PSI-4 Parenting Stress Index Fourth Edition

Richard R. Abidin
Polish adaptation:
Joanna Niedziela, Emilia Wrocławska-Warchala
Parents of children aged 0–10
Individual or group administration, no time limit, average time for the full version: 20–30 min., for the abbreviated version PSI-4-SF: 10–15 min.
Especially useful for:
Psychologists (MA in psychology required), other specialists working with children and parents after training in psychometrics and examination method (educational counsellors, psychiatrists, paediatric and psychiatric nurses)
B2 – for psychologists; other professionals only after general psychometric training and test training

The tool is designed to measure the intensity of parental stress understood as a set of processes conducive to aversive psychological and physiological reactions and caused by the attempt to adapt to the requirements of parenthood. The tool focuses on three sources of stress: related to child characteristics, to parent characteristics and, finally, to situational or demographic factors.

The PSI-4 is composed of 120 items, of which 101 are included in the two main scales: the Parent scale and the Child scale. The Parent scale includes the following subscales:

  • Competence (C) – measures how comfortable the parent feels in his/her role and whether his/her performance is successful
  • Attachment (A) – measures how close the relationship between parent and child is as well as a parent’s ability to recognize and fulfil his/her child’s needs
  • Depression (D) – measures a parent’s mood
  • Health (H) measures the extent to which a parent’s health condition affects his/her level of stress   
  • Isolation (I) – measures social support a parent is provided with
  • Role Restriction (RR) – measures the degree to which a parent feels his/her freedom is limited and his/her identity is endangered by the performing of the parent role
  • Spouse/Parenting Partner Relationship (PPR) – measures the sense of emotional and physical support provided by a parent’s spouse or partner 

The Child scale includes the following subscales:

  • Distractability/Hyperactivity (DH) – measures features of child behaviour which fit the symptoms of ADHD
  • Adaptability (AD) – measures the child’s ability to adapt to changes in the social or physical environment
  • Demandigness (D) – measures the parent’s perception of his/her child’s demands
  • Mood (M) – measures the child’s mood
  • Reinforces Parent (RP) – measures the parent’s experience of a relationship with his/her child as reinforcing
  • Acceptability (AC) – measures the extent to which the child’s characteristics fulfil the parent’s demands

The examinee formulates answers using the five grades scale or chooses from among four or five options provided. The Parent and the Child scales together make up the Total Stress Index. Another 19 items are included in the additional Life Stress scale which allows to identify sources of stress beyond the parent-child system (such as a loss of job, death of a family member, divorce). In this case the examinee chooses the Yes or No answer – depending on whether a given event took place within 12 months before the examination. It takes approx. 20 min. to fill out the full version of the PSI-4.

The abbreviated version PSI-4-SF is composed of 36 items drawn from the full version and distributed equally among three scales: Parental Distress (PD), Parent-Child Dysfunctional Interaction (P-CDI) and Difficult Child (DC). Together they form the Total Stress Index. It takes approx. 10-15 min. to fill out the abbreviated version. It allows for a provisional assessment of main stress dimensions and suggesting further diagnosis.

The advantage of the tool is that its clear and coherent theoretical model is solidly embedded in practice. 


  • The theoretical model and the structure of the tool enable to assess parental stress in the context of the whole functioning family system and environment in which the family is located; the subscales allow to locate precisely the sources of stress.

Embedded in practice:

  • Items are clear and straightforward, close to the way parents themselves talk about their problems
  • Scores in scales enable to develop further assessment guidelines
  • The scores also show how the intervention can be planned – whether it should be focused on helping a parent, a child or on strengthening their mutual relationship.

Reliability: The Total Stress Index has a very high internal consistency and so do the main scales in both the PSI-4 and PSI-4-SF. Consistencies for subscales are satisfactory. All scales and subscales have also very high stabilities (as proved in 4 weeks retests).

Validity: To verify validities of the Child and Difficult child scales which measure stress related to aspects of child functioning correlations with children disorders measures such as ASRS, CDI-2, CONNERS-3 and SENA were examined. Correlations between, on the one hand, the Parent scale in the PSI-4 and the Parental Distress scale in the PSI-4-SF and, on the other, the general measure of experienced stress PSS-10 and the stress personality as pleasured by the DS-14 were also examined. Expected correlations were found out and the research with clinical groups proved that intensities of parental stress measured by the PSI-4 were higher in parents with children diagnosed with autism spectrum disorders as well as in parents having premature babies who experienced serious health problems.

Norms: S-ten and centile norms common for mothers and fathers.
The sample contained a total of 924 parents (incl. 497 mothers and 427 fathers) ; there was an equal representation of the parents of boys and girls as well as proportionate representations of various child ages.


  • The PSI-4 is applicable for family therapies and programs serving to increase parental competences through diagnosis of problematic areas incl. programs which are preventive and directed at an early stage intervention – the high level of stress may be related to child neglect, use of violence or bad parental practices).
  • The PSI-4 serves to identify problematic areas in the parent-child system and to recognize whether therapeutic intervention should be focused on helping a parent or a child or on strengthening their mutual relationship  
  • As the high level of stress is often related to a parent’s premature decision to discontinue his/her child’s therapy or to a failure to observe medical recommendations the PSI-4 may be of much help in such situations suggesting a parent-focused intervention.

The tool may be especially useful to examine:

  • Parents reporting educational problems with their children  
  • Single parents or those having problems with their partner-parents or with establishing parental alliance
  • Parents of children diagnosed with neuro-developmental disorders, mood disorders and having other health problems – to evaluate the intensity of stress related to upbringing of a child who requires high level of parental commitment
  • Foster or adoptive parents – to define the type of support a family is in need of and/or to evaluate a possibility of including another child in it.


  • Original manual (translated into Polish)
  • Polish manual
  • PSI-4 question sheets (25 cop.)
  • Multi-layered PSI-4 answer sheets with a key (25 cop.)
  • PSI-4 profile sheets (25 cop.)
  • Multi-layered PSI-4-SF question and answer sheets with a key and norms (25 cop.)
Please note: All of our tests are published in Polish. There are not available other language versions of our tools.

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