Social Adjustment Scale-Self Report (SAS)

WORK OUTSIDE THE HOME
Please check the situation that best describes you.
I am: (1) a worker for pay‚ (2) a housewife (3) a student (4) retired (5) unemployed
Do you usually work for pay more than 15 hours per week? (1) YES‚ (2) NO
Did you work any hours for pay in the last two weeks? (1) YES‚ (2) NO
Check the answer that best describes how you have been in the last two weeks
1.    How many days did you miss from work in the last two weeks?
(1) No days missed. (2) One day. (3) I missed about half the time. (4) Missed more than half the time but did make at least one day. (5) I did not work any days. (8) On vacation all of the last two weeks.
If you have not worked any days in the last two weeks‚ go on to Question 7.
2.    Have you been able to do your work in the last 2 weeks?
(1) I did my work very well. (2) I did my work well but had some minor problems. (3) I needed help with work and did not do well about half the time. (4) I did my work poorly most of the time. (5) I did my work poorly all the time.
3.    Have you been ashamed of how you do your work in the last 2 weeks?
(1) I never felt ashamed. (2) Once or twice I felt a little ashamed. (3) About half the time I felt ashamed. (4) I felt ashamed most of the time. (5) I felt ashamed all the time.
4.    Have you had any arguments with people at work in the last 2 weeks?
(1) I had no arguments and got along very well. (2) I usually got along well but had minor arguments. (3) I had more than one argument. (4) I had many arguments. (5) I was constantly in arguments.
5.    Have you felt upset‚ worried‚ or uncomfortable while doing your work during the last 2 weeks?
(1) I never felt upset. (2) Once or twice I felt upset. (3) Half the time I felt upset. (4) I felt upset most of the time. (5) I felt upset all of the time.
6.    Have you found your work interesting these last two weeks?
(1) My work was almost always interesting. (2) Once or twice my work was not interesting. (3) Half the time my work was uninteresting. (4) Most of the time my work was uninteresting. (5) My work was always uninteresting.
WORK AT HOME—HOUSEWIVES ANSWER QUESTIONS 7–12. OTHERWISE‚ GO ON TO QUESTION 13.
7.    How many days did you do some housework during the last 2 weeks?
(1) Every day. (2) I did the housework almost every day. (3) I did the housework about half the time. (4) I usually did not do the housework. (5) I was completely unable to do housework. (8) I was away from home all of the last two weeks.
8.    During the last two weeks‚ have you kept up with your housework? This includes cooking‚ cleaning‚ laundry‚ grocery shopping‚ and errands.
(1) I did my work very well. (2) I did my work well but had some minor problems. (3) I needed help with my work and did not do it well about half the time. (4) I did my work poorly most of the time. (5) I did my work poorly all of the time.
9.    Have you been ashamed of how you did your housework during the last 2 weeks?
(1) I never felt ashamed. (2) Once or twice I felt a little ashamed. (3) About half the time I felt ashamed. (4) I felt ashamed most of the time. (5) I felt ashamed all the time.
10.Have you had any arguments with salespeople‚ tradesmen or neighbors in the last 2 weeks?
(1) I had no arguments and got along very well. (2) I usually got along well‚ but had minor arguments. (3) I had more than one argument. (4) I had many arguments. (5) I was constantly in arguments.
11.Have you felt upset while doing your housework during the last 2 weeks?
(1) I never felt upset. (2) Once or twice I felt upset. (3) Half the time I felt upset. (4) I felt upset most of the time. (5) I felt upset all of the time.
12.Have you found your housework interesting these last 2 weeks?
(1) My work was almost always interesting. (2) Once or twice my work was not interesting. (3) Half the time my work was uninteresting. (4) Most of the time my work was uninteresting. (5) My work was always uninteresting.
FOR STUDENTS
Answer Questions 13–18 if you go to school half time or more. Otherwise‚ go on to Question 19.
What best describes your school program? (Choose one)
(1) Full Time‚ (2) 3/4 Time‚ (3) Half Time‚
Check the answer that best describes how you have been the last 2 weeks.
13.How many days of classes did you miss in the last 2 weeks?
