Methods for Toolbox Selection
Based on theory and expert consensus, the Network developed a list of psychological stressors known to be important for health. These are major life events, traumatic events, perceived stress, early life stress, caregiver stress, social isolation, loneliness, stigma/ discrimination, work stress, burnout, relationship conflict, financial strain, neighborhood safety and cohesion, and daily stress. The impact of stress on health depends in part on one’s appraisal of the stressor and trait level factors that make one more or less vulnerable to the impacts of stress, thus we also include measures that capture acute stress appraisals, measures of threat sensitivity, and psychological resilience measures. We also include descriptions of stress-related biomarkers, with the hopes of growing this section over time.
Network members and affiliates were asked to write a brief summary of key measures within each domain given their expertise, and to have it reviewed by experts in that stress domain. Members chose measures based on their face validity, psychometric qualities, evidence linking them to physical and health outcomes, and length of time it takes to complete them. There were not formal literature reviews or meta-analyses conducted in each domain area. Instead, we relied on the experience of area experts to give us their opinion based on years of work in this area. Because our goal is to help improve stress measurement in epidemiologic studies in particular, we asked Network experts to select short measure in their evaluation. Note that for self-report measures, we discourage choosing specific items from the scale. In order to compare effect sizes or results across studies, it is important to have the full scale so scores can be calculated accurately and consistently.
Stress measures can be self-report questionnaires, interviews, physiological measurements, or task-based measures. We have not included full information on task-based measures. Other resources have been created that take more comprehensive and empirical approaches to psychosocial measure recommendations such as those found here: ADOPT, NIH Toolbox, PROMIS, and PhenX Toolkit.
We'd appreciate any input on these summaries, and welcome additions entries. Contact information is provided at the end of each Toolbox entry, and general questions can be directed at .