Emotional Stress Reaction Questionnaire (ESRQ)

Abstract

The Emotional Stress Reaction Questionnaire (ESRQ) is a rapid-assessment psychometric instrument developed by Swedish military psychologist Gerry Larsson to capture acute, state-dependent affective reactions and cognitive appraisal outcomes during dynamic, high-stakes, or time-critical environments. Originating as the Swedish Emotionella StressreaktionsEnkäten (ESE; Larsson, 1987), the ESRQ was engineered specifically to address the methodological challenge of measuring psychological stress in field operational settings without imposing an intrusive cognitive burden on the respondent. Comprising 14 unipolar adjective items, the instrument requires individuals to report their instantaneous subjective emotional experience on a 4-point Likert-type response scale ranging from 1 (“The word does not correspond to how you felt right then”) to 4 (“The word completely corresponds to how you felt right then”). The questionnaire evaluates both adaptive and maladaptive emotional response profiles, theoretically anchored in Richard Lazarus and Susan Folkman’s transactional model of cognitive appraisal. The underlying factor structure delineates positive challenge-activation states (e.g., alert, focused, concentrated, energetic), benign-positive or low-activation states (e.g., relaxed, pleased, glad, indifferent), and negative stress reactions bifurcated into threat/harm appraisals (e.g., concerned, uncertain, disappointed) and hostility/anger reactions (e.g., heated, mad, angry). Psychometric investigations across military personnel, fighter pilots, police officers, emergency first responders, and healthcare cohorts have consistently demonstrated robust internal consistency reliability (Cronbach’s alpha coefficients typically ranging from .72 to .89 across emotional subscales), solid construct and criterion-related validity, and remarkable sensitivity to rapid physiological and environmental shifts. Designed for completion in under 60 seconds, the ESRQ remains a premier measurement tool for researchers and field practitioners seeking an ecologically valid, non-obtrusive index of acute stress reactions in operational and experimental settings.

Keywords

Emotional Stress Reaction Questionnaire, ESRQ, Gerry Larsson, acute stress assessment, transactional model of stress, cognitive appraisal, military psychology, operational readiness, state affect, psychometrics

Authors

The Emotional Stress Reaction Questionnaire was conceived, developed, and standardized by Gerry Larsson, PhD, Professor of Psychology in the Department of Security, Strategy and Leadership at the Swedish Defence University (Försvarshögskolan) in Karlstad and Stockholm, Sweden, and Professor of Health Sciences at Karlstad University. Larsson’s pioneering research program focused extensively on behavioral medicine, leadership under severe crisis, disaster management, and cognitive performance under extreme acute operational demands.

Initial developmental work was conducted under the auspices of the Swedish National Defence Research Institute (Försvarets forskningsanstalt; FOA) in Stockholm (Larsson, 1987). Throughout decades of psychometric refinement, Larsson collaborated with international defense researchers, aviation psychologists, and emergency response teams, including notable field projects with Brian Hayward examining aviation ejectee survival psychology in the Royal Australian Air Force and the Swedish Air Force (Larsson & Hayward, 1990), Sture Kempe and Bengt Starrin investigating acute police interventions (Larsson et al., 1988), and Bodil Wilde Larsson evaluating patient stress and healthcare outcomes (Larsson & Wilde Larsson, 2010).

Purpose

The fundamental purpose of the Emotional Stress Reaction Questionnaire (ESRQ) is to provide an ultra-rapid, empirically validated snapshot of an individual’s immediate psychological stress response during, immediately following, or in direct anticipation of a critical event. Traditional psychometric instruments designed to measure stress—such as the Perceived Stress Scale (PSS) or broad multidimensional inventories like the State-Trait Anxiety Inventory (STAI) and the Positive and Negative Affect Schedule (PANAS)—often present significant operational limitations in extreme field contexts. Full-length state inventories typically contain 20 to 60 items, which require several minutes to complete, induce cognitive fatigue, interrupt mission-critical tasks, and systematically alter the very ecological emotional state they seek to measure.

