Perceived Wellness Survey (PWS)

1. Abstract

The Perceived Wellness Survey (PWS) is a multidimensional, salutogenic psychometric instrument developed by Troy B. Adams, Janet R. Bezner, and Mary A. Steinhardt (1997) to measure an individual’s perception of their overall wellness across six interconnected life domains. Distinct from traditional pathogenic or deficit-oriented health status inventories that assess symptoms, disease prevalence, or functional limitations, the PWS is anchored in positive psychological theory and holistic systems models of wellness. It conceptualizes wellness not merely as the absence of illness, but as an active, integrated process characterized by positive self-evaluations across six primary dimensions: psychological (often termed mental health/optimism), emotional (self-esteem and self-concept), social (perceived interpersonal support and mutual trust), physical (perceived bodily efficacy and vitality), spiritual (meaning, purpose, and mission in life), and intellectual (optimal mental stimulation and continuous cognitive engagement).

Comprising 36 items equally distributed across the six subscales (6 items per dimension), the instrument utilizes a fully anchored, balanced 6-point Likert response format ranging from 1 (Very strongly Disagree) to 6 (Very strongly Agree), deliberately omitting an ambivalent midpoint to elicit decisive evaluations. Half of the inventory items (18 items) are negatively worded and reverse-scored to attenuate acquiescence response set bias. A unique structural and theoretical feature of the PWS is its dual-parameter scoring methodology: it computes not only dimension-specific composite scores and a composite Wellness Magnitude score (the unweighted mean across all six dimensions), but also a Wellness Balance metric (operationalized using the standard deviation across dimension means). This balance index quantifies systemic equilibrium versus dimensional disparity, operationalizing the holistic axiom that genuine wellness requires equitable resource allocation across all functional spheres.

Extensive psychometric investigations across diverse adult, collegiate, and clinical populations have consistently demonstrated strong psychometric properties for the PWS. Dimensional internal consistency reliability coefficients (Cronbach’s α) typically range from .64 to .85 across subscales, with composite perceived wellness demonstrating high reliability ranging from .88 to .93. Confirmatory factor analyses (CFA) have affirmed the viability of a hierarchical, multidimensional structure comprising six correlated first-order factors subsumed under an overarching second-order perceived wellness construct. Convergent and construct validity have been robustly corroborated through significant correlations with dispositional optimism, hardiness, self-actualization, physical vitality, and systemic physiological markers (such as cardiovascular risk profiles and immune markers), alongside significant negative associations with perceived stress, depression, anxiety, and somatic distress.

2. Keywords

Perceived Wellness Survey, PWS, holistic wellness, multidimensional health assessment, salutogenesis, psychological wellness, spiritual well-being, wellness balance, psychometrics, health promotion, positive psychology, quality of life

3. Authors

The Perceived Wellness Survey was conceptualized and empirically validated through the collaborative academic efforts of:

• Troy B. Adams, Ph.D. — Department of Kinesiology and Health Education, The University of Texas at Austin; subsequent appointments in health promotion and behavioral science research. Dr. Adams pioneered the operationalization of the wellness balance paradigm and the development of salutogenic assessment instruments in lifestyle medicine and workplace health.
• Janet R. Bezner, PT, Ph.D., FAPTA — Associate Professor and later Chair/Professor in the Department of Physical Therapy at Texas State University; former Vice President of Education and Governance for the American Physical Therapy Association (APTA). Dr. Bezner specializes in health promotion, wellness integration in physical rehabilitation, and preventative lifestyle interventions.
• Mary A. Steinhardt, Ed.D., LPC — Professor of Health Behavior and Health Education, Department of Kinesiology and Health Education, The University of Texas at Austin. Dr. Steinhardt is widely recognized for her empirical research on psychological resilience, occupational stress resilience, chronic disease self-management, and motivational determinants of well-being.
• Collaborating Psychometricians on Extended Validation Studies: Laura L. Garner, Ph.D., Susan I. Woodruff, Ph.D. (San Diego State University), and Robert J. Zambarano, Ph.D. (The University of Texas at Austin).

