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Background

The transactional model of stress describes a psychological and physiological stress response that is elicited when an environmental demand is perceived to outweigh the ability to cope with the demand. With perception at its core, this theory explains large variances in human stress responses. A frequently cited measure of stress perception is the Perceived Stress Scale (PSS). A two-step approach to structural equation modelling (SEM) necessitates that a valid measurement model for stress be first established through confirmatory factor analysis (CFA), and then the impact of stress on the biomarkers be assessed.