(1) No days missed. (2) A few days missed. (3) I missed about half the time. (4) Missed more than half time but did make at least one day. (5) I did not go to classes at all. (8) I was on vacation all of the last two weeks.
14.Have you been able to keep up with your class work in the last 2 weeks?
(1) I did my work very well. (2) I did my work well but had minor problems. (3) I needed help with my work and did not do well about half the time. (4) I did my work poorly most of the time. (5) I did my work poorly all the time.
15.During the last 2 weeks‚ have you been ashamed of how you do your school work?
(1) I never felt ashamed. (2) Once or twice I felt ashamed. (3) About half the time I felt ashamed. (4) I felt ashamed most of the time. (5) I felt ashamed all of the time.
16.Have you had any arguments with people at school in the last 2 weeks?
(1) I had no arguments and got along very well. (2) I usually got along well but had minor arguments. (3) I had more than one argument. (4) I had many arguments. (5) I was constantly in arguments. (8) Not applicable; I did not attend school.
17.Have you felt upset at school during the last 2 weeks?
(1) I never felt upset. (2) Once or twice I felt upset. (3) Half the time I felt upset. (4) I felt upset most of the time. (5) I felt upset all of the time. (8) Not applicable; I did not attend school.
18.Have you found your school work interesting these last 2 weeks?
(1) My work was almost always interesting. (2) Once or twice my work was not interesting. (3) Half the time my work was uninteresting. (4) Most of the time my work was uninteresting. (5) My work was always uninteresting.
SPARE TIME—EVERYONE ANSWER QUESTIONS 19–27.
Check the answer that best describes how you have been in the last 2 weeks.
19.How many friends have you seen or spoken to on the telephone in the last weeks?
(1) Nine or more friends. (2) Five to eight friends. (3) Two to four friends. (4) One friend. (5) No friends.
20.Have you been able to talk about your feelings and problems with at least one friend during the last 2 weeks?
(1) I can always talk about my innermost feelings. (2) I usually can talk about my feelings. (3) About half the time I felt able to talk about my feelings. (4) I usually was not able to talk about my feelings. (5) I was never able to talk about my feelings. (8) Not applicable; I have no friends.
21.How many times in the last two weeks have you gone out socially with other people? For example‚ visited friends‚ gone to movies‚ bowling‚ church‚ restaurants‚ invited friends to your home?
(1) More than 3 times. (2) Three times. (3) Twice. (4) Once. (5) None.
22.How much time have you spent on hobbies or spare time interests during the last 2 weeks? For example‚ bowling‚ sewing‚ gardening‚ sports‚ reading?
(1) I spent most of my spare time on hobbies almost every day. (2) I spent some spare time on hobbies some of the days. (3) I spent a little spare time on hobbies. (4) I usually did not spend any time on hobbies but did watch TV. (5) I did not spend any spare time on hobbies or watch TV.
23.Have you had open arguments with your friends in the last 2 weeks?
(1) I had no arguments and got along very well. (2) I usually got along well but had minor arguments. (3) I had more than one argument. (4) I had many arguments. (5) I was constantly in arguments. (8) Not applicable; I have no friends.
24.If your feelings were hurt or offended by a friend during the last two weeks‚ how badly did you take it?
(1) It did not affect me or it did not happen. (2) I got over it in a few hours. (3) I got over it in a few days. (4) I got over it in a week. (5) It will take me months to recover. (8) Not applicable; I have no friends.
25.Have you felt shy or uncomfortable with people in the last 2 weeks?
(1) I always felt comfortable. (2) Sometimes I felt uncomfortable but could relax after a while. (3) About half the time I felt uncomfortable. (4) I usually felt uncomfortable. (5) I always felt uncomfortable. (8) Not applicable; I was never with people.
26.Have you felt lonely and wished for more friends during the last 2 weeks?
(1) I have not felt lonely. (2) I have felt lonely a few times. (3) About half the time I felt lonely. (4) I usually felt lonely. (5) I always felt lonely and wished for more friends.
27.Have you felt bored in your spare time during the last 2 weeks?
(1) I never felt bored. (2) I usually did not feel bored. (3) About half the time I felt bored. (4) Most of the time I felt bored. (5) I was constantly bored.
