Make your own free website on Tripod.com

Mouth Ulcers & PSS (Perceived Stress Scale)


Note: Please remember All results are in the strictest confidence.

Section A.

Are you male or female?

female
male

What is your age?

up to 15
16-25
26-35
36-45
46-55
56-65
66+

1. Have you experienced any small, but painful, ulcerations in your mouth over the last month?

no
yes

If 'yes' how many?

2. Are you aware of any alergies that may have caused the ulceration(s) in your mouth?

no
yes

If 'yes' what substance may have caused it/them?

3. Are you suffering from any medical condition that may have caused the ulceration(s) in your mouth?

no
yes

If 'yes' what condition may have caused it/them? (This is optional, you may leave this blank .


4. Do you have a history of mouth ulcers, i.e. have you suffered from them for some time?

no
yes

If 'yes' can you remember how many years (approx.) you have suffered from them?


Section B.

The Perceived Stress Scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is a measure of the degree to which situations in your life are appraised as stressful. Items were designed to tap how unpredictable, uncontrollable, and overloaded you find your life. The scale also includes a number of direct queries about current levels of experienced stress.

Directions: The questions in this scale ask you about your feelings and thoughts during the last month. In each case, you will be asked to indicate how often you felt or thought a certain way.

For each question choose from the following alternatives:

  1. never
  2. almost never
  3. sometimes
  4. fairly often
  5. very often




1. In the last month, how often have you been upset because of something that happened unexpectedly?
never
almost never
sometimes
fairly often
very often

2. In the last month, how often have you felt that you were unable to control the important things in your life?
never
almost never
sometimes
fairly often
very often

3. In the last month, how often have you felt nervous and "stressed"?
never
almost never
sometimes
fairly often
very often

4. In the last month, how often have you felt confident about your ability to handle your personal problems?
never
almost never
sometimes
fairly often
very often

5. In the last month, how often have you felt that things were going your way?
never
almost never
sometimes
fairly often
very often

6. In the last month, how often have you found that you could not cope with all the things that you had to do?
never
almost never
sometimes
fairly often
very often

7. In the last month, how often have you been able to control irritations in your life?
never
almost never
sometimes
fairly often
very often

8. In the last month, how often have you felt that you were on top of things?
never
almost never
sometimes
fairly often
very often

9. In the last month, how often have you been angered because of things that were outside of your control?
never
almost never
sometimes
fairly often
very often

10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
never
almost never
sometimes
fairly often
very often






Back to the mainpage.