Questionnaire on Stress (Part 1)

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Name: Khushi Nikhil Agarwal Class: X
Age: 15 School: Unison World
School
Instructions:
• Please indicate your choice of response in the statements mentioned honestly. This
information will not be shared with anyone.
• Simultaneously, please indicate the extent to which you feel stressed because of these
statements.
Do you feel
it’s a cause of To what extent has this issue been a cause of stre
stress for for you?
S.N Statements you?
Yes No Very High Okay It’s a good Not
High kind of /Minimal
stress stressful
1. Homework is a very big source of Yes Yes
stress for me.
2. I am very stressed out because I Yes Yes
need to get good grades.
3. I have very high expectations from Yes Yes
myself.
4. My family and my teachers expect Yes Yes
me to do well
5. Physical appearance is very No No
important for me.
6. Maintaining a normal weight is an No No
issue I face.
7. My self-esteem has to be Yes Yes
maintained at any cost.
8. I regularly go for medical check-ups No No
to rule out any disease that I have
caught.
9. Reaching Puberty really hit me No No
hard.
10. My parents’ parenting style is a little No No
strict in nature.
11. My parents could have given me No No
more attention when I needed it the
most.
12. My parents’ lack in giving me the No No
emotional support I need at times.
13. My friendship issues can take up a No No
lot of my time and attention.
14. I face/have faced bullying. No No
15. I need to maintain a good lifestyle Yes Yes
to be able to be mentally healthy.
16. Decisions relating to my Yes Yes
career/courses/colleges keep me up
at night.
17. I have a lot of guilt regarding some No No
aspects of my life.
18. My transitions from one phase to No No
another have caused me anxiety.
19. I am really hard on myself. No No
20. I wish people liked me for who I No No
am.

Scoring:
This questionnaire assesses the causes of stress. Per segment mentioned as the following, for
every Yes, add one mark; for every No, add zero:
• The items number 1, 2, 3, 4 relate to academic stress

Total:

• The items number 5, 6, 7, 8, 9 relate to health-related stress

Total:

• The items number 10, 11, 12 relate to family stress

Total:

• The items number 13, 14, 15 relate to social stress

Total:

• The items number 16, 17, 18, 19, 20 relate to other areas of stress

Total: