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>
Conflict / Stress Questionnaire
Conflict / Stress Questionnaire
Step
1
of
2
50%
Name
*
First
Last
Section (e.g. W001)
*
Headaches
*
Never
Rarely
Sometimes
Often
Always
Stomach aches or tension
*
Never
Rarely
Sometimes
Often
Always
Backaches
*
Never
Rarely
Sometimes
Often
Always
Stiffness in the neck and shoulders
*
Never
Rarely
Sometimes
Often
Always
Inability to concentrate
*
Never
Rarely
Sometimes
Often
Always
Elevated blood pressure
*
Never
Rarely
Sometimes
Often
Always
Fatigue
*
Never
Rarely
Sometimes
Often
Always
General irritability
*
Never
Rarely
Sometimes
Often
Always
Crying
*
Never
Rarely
Sometimes
Often
Always
Forgetfulness
*
Never
Rarely
Sometimes
Often
Always
Nervous, high-pitched laughter
*
Never
Rarely
Sometimes
Often
Always
Yelling
*
Never
Rarely
Sometimes
Often
Always
Blaming
*
Never
Rarely
Sometimes
Often
Always
Feelings of weakness, dizziness
*
Never
Rarely
Sometimes
Often
Always
Bossiness
*
Never
Rarely
Sometimes
Often
Always
Compulsive gum chewing
*
Never
Rarely
Sometimes
Often
Always
Frequent nightmares
*
Never
Rarely
Sometimes
Often
Always
Frequent heartburn
*
Never
Rarely
Sometimes
Often
Always
Compulsive eating or loss of appetite
*
Never
Rarely
Sometimes
Often
Always
Worrying
*
Never
Rarely
Sometimes
Often
Always
Accident prone
*
Never
Rarely
Sometimes
Often
Always
Depression
*
Never
Rarely
Sometimes
Often
Always
Agitation
*
Never
Rarely
Sometimes
Often
Always
Diarrhea, vomiting
*
Never
Rarely
Sometimes
Often
Always
Impatience
*
Never
Rarely
Sometimes
Often
Always
Anger
*
Never
Rarely
Sometimes
Often
Always
Trembling, nervous tics
*
Never
Rarely
Sometimes
Often
Always
Frustration
*
Never
Rarely
Sometimes
Often
Always
Loneliness
*
Never
Rarely
Sometimes
Often
Always
Tendency to startle easily
*
Never
Rarely
Sometimes
Often
Always
Powerlessness
*
Never
Rarely
Sometimes
Often
Always
Inflexibility
*
Never
Rarely
Sometimes
Often
Always
Stuttering
*
Never
Rarely
Sometimes
Often
Always
Compulsive smoking
*
Never
Rarely
Sometimes
Often
Always
Drinking heavily
*
Never
Rarely
Sometimes
Often
Always
Teeth grinding
*
Never
Rarely
Sometimes
Often
Always
Insomnia
*
Never
Rarely
Sometimes
Often
Always
High sugar/caffeine consumption
*
Never
Rarely
Sometimes
Often
Always
Physical Stress Number
Emotional Stress Number
Behavioral Stress Number
Results - Physical Stress
According to your responses, you may experience physical symptoms of stress. Read through the remainder of the powerpoint for more information and suggestions on relieving symptoms of stress. Please note the campus, community and web resources we have provided.
Results - Emotional Stress
According to your responses, you may experience symptoms of emotional stress. Read through the remainder of the powerpoint for more information and suggestions on relieving symptoms of stress. Please note the campus, community and web resources we have provided.
Results - Behavioral Stress
According to your responses, you may experience symptoms of behavioral stress. Read through the remainder of the powerpoint for more information and suggestions on relieving symptoms of stress. Please note the campus, community and web resources we have provided.
Results - Managable Stress
Your stress levels seem to be low and manageable.
Submit this form to complete this assignment.
Δ
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