4. Purpose

The primary purpose of the Perceived Wellness Survey is to provide a theoretically grounded, psychometrically rigorous instrument capable of assessing perceived health and vitality through a positive, non-deficit framework. For decades, medicine, clinical psychology, and epidemiologic public health defined health primarily through a pathogenic paradigm—measuring morbidity, physical symptomatology, psychiatric disorders, physical impairment, and mortality risk. While measures such as the Medical Outcomes Study 36-Item Short Form (SF-36) successfully captured health-related quality of life, they remained tethered to limitations in functional ability and symptom burden. The PWS was deliberately engineered to transcend this deficit model by capturing the salutogenic, proactive, and self-actualizing dimensions of human existence.

The instrument was built to fulfill three major clinical and empirical objectives:

1. Operationalization of Salutogenic Wellness: The PWS measures how individuals cognitively perceive their capabilities, resources, and vitality across their psychological, emotional, social, physical, spiritual, and intellectual spheres. By focusing on perceived internal reserves rather than objective pathology, the tool captures an individual’s subjective appraisal of salutary resilience.
2. Empirical Assessment of the Balance Paradigm: A fundamental tenet of holistic wellness philosophy is that wellness is not simply a high score in one dominant domain (e.g., hyper-focusing on physical fitness while neglecting interpersonal relationships or spiritual purpose). Rather, wellness is an interactive, integrated system where discordance or extreme imbalance between dimensions introduces systemic vulnerability. The PWS provides an explicit operational model to measure both the magnitude (overall elevation) and the balance (degree of parity or minimal variance across subscales) of an individual’s perceived wellness.
3. Application Across Preventative, Corporate, and Clinical Settings: In preventative medicine, corporate health promotion, university counseling, and physical therapy, the PWS serves as a baseline diagnostic profile, an educational intervention framework, and an outcome assessment measure. Practitioners utilize the six-dimensional profile to help clients identify neglected dimensions of health, cultivate cognitive-emotional strengths, and monitor longitudinal improvements resulting from lifestyle medicine interventions.

5. Psychological Construct

The construct assessed by the Perceived Wellness Survey is Perceived Wellness, conceptualized as a multi-layered, holistic constellation of positive cognitive appraisals concerning one’s personal resources, self-efficacy, and functional capacity across six primary domains of human functioning. Crucially, Adams and colleagues emphasized that wellness is inherently subjective: how an individual perceives and evaluates their status within each domain exerts a more direct and profound influence on neuroendocrine function, behavioral health choices, and affective states than objective physiological parameters or external socio-demographic criteria alone.

The six dimensions evaluated within the PWS construct are defined as follows:

1. Psychological Wellness (Mental Health / Dispositional Optimism)

Psychological wellness reflects an individual’s cognitive appraisal of their future expectations and generalized positive life outlook. Rooted in the dispositional optimism framework of Scheier and Carver, this dimension assesses the degree to which an individual expects positive rather than negative outcomes to manifest in their life. Individuals exhibiting high psychological wellness anticipate favorable circumstances, view life challenges as surmountable, and maintain an enduring cognitive conviction that good things will predominate. Representative items evaluate prospective hopefulness versus generalized pessimism (e.g., expecting the best, anticipating bright prospects, or anticipating pervasive failure).

2. Emotional Wellness (Self-Esteem and Self-Acceptance)

Emotional wellness evaluates an individual’s self-concept, sense of self-worth, and internal security. Departing from transient mood states or emotional reactivity, emotional wellness within the PWS operationalizes enduring feelings of self-confidence, unconditional self-worth, and positive self-regard. High emotional wellness is manifested in an individual who respects themselves, maintains a stable sense of security in social or unfamiliar situations, and is insulated against chronic feelings of inferiority or worthlessness. Conversely, compromised emotional wellness involves deep-seated self-doubt, vulnerability to external invalidation, and perceived inadequacy.

3. Social Wellness (Interpersonal Connectedness and Social Support Reciprocity)

Social wellness represents an individual’s perception of having a stable, trustworthy, and mutually rewarding social support network. Grounded in interpersonal attachment theory and social capital research, this dimension captures both the availability of support (family and friends who are perceived as reliably accessible during times of crisis) and reciprocal support efficacy (the subjective sense that others value, seek out, and confide in the individual for guidance). High social wellness reflects embeddedness in high-trust relationships, whereas low social wellness signifies isolation, perceived abandonment, and relational estrangement.

