Translation and psychometric validation of the Taiwanese daily stress inventory in a young university sample

Abstract

Accurate assessment of daily stressors is crucial for understanding stress-health dynamics, yet culturally adapted instruments are needed for diverse populations. This study translated and psychometrically evaluated the Taiwanese Daily Stress Inventory (TDSI), a Traditional Chinese adaptation of the Daily Stress Inventory (DSI). Data were collected from 470 Traditional Chinese-speaking young adults, predominantly female (86% female, 14% male), with an average age of 19.82 (SD = 2.50). The TDSI demonstrated excellent internal consistency for its core indices (Cronbach’s α and McDonald’s ω > 0.80). Construct validity was supported by significant negative correlations between TDSI indices (Frequency, Sum, Average Impact Rating) and self-reported physical and mental health, confirming that higher daily stress corresponds with poorer health. Analyses of meditation experience were treated as exploratory, given the small proportion of regular practitioners. The findings support the TDSI as a reliable and valid instrument for assessing daily stress in Traditional Chinese-speaking young adults, contributing a needed tool for cross-cultural psychological assessment research and practices.

Supplementary Information

The online version contains supplementary material available at 10.1038/s41598-025-31072-4.

Introduction

Chronic stress is a significant risk factor for developing physical and mental health problems, including cardiovascular disease, anxiety disorders, and depression^1,2. Studies highlight the role of daily stress, distinct from major life events, in exacerbating chronic health conditions such as cardiovascular disease^3–5. Daily stress inventories, such as the original instrument developed by P. Brantley et al.⁴, have provided reliable and valid measures to quantify daily stress and its impacts through standardized self-report assessments^4,6. These tools are essential for advancing research into stress-health relationships, particularly in exploring short-term stress responses and their long-term implications. However, the adaptation of such instruments into different languages and cultural contexts requires meticulous translation to ensure psychometric equivalence. Translation studies must confirm that the translated questionnaire maintains validity, internal consistency, and reliability of the instrument while addressing cultural nuances in stress perception and reporting^7,8. Furthermore, the integration of health-related moderators into the evaluation process is critical^3,9,10.

The Daily Stress Inventory (DSI) is widely recognized for its ability to capture the nuanced relationship between daily stressors and health outcomes. Its three indices—Frequency (FREQ), which quantifies the number of stress events; Sum (SUM), representing the cumulative perceived stress; and Average Impact Rating (AIR), calculated as SUM divided by FREQ to indicate the average intensity of stress—offer a comprehensive framework for understanding stress experiences. These metrics have been associated with both psychological and physiological outcomes, providing valuable insights into the cumulative and immediate effects of daily stressors^4,6. Research has shown that SUM and AIR scores, in particular, are strongly correlated with measures of emotional distress and physiological stress markers, including blood pressure variability and pulse rate fluctuations, while FREQ highlights exposure to stress events^11–13. Despite its established reliability and validity over 35 years in English-speaking populations, the utility of the DSI across cultural contexts has been limited by the lack of peer-reviewed translations.

Language and culture significantly shape how stress is perceived, appraised, and reported^14–17. For instance, collectivist cultures often emphasize relational stressors, such as interpersonal conflict, more than individualistic cultures, while interpersonal conflicts are potent stressors across cultures^2,15,18. Many of the items in the original DSI focus on interpersonal daily stressors, such as “Criticized or verbally attacked,” “Ignored by others,” and “Was misunderstood.” These types of stressors may be perceived differently across cultures. In collectivist societies like Taiwan or Hong Kong, where maintaining social harmony and fulfilling relational expectations are highly valued, such interpersonal events may elicit stronger emotional and cognitive responses compared to individualist cultures¹⁶.

Existing research on the DSI primarily reflects Western cultural contexts, limiting its generalizability to Eastern populations. While the DSI has been validated in Spanish- and Korean-speaking populations^19,20, no psychometrically translated version exists for Traditional Chinese speakers. Although the DSI has been used in simplified Chinese contexts^21–23, these studies did not undergo peer-reviewed translation. Due to differences in character systems, expression, as well as sociocultural norms, traditional and simplified Chinese are not interchangeable. A culturally and linguistically validated Traditional Chinese version is thus essential for use in regions such as Taiwan and Hong Kong, where Traditional Chinese is widely used. This adaptation ensures not only linguistic equivalence but also cultural relevance, addressing unique patterns of stress perception and appraisal.