Are you a Single‚ Separated‚ or Divorced Person not living with a person of opposite sex; please answer below:
(1) YES‚ Answer questions 28 & 29. (2) NO‚ go to question 30.
28.How many times have you been with a date these last 2 weeks?
(1) More than 3 times. (2) Three times. (3) Twice. (4) Once. 5 Never.
29.Have you been interested in dating during the last 2 weeks? If you have not dated‚ would you have liked to?
(1) I was always interested in dating. (2) Most of the time I was interested. (3) About half of the time I was interested. (4) Most of the time I was not interested. (5) I was completely uninterested.
FAMILY
Answer Questions 30–37 about your parents‚ brothers‚ sisters‚ in laws‚ and children not living at home. Have you been in contact with any of them in the last two weeks?
(1) YES‚ Answer questions 30–37. (2) NO‚ Go to question 36.
30.Have you had open arguments with your relatives in the last 2 weeks?
(1) We always got along very well. (2) We usually got along very well but had some minor arguments. (3) I had more than one argument with at least one relative. (4) I had many arguments. (5) I was constantly in arguments.
31.Have you been able to talk about your feelings and problems with at least one of your relatives in the last 2 weeks?
(1) I can always talk about my feelings with at least one relative. (2) I usually can talk about my feelings. (3) About half the time I felt able to talk about my feelings. (4) I usually was not able to talk about my feelings.  (5) I was never able to talk about my feelings.
32.Have you avoided contacts with your relatives these last two weeks?
(1) I have contacted relatives regularly. (2) I have contacted a relative at least once. (3) I have waited for my relatives to contact me. (4) I avoided my relatives‚ but they contacted me. (5) I have no contacts with any relatives.
33.Did you depend on your relatives for help‚ advice‚ money or friendship during the last 2 weeks?
(1) I never need to depend on them. (2) I usually did not need to depend on them.  (3) About half the time I needed to depend on them. (4) Most of the time I depend on them. (5) I depend completely on them.
34.Have you wanted to do the opposite of what your relatives wanted in order to make them angry during the last 2 weeks?
(1) I never wanted to oppose them. (2) Once or twice I wanted to oppose them. (3) About half the time I wanted to oppose them. (4) Most of the time I wanted to oppose them. (5) I always opposed them.
35.Have you been worried about things happening to your relatives without good reason in the last 2 weeks?
(1) I have not worried without reason. (2) Once or twice I worried. (3) About half the time I worried. (4) Most of the time I worried. (5) I have worried the entire time. (8) Not applicable; my relatives are no longer living.
EVERYONE answer Questions 36 and 37‚ even if your relatives are not living.
36.During the last two weeks‚ have you been thinking that you have let any of your relatives down or have been unfair to them at any time?
(1) I did not feel that I let them down at all. (2) I usually did not feel that I let them down. (3) About half the time I felt that I let them down. (4) Most of the time I have felt that I let them down.  (5) I always felt that I let them down.
37.During the last two weeks‚ have you been thinking that any of your relatives have let you down or have been unfair to you at any time?
(1) I never felt that they let me down. (2) I felt that they usually did not let me down. (3) About half the time I felt they let me down. (4) I usually have felt that they let me down. (5) I am very bitter that they let me down.
Are you living with your spouse or have you been living with a person of the opposite sex in a permanent relationship?
(1) YES‚ Please answer questions 38–46. (2) NO‚ Go to question 47.
38.Have you had open arguments with your partner in the last 2 weeks?
(1) We had no arguments and we got along well. (2) We usually got along well but had minor arguments. (3) We had more than one argument. (4) We had many arguments. (5) We were constantly in arguments.
39.Have you been able to talk about your feelings and problems with your partner during the last 2 weeks?
(1) I could always talk freely about my feelings. (2) I usually could talk about my feelings. (3) About half the time I felt able to talk about my feelings. (4) I usually was not able to talk about my feelings.  (5) I was never able to talk about my feelings.
40.Have you been demanding to have your own way at home during the last 2 weeks?
