Therapy in LA
Therapy in L.A.

 

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June 2016
STRESS AND LIFESTYLE QUESTIONNAIRE
by
Malcolm Miller, Ph.D.

This questionnaire is a briefer form of one I use in my practice and has been developed from my own work and the work of others.
It is most valid when answered honestly and when not too much time is spent on any one item.
Each item is measured on a 5-point scale. Please write down the number on each item that best represents your self-assessment.

1 almost never 2 rarely 3 sometimes 4 quite often 5 most of the time

1. It is important for me to do my work perfectly
2. I keep repeating negative thoughts to myself
3. There is a lot of tension at home
4. I get too busy or forget to play and have fun
5. It is hard for me to either fall asleep or remain asleep
6. I am forgetful
7. I am troubled by minor illnesses
8. I worry about what others think of me
9. I lose my temper over little irritations
10. At the end of my working day, I find myself emotionally empty

Add your score

30 or below -- you experience the usual stressors of daily life.
31 - 37 -- seriously examine ways to reduce your stress and increase your pleasure in life
38 and above -- stress is too much a part of your life and is probably affecting your health; seriously consider getting some assistance.

Also see Dr. Miller's article, "How Stress Reduction Can Save Your Life"

*This material is protected under copyright laws and may not be reproduced, for other than personal use in part or whole, without the express permission of Malcolm Miller, Ph.D.


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