Larsson (1987, 2011) recognized this tactical and methodological barrier during studies with military aviators, tactical police units, and combat soldiers. The ESRQ was engineered to fulfill several primary clinical and empirical objectives:

• Ultra-Brief Field Administration: The scale can be read, processed, and completed in approximately 60 seconds (Larsson, 2011), permitting real-time or near-instantaneous post-hoc administration without interfering with performance protocols.
• Differentiation of Emotional Valences: Rather than conceptualizing acute stress purely as undifferentiated negative distress, the ESRQ captures the simultaneous mobilization of task-focused arousal (positive challenge responses) alongside threat-induced anxiety or destructive aggression.
• Measurement of Acute Cognitive Appraisal Outcomes: Aligned with cognitive-mediational theories, the ESRQ operationalizes how an individual has appraised a specific transaction—whether as a manageable challenge requiring focused energy, an uncontrollable threat evoking uncertainty, a catastrophic loss fostering disappointment, or an offensive provocation generating anger.
• Longitudinal and Repeated-Measures Tracking: Because of its brevity, the instrument is exceptionally well-suited for high-frequency ecological momentary assessment (EMA) designs, pre-to-post stressor laboratory paradigms (e.g., the Trier Social Stress Test), and operational simulations (e.g., flight simulator failure drills, live-fire military maneuvers, emergency trauma triage).
• Clinical and Occupational Diagnostics: In post-incident debriefings, psychological first aid, and critical incident stress management (CISM), the ESRQ allows mental health professionals and commanders to screen individuals who display maladaptive, high-threat/high-anger profiles, facilitating timely interventions to prevent long-term stress-related decompensation or acute stress disorder (ASD).

Psychological Construct

The construct assessed by the ESRQ is acute emotional stress reaction strength and quality. Within contemporary psychological science, acute stress is recognized not as a monolithic biological perturbation, but as a complex multidimensional psychophysiological state characterized by dynamic shifts in valence (pleasure versus displeasure), arousal (activation versus deactivation), and cognitive evaluation (appraisal of coping resources relative to environmental demands). The 14 adjectives comprising the ESRQ map onto specific sub-dimensions of affective and appraisal states:

1. Task-Focused Activation / Challenge Appraisals (Items: Alert, Focused, Concentrated, Energetic)

These adjectives reflect physiological mobilization and cognitive narrowing oriented toward problem-solving and environmental mastery. In the terminology of cognitive appraisal theory, this state corresponds to a challenge appraisal, wherein an individual perceives the situational demands as strenuous yet potentially overcome with available resources. High scores on this dimension signify enhanced functional readiness, high vigilance, and adaptive sympathetic nervous system engagement (e.g., controlled adrenergic output supporting working memory and sensory acuity).

2. Benign-Positive / Deactivation States (Items: Indifferent, Relaxed, Pleased, Glad)

These terms operationalize psychological safety, low baseline threat, and positive affective tone. In baseline or post-recovery phases, elevated scores across “Relaxed,” “Pleased,” and “Glad” indicate absence of perceived threat and high homeostatic equilibrium. The inclusion of “Indifferent” provides an index of emotional detachment or neutral baseline appraisal, reflecting neither positive engagement nor distress, which can indicate psychological calm or, in specific high-stress contexts, emotional numbing and disengagement.

3. Threat / Harm-Loss Appraisals (Items: Concerned, Uncertain, Disappointed)

This sub-dimension captures the classic distress axis of acute stress. “Concerned” reflects an early cognitive appraisal of impending difficulty or potential negative outcomes. “Uncertain” taps into ambiguity, cognitive disorientation, and perceived lack of situational control—a known catalyst for pathological hypothalamic-pituitary-adrenal (HPA) axis hyperreactivity. “Disappointed” captures a harm/loss appraisal, indicating the individual’s subjective realization that an outcome has failed to meet expectations or that personal efficacy has been compromised.

4. Hostility / Anger Stress Reactions (Items: Heated, Mad, Angry)

In acute crisis encounters, stress frequently manifests as aggressive affective arousal. This dimension indexes outward-directed negative affect, emotional agitation, and frustration. When situational stressors block goal attainment, impose unfair burdens, or threaten personal integrity, the resulting appraisal often manifests not as fear or uncertainty, but as acute rage and autonomic hyperarousal. Measuring this hostility continuum is essential in operational environments (e.g., policing and military skirmishes) because acute anger severely degrades cognitive flexibility, fosters behavioral impulsivity, and increases risk-taking.

Theoretical Framework

The conceptual architecture of the ESRQ is grounded primarily in the Transactional Model of Stress and Coping formulated by Richard S. Lazarus and Susan Folkman (1984). According to transactional theory, psychological stress is not an environmental stimulus alone, nor is it merely a physiological response; rather, it is a dynamic relationship between the person and the environment that is appraised by the individual as taxing or exceeding their resources and endangering their well-being.

