Fletcher, D., Spahr, C. M., Slavich, G. M., & Moore, L. J. (2022). Assessing lifetime stressor exposure in sport performers: Associations with trait stress appraisals, health, well-being, and performance. Psychology of Sport and Exercise, 58, 102078. doi: 10.1016/j.psychsport.2021.102078 |  |
| 34 | Gillespie, S. L., Bose-Brill, S., Giurgescu, C., Gondwe, K. W., Nolan, T. S., Spurlock, E. J., & Christian, L. M. (2021). Racial discrimination and stress across the life course. Nursing Research, 70 (5S), S21-S30. doi: 10.1097/NNR.0000000000000525 | |
| 33 | Senft Miller, A., Nop, O., Slavich, G. M., & Dumas, J. A. (in press). Lifetime stress exposure, cognition, and psychiatric wellbeing in women. Aging & Mental Health. doi: 10.1080/13607863.2021.1958144 | |
| 32 | Byrne, M. L., Lind, M. N., Horn, S. R., Mills, K. L., Nelson, B. W., Barnes, M. L., Slavich, G. M., & Allen, N. B. (2021). Using mobile sensing data to assess stress: Associations with perceived and lifetime stress, mental health, sleep, and inflammation. Digital Health, 7, 1-11. doi: 10.1177/20552076211037227 | |
| 31 | Polick, C. S., Polick, S. R., Stoddard, S. A., Braley, T. J., & Slavich, G. M. (2021). The importance of assessing life stress exposure in multiple sclerosis: A case report. Multiple Sclerosis and Related Disorders, 54, 103145. doi: 10.1016/j.msard.2021.103145 | |
| 30 | Banica, I., Sandre, A., Shields, G. S., Slavich, G. M., & Weinberg, A. (in press). Associations between lifetime stress exposure and the error-related negativity (ERN) differ based on stressor characteristics and exposure timing in young adults. Cognitive, Affective, & Behavioral Neuroscience. doi: 10.3758/s13415-021-00883-z | |
| 29 | Malat, J., Johns-Wolfe, E., Smith, T., Shields, G. S., Jacquez, F., & Slavich, G. M. (in press). Associations between lifetime stress exposure, race, and first-birth intendedness in the United States. Journal of Health Psychology. doi: 10.1177/1359105320963210 | |
| 28 | McMullin, S. D., Shields, G. S., Slavich, G. M., & Buchanan, T. W. (2021). Cumulative lifetime stress exposure predicts greater impulsivity and addictive behaviors. Journal of Health Psychology, 26, 2921-2936. doi: 10.1177/1359105320937055 | |
| 27 | Moseley, R. L., Turner-Cobb, J. M., Spahr, C. M., Shields, G. S., & Slavich, G. M. (2021). Lifetime and perceived stress, social support, loneliness, and health in autistic adults. Health Psychology, 40, 556-568. doi: 10.1037/hea0001108 | |
| 26 | Kim, S., Zhang, W., Pak, V., Aqua, J. K., Hertzberg, V. S., Spahr, C. M., Slavich, G. M., & Bai, J. (2021). How stress, discrimination, acculturation and the gut microbiome affect depression, anxiety and sleep among Chinese and Korean immigrants in the USA: A cross-sectional pilot study protocol. BMJ Open, 11(7):e047281. doi: 10.1136/bmjopen-2020-047281 | |
| 25 | McLoughlin, E., Fletcher, D., Slavich, G. M., Arnold, R., & Moore, L. J. (2021). Cumulative lifetime stress exposure, depression, anxiety, and well-being in elite athletes: A mixed-method study. Psychology of Sport and Exercise, 52, 101823. doi: 10.1016/j.psychsport.2020.101823 | |
| 24 | Cooper, J. A., Nuutinen, M. R., Lawlor, V. M., DeVries, B. A. M., Barrick, E. M., Hossein, S., Cole, D. J., Leonard, C. V., Hahn, E. C., Teer, A. P., Shields, G. S., Slavich, G. M., Ongur, D., Jensen, J. E., Du, F., Pizzagalli, D. A., & Treadway, M. T. (2021). Reduced adaptation of glutamatergic stress response is associated with pessimistic expectations in depression. Nature Communications, 12(1):3166. doi: 10.1038/s41467-021-23284-9 | |
| 23 | Foubert, L., Noël, Y., Spahr, C. M., Slavich, G. M. (2021). Beyond WEIRD: Associations between socioeconomic status, gender, lifetime stress exposure, and depression in Madagascar. Journal of Clinical Psychology, 77, 1644-1665. doi: 10.1002/jclp.23131 | |
| 22 | Smith, T., Johns‐Wolfe, E., Shields, G. S., Malat, J., Jacquez, F., & Slavich, G. M. (2020). Associations between lifetime stress exposure and prenatal health behaviors. Stress and Health, 36, 384-395. doi: 10.1002/smi.2933 | |