4. Physical Wellness (Perceived Somatic Competence and Biological Resilience)

Physical wellness reflects the subjective perception of one’s bodily vigor, physical resilience, and functional immunity against illness. Rather than enumerating specific medical diagnoses or lab values, this dimension captures the individual’s cognitive appraisal of their somatic capability—whether their physical body enables unhindered participation in desired life pursuits, resists infections effectively, and maintains enduring stamina. High scorers view their body as a reliable, robust instrument of personal vitality, whereas low scorers perceive their body as fragile, chronically restrictive, or vulnerable to deterioration.

5. Spiritual Wellness (Existential Purpose and Transcendent Meaning)

Spiritual wellness captures the degree to which an individual experiences an overarching sense of meaning, existential coherence, and personal mission in life. Independent of formal sectarian dogma, this construct operationalizes the human need for teleological grounding—the conviction that one’s life possesses intrinsic value, intentionality, and positive direction. Individuals with high spiritual wellness report a clear sense of personal destiny or mission, understand their fundamental life purpose, and exhibit resilience when confronted with existential ambiguity. Low spiritual wellness is characterized by feelings of futility, aimlessness, and existential despair.

6. Intellectual Wellness (Cognitive Engagement and Stimulus Optimization)

Intellectual wellness assesses an individual’s proactive engagement in mentally stimulating activities, cognitive curiosity, and the perception of optimal informational processing. Grounded in flow theory and cognitive appraisal models, this dimension evaluates whether an individual seeks out intellectual challenges, actively utilizes critical reasoning to solve problems, and experiences an optimal balance in daily cognitive inputs (avoiding both intellectual boredom and cognitive sensory overload). High scorers actively seek learning opportunities and view cognitive growth as indispensable to their well-being.

6. Theoretical Framework

The Perceived Wellness Survey is grounded in an integrative synthesis of general systems theory, salutogenic health paradigms, and positive humanistic psychology. The theoretical architecture developed by Adams, Bezner, and Steinhardt (1997) rests upon three foundational conceptual pillars:

1. Antonovsky’s Salutogenic Paradigm and the Health-Ease vs. Dis-ease Continuum

The philosophical cornerstone of the PWS is derived from Aaron Antonovsky’s salutogenic model of health (1979, 1987). Antonovsky argued that Western medicine operated under a deeply flawed, binary assumption that categorized individuals as either “diseased” or “healthy.” Instead, he posited that all human beings navigate an omnipresent continuum between total “dis-ease” and “health-ease.” The primary determinant of an individual’s location along this continuum is their cognitive appraisal of Generalized Resistance Resources (GRRs)—factors such as optimism, social support, existential purpose, and cognitive capacity that enable adaptive coping. The PWS explicitly operationalizes GRRs across six human dimensions, measuring the presence of internal and interpersonal assets rather than measuring symptom severity.

2. General Systems Theory and the Concept of Wellness Balance

Drawing directly from Ludwig von Bertalanffy’s General Systems Theory, Adams and colleagues conceptualized the human organism as an open, dynamic, self-regulating biological and psycho-social system. Within this systems framework, the whole is greater than the sum of its constituent parts, and every subsystem interacts non-linearly with all others. A critical postulate introduced in the PWS theoretical framework is that balance across dimensions is structurally paramount. In systemic terms, an organism exhibiting extreme functional discrepancy—for instance, an individual who maximizes physical and intellectual performance while suffering from chronic emotional self-loathing or relational isolation—maintains an unstable system vulnerable to catastrophic collapse under stress.

To mathematically capture this systemic property, Adams et al. (1997) proposed a mathematical wellness algorithm that computes wellness balance ($B$) based on the standard deviation ($SD$) of the respondent’s dimension scores:

$$\text{Perceived Wellness Composite} = \overline{X}_{\text{Magnitude}} \times \left(1 – \frac{SD_{\text{Dimensions}}}{\text{Max Scale Variance Factor}}\right)$$

Through this formula, individuals with identical mean scores (Magnitude) achieve differential composite scores depending on their balance: individuals with balanced profiles retain their high magnitude, whereas individuals with high internal dimensional dispersion suffer a mathematical penalty that reflects systemic vulnerability.