Buddhism-originated meditation has been widely recognized as an effective stress-reducing intervention for over forty years^2,24,25. A growing body of research has demonstrated its benefits for self-regulation, emotional management, and both mental and physical health^26–29. People with meditation experience generally show advantages in these domains compared with meditation-naïve counterparts^30–32. Given this evidence, the present study also explored whether meditation experience might influence daily stress appraisal as measured by the TDSI^33,34.

The present study had three main aims. The first objective was to translate and culturally adapt the DSI into Traditional Chinese. The second objective was to evaluate its internal consistency and validity by conducting a thorough analysis aligned with international standards for psychological measurement³⁵. The third objective was to explore the relationship between TDSI indices, FREQ, SUM, and AIR, and self-reported health measures, to provide a comprehensive understanding of stress-health dynamics in this population. By achieving these objectives, this study contributes to the literature on cross-cultural stress measurement, offering a validated tool for researchers and clinicians and advancing our understanding of the unique stress-health relationships in Traditional Chinese-speaking contexts.

Methods and materials

Participants

This study recruited 594 participants between September 2023 and January 2024 from undergraduate and graduate student populations. Eligibility was restricted to “emerging adults” (ages 18–29) to ensure developmental and physiological homogeneity³⁶. Forty volunteers aged 30 or older were excluded because by the early 30s, resting blood pressure and heart-rate variability begin to shift with age³⁷. The final sample comprised 470 healthy young adults, predominantly female (405 females, 65 males) with an average age of 19.57 years (SD = 1.54) and an average body mass index (BMI) of 20.12 (SD = 2.15). None of the participants reported smoking habits, and all were free from chronic health conditions, ensuring sample homogeneity. Among the participants, 55.74% had prior experience with meditation, with an average practice duration of 0.60 years (SD = 1.02). Only 5.53% reported engaging in regular meditation practice in the three months preceding the study. Demographic and lifestyle data are summarized in Table 1 and Supplementary Table S1. Participants were recruited through university-wide advertisements and signed informed consent forms prior to participation.

Table 1.

Demographic characteristics of Participants.

	Full sample
	(n = 470)
	N	%	M	SD	Min	Max	Range
Biological Sex
Female	405	86.17
Male	65	13.83
Age			19.57	1.54	18.00	23.00	5.00
BMI			20.12	2.15	15.78	26.67	10.89
Education
Bachelor	457	97.23
Master	13	2.77
Smoking
Never	470	100
Quitted	0	0.00
Smoking habit
Quitting years			0.00	0.00	0.00	0.00	0.00
Years of smoking			0.00	0.00	0.00	0.00	0.00
Cigarettes everyday			0.00	0.00	0.00	0.00	0.00
Drinking
Never	392	83.40
Quitted	0	0.00
Have drinking habit	78	16.60
Drinking habit
Frequency of drinking (times/ week)			0.24	0.77	0.00	3.50	3.50
Glasses of drink every time (270 cc/ glass)			0.65	2.17	0.00	12.50	12.50
Exercise
Without exercise habit	221	47.02
Have exercise habit	249	52.98
Frequency of exercise (time/week)			1.56	1.91	0.00	6.50	6.50
Satisfaction of economic status			3.81	0.77	2.00	5.00	3.00
Meditation Experience
Without meditation experience	208	44.26
With meditation experience	278	55.74
Meditation practice during the last 3 months
Without meditation practice habit	444	94.47
With meditation practice habit	26	5.53
Meditation practice
Years of learning meditation			0.60	1.02	0.00	3.50	3.50
Times of meditation practice each week during the last 3 months			0.06	0.23	0.00	1.00	1.00
Duration of each meditation session			0.97	4.97	0.00	30.00	30.00
Religion
No	313	66.60
Buddhism	13	2.77
Taoism	92	19.57
Christianity	52	11.06
Other	0	0.00

Includes education level, smoking habits, drinking habits, exercise habits, religious affiliations, and meditation experience. Frequency values are presented as counts and percentages. Descriptive statistics (mean and standard deviation) for age, body mass index (BMI), exercise, smoking and drinking habits, and meditation practice duration are reported.

