The Stress and Adversity Inventory for Adults (Adult STRAIN) in Brazilian Portuguese: Initial Validation and Links With Executive Function, Sleep, and Mental and Physical Health

Abstract

It has been widely hypothesized that stressors occurring over the lifespan exert a cumulative impact on health, but little work has directly tested these theories given the difficulty associated with measuring cumulative stress exposure over the lifespan. We addressed this issue in Brazil by translating the Stress and Adversity Inventory for Adults (Adult STRAIN) into Brazilian Portuguese. We then examined the instrument's usability and acceptability; concurrent, discriminant, predictive, and incremental validity; and test-retest reliability. Participants were 330 Brazilian adults (238 women; M age = 32.16; range: 18-76 years old) who completed the Adult STRAIN in Brazilian Portuguese, Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Perceived Stress Scale (PSS). They also completed measures of socioeconomic status, personality, social desirability, negative affect, physical and mental health complaints, sleep quality, executive function, and doctor-diagnosed general health problems and autoimmune disorders. The STRAIN exhibited excellent usability and acceptability and was completed in 16 min and 27 s, on average. It showed good concurrent validity relative to the CTQ-SF and PSS (rs ≥ 0.377) and good discriminant validity, both with and without adjusting for covariates. In addition, the STRAIN significantly predicted all of the health outcomes assessed except for executive function and explained substantial variance in these outcomes over and above the CTQ-SF, PSS, and covariates assessed. Finally, the test-retest reliability indices for total lifetime stressor count and severity were outstanding (r icc = 0.936 and 0.953, respectively, over M = 34.86 days). The Adult STRAIN in Brazilian Portuguese thus exhibits excellent usability and acceptability, good concurrent and discriminant validity, strong predictive and incremental validity across a variety of health outcomes, and outstanding test-retest reliability. We therefore conclude that the STRAIN is a practical, valid, and reliable instrument for researchers and clinicians looking to efficiently assess cumulative lifetime stress exposure in Brazilian Portuguese.

Cumulative lifetime stress exposure predicts greater impulsivity and addictive behaviors

“…The STRAIN has excellent concurrent, discriminate, and incremental validity, and has been shown to predict a wide variety of cognitive, biological, and health outcomes (e.g. Cazassa et al, 2020; Lam et al, 2019; Mayer et al, 2019; Olvera Alvarez et al, 2019; Pegg et al, 2019; Sturmbauer et al, 2019).…”

Cumulative lifetime stress exposure assessed by the STRAIN predicts economic ambiguity aversion

“…Finally, although the STRAIN has been shown to be insensitive to negative mood and social desirability that can influence participants' reporting of stressors (36,50,51), it is possible that stressors could have been differentially recalled as a result of these or other factors, including individuals' cognitive or resilience profiles. Therefore, we acknowledge that because life stress exposure was retrospectively assessed, we cannot rule out possible reporting or disclosure biases.…”

Using mobile sensing data to assess stress: Associations with perceived and lifetime stress, mental health, sleep, and inflammation

“…The STRAIN has been extensively validated in relation to many different psychological, biological, and health outcomes (e.g. Cazassa et al 30 , Mayer et al 30 , and Sturmbauer et al 32 ). For analyses, we focused on three of the STRAIN’s main outcomes: total count of all stressors, all acute stressors, and all chronic stressors occurring over the life course.…”