3. Cognitive Phenomenological Theory

The theoretical framing of the PWS relies extensively on Richard Lazarus and Susan Folkman’s Cognitive Mediational Theory of Stress and Coping. Lazarus demonstrated that objective external realities are filtered through primary and secondary cognitive appraisals. Whether an event induces neuroendocrine distress or promotes growth depends on the individual’s appraisal of their resources relative to external demands. By assessing perceptions of wellness across domains rather than external metrics (e.g., assessing whether the respondent perceives their family as supportive, rather than counting the number of family members), the PWS evaluates the psychological reality that directly drives physiological stress responses, endocrine regulation, and lifestyle decision-making.

7. Validity

The psychometric validity of the Perceived Wellness Survey has been rigorously evaluated across a broad spectrum of empirical studies involving collegiate samples, corporate employees, community adults, and clinical cohorts.

Construct and Factorial Validity

Construct validity was initially established through both exploratory and confirmatory factor analytic studies by Adams, Bezner, and Steinhardt (1997) and subsequently cross-validated in independent cohorts (Adams, Bezner, Garner, & Woodruff, 1998; Adams et al., 2000). Confirmatory factor analysis (CFA) supported the hypothesized six-dimensional oblique model, confirming that the six dimensions reflect distinct yet inter-correlated facets of a higher-order wellness construct. Factor loadings for individual items onto their designated target latent factors consistently demonstrate moderate to high magnitudes, ranging predominantly between .50 and .84.

Convergent and Concurrent Validity

Convergent validity has been repeatedly demonstrated through expected correlations with established, gold-standard psychological and health measures:

• Dispositional Optimism: The Psychological subscale correlates strongly with the Life Orientation Test-Revised (LOT-R) ($r = .65$ to $.78, p < .001$), supporting its grounding in optimism theory.
• Self-Esteem: The Emotional subscale demonstrates high convergent validity with the Rosenberg Self-Esteem Scale (RSES) ($r = .70$ to $.82, p < .001$).
• Social Support: The Social subscale correlates substantially with the Multidimensional Scale of Perceived Social Support (MSPSS) ($r = .62$ to $.75, p < .001$).
• Spiritual Meaning: The Spiritual subscale correlates significantly with the Purpose in Life Test (PIL) and the Spiritual Well-Being Scale (SWBS) ($r = .68$ to $.81, p < .001$).
• General Hardiness: Total PWS composite scores correlate positively with Kobasa’s Hardiness Scale ($r = .55$ to $.68$), demonstrating that high perceived wellness aligns with high commitment, control, and challenge orientations.

Discriminant and Criterion-Related Validity

Discriminant validity has been demonstrated by significant inverse relationships with clinical distress inventories. Total perceived wellness correlates negatively with Cohen’s Perceived Stress Scale (PSS; $r = -.52$ to $-.66$), the Beck Depression Inventory (BDI; $r = -.48$ to $-.61$), and the State-Trait Anxiety Inventory (STAI; $r = -.45$ to $-.58$). Furthermore, studies testing physiological criterion validity revealed that higher composite PWS scores significantly predict lower cardiovascular disease risk factors, reduced resting blood pressure, healthier lipid profiles (higher HDL/LDL ratios), and lower absenteeism rates in corporate workplace environments (Adams et al., 1998).

Cross-Cultural Validity

The cross-cultural applicability of the PWS has been corroborated across multiple global translations and cultural contexts. For example, Kaveh, Ostovarfar, Keshavarzi, and Ghahremani (2016) validated the Persian version of the PWS in an Iranian population, reporting robust fit indices for the six-factor model and confirmation of convergent validity with physical and mental health summary scales of the SF-12 ($p < .001$).

8. Reliability

The reliability of the Perceived Wellness Survey has been examined through internal consistency calculations (Cronbach’s alpha, α) and temporal stability tests (test-retest intraclass correlation coefficients):

Internal Consistency Reliability

Across validation samples, the PWS has consistently shown acceptable to excellent internal consistency:

• Composite PWS Scale (Total 36 Items): Cronbach’s α ranges between .88 and .93 in baseline and cross-validation cohorts (Adams et al., 1997, 1998; Harari et al., 2005), indicating high internal cohesion for the overall perceived wellness measurement.
• Psychological Subscale (6 items): α = .75 to .84
• Emotional Subscale (6 items): α = .73 to .82
• Social Subscale (6 items): α = .71 to .80
• Physical Subscale (6 items): α = .72 to .85
• Spiritual Subscale (6 items): α = .76 to .86
• Intellectual Subscale (6 items): α = .64 to .74

While the intellectual subscale occasionally registers internal consistency values slightly below .70 in certain young adult or collegiate samples (attributed to varying interpretations of daily informational volume balance), the remaining five subscales and the total composite scale consistently meet the strict psychometric benchmark of α ≥ .70 established for research and screening tools.