Taiwanese daily stress inventory (TDSI)

The TDSI is a 58-item self-report questionnaire that is a direct translation of the original DSI, designed to measure daily stressors and their perceived impact over the past 24 hours. Participants rated the stressfulness of each event on a Likert-type scale ranging from 1 (“occurred but was not stressful”) to 7 (“caused me to panic”). Events that did not occur were assigned a score of 0. The TDSI includes three primary indices:

• Frequency (FREQ): The total number of stressful events experienced in the past 24 hours.

• Sum (SUM): The cumulative perceived stress across all events.

• Average Impact Rating (AIR): The mean stressfulness of events, calculated as SUM divided by FREQ.

The TDSI was adapted from the original Daily Stress Inventory (DSI)⁴ and translated into Traditional Chinese using a standardized forward and backward translation process. Two bilingual translators independently translated the items into Traditional Chinese, followed by back-translation by two other independent translators. Expert panel reviews and pilot testing ensured cultural and linguistic equivalence to the original instrument. Discrepancies were resolved through discussion within an expert panel³⁵. The full translation inventory is available in “Availability of data and materials”.

Cardiovascular measurements

Resting systolic and diastolic blood pressure, as well as pulse rate, were recorded once per participant using the Omron HEM-1000 arm blood pressure monitor. Measurements were taken after participants had rested for five minutes in a seated position with their feet flat on the floor in a temperature-controlled (22 °C) and quiet room. All measurements were taken on the left upper arm and were obtained during sessions scheduled throughout the day. These indices were chosen as objective markers of cardiovascular health and their known sensitivity to daily stress^12,38. Although a small number of participants exhibited measurements in the hypertensive or clinically elevated range, these values fell within physiologically plausible limits and were not identified as measurement errors. Given the relatively large sample size (N = 470), the impact of these values on the overall results was minimized. Data collection was conducted during morning sessions (8:30 a.m. − 12:00 p.m.), afternoon sessions (12:01 p.m. − 6:00 p.m.), and evening sessions (6:01 p.m. − 10:00 p.m.), with 18.09%, 45.53%, and 36.38% of the data collected, respectively. The effects of time sessions on cardiovascular indices were examined. The detailed results are provided in Supplementary Table S2, Supplementary Table S4, and Supplementary Figure S1.

Health state questions

Participants responded to three single-item questions regarding their health state on a 5-point Likert scale ranging from 1 (“very poor”) to 5 (“excellent”): (1) current physical health, (2) physical health in the past month, and (3) mental health in the past month. These questions were included as part of the demographic questionnaire alongside items on economic status and other background variables, to explore the relationship between self-reported health and daily stress.

Procedure

Participants were individually tested in a controlled laboratory setting. After completing an informed consent form, participants were instructed to rest quietly for five minutes, following which their cardiovascular measurements were recorded. They were then provided with the TDSI and a demographic questionnaire. Variables assessed included health state, drinking and smoking habits, exercise frequency, body mass index (BMI), and meditation experience.

All responses were completed electronically to ensure accuracy and efficiency. Researchers ensured that the environment was quiet and free from external stressors to obtain reliable baseline measures. Upon completing the assessments, participants were debriefed about the purpose of the study and provided with contact information for counseling services, should they feel the need for emotional support.

Statistical analysis

All statistical analyses were conducted using JASP 0.18.3 ³⁹. Descriptive statistics were computed for demographic variables, TDSI indices (FREQ, SUM, AIR), self-reported health measures, and cardiovascular indices (systolic and diastolic blood pressure, pulse rate). Internal consistency of the TDSI was evaluated using Cronbach’s α and McDonald’s ω, with coefficients ≥ 0.80 indicating acceptable reliability⁴⁰. Pearson’s correlations were conducted to assess the associations between TDSI indices and self-reported health measures. For correlation analysis, 95% confidence intervals based on 5,000 bootstrap samples were calculated to enhance the robustness of parameter estimates. Statistical significance was set at p < .05 for all analyses.

Analyses involving Type III ANOVA/ANCOVA and partial correlations of biological sex, as well as meditation experience, were treated as exploratory due to the small number of male participants and the low prevalence of regular meditation practice (approximately 5%). Full results, including sex differences, sex × time interactions, meditation effects, and partial correlations, are presented in the Supplementary Materials.

