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Updated: Aug 1, 2026

Psychophysiological Stress Assessment Using Biofeedback
Published on: July 31, 2009
Validation of a five-point self-rated stress score
Lionel S Lim1, Donald E Williams, Philip T Hagen
1Division of Preventive and Occupational Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. lionel_lim@hotmail.com
The five-point self-rated stress score (SRSS) effectively identifies psychological distress. Higher SRSS scores significantly correlate with increased risk, making it a useful screening tool in clinical settings.
Area of Science:
- Psychological distress and mental health assessment.
- Clinical health psychology and patient screening.
Background:
- Psychological distress is a significant concern in patient care.
- Accurate and efficient screening tools are needed in outpatient settings.
Purpose of the Study:
- To validate the five-point self-rated stress score (SRSS) against the Symptom Checklist-90-Revised (SCL-90-R).
- To assess the utility of SRSS in identifying psychological distress.
Main Methods:
- A retrospective cohort study of 266 patients.
- Patients completed the SRSS (1-5 scale) and SCL-90-R.
- Global Severity Index (GSI) was calculated from SCL-90-R.
Main Results:
- SRSS showed a positive correlation with SCL-90-R GSI (r = .40, p < .001).
- Elevated SRSS scores (4 and 5) were significantly associated with increased odds of psychological distress (ORs 6.1 and 24.8, respectively).
Conclusions:
- The SRSS is a simple and potentially valuable tool for screening psychological distress in outpatient settings.
- Highest self-rated stress levels indicate a significantly increased risk of psychological distress.
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