Test-Retest Temporal Stability

Test-retest reliability was evaluated across a two-week interval in an adult validation cohort ($N = 112$). Intraclass correlation coefficients (ICC) demonstrated high temporal stability over time without exhibiting undue trait-level rigidity:

• Composite Perceived Wellness score: $r_{tt} = .87$
• Psychological subscale: $r_{tt} = .83$
• Emotional subscale: $r_{tt} = .81$
• Social subscale: $r_{tt} = .85$
• Physical subscale: $r_{tt} = .88$
• Spiritual subscale: $r_{tt} = .84$
• Intellectual subscale: $r_{tt} = .79$

These values demonstrate that the PWS measures enduring cognitive dispositions while remaining sensitive enough to capture real shifts resulting from lifestyle modifications, psychotherapy, or health coaching.

9. Factor Analysis

The structural dimensionality of the Perceived Wellness Survey was determined using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) techniques across distinct development and calibration samples.

Exploratory Factor Analysis (EFA)

During preliminary scale purification, item pools were subjected to principal axis factoring with Promax (oblique) rotation to account for expected theoretical correlations among wellness domains. Scree plot inspection and the Kaiser-Guttman criterion (eigenvalues > 1.0) supported a six-factor solution accounting for over 52% of the total variance across the item pool. Items demonstrating severe cross-loadings (> .30 on secondary factors) or inadequate primary loadings (< .40) were eliminated, yielding the final 36-item balance (exactly 6 items per factor).

Confirmatory Factor Analysis (CFA) and Model Fit

In the primary construct validation study by Adams, Bezner, and Steinhardt (1997), CFA was executed to test competing structural models: a single-factor unidimensional model, a six-factor orthogonal model, a six-factor oblique (correlated) model, and a second-order hierarchical model where six first-order factors load onto a general “Perceived Wellness” macro-construct.

As illustrated above, both the six-factor oblique model and the hierarchical second-order model exhibit superior fit compared to unidimensional or orthogonal configurations, with a Root Mean Square Error of Approximation (RMSEA) ≤ .05 and Comparative Fit Index (CFI) ≥ .91. Moderate inter-factor correlations (ranging from $r = .32$ to $.61$) among first-order factors supported their distinction as separate subscales while affirming that they converge on an overarching holistic wellness construct.

10. Instrument / Measurement Tool

• Test Designation: Perceived Wellness Survey (PWS)
• Authors / Developers: Troy B. Adams, Ph.D., Janet R. Bezner, Ph.D., and Mary A. Steinhardt, Ed.D. (1997)
• Construct Assessed: Multidimensional Perceived Salutogenic Wellness (Magnitude and Balance)
• Total Item Count: 36 items
• Dimensional Breakdown (6 items per scale):
  • Psychological Health (Optimism): Items 1, 7*, 13, 19, 25*, 31*
  • Emotional Health (Self-Esteem): Items 2*, 8, 14*, 20*, 26, 32
  • Social Health (Interpersonal Support): Items 3, 9*, 15, 21, 27*, 33
  • Physical Health (Perceived Somatic Vigor): Items 4*, 10, 16, 22, 28, 34*
  • Spiritual Health (Existential Purpose): Items 5, 11*, 17*, 23, 29*, 35
  • Intellectual Health (Cognitive Engagement): Items 6, 12*, 18, 24, 30, 36*
• Item Polarity and Balance: Exactly 18 items are positively worded (scored directly) and 18 items are negatively worded (indicated with an asterisk *, requiring reverse coding: $7 – \text{raw score}$).
• Response Scale: 6-point Likert response scale without a neutral midpoint:
  • 1 = Very strongly Disagree
  • 2 = Strongly Disagree
  • 3 = Disagree
  • 4 = Agree
  • 5 = Strongly Agree
  • 6 = Very strongly Agree
• Administration Format: Self-administered paper-and-pencil or computerized questionnaire. Average administration duration is approximately 7 to 10 minutes.
• Scoring Protocol:
  1. Reverse Coding: Invert all 18 reverse items (Items 2, 4, 7, 9, 11, 12, 14, 17, 20, 25, 27, 29, 31, 34, 36) such that $1 to 6$, $2 to 5$, $3 to 4$, $4 to 3$, $5 to 2$, and $6 to 1$.
  2. Subscale Mean Scores: Calculate the mean of the 6 items for each of the six dimensions (yielding dimensional scores ranging from 1.00 to 6.00).
  3. Composite Wellness Magnitude ($M$): Calculate the overall arithmetic mean across all 36 items (or the mean of the six subscale scores).
  4. Composite Wellness Balance ($B$): Compute the sample standard deviation ($SD$) across the respondent’s 6 subscale mean scores. Lower standard deviations indicate greater balance across dimensions.
  5. Overall Perceived Wellness Score: Calculate the integrated composite metric using the standard Adams et al. formula incorporating both magnitude and balance parameters.