Results

Reliability of the TDSI

The internal consistency of the TDSI was excellent, with Cronbach’s α of 0.86 for FREQ and 0.90 for SUM, and McDonald’s ω of 0.87 for FREQ and 0.91 for SUM. These reliability coefficients exceeded the threshold of 0.80, indicating strong internal consistency and alignment with prior research on the original DSI⁴. Detailed reliability statistics are presented in Table 2.

Table 2.

Internal Consistency, reliability and mean for TDSI Score.

	M	SD	Min	Max	Range	ω	α
FREQ	14.87	7.42	0.00	50.00	50.00	0.87	0.86
						[0.85, 0.88]	[0.84, 0.88]
SUM	38.65	25.81	0.00	207.00	207.00	0.91	0.90
						[0.90, 0.92]	[0.89, 0.91]
AIR	2.51	0.88	0.00	5.25	5.25

AIR is calculated as SUM divided by FREQ; therefore, Cronbach’s α and McDonald’s ω are reported for both FREQ and SUM. Reliability coefficients exceeding .80 indicate high internal consistency. Numbers in parentheses represented 95% confidence intervals.

Item-Level prevalence and distributions of daily stressors

Several stressors occurred in more than half of participants, including unfinished work (Q3), inability to complete daily plans (Q39) or tasks (Q18), the coming deadline (Q4), thought about the future (Q30), performance at task (Q1), and personal appearance (Q49). These findings indicated that work and self-related demands represent the most frequent sources of daily stress. Detailed frequency distributions and cumulative percentages for all 58 items are shown in Figs. 1 and 2, and descriptive statistics are provided in Tables 3 and 4.

Fig. 1.

TDSI Scores. Note: A, B, and C plots represent the average number (FREQ), cumulative perceived impact (SUM), and average perceived stress impact (AIR). The box plots display the interquartile range.

Fig. 2.

Distribution and Cumulative Percentage of Responses to TDSI Questions.

Table 3.

Correlations between TDSI Scores, Self-reported Health, and cardiovascular Indices.

				FREQ	SUM	AIR	self-perceived current physical health	physical health in the past month	mental health in the past month	systolic blood pressure	diastolic blood pressure	pulse rate
	N	M	SD	1	2	3	4	5	6	7	8	9
1. FREQ	470	14.87	7.42	–
				–
2. SUM	470	38.65	25.81	0.86***	–
				[0.83, 0.88]	–
3. AIR	470	2.51	0.88	0.20***	0.59***	–
				[0.10, 0.29]	[0.52, 0.65]	–
4. self-perceived current physical health	470	2.69	1.08	− 0.22***	− 0.23***	− 0.17***	–
				[-0.31, − 0.12]	[-0.33, − 0.14]	[-0.25, − 0.08]	–
5. physical health in the past month	470	2.58	1.09	− 0.25***	− 0.26***	− 0.16***	0.86***	–
				[-0.33, − 0.16]	[-0.34, − 0.18]	[-0.25, − 0.08]	[0.84, 0.89]	–
6. mental health in the past month	470	2.75	1.01	− 0.31***	− 0.35***	− 0.25***	0.67***	0.69***	–
				[-0.38, − 0.24]	[-0.43, − 0.28]	[-0.33, 0.17]	[0.63, 0.71]	[0.65, 0.72]	–
7. systolic blood pressure	470	114.92	12.73	− 0.12*	− 0.02	− 0.01	− 0.15**	− 0.01	0.04	–
				[-0.20, − 0.04]	[-0.11, 0.06]	[-0.02, 0.17]	[-0.23, − 0.07]	[-0.11, 0.08]	[-0.06, 0.13]	–
8. diastolic blood pressure	470	69.09	1.07	− 0.09	− 0.05	0.08	− 0.01	0.03	0.06	0.58***	–
				[-0.17, <-0.01]	[-0.14, 0.04]	[-0.05, 0.14]	[-0.09, 0.08]	[-0.06, 0.12]	[-0.03, 0.15]	[0.52, 0.64]	–
9. pulse rate	470	79.74	13.37	0.02	0.02	0.02	0.09	0.11**	0.09	0.07	0.20***	–
				[-0.08, 0.11]	[-0.07, 0.11]	[-0.07, 0.12]	[< 0.01, 0.17]	[0.02, 0.19]	[0.02, 0.16]	[-0.03, 0.16]	[0.10, 0.29]	–

Table 4.

Frequency distribution and descriptive statistics for each item in the traditional daily stress inventory (TDSI).

