Stress & stressors

Perceived stress


Contact: Almar Kok

Stress is experienced when the environmental demands exceeds a person’s adaptive capacity and is associated with health and diseases such as depression and cardiovascular diseases (Cohen et al. 2007). Stress can be quantified in different ways. Stressors can be measured, for example by asking about negative life events which are experienced. The number of life events can then be used as a measure of cumulative stress. However, people might react differently to stressors and  other sources of stress such as ongoing stressors, expectations of the future, and negative events in the lives of loved ones are not included when asking about life events.

A global measure of perceived stress gives information about the amount of stress which is currently experienced in a person’s live.

Measurement instruments in LASA
In LASA the Perceived Stress Scale (PSS) is used to measure perceived stress (Cohen et al. 1983). This questionnaire measures the global levels of stress in the last month by asking to which degree persons find their lives unpredictable, uncontrollable and overloaded.

Van Eck et al. (1996) translated the 10-item version of the PSS into Dutch and showed that the norms for perceived stress was comparable to those of the U.S. In their study no relationship was found between experienced stress and cortisol levels. Unfortunately this translation was not available, so we had to make a new translation.


For use in LASA the 10-item version has been translated from English into Dutch by someone Dutch-speaking in origin, but fluent in English and back to English by a native English-speaking person who is also fluent in Dutch. About the items where the back translation was not quite right, they reached consensus on the desired translation. 


Questions are answered on a Likert scale from 0-4 from ‘never’ to ‘very often’. The scale consisted of 6 negatively worded items and 4 positively worded items. For the total score the positively worded items were recoded so that higher scores indicated greater stress, the sum score ranged from 0-40. Higher scores indicate higher levels of stress.


The scale perceived stress scale includes two subscales, the perceived helplessness and the perceived self-efficacy subscale. The perceived helplessness scale consisted of the negative worded items 1,2,3,6,9,10 (ranging from 0-24) and the perceived self-efficacy scale consisted of the positive worded items 4,5,7,8 (ranging from 0-16).

LASAH104 / LAS3B104 (self-administered questionnaire, in Dutch).

Variable information
LASAH104 / LAS3B104;
LASAH304 / LAS3B304 (scale scores)

Availability of information per wave 1

























 1 More information about the LASA data collection waves is available here.

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort

Sa=data collected in self-administered questionnaire

Previous use in LASA
The PSS is used in a publication of Korten et al. (2017) in which the association between perceived stress and cognitive functioning is examined.


  1. Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA 2007;298:1685-1687.
  2. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behaviour 1983;24:385-396.
  3. Korten NCM, Comijs HC, Penninx BWJH, Deeg DJH. (2017). Perceived stress and cognitive function in older adults: which aspect of perceived stress is important? International Journal of Geriatric Psychiatry, 32, 4, 439-445.
  4. van Eck M, Berkhof H, Nicolson N, Sulon J. The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosom Med. 1996;58(5):447-58.