| 1 | I seek approval and affirmation from others, and I am afraid of criticism. | 1 2 3 4 5 |
| 2 | I guess at what normal behavior is, and I usually feel as if I am different from other people. |
1 2 3 4 5 |
| 3 |
I isolate myself from and am afraid of people in
authority roles. |
1 2 3 4 5 |
| 4 |
I am not able to appreciate my own accomplishments
and good deeds. |
1 2 3 4 5 |
| 5 |
I tend to have difficulty following a project
through from beginning to end. |
1 2 3 4 5 |
| 6 |
I get frightened or stressed when I am in the
company of an angry person. |
1 2 3 4 5 |
| 7 |
In order to avoid a conflict, I find it easier to
lie than tell the truth. |
1 2 3 4 5 |
| 8 |
I have problems with my own compulsive behavior,
e.g., drinking, drug use, gambling, overeating, smoking, use of
sex, shopping, etc. |
1 2 3 4 5 |
| 9 |
I judge myself without mercy. I am my own worst
critic, and I am harder on myself than I am on others. |
1 2 3 4 5 |
| 10 |
I feel more alive in the midst of a crisis, and I
am uneasy when my life is going smoothly; I am continually
anticipating problems. |
1 2 3 4 5 |
| 11 |
I have difficulty having fun. I don't seem to know
how to play for fun and relaxation. |
1 2 3 4 5 |
| 12 |
I am attracted to others whom I perceive to have
been victims, and I develop close relationships with them. In this
way I confuse love with pity, and I love people I can pity and
rescue. |
1 2 3 4 5 |
| 13 |
I need perfection in my life at home and work, and
I expect perfection from others in my life. |
1 2 3 4 5 |
| 14 |
I seek out novelty, excitement, and the challenge
of newness in my life with little concern given to the
consequences of such action. |
1 2 3 4 5 |
| 15 |
I take myself very seriously, and I view all of my
relationships just as seriously.
|
1 2 3 4 5 |
| 16 |
I have problems developing and maintaining
intimate relationships. |
1 2 3 4 5 |
| 17 |
I feel guilty when I stand up for myself or take
care of my needs first, instead of giving in or taking care of
others' needs first. |
1 2 3 4 5 |
| 18 |
I seek and/or attract people who have compulsive
behaviors (e.g., alcohol, drugs, gambling, food, shopping, sex,
smoking, overworking, or seeking excitement.) |
1 2 3 4 5 |
| 19 |
I feel responsible for others and find it easier
to have concern for others than for myself. |
1 2 3 4 5 |
| 20 |
I am loyal to people for whom I care, even in the
face of evidence that the loyalty is undeserved. |
1 2 3 4 5 |
| 21 |
I cling to and will do anything to hold on to
relationships because I am afraid of being alone and fearful of
being abandoned. |
1 2 3 4 5 |
| 22 |
I am impulsive and act too quickly, before
considering alternative actions or possible consequences. |
1 2 3 4 5 |
| 23 |
I have difficulty in being able to feel or to
express feelings; I feel out of touch with my feelings. |
1 2 3 4 5 |
| 24 |
I mistrust my feelings and the feelings expressed
by others. |
1 2 3 4 5 |
| 25 |
I isolate myself from other people, and I am
initially shy and withdrawn in new social settings. |
1 2 3 4 5 |
| 26 |
I feel that I am being taken advantage of by
individuals and society in general; I often feel victimized. |
1 2 3 4 5 |
| 27 |
I can be over-responsible much of the time, but I
can be extremely irresponsible at other times. |
1 2 3 4 5 |
| 28 |
I feel confused and angry at myself and not in
control of my environment or my life when the stresses are great. |
1 2 3 4 5 |
| 29 |
I spend a lot of time and energy rectifying or cleaning up my
messes and the negative consequences of ill-thought-out or
impulsive actions for which I am responsible.
|
1 2 3 4 5 |
| 30 |
I deny that my current problems stem from my past
life. I deny that I have stuffed-in feelings from the past which
are impeding my current life. |
1 2 3 4 5 |
1
= never