	M	SD	Possibility of occurrence (%)	Prevalence of Scale
				0	1	2	3	4	5	6	7
Q3. Thought about unfinished work	3.21	1.72	91.06	42	39	78	94	92	90	32	3
Q30. Thought about the future	2.32	1.84	74.68	119	50	85	80	76	38	19	3
Q39. Unable to complete all plans for today	2.16	1.96	67.23	154	55	59	62	63	60	16	1
Q4. Hurried to meet deadline	2.34	2.05	66.38	158	21	71	65	65	57	33	0
Q49. Concerned over personal appearance	1.40	1.49	60.85	184	98	79	54	40	13	0	2
Q1. Performed poorly at task	1.56	1.70	56.17	206	50	73	68	41	25	6	1
Q8. Unable to complete a task	1.77	1.92	55.74	208	41	52	57	61	37	12	2
Q7. Did something you are unskilled at	1.20	1.55	47.45	247	53	72	55	23	14	4	2
Q9. Was unorganized	1.37	1.73	47.45	247	36	67	50	38	23	7	2
Q31. Ran out of food/ personal article	0.62	0.86	46.60	251	175	26	11	3	4	0	0
Q54. Worried about another’s problem	1.45	1.80	46.60	251	23	56	57	54	20	5	4
Q5. Interrupted during task/ activity	1.00	1.37	45.11	258	72	72	34	23	7	4	0
Q53. Failed to understand something	1.19	1.61	44.47	261	51	54	49	30	20	4	1
Q38. Did something that you did not want to do	1.05	1.44	42.13	272	43	61	54	33	6	1	0
Q15. Was forced to socialized	0.94	1.39	40.43	280	63	50	43	23	10	0	1
Q2. Performed poorly due to others	1.09	1.56	39.57	284	26	63	49	30	14	3	1
Q22. Was embarrassed	0.95	1.43	38.51	289	42	64	37	28	7	1	2
Q24. Forgot something	0.89	1.44	35.96	301	52	47	26	30	11	3	0
Q18. Was stared at	0.74	1.24	34.04	310	59	46	31	17	6	1	0
Q23. Had your sleep disturbed	0.73	1.31	31.91	320	56	39	29	14	9	1	2
Q35. Interrupted while thinking/ relaxing	0.69	1.19	31.70	321	48	49	32	16	4	0	0
Q19. Did not hear from someone you expected to hear from	0.69	1.23	29.15	333	28	54	37	12	5	1	0
Q34. Waited longer than you wanted	0.66	1.26	28.51	336	51	35	17	19	12	0	0
Q14. Interrupted while talking	0.39	0.75	27.66	340	99	16	11	3	1	0	0
Q26. Experienced illness/ physical discomfort	0.70	1.36	27.45	341	33	42	24	13	13	4	0
Q58. Was late for work/ appointment	0.65	1.29	26.38	346	39	33	20	21	9	2	0
Q11. Ignored by others	0.54	1.13	24.47	355	42	34	20	13	4	2	0
Q45. Bad weather	0.48	1.02	23.62	359	49	24	27	8	3	0	0
Q48. Heard some bad news	0.49	1.11	22.13	366	43	24	20	9	7	0	1
Q52. “pet peeve” violated (someone fails to knock, etc.)	0.49	1.08	21.49	369	26	38	25	8	2	1	1
Q12. Spoke or performed in public	0.45	1.15	18.30	384	31	21	10	15	5	4	0
Q17. Competed with someone	0.34	0.93	15.32	398	26	20	15	8	2	1	0
Q46. Unexpected expense (fines, traffic ticket, etc.)	0.27	0.80	13.19	408	22	24	10	3	3	0	0
Q51. Exposed to upsetting TV show, movie, book	0.24	0.70	13.19	408	32	15	11	4	0	0	0
Q50. Exposed to feared situation or object	0.37	1.08	12.77	410	6	19	17	13	3	0	2
Q21. Was misunderstood	0.35	1.07	12.55	411	16	13	10	11	6	3	0
Q42. Money problem	0.34	1.04	12.34	412	14	14	13	9	6	1	1
Q37. Performed poorly at sport/ game	0.22	0.71	10.85	419	20	20	4	6	1	0	0
Q10. Criticized or verbally attacked	0.23	0.79	9.79	424	15	14	9	5	2	1	0
Q6. Someone spoiled your completed task	0.22	0.80	9.15	427	11	16	7	6	2	1	0
Q25. Feared illness/ pregnancy	0.17	0.70	8.09	432	17	12	2	4	2	0	1
Q43. Store lacked a desired item	0.14	0.61	7.87	433	24	6	2	2	2	1	0
Q44. Misplaced something	0.09	0.35	7.45	435	32	1	1	1	0	0	0
Q13. Dealt with rude waiter/ waitress/ salesperson	0.15	0.66	6.81	438	13	5	9	3	2	0	0
Q29. Had minor accident (boke something, tore clothing)	0.14	0.58	6.81	438	12	13	3	3	1	0	0
Q56. Stopped unwanted personal habit (overeating, smoking, nailbiting)	0.15	0.63	6.81	438	9	13	5	4	1	0	0
Q16. Someone broke a promise/ appointment	0.14	0.62	6.38	440	12	7	6	3	2	0	0
Q32. Argued with spouse/ boyfriend/ girlfriend	0.20	0.90	5.32	445	3	3	4	6	7	2	0
Q55. Experienced narrow escape from danger	0.15	0.73	5.32	445	5	6	8	3	1	1	1
Q20. Experienced unwanted physical contact (crowded, pushed)	0.09	0.51	4.47	449	10	3	5	2	1	0	0
Q36. Someone “cut” ahead of you in a line	0.08	0.43	4.26	450	9	5	5	1	0	0	0
Q33. Argued with other person	0.11	0.60	3.83	452	3	7	3	2	2	1	0
Q40. Had car trouble	0.09	0.61	2.77	457	4	2	0	2	4	1	0
Q41. Had difficulty in traffic	0.06	0.44	2.55	458	6	2	2	0	1	1	0
Q28. Your property was damaged	0.05	0.37	2.13	460	4	3	1	1	1	0	0
Q27. Someone borrowed something without your permission	0.03	0.25	1.70	462	4	2	2	0	0	0	0
Q57. Had problem with kid(s)	0.03	0.32	1.49	463	4	2	0	0	0	1	0
Q47. Had confrontation with an authority figure	0.03	0.36	1.06	465	1	2	0	1	0	1	0

