Life Experiences Survey

Listed here are some events which sometimes bring about change in the lives of those who experience them and which necessitate social readjustment. Please choose those events which you have experienced in the recent past and indicate the time period during which you have experienced each event. Be sure that all check marks are directly across from the items they correspond to.

Also, for each item checked below, please indicate the extent to which you viewed the event as having either a positive or negative impact on your life at the time the event occurred. That is, indicate the type and extent of impact that the event had. A rating of -3 would indicate an extremely negative impact. A rating of 0 suggests no impact either positive or negative. A rating of +3 would indicate an extremely positive impact.



Section 1

  • Marriage
  • Detention in jail or comparable institution
  • Death of spouse
  • Major change in sleeping habits (much more or much less sleep)
  • Death of close family member:
    • mother
    • father
    • brother
    • sister
    • grandmother
    • grandfather
    • other (specify)
  • Major change in eating habits (much more or much less food intake)
  • Foreclosure on mortgage or loan
  • Death of close friend
  • Outstanding personal achievement
  • Minor law violations (traffic tickets, disturbing the peace, etc.)
  • For men: wife/girlfriend's pregnancy
  • For women: pregnancy
  • Changed work situation (different work responsibility, major change in working conditions, working hours, etc.)
  • New job
  • Serious illness or injury of close family member:
    • father
    • mother
    • sister
    • brother
    • grandfather
    • grandmother
    • spouse
    • other (specify)
  • Sexual difficulties
  • Trouble with employer (in danger of losing job, being suspended, demoted, etc.)
  • Trouble with in-laws
  • Major change in financial status (a lot better off or a lot worse off)
  • Major change in closeness of family members (increased or decreased closeness)
  • Gaining a new family member (through birth, adoption, family member moving in, etc.)
  • Change of residence
  • Marital separation from mate (due to conflict)
  • Major change in church activities (increased or decreased attendance)
  • Marital reconciliation with mate
  • Major change in number of arguments with spouse (a lot more or a lot less arguments)
  • Married men: Change in wife's work outside the home (beginning work, ceasing work, changing to a new job, etc.)
  • Married women: Change in husband's work (loss of job, beginning new job, retiren1ent, etc.)
  • Major change in usual type and/or amount of recreation
  • Borrowing more than $10,000 (buying home1 business, etc.)
  • Borrowing less than $10,000 (buying car, TV, getting school loan, etc.)
  • Being fired from job
  • Men: Wife/girlfriend having abortion
  • Women: Having abortion
  • Major personal illness or injury
  • Major change in social activities, e.g., parties, movies, visiting (increased or decreased participation)
  • Major change in living conditions of family (building new home, remodelling, deterioration of home, neighbourhood, etc.)
  • Divorce
  • Serious injury or illness of close friend
  • Retirement from work
  • Son or daughter leaving home (due to marriage, college, etc.)
  • Ending of formal schooling
  • Separation from spouse (due to work, travel, etc.)
  • Engagement
  • Breaking up with boyfriend/girlfriend
  • Leaving home for the first time
  • Reconciliation with boyfriend/girlfriend

Section 2: Students only

  • Marriage
  • Beginning a new school experience at a higher academic level (college, graduate school, professional school, etc.)
  • Changing to a new school at same academic level (undergraduate, graduate, etc.)
  • Academic probation
  • Being dismissed from dormitory or other residence
  • Failing an important exam
  • Changing a major
  • Failing a course
  • Dropping a course
  • Joining a fraternity /sorority
  • Financial problems concerning school (in danger of not having sufficient money to continue)


There are no right or wrong answers, and consequently no scores. This is an exercise to make you think about the stress in your life, to highlight the issues that may be causing you stress without realising it and to determine for yourself what impact that could be having on your performance, your home life, your work life or any other aspect of your life.