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What’s the scale of judging degree of stress on the PSS?

Chris Kresser: This is one of the questionnaires I provided as an assessment tool for assessing perceived stress back in the HPA axis unit. I believe I mentioned this there, but one of the kind of downsides of that assessment tool is that there is no kind of reference range, per se, where you say, OK, if the client or patient has below this score then they’re OK, and if it’s above this range they’re not OK. The PSS is not really a diagnostic instrument. There are no score cutoffs. There are only comparisons within groups. But there’s a slide from the HPA diagnosis presentation. It was early on in the presentation where we talked about the scale, and it showed the averages segmented by gender, age, and race. The average ranges from about 12 to 14. So the way to use this is if someone has a significantly higher score than is indicated by the average for their gender, age, or race, then there’s more of a likelihood for HPA-D, whereas if there is a significantly lower score, then there’s less of a likelihood—only from the perspective of perceived stress, and remember, that’s only one of the four primary triggers, so it’s possible that perceived stress could be really low, but they have, like, glycemic dysregulation, circadian disruption, and other things that are contributing. Hopefully that helps.

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