Correlation coefficients for TDSI indices (FREQ, SUM, AIR) and measures of physical and mental health, systolic and diastolic blood pressure, and pulse rate. Numbers in parentheses represented Pearson’s partial correlation 95% confidence intervals based on 5000 bootstrap replicates. * p < .05, ** p < .01, *** p < .001.

Correlations between TDSI indices, health measures, and cardiovascular indices

Pearson’s correlation analyses revealed significant relationships between TDSI indices and self-reported health measures. FREQ, SUM, and AIR were negatively correlated with current self-perceived physical health, r = − .23 to − .17, p < .001, physical health over the past month, r = − .26 to − .16, p < .001, and mental health over the past month, r = − .35 to − .25, p < .001. These findings indicate that higher levels of daily stress are associated with poorer self-reported health. For cardiovascular indices, the only difference among the TDSI indices was that FREQ was negatively correlated with systolic blood pressure, r = − .12, p = .02. Detailed correlation matrices are reported in Table 3, Supplementary Table S5, and Supplementary Table S6.

Exploratory analyses of sex, time, and meditation effects

Exploratory analyses showed that females had lower blood pressure but higher pulse rate than males, and additional time-of-day effects on pulse rate. Participants with meditation experience reported slightly lower stress frequency (FREQ), but no consistent differences for SUM, AIR, or cardiovascular measures. Detailed results are available in the Supplementary Tables S2 –S4, S6 –S7, and Fig S1 –S3.

Discussion

This study translated and psychometrically evaluated the Taiwanese Daily Stress Inventory (TDSI) as a culturally adapted instrument for assessing daily stress in Traditional Chinese-speaking young adults. The scale demonstrated strong reliability and meaningful associations with health outcomes, supporting its utility for both research and clinical applications. Exploratory analyses of biological sex and meditation experience are briefly summarized here, with full details provided in the Supplementary Materials.

The TDSI demonstrated high internal consistency, with both Cronbach’s α and McDonald’s ω exceeding the accepted 0.80 threshold, consistent with prior validation of the original DSI^4,40–42. The high internal consistency confirms that the TDSI is a reliable measure of daily stress in Traditional Chinese-speaking young adults and echoes findings from previous research. Item analyses further indicated that the most frequently endorsed stressors concerned future, upcoming deadlines, task performance, and self-appearance evaluation, recent trends observed among young adults^43,44.