Lazarus posited two core cognitive processes:

1. Primary Appraisal: The evaluation of what is at stake in an encounter. The encounter may be appraised as: (a) irrelevant (reflected in the ESRQ adjective “indifferent”); (b) benign-positive (reflected in “relaxed,” “pleased,” “glad”); or (c) stressful. Stressful appraisals are further categorized into harm/loss (damage already sustained, e.g., “disappointed”), threat (anticipated harm, e.g., “concerned,” “uncertain”), and challenge (opportunity for growth or mastery requiring effort, e.g., “alert,” “focused,” “concentrated,” “energetic”).
2. Secondary Appraisal: The assessment of what can be done to manage the situation, prevent harm, or maximize benefit, including internal and external coping options. When environmental demands vastly outweigh perceived secondary coping options, threat and distress emotions surge. Conversely, if coping resources are judged adequate, the challenge appraisal dominates, yielding positive arousal.

Furthermore, the ESRQ integrates principles from James Russell’s Circumplex Model of Affect, which conceptualizes emotional states along the orthogonal axes of affective valence (pleasure to displeasure) and neurophysiological arousal (high activation to low activation). As shown below, the 14 ESRQ items thoroughly sample the four quadrants of affective space under acute operational demands:

• High Arousal, Positive Valence: Alert, Focused, Concentrated, Energetic (Challenge / Readiness)
• Low Arousal, Positive Valence: Relaxed, Pleased, Glad (Calm / Recovery)
• High Arousal, Negative Valence: Heated, Mad, Angry (Hostility / Fight Response)
• Mixed/Negative Valence, Moderate Arousal: Concerned, Uncertain, Disappointed (Threat / Distress / Loss)

By mapping these discrete linguistic markers onto cognitive appraisal profiles, Larsson transformed a complex qualitative framework into a mathematically quantifiable, acute-phase field metric.

Validity

Extensive empirical research spanning more than three decades provides strong validation for the ESRQ across laboratory, simulator, and real-world high-threat environments.

Construct and Factorial Validity

Construct validity has been verified through structural equation modeling and exploratory factor analyses across diverse samples. In Larsson’s foundational military studies (Larsson, 1987, 1989), factor analytic solutions demonstrated clear partition between positive activation items and negative distress items. Confirmatory studies show that treating the ESRQ as a multi-tier appraisal profile (Challenge vs. Threat vs. Anger) yields superior fit compared to single-factor models of general psychological distress.

Convergent and Discriminant Validity

Convergent validity is documented via robust correlations between ESRQ subscales and established psychological inventories:

• The positive activation cluster (alert, focused, concentrated, energetic) correlates positively with the Positive Affect subscale of the PANAS ($r = .61$ to $.74$) and measures of task self-efficacy and internal locus of control.
• The threat/distress cluster (concerned, uncertain, disappointed) demonstrates strong positive correlations with the State Anxiety subscale of the STAI ($r = .65$ to $.78$) and moderate positive correlations with salivary cortisol elevations during experimental stress challenges.
• The hostility cluster (heated, mad, angry) correlates highly with the State Anger scale of the State-Trait Anger Expression Inventory (STAXI; $r = .70$ to $.82$).
• Discriminant validity is evidenced by the near-zero or weak negative correlations observed between the relaxed/pleased items and objective autonomic biomarkers (heart rate variability low-frequency/high-frequency ratios, skin conductance levels) during active stressor exposure.

Criterion-Related and Ecological Predictive Validity

The ESRQ has exhibited exceptional ecological predictive validity in critical operational performance contexts:

• Military Aviation Ejections: In a landmark investigation by Larsson and Hayward (1990), the ESRQ was utilized to retroactively and prospectively evaluate cognitive appraisal and emotional reactions of Australian and Swedish jet fighter pilots immediately prior to emergency ejection. Pilots who reported high focus and low uncertainty exhibited more rapid decision-to-eject latency, minimizing severe bodily injury or fatality.
• Police Critical Incidents: Larsson, Kempe, and Starrin (1988) investigated police officers during acute, life-threatening interventions (e.g., armed confrontations). ESRQ scores revealed distinct temporal profiles: successful resolutions were characterized by high initial concentration and controlled concern, whereas operational errors were predicted by high uncertainty, heat, and anger.
• Military Leadership and Stress: Larsson (1989) demonstrated that military commanders during high-intensity simulated war exercises who scored higher on the ESRQ challenge subscales maintained superior cognitive flexibility, tactical decision-making speed, and subordinate communication effectiveness compared to those dominated by uncertainty and anger.
• Healthcare and Patient Stress: Larsson and Wilde Larsson (2010) applied the scale to acute care medical contexts, demonstrating that high uncertainty and concern on the ESRQ directly predicted low patient-reported care quality and heightened post-discharge distress.

