uestion 11
The Kiasu Behaviour Scale

Circle one number for each of the statements below which best reflects the way you behave in your everyday life.

I must not lose in any competition. 10 9 8 7 6 5 4 3 2 1 Not bothered about winning or losing.
If I don’t do well people will not respect me. 10 9 8 7 6 5 4 3 2 1 Indifferent to others’ opinion.
When there is an assignment I must read everything on the topic. 10 9 8 7 6 5 4 3 2 1 Will read only the minimum required
Uncomfortable when I hear the success of someone I knew. 10 9 8 7 6 5 4 3 2 1 Glad to hear of others’ success.
Dislike people who are better. 10 9 8 7 6 5 4 3 2 1 No ill feeling towards people who are better.
Losing any competition is shameful. 10 9 8 7 6 5 4 3 2 1 Losing is not shameful.
Feel nervous if I don’t have all the facts at my finger tips. 10 9 8 7 6 5 4 3 2 1 Is calm even if not fully prepared.
Am envious of one or more of my relatives. 10 9 8 7 6 5 4 3 2 1 Not envious of any relatives.
Think most people would want to be better than me. 10 9 8 7 6 5 4 3 2 1 Do not think people want to be better than me.
Don’t like to share information with others. 10 9 8 7 6 5 4 3 2 1 Share information with others.
Total:________
A score of more than 50 indicates a Kiasu behaviour tendency.

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uestion 12
Is there a checklist to assess my stress level?

From our research and clinical experience we have constructed a stress questionnaire, the Stress Assessment Scale (SAS) for the Asian population.

A score of 4 or more points on the SAS indicates a high stress level and 7 or more is very high stress.

Many patients with an SAS score of 4 or more points have symptoms of anxiety or depressive disorders.

STRESS ASSESSMENT SCALE (SAS)

Score one point for every ‘Yes’ answer.

In the past one month, do you:

  1. have difficulty with your sleep?
  2. feel tired easily?
  3. have tightness in your head or chest?
  4. feel constantly under pressure?
  5. have difficulty in concentration?
  6. find that you no longer enjoy your hobbies or other interests?
  7. feel incapable of making decisions?
  8. feel sad?
  9. feel irritable?
  10. feel that everything is hopeless?

4 or more points indicate high stress level.
7 or more points indicate very high stress level.

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uestion 13
What are the stressful events today?

The Life Events Checklist (LEC) shows the common stressors of patients seen at the NUH Stress Clinic. Patients under stress usually score 30 points or more on the LEC.

LIFE EVENTS CHECKLISTS (LEC)

Put a ( * ) in the ‘Yes’ column for each event which has taken place in the last six months. Then circle a number on the scale, which best describes how stressful the event was to you, e.g. 10 for death of parent or spouse.

Event Yes Scale
1. Death of a spouse 1 2 3 4 5 6 7 8 9 10
2. Death of a parent 1 2 3 4 5 6 7 8 9 10
3. Death of other relatives 1 2 3 4 5 6 7 8 9 10
4. Death of close friend 1 2 3 4 5 6 7 8 9 10
5. Illness (self) 1 2 3 4 5 6 7 8 9 10
6. Caring for elderly or sick person 1 2 3 4 5 6 7 8 9 10
7. Family member unwell 1 2 3 4 5 6 7 8 9 10
8. Marital problem 1 2 3 4 5 6 7 8 9 10
9. Divorce 1 2 3 4 5 6 7 8 9 10
10. Relationship conflict with children/parents 1 2 3 4 5 6 7 8 9 10
11. Relationship conflict with other relatives 1 2 3 4 5 6 7 8 9 10
12. Problems with friends/neighbours 1 2 3 4 5 6 7 8 9 10
13. Getting married 1 2 3 4 5 6 7 8 9 10
14. Pregnancy 1 2 3 4 5 6 7 8 9 10
15. Birth of baby 1 2 3 4 5 6 7 8 9 10
16. Child starting school/nursery 1 2 3 4 5 6 7 8 9 10
17. Family member left home 1 2 3 4 5 6 7 8 9 10
18. Moved house or major house renovation 1 2 3 4 5 6 7 8 9 10
19. Work-related problems 1 2 3 4 5 6 7 8 9 10
20. Change in nature of work 1 2 3 4 5 6 7 8 9 10
21. Changed job 1 2 3 4 5 6 7 8 9 10
22. Unemployed 1 2 3 4 5 6 7 8 9 10
23. Retired 1 2 3 4 5 6 7 8 9 10
24. Financial difficulty 1 2 3 4 5 6 7 8 9 10
25. Others (indicate) 1 2 3 4 5 6 7 8 9 10
Total Score:________

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uestion 14
What is the association between stress and illness?

Stress is related to illnesses in four possible ways. It can:

  1. precipitate an illness,
  2. aggravate an existing illness,
  3. decrease resistance to illness, and
  4. often lead to unhealthy or illness-generating behaviours

Physical illnesses include diseases of the heart, lungs, skin and gut, while mental consequences include anxiety disorders, depression, substance abuse and sometimes hysteria.

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uestion 15
How does stress affect hypertension and heart disease?

Although factors such as diet, obesity, inactivity and smoking are contributory factors in the causation of hypertension, many researchers now agree that stress is probably a primary cause. The connection is as follows: continual activation of the sympathetic nervous system causes release of chemicals, which reduce the elasticity of arteries. This results in changes in the resistance of the blood vessels leading to raised blood pressure. The resulting hypertension can lead to heart disease because of the increased workload on the heart. Raised blood pressure also increases the likelihood of a ruptured artery as in stroke.

Chronic stress and its resulting release of fats into the blood stream are also believed to increase the risk of coronary heart disease due to fatty deposits on the lining of coronary arteries.

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