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Objective: Stress perception depends on cultural and social aspects that vary from one country to another. One of the most widely disseminated methods of assessing psychological stress is the Perceived Stress Scale (PSS-4). Therefore, in order to identify these factors and their impact on mental health, the present study compares the PSS-4 results among three European countries (Great Britain, France and Spain). This study focuses on PSS-4 results within a Spanish sample to determine: (1) normative data, reliability and validity of PSS-4 in a Spanish sample and (2) how stress perception changes depending on cultural and social factors.Methods: The data were obtained from a website representing a service of a smoking cessation program, the study represented a service that was open to all individuals. The number of participants were 37,451. They reported their age, gender, nationality, marital status, education and employment status, and completed two psychological questionnaires (PPS-4 and the anxiety and depression scales of the Symptom Checklist-90-Revised, SCL 90-R).Results: The PSS-4 scores could differentiate between relevant sociodemographic variables (such as sex, age, nationality, marital status, education, parental status, employment status, and income class). The PSS-4 scores showed a positive correlation with the SCL 90-R anxiety and depression scales. The normed values for interpreting the PSS-4 scores are presented. The PSS-4 showed adequate internal consistency and reliability.Conclusions: The PSS-4 is a useful instrument for assessing stress perception levels in the general population in different countries. Its internal consistency is sufficient for a 4-item scale.

Background Internet psychology services are rapidly increasing and that implies online assessment. To guarantee the results of these new online evaluation procedures, it is necessary to have reliable and valid assessment tools.Objective In this work we analyzed the online versions of two popular psychopathology screening questionnaires: the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R).Methods A total of 185 psychology students were recruited from two universities in Madrid, Spain. All of them had Internet access at home. A test-retest situation and factorial analysis were used to generate reliability and validity data. Both paper-and-pencil questionnaires (test) and their online versions (retest) were completed by 100 participants (median gap = 17 days).Results Results suggest that both online questionnaires were fairly equivalent to their paper-and-pencil versions, with higher reliability values for the SCL-90-R. Factorial analysis tended to reproduce the structure shown in former investigations of both questionnaires, replicating the four-factor structure of the GHQ-28 but failing to do so with the nine-factor structure of the SCL-90-R. Instead, a large unrotated factor appeared.Conclusions Further research should be carried out to confirm these data, but our work supports the online use of both assessment tools. The psychometric properties of the online version of GHQ-28 is similar to the paper-and-pencil and we can recommend its utilization in a Web environment. In contrast, SCL-90-R can only be recommended as a global index for psychological distress, using the Global Severity Index (GSI), not necessarily its subscales; and it should be considered that the online scores were lower than the ones with the paper-and-pencil version.

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