Validation of the Perceived Stress Scale in a community sample of older adults

Background Three versions of Perceived Stress Scale (PSS-14, PSS-10, and PSS-4) are among the most widely used measures of stress. The aim of the current study was to validate this instrument in a sample of nondemented older adults to facilitate studies of the impact of stress on health. Methods Seven hundred sixty-eight nondemented adults over the age of 70 years completed the PSS-14 questionnaire and other neuropsychological tests. Exploratory factor analysis was used to determine the underlying factor structure of all PSS versions, and confirmatory factor analysis was used to test the construct validity of factors. The internal consistency reliability of the scales was assessed using Cronbach's alpha, and concurrent validity was evaluated by examining PSS relation with age, gender, depression, anxiety, and Positive Affect and Negative Affect Schedule. Results A two-factor model was the optimal fit for the 14-item and 10-item versions of PSS. For PSS-14, all items' loadings exceeded 0.4 for one of the two factors except item 12. Therefore, we studied a 13-item version of PSS and 10-item and 4-item subsets representing PSS-10 and PSS-4. Internal consistency coefficients were satisfactory for the full scale of PSS-13 and PSS-10 but not for PSS-4. Women reported higher levels of stress than men. Higher levels of total PSS scores showed association with higher levels of depression, anxiety, and negative affect, and lower level of positive affect. Conclusions The 13-item and 10-item versions of PSS may be used to understand the experience of stress among older adults.