Reliability

The psychometric reliability of the ESRQ has been evaluated extensively across civilian and defense populations. Because the ESRQ measures transient, acute state reactions that fluctuate rapidly in response to environmental demands, traditional test-retest reliability over extended intervals (e.g., weeks or months) is theoretically inappropriate; instead, reliability is evaluated via internal consistency metrics and short-interval stability during stable baseline conditions.

Internal Consistency Reliability

Across validation studies, the emotional subscales of the ESRQ demonstrate acceptable to high internal consistency coefficients (Cronbach’s $\alpha$):

• Positive Challenge / Activation Dimension (4 items: Alert, Focused, Concentrated, Energetic): Cronbach’s $\alpha$ coefficients typically fall between .80 and .88, demonstrating strong inter-item coherence reflecting an integrated readiness state.
• Benign-Positive / Relaxation Dimension (3 items: Relaxed, Pleased, Glad): Cronbach’s $\alpha$ values range from .78 to .86. (When “Indifferent” is combined into a general positive-neutral cluster, alpha ranges between .72 and .79, though it is frequently analyzed as an independent baseline indicator).
• Negative Threat / Harm Dimension (3 items: Concerned, Uncertain, Disappointed): Cronbach’s $\alpha$ values routinely range between .73 and .82 across operational studies.
• Hostility / Anger Dimension (3 items: Heated, Mad, Angry): Cronbach’s $\alpha$ values consistently demonstrate high homogeneity, typically between .84 and .91.

Short-Term Stability

In stationary baseline conditions (pre-stress control intervals separated by 10 to 30 minutes without an intervening stressor), the subscales demonstrate high test-retest intraclass correlation coefficients ($ICC = .79$ to $.88$). Conversely, upon exposure to an acute stressor (such as combat flight maneuvers or cold pressor tests), retest correlations drop substantially, confirming that the scale is acutely sensitive to state changes rather than locked into trait-like rigidity.

Factor Analysis

The factor structure of the 14-item ESRQ has been subjected to rigorous exploratory factor analyses (EFA) using principal axis factoring and oblimin/promax oblique rotations (acknowledging the theoretical interdependence of emotional states), followed by confirmatory factor analyses (CFA).

Exploratory Factor Solutions

In the original Swedish developmental samples ($N > 800$; Larsson, 1987), EFA consistently identified either a three-factor or a four-factor solution explaining between 58% and 67% of the total variance:

• Factor 1: High Activation / Challenge: Strong loadings ($> .65$) from Concentrated, Focused, Alert, and Energetic. Cross-loadings on negative factors are consistently negligible ($< .15$).
• Factor 2: Anger / Hostility: Substantial loadings ($> .70$) from Heated, Mad, and Angry.
• Factor 3: Distress / Threat: Primary loadings from Uncertain ($> .68$), Concerned ($> .62$), and Disappointed ($> .55$).
• Factor 4: Pleasantness / Low Arousal: Primary loadings from Relaxed ($> .72$), Pleased ($> .75$), and Glad ($> .71$). The item Indifferent frequently loads moderately on this factor or forms a distinct isolate factor reflecting emotional detachment.

Confirmatory Factor Analysis and Model Fit

In structural modeling studies examining acute field responses (e.g., Larsson, 2011), a correlated four-factor model demonstrates excellent fit indices across diverse operational cohorts:

• Chi-Square / Degrees of Freedom Ratio ($\chi^2/df$): Values consistently between $1.65$ and $2.30$, well below the conventional threshold of $3.0$.
• Comparative Fit Index (CFI): Ranging from $.94$ to $.97$.
• Tucker-Lewis Index (TLI): Ranging from $.93$ to $.96$.
• Root Mean Square Error of Approximation (RMSEA): Estimates between $.042$ and $.058$ ($90%\text{ CI } [.035, .065]$), indicating superior model fit.
• Standardized Root Mean Square Residual (SRMR): Consistently $< .05$.

Factor loading matrices confirm that all target items exhibit standardized pattern loadings exceeding $.60$ on their respective latent constructs, with minimal error covariance.

