Structured Trauma-Related Experiences & Symptoms Screener
The Structured Trauma-Related Experiences & Symptoms Screener (STRESS) for adults is a 10- to 15-minute self-report instrument designed to assess (1) lifetime exposure to several domains of potentially traumatic and other adverse experiences and age of occurrence (52 items), (2) PTSD symptoms that map onto symptom criteria defined in the Diagnostic and Statistical Manual for Mental Disorders 5th Edition (DSM-5) and applicable to one or more traumatic events (25 items), and functional impairment (6 items).
A youth version of the STRESS is also available.
Damion J. Grasso, Julian D. Ford, Julia W. Felton, and Kathy Reid-Quiñones
Damion J. Grasso
Department of Psychiatry
University of Connecticut School of Medicine
253 Farmington Avenue, MC 1410
Farmington, CT 06030-1410
The STRESS is a 10- to 15-minute self-report instrument that assesses (1) lifetime exposure to several domains of potentially traumatic experiences in childhood and adulthood (52 items), (2) PTSD symptoms that map onto DSM-5 symptom criteria and applicable to one or more traumatic events (25 items), and functional impairment (6 items). Two symptom items assess dissociative symptoms of depersonalization and derealization. Symptom items are assessed over the past week on a 4-point scale: 0 (None), 1 (1 Day), 2 (2-3 Days), 3 (Most Days). Symptoms rated 2 or higher are considered positive. One question asks whether symptoms were present for at least the past month.
The web-based version reads questions aloud, auto scores, and generates a report with a list of endorsed trauma exposures, age of occurrence, symptom criteria, and self-reported criteria for partial or full PTSD. The STRESS has been tested in various adult populations, including pregnant women and domestic violence exposed men/women, with excellent internal consistency for criterion specific and total symptom severity, construct validity as indicated by an excellent fit with the DSM-5 four-factor symptom structure, and concurrent validity when examined alongside other validated psychosocial measures.
The STRESS for adults was carefully designed to support administration and interpretation by both clinicians and non-clinical professionals. It can be completed on paper or self-administered via a secure website that reads questions aloud, auto scores, and generates a downloadable report.
Download paper copies of the STRESS for free or subscribe to access the web-based administration tools at www.traumascreens.com. These resources are intended to be used only as instructed and in an ethical and responsible manner.
Versions are available in English and Spanish.
Scoring and Interpretation
Symptom severity can be calculated as a total score or separately for intrusion (Criterion B), avoidance (Criterion C), alterations in cognition/mood (Criterion D), arousal/reactivity (Criterion E), and Dissociation (specifier). Although no symptom cut-off currently exists, severity scores can be used to monitor symptom change over time. Probable PTSD (partial/full) is determined categorically by counting the number of positive symptom criteria in each of the four symptom clusters and evaluating symptom duration and functional impairment. A count of endorsed trauma types has been shown to be sensitive to other measures of psychosocial risk and may be evaluated as an indicator of polyvictimization or cumulative trauma exposure.
The STRESS has been tested in various adult populations, including in pregnant women and domestic violence exposed men/women, with excellent internal consistency for total symptom severity (Cronbach’s alpha >.90), construct validity as indicated by an excellent fit with the DSM-5 four-factor symptom structure, and concurrent validity when examined alongside other validated measures of internalizing and externalizing behavior problems. Further, total count of endorsed trauma types has been shown to associate with other validated measures of stress/trauma exposure and impairment.
Grasso, D. J., Ford, J. D., & Greene, C. A. (2019). Preliminary psychometrics of the Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A) in an urban prenatal healthcare clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 11(8), 927.
McGuire, A., Beebe, R., Stover, C., Clough, M., DiVietro, S., & Grasso, D. J. (2021). Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A): Validation in a child welfare sample of mothers and fathers with active domestic violence. Psychological trauma: theory, research, practice, and policy.
Goldstein, B. L., Briggs-Gowan, M. J., & Grasso, D. J. (2020). The Effects of Intimate Partner Violence and a History of Childhood Abuse on Mental Health and Stress during Pregnancy. Journal of Family Violence, 1-10.
Grasso, D. J., Drury, S., Briggs-Gowan, M., Johnson, A., Ford, J., Lapidus, G., ... & Covault, J. (2020). Adverse childhood experiences, posttraumatic stress, and FKBP5 methylation patterns in postpartum women and their newborn infants. Psychoneuroendocrinology, 114, 104604.
Greene, C. A., McCoach, D. B., Briggs-Gowan, M. J., & Grasso, D. J. (2021). Associations among childhood threat and deprivation experiences, emotion dysregulation, and mental health in pregnant women. Psychological trauma: theory, research, practice, and policy.
Stover, C. S., Beebe, R., Clough, M., DiVietro, S., Madigan, L., & Grasso, D. J. (2020). Evaluation of a Statewide Implementation of Fathers for Change: a Fathering Intervention for Families Impacted by Partner Violence. Journal of Family Violence, 1-11.
General instructions are provided with the instrument and further guidance is available at www.traumascreens.com.
Information about the STRESS, consultation, and training on trauma screening and assessment can be obtained by contacting Damion J. Grasso.