The TDSI also showed robust construct validity, with significant correlations between its indices and self-reported health outcomes. Brantley et al. ⁴ noted that the exacerbation of chronic disease, also known as noncommunicable disease (NCD), was influenced more by everyday stressors than by infrequent major life events⁴⁵. FREQ, SUM, and AIR were negatively correlated with physical and mental health conditions. The observed associations suggest a potential link between acute daily stress exposure and broader perceptions of well-being^9,38,46–48. These results highlight that both the frequency and perceived intensity of daily stressors are meaningful indicators of subjective health, even within a demographically restricted sample. Daily stress has been implicated in the exacerbation of cardiovascular conditions, with minor stressors influencing blood pressure and pulse rate^3,38,49–52.

Although P. Brantley et al. ⁴ did not measure cardiovascular markers, their inclusion in our study provides a more comprehensive understanding of how stress impacts physical health. Cardiovascular analyses revealed only a small negative correlation between stress frequency (FREQ) and systolic blood pressure, with no other significant associations, as all measurements were obtained at rest. Findings align with previous research that TDSI generally did not exhibit distinct correlations with blood pressure in young adults, highlighting age-specific physiological responses to stress and their potential health implications⁵³. Exploratory analyses further suggested that meditation experience was associated with slightly lower stress frequency (FREQ), but the effects were inconsistent and constrained by the low prevalence of regular meditators (approximately 5%). Prior studies have shown meditation’s benefits for self-regulation and cardiovascular health^5,29,54–56. From a mindfulness perspective, diligence in practice remains central^34,57. Future research with more balanced samples is needed to clarify these associations.

This study represents an important advancement in cross-cultural stress research by establishing the TDSI as a reliable and culturally appropriate tool for Traditional Chinese-speaking young adults. The TDSI’s ability to capture nuanced stress experiences enhances its applicability in both research and clinical settings, providing a valuable tool for exploring the role of daily stress in health across diverse populations^18,58,59.

While this study provides important insights, it is not without limitations. The sample consisted primarily of young female adults, limiting the generalizability of the findings to males, older populations, or individuals with different life experiences. Analyses of biological sex and meditation experience should thus be interpreted with caution as exploratory findings. Additionally, the cross-sectional design precludes causal inferences about the relationships between stress and health outcomes. Longitudinal studies are needed to establish the temporal dynamics of these associations and to explore potential mediating mechanisms. Moreover, while the inclusion of cardiovascular indices enhances the study’s relevance, other social stressors, mental condition assessments, and physiological markers of stress, such as depression, anxiety, cortisol levels, or pulse rate variability, were not assessed. Future studies should incorporate a broader range of biomarkers to provide a more comprehensive understanding of the physiological effects of stress.

The validation of the TDSI represents a significant contribution to the field of stress research, providing a reliable and culturally sensitive tool for assessing daily stress in Traditional Chinese-speaking populations. By demonstrating its strong psychometric properties and associations with health outcomes, this study establishes the TDSI as a valuable instrument for both research and clinical applications. These findings contribute to a deeper understanding of stress-health dynamics and support the development of targeted interventions to mitigate the adverse effects of daily stress on health.

Supplementary Information

Below is the link to the electronic supplementary material.

Author contributions

J.T.C. and Z.F.Y. contributed to the study conception and design. J.T.C. performed material preparation, data collection, and analysis. J.T.C. prepared figures. Z.F.Y. supervised and wrote the first draft of the manuscript. Both authors commented on previous versions of the manuscript and approved the final manuscript.

Funding

This work was supported by the Interdisciplinary Grant of National Tsing Hua University, grant number 112Q272E1 (Z.-F. YAO).

Data availability

All raw data, analysis files, outputs (https://osf.io/b7fnr/files/osfstorage/68960c7f3ed783adbc6b0e12), and the Taiwanese Daily Stress Inventory (https://osf.io/cemxt/overview? view_only=ce21fd8244ab47e3b1b06bce082e00c8) are publicly accessible via the provided OSF links.

Declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the institutional review board of National Tsing Hua University under number 11204HT041 and complied with ethical standards for research involving human participants.