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.

George M. Slavich,Grant S. Shields,Margareth da S. Oliveira,Milton J. Cazassa,Chandler M. Spahr

doi:10.3389/fpsyg.2019.03083

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; Mage = 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 (ricc = 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.

Highlights

A large literature demonstrates that acute and chronic stress exposure can affect individuals’ quality of life, subjective wellbeing, and mental and physical health (Sadir et al, 2010; Slavich, 2016a,b; Epel et al, 2018)
Many major contemporary theories of stress and health posit that stressors occurring over the entire lifespan can exert a cumulative effect on health, whereby stress burden and its negative effects increase over time, very few empirical studies have assessed individuals’ lifetime stress exposure given the difficulty of doing so (Shields and Slavich, 2017)
We addressed this important issue in the present study by translating the Adult Stress and Adversity Inventory (STRAIN) into Brazilian Portuguese, with the ultimate goal of helping to extend high-quality stress assessment to Brazil

Summary

INTRODUCTION

A large literature demonstrates that acute and chronic stress exposure can affect individuals’ quality of life, subjective wellbeing, and mental and physical health (Sadir et al, 2010; Slavich, 2016a,b; Epel et al, 2018). We hypothesized that cumulative lifetime stress exposure, as measured by the Brazilian Portuguese STRAIN, would be associated with the six outcomes assessed but that these effects would vary by stressor type, which has been found previously with the Adult STRAIN (Slavich and Shields, 2018; Slavich et al, 2019a; Sturmbauer et al, 2019) and with other interview-based measures of life stress (e.g., the Life Events and Difficulties Schedule; Brown et al, 1995)

Participants and Procedure

RESULTS

DISCUSSION

ETHICS STATEMENT