| 21 | Banica, I., Sandre, A., Shields, G. S., Slavich, G. M., & Weinberg, A. (2020). The error-related negativity (ERN) moderates the association between interpersonal stress and anxiety symptoms six months later. International Journal of Psychophysiology, 153, 27-36. doi: 10.1016/j.ijpsycho.2020.03.006 | |
| 20 | Cazassa, M. J., Oliveira, M. D. S., Spahr, C. M., Shields, G. S., & Slavich, G. M. (2020). The Stress and Adversity Inventory for Adults (Adult STRAIN) in Brazilian Portuguese: Initial validation and links with executive function, sleep, and mental and physical health. Frontiers in Psychology, 10:3083. doi: 10.3389/fpsyg.2019.03083 | |
| 19 | Slavich, G. M., Stewart, J. G., Esposito, E. C., Shields, G. S., & Auerbach, R. P. (2019). The Stress and Adversity Inventory for Adolescents (Adolescent STRAIN): associations with mental and physical health, risky behaviors, and psychiatric diagnoses in youth seeking treatment. Journal of Child Psychology and Psychiatry, 60, 998-1009. doi: 10.1111/jcpp.13038 | |
| 18 | Schüssler-Fiorenza Rose, S. M., Contrepois, K., Moneghetti, K. J., Zhou, W., Mishra, T., Mataraso, S., Dagan-Rosenfeld, O., Ganz, A., Dunn., J., Hornburg, D., Rego, S., Perelman, D., Ahadi, S., Reza Sailani, M., Zhou, Y., Leopold, S., Chen, J., Ashland, M., Christle, J. W., Avina, M., Limcaoco, P., Ruiz, C., Tan, M., Butte, A. J., Weinstock, G. M., Slavich, G. M., Sodergren, E., McLaughlin, T. L., Haddad, F., & Snyder, M. P. (2019). A longitudinal big data approach for precision health. Nature Medicine, 25, 792-804. doi: 10.1038/s41591-019-0414-6 | |
| 17 | Olvera Alvarez, H. A., Provencio-Vasquez, E., Slavich, G. M., Laurent, J. G. C., Browning, M., McKee-Lopez, G., Robbins, L., & Spengler, J. D. (2019). Stress and health in nursing students: The Nurse Engagement and Wellness Study. Nursing Research, 68, 453-463. doi: 10.1097/NNR.0000000000000383 | |
| 16 | Pegg, S., Ethridge, P., Shields, G. S., Slavich, G. M., Weinberg, A., & Kujawa, A. (2019). Blunted social reward responsiveness moderates the effect of lifetime social stress exposure on depressive symptoms. Frontiers in Behavioral Neuroscience, 13:178. doi: 10.3389/fnbeh.2019.00178 | |
| 15 | Lam, J. C. W., Shields, G. S., Trainor, B. C., Slavich, G. M., & Yonelinas, A. P. (2019). Greater lifetime stress exposure predicts blunted cortisol but heightened DHEA responses to acute stress. Stress and Health, 35, 15-26. doi: 10.1002/smi.2835 | |
| 14 | Mayer, S. E., Prather, A. A., Puterman, E., Lin, J., Arenander, J., Coccia, M., Shields, G. S., Slavich, G. M., & Epel, E. S. (2019). Cumulative lifetime stress exposure and leukocyte telomere length attrition: The unique role of stressor duration and exposure timing. Psychoneuroendocrinology, 104, 210-218. doi: 10.1016/j.psyneuen.2019.03.002 | |
| 13 | Shields, G. S., Ramey, M. M., Slavich, G. M., & Yonelinas, A. P. (2019). Determining the mechanisms through which recent life stress predicts working memory impairments: Precision or capacity? Stress, 22, 280-285. doi: 10.1080/10253890.2018.1556635 | |
| 12 | Stewart, J. G., Shields, G. S., Esposito, E. C., Cosby, E. A., Allen, N. B., Slavich, G. M., & Auerbach, R. P. (2019). Life stress and suicide in adolescents. Journal of Abnormal Child Psychology, 47, 1707-1722. doi: 10.1007/s10802-019-00534-5 | |
| 11 | Sturmbauer, S. C., Shields, G. S., Hetzel, E. L., Rohleder, N., & Slavich, G. M. (2019). The Stress and Adversity Inventory for Adults (Adult STRAIN) in German: An overview and initial validation. PLoS One, 14(5):e0216419. doi: 10.1371/journal.pone.0216419 | |
| 10 | Slavich, G. M., & Shields, G. S. (2018). Assessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation. Psychosomatic Medicine, 80, 17-27. doi: 10.1097/PSY.0000000000000534 | |
| 9 | Gillespie S. L., Christian, L. M., Alston, A. D., & Salsberry, P. J. (2017). Childhood stress and birth timing among African American women: Cortisol as biological mediator. Psychoneuroendocrinology, 84, 32-41. doi: 10.1016/j.psyneuen.2017.06.009 | |