(1) I have not insisted on always ha‎ving my own way. (2) I usually have not insisted on ha‎ving my own way.  (3) About half the time I insisted on ha‎ving my own way. (4) I usually insisted on ha‎ving my own way. (5) I always insisted on ha‎ving my own way.
41.Have you been bossed around by your partner these last 2 weeks?
(1) Almost never. (2) Once in a while. (3) About half the time. (4) Most of the time. (5) Always.
42.How much have you felt dependent on your partner these last 2 weeks?
(1) I was independent. (2) I was usually independent. (3) I was somewhat dependent. (4) I was usually dependent. (5) I depended on my partner for everything.
43.How have you felt about your partner during the last 2 weeks?
(1) I always felt affection. (2) I usually felt affection. (3) About half the time I felt dislike and half the time affection. (4) I usually felt dislike. (5) I always felt dislike.
44.How many times have you and your partner had intercourse?
(1) More than twice a week. (2) Once or twice a week. (3) Once every two weeks. (4) Less than once every two weeks but at least once in the last month.  (5) Not at all in a month or longer.
45.Have you had any problems during intercourse‚ such as pain these last two weeks?
(1) None. (2) Once or twice. (3) About half the time. (4) Most of the time. (5) Always. (8) Not applicable; no intercourse in the last two weeks.
46.How have you felt about intercourse during the last 2 weeks?
(1) I always enjoyed it. (2) I usually enjoyed it. (3) About half the time I did and half the time I did not enjoy it. (4) I usually did not enjoy it. (5) I never enjoyed it.
CHILDREN
Have you had unmarried children‚ stepchildren‚ or foster children living at home during the last two weeks?
(1) YES‚ Answer questions 47–50. (2) NO‚ Go to question 51.
47.Have you been interested in what your children are doing school‚ play or hobbies during the last 2 weeks?
(1) I was always interested and actively involved. (2) I usually was interested and involved. (3) About half the time interested and half the time not interested. (4) I usually was disinterested. (5) I was always disinterested.
48.Have you been able to talk and listen to your children during the last 2 weeks? Include only children over the age of 2.
(1) I always was able to communicate with them. (2) I usually was able to communicate with them. (3) About half the time I could communicate. (4) I usually was not able to communicate. (5) I was completely unable to communicate. (8) Not applicable; no children over the age of 2.
49.How have you been getting along with the children during the last 2 weeks?
(1) I had no arguments and got along very well. (2) I usually got along well but had minor arguments. (3) I had more than one argument. (4) I had many arguments. (5) I was constantly in arguments.
50.How have you felt toward your children these last 2 weeks?
(1) I always felt affection. (2) I mostly felt affection. (3) About half the time I felt affection. (4) Most of the time I did not feel affection. (5) I never felt affection toward them.
FAMILY UNIT
Have you ever been married‚ ever lived with a person of the opposite sex‚ or ever had children? Please check
(1) YES‚ Please answer questions 51–53. (2) NO‚ Go to question 54.
51.Have your worried about your partner or any of your children without any reason during the last 2 weeks‚ even if you are not living together now?
(1) I never worried. (2) Once or twice I worried. (3) About half the time I worried. (4) Most of the time I worried. (5) I always worried. (8) Not applicable; partner and children not living.
52.During the last 2 weeks have you been thinking that you have let down your partner or any of your children at any time?
(1) I did not feel I let them down at all. (2) I usually did not feel that I let them down. (3) About half the time I felt I let them down. (4) Most of the time I have felt that I let them down. (5) I let them down completely.
53.During the last 2 weeks‚ have you been thinking that your partner or any of your children have let you down at any time?
(1) I never felt that they let me down. (2) I felt they usually did not let me down. (3) About half the time I felt they let me down. (4) I usually felt they let me down. (5) I feel bitter that they have let me down.
FINANCIAL—EVERYONE PLEASE ANSWER QUESTION 54.
54. Have you had enough money to take care of your own and your family’s financial needs during the last 2 weeks?
(1) I had enough money for needs. (2) I usually had enough money with minor problems. (3) About half the time I did not have enough money but did not have to borrow money. (4) I usually did not have enough money and had to borrow from others.  (5) I had great financial difficulty.
 
 

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