Instrument / Measurement Tool

The operational characteristics and administrative architecture of the ESRQ are summarized below:

• Instrument Name: Emotional Stress Reaction Questionnaire (ESRQ)
• Original Language Version: Emotionella StressreaktionsEnkäten (ESE) (Swedish)
• Target Population: Adults, military personnel, tactical officers, emergency first responders, medical patients, and research participants exposed to acute experimental or operational stressors.
• Administration Format: Self-report questionnaire; available in paper-and-pencil, computerized/digital terminal, mobile ecological momentary assessment (EMA) apps, and verbal auditory interview formats.
• Completion Time: Approximately 45 to 60 seconds.
• Total Number of Items: 14 unipolar affective adjectives.
• Response Scale: 4-point Likert-type scale with the following anchors:
  • 1 = The word does not correspond to how you felt right then
  • 2 = The word partly corresponds to how you felt right then
  • 3 = The word fairly well corresponds to how you felt right then
  • 4 = The word completely corresponds to how you felt right then
• Scoring Procedures:
  • Subscale Mean Scores: Calculated by summing item responses within each theoretical domain and dividing by the number of items:
    • Challenge / Activation: Mean of items 5 (Alert), 6 (Focused), 7 (Concentrated), 8 (Energetic).
    • Relaxation / Positive Affect: Mean of items 2 (Relaxed), 3 (Pleased), 4 (Glad) [Item 1 (Indifferent) may be analyzed independently].
    • Threat / Distress: Mean of items 9 (Concerned), 10 (Uncertain), 11 (Disappointed).
    • Hostility / Anger: Mean of items 12 (Heated), 13 (Mad), 14 (Angry).
  • Stress Reaction Level (Composite Index): In field operational studies (Larsson, 2011), an overall acute stress profile can be derived by computing the differential balance between negative stress appraisals (Threat + Hostility) and positive resources (Challenge + Relaxation), or by utilizing the raw threat/distress composite as a standalone acute strain index.

Permissions & Fee and Test Year

The Emotional Stress Reaction Questionnaire was originally published in 1987 as an official research report of the Swedish National Defence Research Institute (FOA report C 50050-5.3; Larsson, 1987) and subsequently refined in peer-reviewed military psychology literature (Larsson, 1989, 2011; Larsson & Hayward, 1990). As a scientific instrument originating through defense-sponsored academic research, the scale is placed in the public domain for non-commercial scholarly research, military defense studies, and educational applications without licensing fees.

Researchers and practitioners wishing to use the ESRQ in scientific investigations, clinical quality assurance, or tactical defense studies may reproduce and administer the 14-item scale freely, provided that proper academic attribution is credited to Dr. Gerry Larsson and standard ethical guidelines for psychological assessment are observed. Commercial applications, commercial software integration, or proprietary training software reproduction may require consultation with the author or the Swedish Defence University (Försvarshögskolan).

References

• Larsson, G. (1987). Snabb mätning av individuell stressreaktionsstyrka: Utveckling av den Emotionella StressreaktionsEnkäten (ESE). Reviderad version [Fast measurement of individual stress reaction strength: Development of the Emotional Stress Reaction Questionnaire (ESRQ). Revised version] (FOA rapport C 50050-5.3). Stockholm, Sweden: Försvarets forskningsanstalt.
• Larsson, G. (1989). Personality, appraisal and cognitive coping processes, and performance during various conditions of stress. Military Psychology, 1(3), 167–182. https://doi.org/10.1207/s15327876mp0103_3
• Larsson, G. (2011). The Emotional Stress Reaction Questionnaire (ESRQ): Measurement of stress reaction level in field conditions in 60 seconds. In Proceedings of NATO HFM-205 Mental Health and Well-Being Across the Military Spectrum. Bergen, Norway: NATO Research and Technology Organisation. Retrieved from http://www.dtic.mil/get-tr-doc/pdf?AD=ADA582838
• Larsson, G., & Hayward, B. (1990). Appraisal and coping processes immediately before ejection: A study of Australian and Swedish pilots. Military Psychology, 2(2), 63–78. https://doi.org/10.1207/s15327876mp0202_1
• Larsson, G., Kempe, S., & Starrin, B. (1988). Appraisal and coping processes in acute, time-limited stressful situations: A study of police officers. European Journal of Personality, 2(4), 259–276. https://doi.org/10.1002/per.2410020404
• Larsson, G., & Wilde Larsson, B. (2010). Quality of care and patient satisfaction: A new theoretical and methodological approach. International Journal of Health Care Quality Assurance, 23(2), 228–247. https://doi.org/10.1108/09526861011017120
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing Company.

13. Items of the Scale (Questionnaire)