Stress Response Scale-18 (SRS-18)

We used the Stress Response Scale (SRS-18) to evaluate psychological stress [³⁹]. The SRS-18 has 18 items involving three factors: depression-anxiety, irritability-anger, and helplessness [³⁹]. Participants rated stress response on a 4-point Likert scale ranging from 0 (“never true”) to 3 (“almost always true”). Higher scores indicated greater levels of stress response. The SRS-18 has adequate reliability and content and discriminant validity [³⁹]. Cronbach’s alpha coefficient was 0.96 in this study.