1. Pain causes me to leave the table before others are finished eating.
2. Pain makes me irritable.
3. When I wake up in the morning I dread the start of a new day.
4. I am likely to lose patience with problems that can't be easily solved.
5. I find it hard to be objective and realistic.
6. Drinking alcohol makes my pain less burdensome.
7. I fail to get my exercise during the course of the day.
8. Entertaining friends increases my pain discomfort.
9. When I visit the doctor, pain is my usual complaint.
10. I use narcotic pain relievers.
11. Sexual relations are difficult and tense.
12. When I am hurting, I want to be left alone.
13. My children find me grouchy.
14. Friends avoid asking me about my pain.
15. I take more than 10 pills a day.
16. I have sexual relations less than once a week.
17. I frequently call in sick to my job.
18. Life's problems seem to pile up.
19. I will leave a movie or show early because of physical discomfort.
20. I have the feeling that my husband/wife is not as close to me as he/she once was. Answer key
1 -- Frequently
2 -- Occasionally
3 -- Hardly ever Score
Less than 30 -- Major stress
30-45 -- Moderate stress
More than 45 -- Little effect From the book, Pain Control, the Bethesda Program