11. Permissions & Fee and Test Year

The Perceived Wellness Survey was first published and placed in the public domain for research and instructional purposes in 1997 in the American Journal of Health Promotion. The authors—Troy B. Adams, Janet R. Bezner, and Mary A. Steinhardt—designed the instrument to advance preventative lifestyle medicine, academic inquiry, and health promotion evaluation.

• Academic and Non-Commercial Research Use: The PWS is available free of charge for non-commercial academic research, university dissertations, clinical education, and non-profit community health evaluation. Formal permission from the authors is not typically required for non-profit academic research, provided that the instrument is cited appropriately and its item wording and response scaling remain unaltered.
• Commercial and Corporate Consulting Licensing: Commercial organizations, corporate wellness consultants, for-profit technology platforms, and digital assessment distributors seeking to integrate the PWS into proprietary products or fee-for-service wellness platforms should seek formal permissions from the primary copyright holders or institutional licensing offices.
• Primary Historical Archival Contact: Detailed psychometric documentation and historical scoring resources were originally archived via the Perceived Wellness research portal at http://www.perceivedwellness.com/.

12. References

Adams, T., Bezner, J., & Steinhardt, M. (1997). The conceptualization and measurement of perceived wellness: Integrating balance across and within dimensions. American Journal of Health Promotion, 11(3), 208–218. https://doi.org/10.4278/0890-1171-11.3.208

Adams, T., Bezner, J., Garner, L., & Woodruff, S. (1998). Construct validation of the Perceived Wellness Survey. American Journal of Health Studies, 14(4), 212–219.

Adams, T. B., Bezner, J. R., Drabbs, M. E., Zambarano, R. J., & Steinhardt, M. A. (2000). Conceptualization and measurement of the spiritual and psychological dimensions of wellness in a college population. Journal of American College Health, 48(4), 165–173. https://doi.org/10.1080/07448480009595692

Adams, T. B., Bezner, J. R., & Steinhardt, M. A. (2013). Perceived Wellness Survey. In C. A. Simmons & P. Lehmann (Eds.), Tools for Strengths-Based Assessment and Evaluation (pp. 138–140). Springer Publishing Company.

Antonovsky, A. (1979). Health, Stress, and Coping: New Perspectives on Mental and Physical Well-Being. Jossey-Bass.

Antonovsky, A. (1987). Unraveling the Mystery of Health: How People Manage Stress and Stay Well. Jossey-Bass.

Harari, M. J., Waehler, C. A., & Rogers, J. R. (2005). An empirical investigation of a theoretically based measure of perceived wellness. Journal of Counseling Psychology, 52(1), 93–103. https://doi.org/10.1037/0022-0167.52.1.93

Kaveh, M. H., Ostovarfar, J., Keshavarzi, S., & Ghahremani, L. (2016). Validation of Perceived Wellness Survey (PWS) in a sample of Iranian population. Malaysian Journal of Medical Sciences, 23(4), 46–53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025062/

Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. Springer Publishing Company.

Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67(6), 1063–1078. https://doi.org/10.1037//0022-3514.67.6.1063

13. Items of the Scale