| 8 | Shields, G. S., Doty, D., Shields, R. H., Gower, G., Slavich, G. M., Yonelinas, A. P. (2017). Recent life stress exposure is associated with poorer long-term memory, working memory, and self-reported memory. Stress, 20, 598-607. doi: 10.1080/10253890.2017.1380620 | |
| 7 | Cuneo, M. G., Schrepf, A., Slavich, G. M., Thaker, P. H., Goodheart, M., Bender, D., Cole, S. W., Sood, A. K., & Lutgendorf, S. K. (2017). Diurnal cortisol rhythms, fatigue and psychosocial factors in five-year survivors of ovarian cancer. Psychoneuroendocrinology, 84, 139-142. doi: 10.1016/j.psyneuen.2017.06.019 | |
| 6 | Dooley, L. N., Slavich, G. M., Moreno, P. I., & Bower, J. E. (2017). Strength through adversity: Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress and Health, 33, 549-557. doi: 10.1002/smi.2739 | |
| 5 | Goldfarb, E. V., Shields, G. S., Daw, N. D., Slavich, G. M., & Phelps, E. A. (2017). Low lifetime stress exposure is associated with reduced stimulus-response memory. Learning and Memory, 24, 162-168. doi: 10.1101/lm.045179.117 | |
| 4 | Shields, G. S., Moons, W. G., & Slavich, G. M. (2017). Better executive function under stress mitigates the effects of recent life stress exposure on health in young adults. Stress, 20, 75-85. doi: 10.1080/10253890.2017.1286322 | |
| 3 | Toussaint, L., Shields, G. S., Dorn, G., & Slavich, G. M. (2016). Effects of lifetime stress exposure on mental and physical health in young adulthood: How stress degrades and forgiveness protects health. Journal of Health Psychology, 21, 1004-1014. doi: 10.1177/1359105314544132 | |
| 2 | Bower, J. E., Crosswell, A. D., & Slavich, G. M. (2014). Childhood adversity and cumulative life stress: Risk factors for cancer-related fatigue. Clinical Psychological Science, 2, 108-115. doi: 10.1177/2167702613496243 | |
| 1 | Slavich, G. M., & Toussaint, L. (2014). Using the Stress and Adversity Inventory as a teaching tool leads to significant learning gains in two courses on stress and health. Stress and Health, 30, 343-352. doi: 10.1002/smi.2523 | |
STRAIN Superusers
 University of California, Los Angeles |  University of California, Los Angeles |  University of California, San Francisco |
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 Brandeis University |  Clinic Barmelweid, Switzerland |  Columbia University |
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STRAIN Users
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STRAIN in the World
 Milton J. CazassaPontifical Catholic University of Rio Grande do Sul Brazilian Portuguese | Hector A. Olvera, Ph.D. University of Texas Spanish |  Alberto Collazzoni, Ph.D.University of L' Aquila Italian |
 Francisco MS Cardoso, Ph.D.University of Trás-os-Montes and Alto Douro European Portuguese |  Rosangela BertelliUniversity of Trás-os-Montes and Alto Douro European Portuguese |  Svitlana Avramchenko, Ph.D.Cherkasy National University, Bogdan Khmelnitskiy Ukrainian |
 Cornelia Rada, Ph.D. Francisc I. Rainer Institute of Anthropology Romanian |  Stefania RoscaLucian Blaga University of Sibiu Romanian |  Rimovecz Cristina KlariWest University in Timisoara Romanian |
 Ibrahim Yiğit, Ph.D.Baskent University Turkish |  Melike GuzeyAnkara University Turkish |  Koç University School of Medicine Turkish |
 Dora Kirigin M.S.Clinical Hospital Centre Split Croatian |  Dolores Britvic, M.D.University of Split Croatian |  Pål Kraft,Ph.D.University of Oslo Norwegian |
 Zahir Vally, Ph.DUnited Arab Emirates University Arabic |  Akershus University Hospital Norwegian |  Federal University of Rio de Janeiro Brazilian Portuguese |
 Universidad Autónoma de Bucaramanga Spanish |  Nicolas Rohleder,Ph.D.Friedrich-Alexander-University of Erlangen-Nürnberg German |  Pius-Hospital Oldenburg German |
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 Swiss Tropical and Public Health Institute English |  King George's Medical University English |  Central Queensland University Australia |
 Massachusetts General Hospital Dutch |  Rosario National University Argentina |  Universität Siegen German |
 University of Zürich Switzerland |
