Stress and Adversity Inventory (STRAIN)
The Stress and Adversity Inventory (STRAIN) is an NIMH/RDoC-recommended online stress assessment system that measures individuals’ cumulative lifetime exposure to different types of stress that affect health (see http://www.strainsetup.com). The system combines the reliability and sophistication of an interview-based measure of life stress with the simplicity of a self-report instrument. To accomplish this goal, the STRAIN enquires about different types of stressors that cover all major life domains (e.g., health, intimate relationships, friendships, children, education, work, finances, housing, living conditions, crime, etc.) and several social-psychological characteristics (e.g., interpersonal loss, physical danger, role change, entrapment, etc.). Questions are presented one at a time and users register their responses by touching or clicking their answer on the computer screen. For each stressor that is endorsed, users are asked a series of tailored follow-up questions that ascertain the precise severity, frequency, timing, and duration of the stressor. Based on the information collected, the system in turn produces 445 raw variables that can be combined to create 115 different stress exposure summary scores and life charts. Analyses can thus focus on measures of overall lifetime stressor count or cumulative severity, or can be disaggregated into more nuanced indices of lifetime stress exposure that focus on stress exposure timing (e.g., Childhood vs. Distant vs. Recent Life Stress) or on stressors occurring in specific life domains or that involve particular social-psychological characteristics.
Two versions of the STRAIN are presently available, which assess lifetime stress exposure in adolescents (Adolescent STRAIN) and adults (Adult STRAIN), respectively. The Adolescent STRAIN enquires about 75 different acute life events and chronic difficulties, and the Adult STRAIN enquires about 55 different acute life events and chronic difficulties. The validity of these question sets has been examined in numerous studies spanning several populations, all age groups, and all major levels of analysis including social, cognitive, emotional, neural, physiologic, endocrine, molecular, and genomic. To date, these studies have shown that the main STRAIN stress exposure indices predict a variety of health-related outcomes, including doctor-diagnosed mental and physical health problems and autoimmune disorders (Slavich & Shields, 2018), clinician-rated psychiatric diagnoses (Slavich, Stewart, Esposito, Shields, & Auerbach, 2018), computer-assessed and self-reported cognitive function and memory (Goldfarb, Shields, Daw, Slavich, & Phelps, 2017; Shields, Doty, Shields, Gower, Slavich, & Yonelinas, 2017), diurnal cortisol rhythms and reactivity (Cuneo et al., 2017; Lam, Shields, Trainor, Slavich, & Yonelinas, 2018), metabolic health (Kurtzman, O’Donovan, Koslov, Arenander, Epel, & Slavich, 2012), sleep problems (Slavich & Shields, 2018), depressive symptoms in cancer (Dooley, Slavich, Moreno, & Bower, 2017), cancer-related fatigue (Bower, Crosswell, & Slavich, 2014), and self-reported mental and physical health complaints in the general population (Shields, Moons, & Slavich, 2017; Slavich & Shields, 2018; Toussaint, Shields, Dorn, & Slavich, 2016). The STRAIN has also been used as a teaching tool in courses on stress and health (Slavich & Toussaint, 2014). Setup information for the STRAIN is available at http://www.strainsetup.com.
Version date: January 2018
Bower, J. E., Crosswell, A. D., & Slavich, G. M. (2014). Childhood adversity and cumulative life stress: Risk factors for cancer-related fatigue. Clinical Psychological Science, 2, 108-115.
Cuneo, M. G., Schrepf, A., Slavich, G. M., Thaker, P. H., Goodheart, M., Bender, D., Cole, S. W., Sood, A. K., & Lutgendorf, S. K. (2017). Diurnal cortisol rhythms, fatigue and psychosocial factors in five-year survivors of ovarian cancer. Psychoneuroendocrinology, 84, 139-142.
Dooley, L. N., Slavich, G. M., Moreno, P. I., & Bower, J. E. (2017). Strength through adversity: Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress and Health, 33, 549-557.
Goldfarb, E. V., Shields, G. S., Daw, N. D., Slavich, G. M., & Phelps, E. A. (2017). Low lifetime stress exposure is associated with reduced stimulus-response memory. Learning and Memory, 24, 162-168.
Kurtzman, L., O’Donovan, A., Koslov, K., Arenander, J., Epel, E. S., & Slavich, G. M. (2012). Sweating the big stuff: Dispositional pessimism exacerbates the deleterious effects of life stress on metabolic health. European Journal of Psychotraumatology, 3.
Lam, J. C. W., Shields, G. S., Trainor, B. C., Slavich, G. M., & Yonelinas, A. P. (2018). Greater lifetime stress exposure predicts blunted cortisol but heightened DHEA reactivity to acute stress. Under review.
Shields, G. S., Doty, D., Shields, R. H., Gower, G., Slavich, G. M., Yonelinas, A. P. (2017). Recent life stress exposure is associated with poorer long-term memory, working memory, and self-reported memory. Stress, 20, 598-607.
Shields, G. S., Moons, W. G., & Slavich, G. M. (2017). Better executive function under stress mitigates the effects of recent life stress exposure on health in young adults. Stress, 20, 75-85.
Slavich, G. M., & Shields, G. S. (2018). Assessing lifetime stress exposure using the Stress and Adversity Inventory for Adults (Adult STRAIN): An overview and initial validation. Psychosomatic Medicine, 80, 17-27.
Slavich, G. M., Stewart, J. G., Esposito, E. C., Shields, G. C., & Auerbach, R. P. (2018). The Stress and Adversity Inventory for Adolescents: An initial validation study of youth seeking treatment. Under review.
Slavich, G. M., & Toussaint, L. (2014). Using the Stress and Adversity Inventory as a teaching tool leads to significant learning gains in two courses on stress and health. Stress and Health, 30, 343-352.
Toussaint, L., Shields, G. S., Dorn, G., & Slavich, G. M. (2016). Effects of lifetime stress exposure on mental and physical health in young adulthood: How stress degrades and forgiveness protects health. Journal of Health Psychology, 21, 1004-1014.