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This study aimed to develop the Japanese language version of Pro-Change's decisional balance measure for effective stress management (PDSM). Effective stress management refers to activities that are practiced, for at least 20 min per day, to reduce a person's perceived stress. Six hundred and sixty-five female and 456 male Japanese university and college students participated in this study, which consists of two surveys. Through exploratory and confirmatory factor analyses, the Japanese language version of the PDSM was developed, which contains 12 items and consists of two factors, the Pros and the Cons. The levels of internal consistency are acceptable (Pros = 0.78 and Cons = 0.64). The scores for the Pros and the Cons subscores were not affected by social desirability (Pros = −0.04 and Cons = −0.12). We confirmed the construct validity of the Japanese language version of PDSM with theoretically predicted relationships between the decisional balance and the stage of change for effective stress management. The Japanese language version of the PDSM with construct validity and reliability was developed.